Background Even in high income countries , the general public and health care professionals still have some stigma about dementia. Despite campaigns people still delay seeking out help advice when they first start to forget and to worry about their own memory or that of a family member. Method A simple multiple choice questionnaire, with questions about knowledge about Alzheimer's disease, evolution and prognosis and personal questions about perception, feelings and prejudices about the disease, was applied to physicians in the field of neurology and non‐neurologists. The sample was made up of 5 different groups of health professionals : second and third year neurology residents, general neurology assistants, neurologists specializing in dementia , non‐neurologists and nursing technicians working in a neurology ward. Result Doctors are expected to have less prejudice and misconceptions about diseases, however, although rare, we still find some concepts inadequate and mainly, some responses from the questionnaires pointed out a certain stigma in relation to Alzheimer's disease, mainly in the group of non‐neurologists e some nursing technicians. Conclusion Information is the better way to combat the stigma. More campaigns, more medical information and most importantly, more continuing medical education in dementia needs to be provided to health professionals.
Context: Neurological manifestations of Sars-CoV-2 are progressively emerging. Cases of Guillain-Barré syndrome and its variants, with onset about 5-10 days after influenza symptoms, have been described. This paper reports a case of polyneuropathy with onset 90 days after a sore throat episode and persistence of IgM positivity in serology for Sars- Cov-2. We aim to raise awareness of this possibility. Case Report: A 56-year-old male, hypertensive, presented with sore throat on April 21, 2020. Serology for Covid-19 was performed with positive IgM. There was complete improvement of the symptom. At the end of July, he started a symmetrical paresthesia in the feet with ascension to the knees and, on August 20, paresthesia in the hands too. So, he went to IAMSPE (SP) and tactile and painful hypoesthesia in hands and feet, hypopalesthesia in lower limbs, a fall in the lower limbs upon Mingazzini’s maneuver, global hyporeflexia and talon gait were found. Just the following tests were changed: second Covid-19 serology IgM and IgG positives; ENMG: sensory motor polyneuropathy, primarily axonal, with signs of chronicity and without signs of acute denervation in the current. Started gabapentin and physical therapy. Patient still has paresthesia in hands and feet, but with partial improvement. Conclusion: This case alerts to neurological symptoms of Covid-19 in the medium and long term.
Introduction: Alexia Without Agrafia (AWA) is a syndrome in which the patient loses the ability to read while maintaining the ability to write. It’s described in strokes in the territory of the left posterior cerebral artery (PCA) and is usually accompanied by right homonymous hemianopia (HH) or color anomy. Case presentation: Male, 66 years old, complete higher education, righthanded, woke up two days ago with difficulty orienting himself, bumping into objects, visual difficulty in right hemifields. Neurological examination: preserved naming (when presented through sensory means other than visual), fluency, comprehension and writing, but inability to read, anomie for colors, HH on the right (R). CT Skull: hypoattenuating at occipital-temporal region left (L), in addition areas of encephalomalacia in the R occipital-temporal. Electrocardiogram: atrial fibrillation. US Doppler Carotid: no significant stenoses. Magnetic Resonance Imaging (MRI) Skull and Angio-MRI arterial phase: recent ischemia in the L occipital lobe and in L temporal lobe, involvement of splenium of the corpus callosum (CC), diffusion restriction and hypersignal in T2 and FLAIR (Fluid-Attenuated Inversion Recovery); previous ischemic lesion in the R temporal-occipital; hypoflow of bilateral PCA distal branches. Echocardiogram: enlarged L atrium. CT Skull 11 days after ictus with stability. Hospital discharge with Apixaban 5 mg every 12 hours, return to the neurology clinic. Discussion: Lesion in the L occipito-temporal cortex with involvement of the splenium of CC leads to a disconnection syndrome called AWA. The CC has fibers that connect the two cerebral hemispheres. The occipital lobe and splenium are supplied by the PCA. In addition, PCA infarction L leads to HH on the R, thus, visual information (letters) interpreted in the R visual cortex (visual field L), explaining why the patient can see the letters but not read them. Conclusion: Strokes are one of the main causes of morbidity. In the topography of the left PCA, we observed AWA.
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