Neuropatia trigeminal em pacientes urêmicos em hemodiálise
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Data
2011-02-28
Autores
Bertotti, Márcia Elaine Zeugner [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Baseados em trabalhos prévios de nosso grupo de pesquisa, os autores pensam que perdas dentárias na insuficiência renal crônica poderiam estar associadas a neuropatia trigeminal, o que não está descrito na bibliografia consultada. Para investigar a hipótese, foram estudados 30 pacientes urêmicos em programa de hemodiálise durante os últimos 5 anos. Dez foram excluídos devido a história clínica de alcoolismo ou diagnóstico de diabetes. Dentre 20 pacientes urêmicos (sem alcoolismo ou diabetes) evidências clínicas de comprometimento trigeminal foram observadas em 4 (20% dos casos). Estudos do blink reflex sugeriram comprometimentos das aferências trigeminais em 12 (60%). A análise das repostas R1 possibilitou classificar os comprometimentos das aferências trigeminais em axonais ou desmielinizantes. Alterações das respostas R2 sugeriram hiperexcitabilidade ou hipoexcitabilidade dos neurônios internunciais do tronco encefálico, e foram encontradas algumas alterações de R2 possivelmente indicativas de mau prognóstico
Based on anterior works of our research group, the authors believe that teeth lost in chronic renal failure would be associated to trigeminal neuropathy, an association not described in medical literature. This study was conducted to investigate this hypothesis, and 30 uremic patients undergoing hemodialysis were analysed in the last 5 years. Ten were excluded because they have chronic alcoholism or diabetes. From 20 uremic patients, without alcoholism or diabetes, clinical evidences of trigeminal neuropathy was obtained in 4 (20 %), and electrophysiological studies by blink reflex showed abnormalities suggesting trigeminal neuropathy in 12 (60%). From R1 response analysis, it was possible to separate the electrophysiological evidences of impairment of the afferent trigeminal pathways in two groups: axonal or demyelinating pattern. R2 abnormalities suggested hyperexcitability or hypoexcitability of the interneurons in pons and medulla. In addition, the authors believe that some findings in the blink reflex may be of prognostic value
Based on anterior works of our research group, the authors believe that teeth lost in chronic renal failure would be associated to trigeminal neuropathy, an association not described in medical literature. This study was conducted to investigate this hypothesis, and 30 uremic patients undergoing hemodialysis were analysed in the last 5 years. Ten were excluded because they have chronic alcoholism or diabetes. From 20 uremic patients, without alcoholism or diabetes, clinical evidences of trigeminal neuropathy was obtained in 4 (20 %), and electrophysiological studies by blink reflex showed abnormalities suggesting trigeminal neuropathy in 12 (60%). From R1 response analysis, it was possible to separate the electrophysiological evidences of impairment of the afferent trigeminal pathways in two groups: axonal or demyelinating pattern. R2 abnormalities suggested hyperexcitability or hypoexcitability of the interneurons in pons and medulla. In addition, the authors believe that some findings in the blink reflex may be of prognostic value
Descrição
Palavras-chave
Insuficiencia renal cronica, Hemodialise - Complicações e sequelas, Neuropatia, Nervo trigemeo, Chronic renal failure
Como citar
BERTOTTI, Márcia Elaine Zeugner. Neuropatia trigeminal em pacientes urêmicos em hemodiálise. 2011. 98 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2011.