Olfactory dysfunction in Parkinson's disease

Objective: To characterize the olfactory dysfunction in 50 Parkinson's disease (PD) patients with the University of Pennsylvania 12 smell identification test (UPSIT), establishing a comparison with 76 age-matched healthy controls, and associate with clinical and epidemiologic picture. Method: The PD group was evaluated in phase "on" through United Parkinson's disease rating scale, UPSIT, and Hoehn and Yahr stage and the control group with the UPSIT. Results: The mean UPSIT score was 5.7 in PD patients and 9 in the control group. Patients that presented initially resting tremor and those that currently have tremor, rigidity and bradykinesia had a significant lower scores. There were negative correlation between patients' age and PD stage with the UPSIT scores. There were no correlation between olfactory scores, age at the initial PD symptoms and disease duration. Conclusion: Among PD patients 80% had olfactory deficit and, therefore, smell evaluation may be a tool to make PD differential diagnosis.653A64765

Vascular parkinsonism - Analysis of seven cases

Introduction: Neuroimaging studies of elderly individuals reveal alterations in the white matter that are incompatible with the patient's parkinsonism, mistakenly classified as vascular parkinsonism (VP). Method: This study was conducted on a population composed of 20 patients with Parkinson's disease (PD) whose neuroimaging exams revealed vascular alterations in the white matter and seven patients with VP in order to compare diagnostic criteria. Results: Age at disease onset of patients with PD was 55 +/- 12 years and patients with VP it was 62 +/- 13 years. Twelve patients with PD and five patients with VP presented arterial hypertension; three patients with VP and two patients with PD presented gait impairment; all patients with VP presented rigidity and bradykinesia, six of them presented resting tremor; 19 patients with PD presented tremor and 19 of them presented rigidity, while 17 presented bradykinesia. When the symptoms and evolution of both diseases were compared, the vascular alterations in the white matter were considered unspecific. Conclusion: Since clinical symptoms are unspecific, a differential diagnosis requires neuroimaging, good response to levodopa and clinical evolution.643A56857

Reliability study on the application of the Fugl-Meyer scale in Brazil

OBJECTIVE: The aim of this study was to produce a Brazilian version of the original Fugl-Meyer Assessment Scale and to verify the intrarater and interrater reliability in chronic post-stroke patients. METHOD: Fifty hemiparetic patients participated in this study. The Fugl-Meyer assessment was applied to them twice (intrarater reliability) by three physiotherapists (interrater reliability), from three rehabilitation centers. RESULTS: The results showed that the whole Fugl-Meyer scale demonstrated high interrater and intrarater reliability (intraclass correlation coefficient = 0.99 and 0.98, respectively), and high reliability for each subscale (intraclass interrater = 0.99 to 0.94; intraclass intrarater = 0.98 to 0.87). CONCLUSION: It was concluded that the Brazilian Portuguese version of the Fugl-Meyer Assessment Scale did not show any conflicts of interpretation. High intrarater and interrater reliability rates were obtained, thereby allowing this version to be used as instrument for clinical evaluation and research in Brazil.OBJETIVOS: Os objetivos do estudo foram realizar uma versão brasileira da escala original de Fugl-Meyer e verificar a confiabilidade da aplicação inter e intra-observador desta versão em pacientes crônicos pós AVC. MÉTODO: Participaram do estudo 50 pacientes portadores de hemiparesia, os quais foram submetidos a duas avaliações (confiabilidade intra-observador), realizadas por três fisioterapeutas (confiabilidade interobservador), procedentes de três centros de reabilitação. RESULTADOS: Os resultados demonstraram alta confiabilidade inter e intra-observador da EFM total (IC = 0,99 e 0,98; respectivamente), assim como para todas as subescalas (interobservador IC = 0,99 a 0,94; intra-observador IC = 0,98 a 0,87). CONCLUSÃO: Conclui-se neste artigo que não foi verificado conflitos de interpretação na versão brasileira da escala de Fugl-Meyer. Obtivemos alto índice de confiabilidade, tanto intra como interobservador, permitindo assim seu uso como instrumento de avaliação clínica e de pesquisa no Brasil.17718

HIGHLIGHTING INTRACRANIAL-PRESSURE MONITORING IN PATIENTS WITH SEVERE ACUTE BRAIN TRAUMA

Intrcranial pressure (ICP) monitoring was carried out in 100 patients with severe acute brain trauma, primarily by means of a subarachnoid catheter. Statistical associations were evaluated between maximum ICP values and: 1) Glasgow Coma Scale (GCS) scores; 2) findings on computed tomography (CT) scans of the head; and 3) mortality. A significant association was found between low GCS scores (3 to 5) and high ICP levels, as well as between focal lesions on CT scans and elevated ICP. Mortality was significantly higher in patients with ICP > 40 mm Hg than in those;vith ICP less than or equal to 20 mm Hg.533A39039

OLFACTION AND ESSENTIAL TREMOR

Objective: To characterize the olfactory identification in 40 essential tremor (ET) patients, with the University of Pennsylvania 12 Smell Identification Test (UPSIT), to correlate UPSIT scores to clinical and epidemiological data and to compare it to 89 aged matched controls. Method: Patients were assessed using ET Clinical Scale of Evaluation and UPSIT. Results: Inpatients with ET, the UPSIT medium score was 9.10, similar to the control group (9.11), which was also observed in all age groups. ET severity did not correlate to UPSIT scores. Conclusion:This study demonstrated normality of olfactory identification on ET, qualifying UPSIT to be an important tool on tremor differential diagnosis of undetermined origin.671212

Sornatosensory evoked potential and EEG in children with focal idiopathic epilepsies with and without evoked spikes by tapping of the feet or hands

The characteristics of SEP cortical components were studied in 40 children with focal idiopathic epilepsies of childhood. Twenty children had focal idiopathic epilepsies and evoked spikes (FIE-ES) on the EEG and 20 had benign focal epilepsy of childhood with centrotemporal spikes (CTE) but without evoked spikes (ES). These data were compared with those of a control group of 20 normal children. N35 high-amplitude component was more frequent in the CTE group than in the control group (p<0.001). P98 showed high amplitude in 50% of the children of FIE-ES group, and in none of the CTE and control groups (p<0.001). The P98 high amplitude component was more common in the FIE-ES group than in the other groups, and so was the N35 high amplitude component in the CTE group. Lateralization of high-amplitude components of N35 in the CTE group and of P98 in FIE group was not correlated with lateralization of epileptiform activity and evoked spikes. Based on our findings, there are SEPs cortical component differences in childhood focal idiopathic epilepsies according to occurrence or absence of ES.36319419