A importância da vestibulometria no prognóstico e terapêutica do equilíbrio corporal na ataxia espinocerebelar dominante

Abstract

The spinocerebellar ataxias (AEC) are a heterogeneous group hetero of neurodegenerative diseases. They are characterized for the ataxia presence to cerebelar gradual, that it has as initial clinical manifestations deterioration of the balance, the motor coordination and ocular riots. The AECs is part of a roll of illnesses that present important alterations, involving the diverse areas of the health and, more specifically, the multidisciplinary in Otoneurology. Objective: to verify changes through vestibulometry initial and to demonstrate to the importance of the labyrinthine examination in the prognostic and body therapy balance in carrying patients of spinocerebellar ataxias. Method: A retrospective study of transversal cut was carried through. 57 patients had evaluated themselves, 26 female sort and 31male, in the age band enters the 18 70 years, average of age of 42.7 years and shunting line-standard of 8.4 years, directed of the Department of Medical Clinic of the Hospital of Clinics for evaluation in the Sector of Otoneurology of the Tuiuti University of the Paraná with AEC diagnosis (14 AEC type 3, 10 AEC type 2, 1 AEC type 4, 2 AEC type 6, 2 AEC type 7 and 9 AEC type 10) and 19 meets in genetic inquiry to know the type of AEC dominant, and is part of the group of AEC not specified. The diagnosis of the ataxia was carried through by means of genetic test with use of the technique of Reaction in Chain of enzyme DNA Polimerase (PCR, Polymerase Chain Reaction). The patients had been submitted to the following procedures: anamnesis, otorhinolaringologyc evaluation and vestibular contest by means of the vectoeletronistamography (VENG). Result: The related complaints more in anamnesis had been: disequilibrium to the gait (71.9%), dysarthria (49.1%), giddiness (43.8%) and dysphagia (36.8%). In the examination initial, the test caloric (78.9%) the slow saccadics movements (61.4%) and the rotatory tes (49.1%) had been the tests that had presented greaters indices of abnormalitys, with the initial predominance of dysfunction of the central type in 72.0% of the examinations, being that 84.2% of the results of the examinations present alterations. Conclusion: For intermediary of the clinical history of the patient, of the modified oculomotors tests in the examination initial and of its result, either it of peripheral or central origin, we have subsidies enough in such a way to know which personalized protocol to be used in the carrying patient of vestibular and, to become therapeutical the more efficient, efficient one and accomplishes, either for conventional protocols or by means of the virtual reality. Ahead of this, to provide to the AEC carriers an improvement of the motor coordination, corporal balance and performance of its AVDs, allowing independence and quality of life to the patients so suffered by this gradual neurodegenerative illness.