Marques Júnior, Wilson; Barreira, Amilton Antunes; Herrera, Ronaldo Francisco

doi:10.1590/S0004-282X1992000400005

Resumos

O presente estudo foi planejado com a finalidade de avaliar a influência dos exames clínicos e complementares em relação ao diagnóstico das neuropatías periféricas. Avaliação laboratorial foi realizada em 81,8% dos pacientes, eletromiografia em 47,4% e biópsia em 22,5%. O diagnóstico sindrômico foi realizado em 99,0%, o topográfico em 98,6% e o etiológico em 73,2%. Foram solicitados em média 4,8 exames laboratoriais por paciente e, dos 93 diferentes tipos de exames pedidos, 36 foram sempre normais. A importância dos achados é discutida.

neuropatias periféricas; diagnóstico; fatores de relevância

The present study was undertaken to evaluate the influence of clinical examination and complementary tests on the diagnosis of peripheral neuropathies. Most of the patients (81.8%) were submitted to laboratory tests, 47.4% were submitted to electromyography, and 22.5% to biopsy. A syndromic diagnosis was made in 99.0% of the patients, topographic diagnosis in 98.6%, and etiological diagnosis in 73.2%. An average of 4.8 tests per patient were requested and 36 of the 93 different tests always gave normal results. The importance of the findings is discussed.

peripheral neuropathies; diagnosis; factors of relevance

Diagnóstico das neuropatias periféricas alguns fatores relevantes para a realização do diagnóstico

Diagnosis of peripheral neuropathies: some factors of relevance for diagnosis

Wilson Marques Júnior^I; Amilton Antunes Barreira^II; Ronaldo Francisco Herrera^I

^IMédico Assistente. Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Freto dia Universidade de São Paulo e Hospital das Clínicas de Ribeirão Freto

^IIProfessor Associado. Departamento de Neuropsiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Freto dia Universidade de São Paulo e Hospital das Clínicas de Ribeirão Freto

RESUMO

O presente estudo foi planejado com a finalidade de avaliar a influência dos exames clínicos e complementares em relação ao diagnóstico das neuropatías periféricas. Avaliação laboratorial foi realizada em 81,8% dos pacientes, eletromiografia em 47,4% e biópsia em 22,5%. O diagnóstico sindrômico foi realizado em 99,0%, o topográfico em 98,6% e o etiológico em 73,2%. Foram solicitados em média 4,8 exames laboratoriais por paciente e, dos 93 diferentes tipos de exames pedidos, 36 foram sempre normais. A importância dos achados é discutida.

Palavras-chave: neuropatias periféricas, diagnóstico, fatores de relevância.

SUMMARY

The present study was undertaken to evaluate the influence of clinical examination and complementary tests on the diagnosis of peripheral neuropathies. Most of the patients (81.8%) were submitted to laboratory tests, 47.4% were submitted to electromyography, and 22.5% to biopsy. A syndromic diagnosis was made in 99.0% of the patients, topographic diagnosis in 98.6%, and etiological diagnosis in 73.2%. An average of 4.8 tests per patient were requested and 36 of the 93 different tests always gave normal results. The importance of the findings is discussed.

Key words: peripheral neuropathies, diagnosis, factors of relevance.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Apoio: CNPq, Processo 501405/91.

Dr. Amilton Antunes Barreira Departamento de Neuropsiquiatria e Psicologia Médica, Faculdade de Medicina de Ribeirão Preto, USP - 14049 Ribeirão Preto SP - Brasil.

