Apresentação de 16 casos de meningomielorradiculopatia esquistossomótica quanto à evolução clínica e do dual citoproteico do líquido cefalorraqueano. É salientado haver tendência à remissão da pleiocitose e manutenção da hiperpro-teinorraquia com o decorrer do tempo de doença. Também é salientado não haver relação entre a evolução clínica, o tratamento medicamentoso e a evolução das variáveis analisadas no LCR.

Data on 16 patients with spinal cord involvement by Schistosomiasis mansoni are evaluated as to the clinical course and the evolution of cerebrospinal fluid changes. According to evidences of radicular involvement cases were divided in two groups: myelitis (9 cases) and radiculomyelitis (7 cases). Cerebrospinal fluid changes were evaluated as to cytology, total protein content and gammaglobulins. Partial remission of clinical symptomatology was more common among patients of the second group than among those of the first group. There was not relationship of CSF changes and their course with the clinical course of the disease. Cerebrospinal fluid changes and their course were not related to clinical aspects of the disease and their course. Remission of hypercytosis was more common than the remission of protein changes along the evolution in the two groups of cases considered.

Foram estudados 44 casos de meningomielorradiculopatias primárias agudas e sub-agudas com relação ao perfil evolutivo da citologia e da concentração proteica do líquido cefalorraqueano nas diversas fases da doença. A evolução da pleocitose para níveis normais ou próximos da normalidade ocorreu na maioria dos casos (96%) ao término do período de estudo (60 dias). A hiperproteinorraquia evoluiu com padrão semelhante, embora de modo mais lento. A análise comparativa desses dados à evolução clínica dos pacientes, inclusive dos efeitos benéficos da terapêutica por ACTH ou corticosteróides em um grupo deles, sugere a importância de fatores autoimunes na deflagração da doença.

Forty four pacients with primary acute and subacute meningomyeloradiculopathies were studied in respect to the evolutive aspects of the cerebrospinal fluid (CSF) cell-protein dual in several periods of the disease. The tendency of CSF hypercytosis to normal values of cell count occurred in most cases (96%) at the end of the period in which the study was performed (60 days). The CSF protein levels had a similar but slower behavior pattern when compared with hypercytosis. The comparative analysis of clinical improvement of two groups of patients (treated and not treated with ACTH or corticosteroids) showed a statiscally significant difference between the two groups favouring the former. This fact enhances the possibility that an auto-immune process plays an important role in cases of primary meningomyeloradiculopathies.

É feita reavaliação dos aspectos que levaram ao diagnóstico etiológico em 353 pacientes com mielopatia não-traumática e não-tumoral observados no decurso de 20 anos: siringomielia, 5 casos; vascular, 15 casos; carencial, 67 casos; infecciosa ou por infestação, 82 casos; pós-vacinação, pós-infecção ou pós-intoxicação, 31 casos; esclerose múltipla e neuromielite óptica, 20 casos; primária, 133 casos. Em função do diagnóstico são analisados os aspectos que podem contribuir aos conhecimentos sobre os mecanismos fisiopatológicos interessados na deflagração do acometimento medular no que tange às alterações imunobiológicas. Nesse sentido é considerado o papel da necrose, da desmielinização e da inflamação e o respectivo interrelacionamento.

A re-evaluation is made of those aspects which led to the etiologic diagnosis in 353 patients who suffered from non-traumatic, non-tumoral myelopathies, and whose cases were studied along a period of 20 years. The cases were distributed as follows: syringomyelia, 5 cases; vascular myelopathy, 15 cases; privation caused myelopathies, 67 cases; infectious or infestation caused myelopathies, 82 cases; post-vaccination, post-infection or post-intoxication, 31 cases; multiple sclerosis and optic neuromyelitis, 20 cases; primary myeolopathy, 133 cases. With basis on the diagnosis, those aspects which may contribute to the existing knowledge about physiopathologic mechanisms related to the onset of spinal cord involvement, as related to immunobiologic alterations, are analysed. The role of necrosis, demyelinization and inflammation, and their respective interrelashionships are considered in this light.