4 research outputs found
Multifocal motor neuropathy with conduction block: a case report
Institute of Neurology and Neurosurgery, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: Multifocal motor neuropathy with conduction block (MMN-BC) is a rare disease
and a distinct entity, its clinical and electrophysiological features differ from other chronic inflammatory
demyelinating neuropathies. Its’ first description in 1988 lead to new diagnosing assessments. The
distinction of this disease is very important as the treatment differs and incorrect treatment can lead to
clinical decline.
Clinical case: We report a case of a 62-year old man who developed muscular weakness in all
his four limbs, muscle wasting of both hands (2005), claudication, difficulty ascending stairs, muscularcramps, palpebral ptosis(2007) on the right eye and diplopia on upward gaze. No other neurological
signs detected. His past medical history included: Amygdalectomy (1985), Hearnia repair(1995),
Chronic pancreatitis.
Results: At first radial compresive neuropathy was suspected, after exclusion of this diagnose
Myastenia gravis the ocular form was suspected. Anti-AchR antibodies were not detected and
anticholinesterase drugs did not show effect. Electroneurography revealed conduction block on the right
medianus nerve, decrease of sensory nerve action potentials (SNAP) on the medianus and ulnaris nerves
bilaterally. Compound muscle action potentials (CMAP) decrease on the left nervus peroneus profundus.
CMAP decrease on the fibers of nervus tibialis posterior bilaterally. Also alfa waves were detected on
the fibers of nervus tibialis posterior bilaterally and latency increase of F waves.
Imunological assay has revealed anti-GM1 and anti-GD1b positive antibodies. The patient was
diagnosed with Multifocal Motor Neuropathy with Conduction Block with flaccid tetraparesis with
oculomotor nerve implication. The patient underwent intravenous immunoglobulin (IVIG) and
cyclophosphamide therapy with prominent improvement in muscle force and other clinical features.
Conclusions: Slow onset of assymetrical limb weakness, sometimes with visible muscle wasting
and fasciculations without any sensory abnormalities should guide the physician to consider MMN-CB
and its’ chronic immune mediated demyelinating course. As this disease is extremely rare we highlight
the importance of this case report to raise awareness on MMN-CB. This condition is often misdiagnosed
at Primary Health Centers and this case shows that time efficient diagnose and corect treatment can
improve the clinical and electrophysiological indicators
Rolul factorilor psihosociali în durerea cronică lombară, impactul lor asupra calităţii vieţii.
Acest articol vizează rolul factorilor psihosociali în geneza şi cronicizarea durerii lombare, impactul lor asupra calităţii vieţii, cu îmbunătăţirea ulterioară a metodelor de screening pentru pacienţii cu risc de instalare a dizabilităţii. Studiul a cuprins 62 de persoane evaluate cu chestionar sociodemografi c, Visual Analog Scale, Beck Depression Inventory, Spielberger’s State Anxiety Inventory, SPF-36 Health Survey, Back Performance Scale, Rolland-Morris Disability Questionnaire
Miastenia gravis: protocol clinic naţional PCN-285
Catedra Neurologie, USMF „Nicolae Testemiţanu”, Laboratorul Vertebroneurologie, IMSP Institutul de Neurologie şi NeurochirurgieAcest protocol clinic naţional a fost elaborat de grupul de lucru al Ministerului
Sănătăţii al Republicii Moldova (MS RM), constituit din specialiştii IMSP Institutului
de Neurologie şi Neurochirurgie şi Universităţii de Stat de Medicină şi Farmacie
„Nicolae Testemiţanu”.
Protocolul clinic naţional este elaborat în conformitate cu ghidurile clinice
internaţionale actuale privind miastenia gravis şi va servi drept bază pentru elaborarea
protocoalelor instituţionale (extras din protocolul clinic naţional aferent pentru
instituţia dată, fără schimbarea structurii, numerotaţiei capitolelor, tabelelor, figurilor,
casetelor etc.) în baza posibilităţilor reale ale fiecărei instituţii în anul curent.
La recomandarea MS RM pentru monitorizarea protocoalelor instituţionale pot
fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional
Actualităţi în diagnosticul şi tratamentul polineuropatiei demielinizante inflamatorii cronice
Acest articol este dedicat analizei detaliate a datelor de literatură în vederea elucidării aspectelor diagnostice, clinice şi terapeutice ale PDIC. Orientările internaţionale specifi ce, dedicate pentru a defini un algoritm de diagnostic şi tratament de prima linie şi follow-up, indiscutabil necesită de a deveni strategice în lupta cu această patologie şi în ţara noastră