1. Asbury AK. Disorders of peripheral nerve. In Asbury AK, MacKhann GM, MacDonald WI (eds): Diseases of the Nervous System. Philadelphia: Saunders, 1986, p 321-337.
2. Cohen AS. Amyloydosis. N Engl J Med 1967, 277:522-530, 628-638.
3. Desmedt JE. Cerebral evoked potentials. In Dyck PJ, Thomas PK, Lambert EH, Bungs R (eds): Peripheral Neuropathy. Ed. 2. Philadelphia: Saunders, 1984, p 1045-1066.
4. Dyck PJ, Karnes J, Lais A, Lofgren EP, Stevens JC. Pathologic alterations of the peripheral nervous system of humans. In Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) : Peripheral Neuropathy. Ed 2. Philadelphia: Saunders, 1984, p 760-870.
5. Eisen A, Schoemer D, Melmed C. The applications of F-wave measurements in the differentiation of proximal and distal upper limb entrapments. Neurology 1977, 27:662-668.
6. Freeman RW, Bleecker ML, Comstock GW, Brookmeyer RS. Validation of self-administered questionaire for study of peripheral neuropathy. Am J Epidemiol 1985, 121:291-300.
7. Gilliat RW, LeQuesne PM, Logue V, Sumner AJ. Wasting of the hand associated with a cervical rib or band. J Neurol Neurosurg Psychiatry 1970, 33:615-624.
8. Gray RG, Poppo MJ, Gottlieb NL. Primary familial bilateral carpal tunnel syndrome. Ann Interm Med 1979, 91:37-40.
9. Kelly JJ Jr. The eleetrodiagnostic findings in peripheral neuropathy associated with monoclonal gtammopathy. Muscle & Nerve 1983, 6:504-509.
10. Mahloudji M. The genetic amyloidosis with particular reference to hereditary neuropathic amyloidosis type II. Medicine 1969, 48:1-38.
11. Marques WJr, Barreira AA. O diagnóstico das neuropatias periféricas: aspectos gerais da população em estudo. Arq Neuro-Psiquiat (São Paulo) 1902, 50:433-440.
12. Nakano KK. The entrapment neuropathies uf rheumatoid arthritis. Orthop Clin North Am 1975, 6:837-860.
13. Nean JP, Rivasseau TH, Rosolacci T, Zai L, Gil R, Lefevre JP. Neuropathies péripheriques d'origene canalaire (première partie). Sem Hôp Paris 1987, 63:2561-2566.
14. O´Duffy JD, Randall RV, MacCarty CS. Median neuropathy (carpal-tunnel syndrome) in acromegaly: a sign of endocrine overactivity. Ann Intern Med 1973, 78-379-383.
15. Scarpalezos S, Lygidakis C, Papageorgiou C, Maliara S, Koukoulommati AS, Koutras PA. Neural and muscular manifestations of hypothyroidism. Arch Neurol 1973, 29:140-144.
16. Shahani BT, Halperin JJ, Boulu P, Cohen J. Sympathetic skin response: a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry 1984, 47:536-542.
17. Sedeq M, Kersner AB, Shean RP. Carpal tunnel syndrome: first manifestation of systemic lupus erythematosus. JAMA 1972, 222:-1416-1417.
18. Stalberg E. Single fiber electromyography and some other electrophysiologic techniques for the motor unit. In Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds): Peripheral Neuropathy. Ed 2. Philadelphia: Saunders, 1984, p 967-980.
19. Valenta LJ. Hyperparathyroidism due to parathyroid adenoma and carpal tunnel syndrome. Ann Intern Med 1975, 82:541-542.
20. Weffort JL. Contribuição ao estudo das neuropatías periféricas que ocorrem em pacientes acometidos por lúpus eritematoso sistêmico. Dissertação de Mestrado, Universidade de São Paulo. Ribeirão Preto, 1989.

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Dez 1992

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[1] 1. Asbury AK. Disorders of peripheral nerve. In Asbury AK, MacKhann GM, MacDonald WI (eds): Diseases of the Nervous System. Philadelphia: Saunders, 1986, p 321-337.

[2] 2. Cohen AS. Amyloydosis. N Engl J Med 1967, 277:522-530, 628-638.

[3] 3. Desmedt JE. Cerebral evoked potentials. In Dyck PJ, Thomas PK, Lambert EH, Bungs R (eds): Peripheral Neuropathy. Ed. 2. Philadelphia: Saunders, 1984, p 1045-1066.

