Ortega Roberta Paiva Magalhães, Rosemberg Sérgio
Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo SP, Brasil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo SP, Brasil.
Arq Neuropsiquiatr. 2019 Jan;77(1):10-18. doi: 10.1590/0004-282X20180153.
To investigate hereditary spastic paraplegia (HSP) in a pediatric Brazilian sample.
Epidemiological, clinical, radiological and laboratory data were analyzed in 35 patients.
Simple HSP (HSP-S) was detected in 12 patients, and complicated HSP (HSP-C) was detected in 23 patients. The mean age of onset of symptoms was 2.9 years in HSP-S and 1.6 years in HSP-C (p = 0.023). The disease was more severe in HSP-C. There were no differences in sex, ethnic background, or family history between groups. Intellectual disability was the most frequent finding associated with HSP-C. Peripheral axonal neuropathy was found in three patients. In the HSP-C group, MRI was abnormal in 13 patients. The MRI abnormalities included nonspecific white matter lesions, cerebellar atrophy, thinning of the corpus callosum and the "ear of the lynx sign".
In children with spastic paraplegia, HSP must be considered whenever similar pathologies, mainly diplegic cerebral palsy, are ruled out.
在巴西儿科样本中研究遗传性痉挛性截瘫(HSP)。
分析了35例患者的流行病学、临床、放射学和实验室数据。
12例患者检测出单纯型HSP(HSP-S),23例患者检测出复杂型HSP(HSP-C)。HSP-S症状的平均发病年龄为2.9岁,HSP-C为1.6岁(p = 0.023)。HSP-C病情更严重。两组在性别、种族背景或家族史方面无差异。智力障碍是与HSP-C相关的最常见表现。3例患者发现周围轴索性神经病。在HSP-C组中,13例患者的MRI异常。MRI异常包括非特异性白质病变、小脑萎缩、胼胝体变薄和“猞猁耳征”。
对于痉挛性截瘫儿童,排除主要为双侧瘫型脑瘫等类似疾病后,必须考虑HSP。