Sanvito W L, Tilbery C P, Villares J C
Arq Neuropsiquiatr. 1982 Mar;40(1):86-94. doi: 10.1590/s0004-282x1982000100009.
The uveomeningoencephalitic syndromes are inflammatory diseases, more prevalent in oriental patients, without sexual predilection and with mean age of 30 years. From the clinical point of view they affect the uvea, retina, meninges, the central nervous system and skin and in most cases the onset is followed by three phases: the meningoencephalitic phase, the acute ophthalmic phase and the dermatologic phase. These includes the Harada disease, the Vogt-Koyanagi disease, the Behçet disease and the idiopathic forms. The Vogt-Koyanagi syndrome is a chronic and severa bilateral exudative uveitis associated with whitening of the hair and eyelashes and varying signs of meningeal irritation, less frequent than in Harada's disease. The Harada syndrome is a posterior uveitis accompanied by signs of meningeal irritation, increased protein levels and pleocytosis of the cerebrospinal fluid. The Behçet's disease is a relapsing illness, characterized by oral and genital aphtous ulcers and ocular inflammation. In many cases there are additional features; in 10 to 25 percent of the cases there are neurologic involvement, and any portion of the nervous system may be affected. The authors studied two cases of uveomeningoencephalic syndrome, one case of Vogt-Koyanagi-Harada disease (case 1) and another of Behçet disease (case 2). The case 1 was a white Brazilian forty-five year-old man, with a acute headache, mental confusion and signs of meningeal irritation. The cerebrospinal fluid was a inflammatory one, with increased lymphocytes and monocytes, the one month after the patient developed bilateral uveit. The patient complicated with amblyopia of the left eye and a Korsakoff syndrome. There was no correlation in the literature of the Korsakoff syndrome and the uveomeningoencephalitic syndrome. The case 2 was a white Brazilian, twenty-four year-old man, with two episodes of meningitis, genital recurrent aphtous ulcers and uveitis in the right eye, with latter blindness of this eye. Some considerations about the etiopathogenic aspects are done and about the controversial use of corticoids in the treatment of these syndromes.
葡萄膜脑膜脑炎综合征是一种炎症性疾病，在东方患者中更为常见，无性别倾向，平均发病年龄为30岁。从临床角度来看，它们会影响葡萄膜、视网膜、脑膜、中枢神经系统和皮肤，大多数情况下发病后会经历三个阶段：脑膜脑炎阶段、急性眼科阶段和皮肤病阶段。这些包括原田病、伏格特-小柳病、白塞病和特发性形式。伏格特-小柳综合征是一种慢性且严重的双侧渗出性葡萄膜炎，伴有头发和睫毛变白以及不同程度的脑膜刺激征，比原田病少见。原田综合征是一种后葡萄膜炎，伴有脑膜刺激征、脑脊液蛋白水平升高和细胞增多。白塞病是一种复发性疾病，其特征为口腔和生殖器阿弗他溃疡以及眼部炎症。在许多情况下还有其他特征；10%至25%的病例存在神经受累，神经系统的任何部位都可能受到影响。作者研究了两例葡萄膜脑膜脑炎综合征病例，一例是伏格特-小柳-原田病（病例1），另一例是白塞病（病例2）。病例1是一名45岁的巴西白人男性，患有急性头痛、精神错乱和脑膜刺激征。脑脊液呈炎性，淋巴细胞和单核细胞增多，在患者出现双侧葡萄膜炎一个月后出现。患者并发左眼弱视和柯萨科夫综合征。柯萨科夫综合征与葡萄膜脑膜脑炎综合征在文献中没有相关性。病例2是一名24岁的巴西白人男性，有两次脑膜炎发作、生殖器复发性阿弗他溃疡和右眼葡萄膜炎，后者导致该眼失明。文中对病因方面以及在这些综合征治疗中使用皮质类固醇的争议进行了一些探讨。
