Small fiber dysfunction in patients with Wilson's disease



Document title: Small fiber dysfunction in patients with Wilson's disease
Journal: Arquivos de neuro-psiquiatria
Database: PERIÓDICA
System number: 000380078
ISSN: 0004-282X
Authors: 1
1
1
1
Institutions: 1Universidade Federal do Ceara, Fortaleza, Ceara. Brasil
Year:
Season: Ago
Volumen: 72
Number: 8
Pages: 592-595
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Caso clínico, analítico
English abstract Objective: Patients with Wilson’s disease (WD) may develop a wide variety of neuropsychiatric symptoms, but there are few reports of autonomic dysfunction. Here, we described evidence of small fiber and/or autonomic dysfunction in 4 patients with WD and levodopa-responsive parkinsonism. Method: We reviewed the charts of 4 patients with WD who underwent evaluation for the presence of neuromuscular dysfunction and water-induced skin wrinkling test (SWT). Results: Two men and 2 women (33±3.5 years) with WD were evaluated. They all had parkinsonism at some point during their disease course. Parkinsonism on patient 4 almost completely subsided with treatment of WD. Two patients had significant sensory and 2 significant autonomic complaints, including syncopal spells. NCS/EMG was normal in all but SWT was abnormal in half of them (mean 4-digit wrinkling of 0.25 and 1). Discussion: A subset of patients with WD exhibit evidence of abnormal skin wrinkling test (small fiber neuropathy)
Portuguese abstract Objetivo: Pacientes com doença de Wilson (DW) podem desenvolver uma ampla variedade de sintomas neuropsiquiátricos, mas existem poucos relatos de disfunção autonômica. Aqui, nós descrevemos evidência de disfunção de fibras finas/autonômica em 4 pacientes com DW e parkinsonismo responsivo à levodopa. Método: Nós revisamos os prontuários de 4 pacientes com DW que foram submetidos a avaliação neuromuscular e ao teste de quantificação do enrugamento cutâneo (TEC). Resultados: Dois homens e 2 mulheres (33±3,5 anos) com DW foram avaliados. Todos apresentaram parkinsonismo durante o curso de sua doença. Parkinsonismo no paciente 4 quase completamente desapareceu com tratamento da DW. Dois pacientes apresentaram queixas sensitivas e 2 apresentaram queixas autonômicas significativas incluindo episódios de síncope. Eletroneuromiografia foi normal em todos e TEC foi anormal em metade deles (score do TEC nos 4 dedos de 0,25 e 1). Discussão: Um subgrupo de pacientes com DW apresenta evidência de TEC anormal (neuropatia de fibras finas)
Disciplines: Medicina
Keyword: Neurología,
Enfermedad de Wilson,
Neuropatías,
Sistema nervioso autónomo,
Parkinsonismo,
Disfunción autónoma
Keyword: Medicine,
Neurology,
Wilson disease,
Neuropathies,
Autonomic nervous system,
Parkinsonism,
Autonomic dysfunction
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