Movimientos anormales identificados en pacientes con tuberculomas intracraneales

Abstract

Introduction movement disorders have been associated with deep brain lesions. This study was performed to describe the frequency and characteristics of movement disorders in patients with intracranial tuberculomas. Methods patients admitted consecutively between 1989 and 2004 to the Neurology Service of Eugenio Espejo Hospital (Quito, Ecuador), with a diagnosis of intracranial tuberculomas. All patients were examined clinically, and laboratory tests and imaging studies performed. Follow-up continued up to one year after the tuberculosis treatment was completed. A nested case-control analysis was performed to compare clinical characteristics, number and location of tuberculomas, between cases with movement disorders and controls. Results forty-nine patients with tuberculomas (31.7 ± 20.5 years; males 53.1%) were studied. We found 16 cases (32.6%; 95%CI = 19.9% - 47.5%) of movement disorders: chorea (n = 7; 43.8%), tremor (n = 5; 31.3%), dystonia (n = 3; 18.8%) and myoclonus (n = 1; 6.3%). Most cases (87.6%) developed early (10.4 ± 5.2 days of hospitalization). On admission, patients with movement disorders showed higher severity of the illness than controls (68.7 vs. 30.3%; p = .01), along with greater motor impairment (75.0 vs. 39.4%; p = .01) and sensitivity impairment (43.8 vs. 9.1%; p = .01). The cases showed higher frequency of multiple tuberculomas (68.7 vs. 36.4%), with deep brain deep (31.3 vs. 21.2%) and more severe motor impairment (25.0 vs. 12.1%). Conclusions our results suggest a causal relationship between tuberculomas and movement disorders. Deep location and multiple tuberculomas may increase the risk of develop movement disorders.