Registro de caso de paciente do sexo masculino com 40 anos de idade em que a tomografia computadorizada revelou a presença de processo expansivo no hemisfério cerebral direito. Os exames do líqüido cefalorraqueano e biópsia cerebral evidenciaram as características de neurossífilis. Após penicilinoterapia foi constatada atrofia focal no hemisfério cerebral direito. Este caso sugere que a forma de Lissauer da paralisia geral progressiva pode manifestar-se como processo expansivo cerebral.

A 40-year-old male patient with progressive dementia presented adversive seizures, and CT scan showed an enlarging focal mass lesion in the right cerebral hemisphere. Cerebrospinal fluid examination and brain biopsy confirmed the diagnosis of neurosyphilis. After a course of penicillin therapy there was disappearance of the cerebral mass lesion and the CT scan showed focal atrophy in the right cerebral hemisphere. This case suggests that Lissauer form of paretic neurosyphilis may present as a focal mass lesion.

Dois grupos de pacientes com miastenia grave adquirida foram analisados evolutivamente, para se verificar a influência da terapêutica no comportamento da doença. Dezenove foram timectomizados (grupo I) e 14 tratados por métodos conservadores (grupo II). Ambos os grupos foram homogeneizados demograficamente. Estabeleceram-se parâmetros que pudessem avaliar a história natural da doença e variáveis com o objetivo maior de análise comparativa na recuperação dos pacientes. Houve influência significativa quanto à utilização de quaisquer terapêuticas individualmente. Ambos os grupos tiveram comportamento semelhante quanto à resposta clínica final. A análise (U-Mann-Whitney) mostrou que os grupos provêm da mesma população. Embora ocorram diferenças quanto a individualidades das variáveis analisadas, a análise discriminante efetuada mostrou-se não significativa, nas doenças de longa evolução.

A restrospective survey of the records of 33 patients with generalized aquired myasthenia gravis treated at Hospital das Clínicas, Medical School of The University of São Paulo, Brazil and in private practice, with and without thymectomy, is reported. Nineteen were thymectomized and 14 non operated. Both groups were demographically homogeneous and were followed from 8 to 24 years. Parameters for evaluating the natural history of disease and other ones for a comparative analysis of the improvement or remissions were established. The influence of the individualized therapy was evaluated by McNemar test (x²); the U-Mann-Whitney was used for evalution of the populational behavior groups; variable parameter with possible influence in the useful life were studied by multivariate analysis. The difference of distance between both groups was not significant: (D2= 0.08894); T2 -7.17 (Hottelling test). There were differences of the isolate clinic parameter responses in both groups, but the global analysis of the parameters did not permit to discriminate them, possibly because of interaction of the parameters influencing the analytic result. Inspite of the fact that superposition of the parameter occured when analysed for a long period, we believe the early thymectomy to be benefic. Our patients who had their operation at a younger age and specially those with recent disease had a maximum improvement.