Diagnosis of acute motor functional disorders through semiology.

Mostrar todas las versiones(2)

Motor functional neurological disorders (FND) are a group of manifestations in movement and strength that present internal inconsistency with any other neurological disease. Objective: to evaluate the adequacy of semiological maneuvers, in an emergency scenario, to demonstrate motor inconsistency. T...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Videla, Pablo Agustín, Ferri, María Eugenia, Tavolini, Darío
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional de Rosario 2021
Materias:
Trastorno funcional
ACV
Emergencia
Diagnóstico
Functional disorder
Stroke
Emergency
Diagnosis
Acceso en línea:https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/26
Aporte de:
FCM Científica de Universidad Nacional de Rosario
id I15-R235-article-26
record_format ojs
spelling I15-R235-article-262023-11-08T14:27:33Z Diagnosis of acute motor functional disorders through semiology. Diagnóstico de trastornos funcionales motores agudos a través de la semiología. Videla, Pablo Agustín Ferri, María Eugenia Tavolini, Darío Trastorno funcional ACV Emergencia Diagnóstico Functional disorder Stroke Emergency Diagnosis Motor functional neurological disorders (FND) are a group of manifestations in movement and strength that present internal inconsistency with any other neurological disease. Objective: to evaluate the adequacy of semiological maneuvers, in an emergency scenario, to demonstrate motor inconsistency. There were 31 patients evaluated who suffered from limb weakness with less than 72 hours of evolution, from the emergency department. From the maneuvers found in the literature, 6 were applied and confronted with the neurology department diagnosis. Validates scales were administered for mood disorders screening. From the patients included in the study, 16 were diagnosed with FND, and the remaining patients as organic. There were no significant demographic differences. The specific signs associated with FND (p<0,01) includes: drift without pronation, “Spinal Injuries Center (SIC) Test”, Hoover’s sign and the abductor sign. The presence of, at least 2 positive signs, has proven to improve its specificity without losing sensitivity. The results show that there is a positive correlation between FND and the presence of depressive symptoms as well as acute psychological stressor. In conclusion, 4 of the evaluated maneuvers have shown adequacy to define the etiology of a motor focus. We consider that the results prioritize the physical examination by the specialist during the evaluation of an acute paresis. Also, these findings help in the conformation of a specific profile. Los trastornos neurológicos funcionales (TNF) motores se refieren al conjunto de manifestaciones en el movimiento y la fuerza que presentan inconsistencia interna e incongruencia con cualquier enfermedad neurológica descrita. Objetivo: evaluar la utilidad de maniobras semiológicas, en un escenario de urgencia, para demostrar inconsistencia motora. Se evaluaron 31 pacientes con debilidad de algún miembro de menos de 72 horas de evolución, que consultaron al servicio de urgencias de un efector público. Se aplicaron 6 maniobras descriptas en la bibliografía enfrentándose con el diagnóstico del servicio de neurología. Se administraron escalas validadas para el tamizaje de trastornos anímicos. De los pacientes reclutados, 16 fueron diagnosticados como TNF y el resto como orgánicos. No hubo diferencias demográficas significativas. Los signos que demostraron asociarse al diagnóstico de TNF (p<0,01) con alta sensibilidad y especificidad fueron: caída sin pronación, “Spinal Injuries Center (SIC) Test”, signo de Hoover y signo de abducción de la cadera. La presencia de al menos dos signos positivos demostró mejorar su especificidad sin menoscabo de la sensibilidad. Se encontró, además, una asociación contundente entre el diagnóstico de TNF y la presencia de síntomas depresivos así como de estresor psicológico agudo. En conclusión, cuatro de las maniobras evaluadas mostraron utilidad a la hora de definir la etiología de un foco motor. Consideramos que los resultados jerarquizan el examen físico del especialista al evaluar una paresia aguda. Además, la suma de hallazgos significativos colabora en la conformación de un perfil distintivo. Universidad Nacional de Rosario 2021-06-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/26 10.35305/fcm.v1i.26 Revista de la Facultad de Ciencias Médicas. Universidad Nacional de Rosario.; Vol. 1 (2020); 104-112 2796-7719 spa https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/26/42 https://creativecommons.org/licenses/by-nc/4.0/
institution Universidad Nacional de Rosario
institution_str I-15
repository_str R-235
container_title_str FCM Científica
language Español
format Artículo revista
topic Trastorno funcional
ACV
Emergencia
Diagnóstico
Functional disorder
Stroke
Emergency
Diagnosis
spellingShingle Trastorno funcional
ACV
Emergencia
Diagnóstico
Functional disorder
Stroke
Emergency
Diagnosis
Videla, Pablo Agustín
Ferri, María Eugenia
Tavolini, Darío
Diagnosis of acute motor functional disorders through semiology.
topic_facet Trastorno funcional
ACV
Emergencia
Diagnóstico
Functional disorder
Stroke
Emergency
Diagnosis
author Videla, Pablo Agustín
Ferri, María Eugenia
Tavolini, Darío
author_facet Videla, Pablo Agustín
Ferri, María Eugenia
Tavolini, Darío
author_sort Videla, Pablo Agustín
title Diagnosis of acute motor functional disorders through semiology.
title_short Diagnosis of acute motor functional disorders through semiology.
title_full Diagnosis of acute motor functional disorders through semiology.
title_fullStr Diagnosis of acute motor functional disorders through semiology.
title_full_unstemmed Diagnosis of acute motor functional disorders through semiology.
title_sort diagnosis of acute motor functional disorders through semiology.
description Motor functional neurological disorders (FND) are a group of manifestations in movement and strength that present internal inconsistency with any other neurological disease. Objective: to evaluate the adequacy of semiological maneuvers, in an emergency scenario, to demonstrate motor inconsistency. There were 31 patients evaluated who suffered from limb weakness with less than 72 hours of evolution, from the emergency department. From the maneuvers found in the literature, 6 were applied and confronted with the neurology department diagnosis. Validates scales were administered for mood disorders screening. From the patients included in the study, 16 were diagnosed with FND, and the remaining patients as organic. There were no significant demographic differences. The specific signs associated with FND (p<0,01) includes: drift without pronation, “Spinal Injuries Center (SIC) Test”, Hoover’s sign and the abductor sign. The presence of, at least 2 positive signs, has proven to improve its specificity without losing sensitivity. The results show that there is a positive correlation between FND and the presence of depressive symptoms as well as acute psychological stressor. In conclusion, 4 of the evaluated maneuvers have shown adequacy to define the etiology of a motor focus. We consider that the results prioritize the physical examination by the specialist during the evaluation of an acute paresis. Also, these findings help in the conformation of a specific profile.
publisher Universidad Nacional de Rosario
publishDate 2021
url https://fcmcientifica.unr.edu.ar/index.php/revista/article/view/26
work_keys_str_mv AT videlapabloagustin diagnosisofacutemotorfunctionaldisordersthroughsemiology
AT ferrimariaeugenia diagnosisofacutemotorfunctionaldisordersthroughsemiology
AT tavolinidario diagnosisofacutemotorfunctionaldisordersthroughsemiology
AT videlapabloagustin diagnosticodetrastornosfuncionalesmotoresagudosatravesdelasemiologia
AT ferrimariaeugenia diagnosticodetrastornosfuncionalesmotoresagudosatravesdelasemiologia
AT tavolinidario diagnosticodetrastornosfuncionalesmotoresagudosatravesdelasemiologia
first_indexed 2023-06-26T22:50:57Z
last_indexed 2024-08-12T21:45:30Z
_version_ 1807219824661626880

Ejemplares similares