Artículos de revistas
Normal Pressure Hydrocephalus In The Spectrum Of Neurological Complications Of Systemic Lupus Erythematosus
Registro en:
Neurological Sciences. , v. 34, n. 6, p. 1009 - 1013, 2013.
15901874
10.1007/s10072-012-1161-3
2-s2.0-84879111040
Autor
De Oliveira F.F.
Cardoso T.A.M.
Sampaio-Barros P.D.
Damasceno B.P.
Institución
Resumen
Normal pressure hydrocephalus is an unusual manifestation of systemic lupus erythematosus and its pathogenesis is still unclear. We report the case of a 39-year-old white woman with systemic lupus erythematosus who developed magnetic gait, speech difficulties, progressive memory impairment, urinary incontinence and episodes of involuntary closure of the eyelids. Signs and symptoms, associated with ventriculomegaly and normal cerebrospinal fluid pressure, suggested normal pressure hydrocephalus, which as a complication of systemic lupus erythematosus believably develops due to the insidious inflammatory process that occurs in the meningeal tissues or to the vasculitis itself. Normal pressure hydrocephalus tends to develop secondary to trauma, infection or subarachnoid haemorrhage, but in 50 % of patients no aetiology is found. Shunt surgery is the only effective treatment, specifically for the gait disorder, which usually improves more than the cognitive symptoms. Since the tap-test showed a strongly positive result, a medium pressure ventriculoperitoneal shunt was inserted, further replaced by a high pressure one in view of the complications, with less than expected improvement. Subdural hematomas and empyemas developed, requiring surgery and antibiotic therapy. A new tap-test was positive, and the patient improved only after a programmable valve was finally placed. However, pressure regulation shall be continuously required, and shunt dysfunction might still develop in the long term. The few similar case reports in the literature are reviewed, confirming the rarity of this neurological complication of systemic lupus erythematosus. © 2012 Springer-Verlag. 34 6 1009 1013 Hanly, J.G., Urowitz, M.B., Sanchez-Guerrero, J., Bae, S.C., Gordon, C., Wallace, D.J., Isenberg, D., Farewell, V., Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: An international inception cohort study (2007) Arthritis Rheum, 56, pp. 265-273. , for the Systemic Lupus International Collaborating Clinics 10.1002/art.22305 17195230 10.1002/art.22305 1:STN:280:DC%2BD2s%2FltlWiuw%3D%3D Di Comite, G., Sabbadini, M.G., Neurological involvement in rheumatological diseases (2005) Neurol Sci, 26, pp. 9-S14. , 10.1007/s10072-005-0391-z 15883701 10.1007/s10072-005-0391-z Tan, E.M., Cohen, A.S., Fries, J.F., Masi, A.T., McShane, D.J., Rothfield, N.F., Schaller, J.G., Winchester, R.J., The 1982 revised criteria for the classification of systemic lupus erythematosus (1982) Arthritis Rheum, 25, pp. 1271-1277. , 7138600 10.1002/art.1780251101 1:STN:280:DyaL3s%2FkvVCmtA%3D%3D Damasceno, B.P., Carelli, E.F., Honorato, D.C., Facure, J.J., The predictive value of cerebrospinal fluid tap-test in normal pressure hydrocephalus (1997) Arq Neuropsiquiatr, 55, pp. 179-185. , 10.1590/S0004-282X1997000200003 9629375 10.1590/S0004-282X1997000200003 1:STN:280:DyaK1c3ptlShsg%3D%3D Stein, S.C., Langfitt, T.W., Normal-pressure hydrocephalus: Predicting the results of cerebrospinal fluid shunting (1974) J Neurosurg, 41, pp. 463-470. , 10.3171/jns.1974.41.4.0463 4479249 10.3171/jns.1974.41.4.0463 1:STN:280:DyaE2M%2FhtlShtw%3D%3D Krauss, J.K., Von Stuckrad-Barre, S.F., Clinical aspects and biology of normal pressure hydrocephalus (2008) Handbook of Clinical Neurology, pp. 887-902. , Duyckaerts C, Litvan I (eds) Elsevier, London. doi: 10.1016/S0072- 9752%2807%2901278-X Folstein, M.F., Folstein, S., McHugh, P.R., Mini-mental state: A practical method for grading the cognitive state of patients for the clinician (1975) J Psychiatr Res, 12, pp. 189-198. , 1202204 10.1016/0022-3956(75)90026-6 1:STN:280:DyaE28%2FntFKjtw%3D%3D Relkin, N., Marmarou, A., Klinge, P., Bergsneider, M., Black, P.M., Diagnosing idiopathic normal-pressure hydrocephalus (2005) Neurosurgery, 57, pp. 2-16. , 10.1227/01.NEU.0000168185.29659.C5 Honda, K., Matsumoto, M., Kaneko, T., Kamei, I., Tatsumi, H., Murai, N., Mineharu, Y., Oita, J., Linear deposition of immunoglobulins and complement components on the dura in normal pressure hydrocephalus complicating systemic lupus erythematosus (2004) J Clin Neurosci, 11, pp. 561-563. , 10.1016/j.jocn.2003.06.007 15177414 10.1016/j.jocn.2003.06.007 Albayrak, R., Albayram, S., Selçuk, H., Saip, S., Yilmaz, H., Degirmenci, B., Islak, C., Communicating hydrocephalus in systemic lupus erythematosus (2006) Turk J Med Sci, 36, pp. 323-326 Mortifee, P.R., Bebb, R.A., Stein, H., Communicating hydrocephalus in systemic lupus erythematosus with antiphospholipid antibody syndrome (1992) J Rheumatol, 19, pp. 1299-1302. , 1404170 1:STN:280:DyaK3s%2FitVygsA%3D%3D Uhl, M.D., Werner, B.E., Romano, T.J., Zidar, B.L., Normal pressure hydrocephalus in a patient with systemic lupus erythematosus (1990) J Rheumatol, 17, pp. 1689-1691. , 2084247 1:STN:280:DyaK3M7psVSitg%3D%3D You, H.Y., Wang, S.R., Normal pressure hydrocephalus in a patient with systemic lupus erythematosus: A case report (1998) Zhonghua Yi Xue Za Zhi (Taipei), 61, pp. 551-555. , 1:STN:280:DyaK1M%2FhsFSguw%3D%3D