[4] 4. Dyck PJ, Karnes J, Lais A, Lofgren EP, Stevens JC. Pathologic alterations of the peripheral nervous system of humans. In Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) : Peripheral Neuropathy. Ed 2. Philadelphia: Saunders, 1984, p 760-870.

[5] 5. Eisen A, Schoemer D, Melmed C. The applications of F-wave measurements in the differentiation of proximal and distal upper limb entrapments. Neurology 1977, 27:662-668.

[6] 6. Freeman RW, Bleecker ML, Comstock GW, Brookmeyer RS. Validation of self-administered questionaire for study of peripheral neuropathy. Am J Epidemiol 1985, 121:291-300.

[7] 7. Gilliat RW, LeQuesne PM, Logue V, Sumner AJ. Wasting of the hand associated with a cervical rib or band. J Neurol Neurosurg Psychiatry 1970, 33:615-624.

[8] 8. Gray RG, Poppo MJ, Gottlieb NL. Primary familial bilateral carpal tunnel syndrome. Ann Interm Med 1979, 91:37-40.

[9] 9. Kelly JJ Jr. The eleetrodiagnostic findings in peripheral neuropathy associated with monoclonal gtammopathy. Muscle & Nerve 1983, 6:504-509.

[10] 10. Mahloudji M. The genetic amyloidosis with particular reference to hereditary neuropathic amyloidosis type II. Medicine 1969, 48:1-38.

[11] 11. Marques WJr, Barreira AA. O diagnóstico das neuropatias periféricas: aspectos gerais da população em estudo. Arq Neuro-Psiquiat (São Paulo) 1902, 50:433-440.

[12] 12. Nakano KK. The entrapment neuropathies uf rheumatoid arthritis. Orthop Clin North Am 1975, 6:837-860.

[13] 13. Nean JP, Rivasseau TH, Rosolacci T, Zai L, Gil R, Lefevre JP. Neuropathies péripheriques d'origene canalaire (première partie). Sem Hôp Paris 1987, 63:2561-2566.

[14] 14. O´Duffy JD, Randall RV, MacCarty CS. Median neuropathy (carpal-tunnel syndrome) in acromegaly: a sign of endocrine overactivity. Ann Intern Med 1973, 78-379-383.

[15] 15. Scarpalezos S, Lygidakis C, Papageorgiou C, Maliara S, Koukoulommati AS, Koutras PA. Neural and muscular manifestations of hypothyroidism. Arch Neurol 1973, 29:140-144.

[16] 16. Shahani BT, Halperin JJ, Boulu P, Cohen J. Sympathetic skin response: a method of assessing unmyelinated axon dysfunction in peripheral neuropathies. J Neurol Neurosurg Psychiatry 1984, 47:536-542.

[17] 17. Sedeq M, Kersner AB, Shean RP. Carpal tunnel syndrome: first manifestation of systemic lupus erythematosus. JAMA 1972, 222:-1416-1417.

[18] 18. Stalberg E. Single fiber electromyography and some other electrophysiologic techniques for the motor unit. In Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds): Peripheral Neuropathy. Ed 2. Philadelphia: Saunders, 1984, p 967-980.

[19] 19. Valenta LJ. Hyperparathyroidism due to parathyroid adenoma and carpal tunnel syndrome. Ann Intern Med 1975, 82:541-542.

[20] 20. Weffort JL. Contribuição ao estudo das neuropatías periféricas que ocorrem em pacientes acometidos por lúpus eritematoso sistêmico. Dissertação de Mestrado, Universidade de São Paulo. Ribeirão Preto, 1989.

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Diagnosis of peripheral neuropathies

Diagnóstico das neuropatias periféricas alguns fatores relevantes para a realização do diagnóstico: some factors of relevance for diagnosis

Resumos

Datas de Publicação