Poster Abstracts Friday, November 11, 2005 $509

Gomes, S z, Dantas, TN, Campanella, CAD, Luna, Pizzato, R, Valle, ELR, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 1Hospital Real e Benem&ita Sociedade Portuguesa de Ben@'cidncia HRBSPB; 2Faculdade de Medicina da Universidade de Sdo Paulo FMUSP, Sao Paulo, Brazil; 3Hospital Geral Exdrcito de Sdo Paulo HGESP, Brazil

Objective: Report one intermittent acute porphyria in patient 18 years of age, caucasian, with clinical scenario of peripheral polineuropathy, abdominal pains and behavioural disturbance. Methods: Results of the ENMG, LCR, general laboratory (ALA+PBE) urinary described the approach way. Results: Intensive hydroelectrolytic replacement, hypercaloric diet, hypertonic glucose with good clinical response. Conclusion: The previously described pathology is a disorder charac- terized by the lffgh production and excretion of porphyrin precursors. The differential diagnosis are important.

1611 Neurological Scenario in the Behcet Disease: Case Report

Gomes, S 2, Cumpanella, CAD, Luna, Pizzato, R, Valle, ELR, Dantas, TN, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 1Hospital Real e Benemdrita Soeiedade Portuguesa de Beneficidncia HRBSPB; 2Faculdade de Medicina da Universidade de Sdo Paulo FMUSP, Sao Paulo, Brazil," 3Hospital Geral Ex&cito de Sdo Paulo HGESP, Brazil

Objective: To describe the case of Behcet disease with neurological manifestations. AAG, 30 years old, with AVCi scenario for 2 years, showing visual disturbances, intense cephalea and motor deficit on the left. Reported the presence of oral and genital ulcers. Developed left peripheral facial paralysis 60 days ago and evolved with temp- erature, diplopia, with meningitis diagnosis. Unsuccesful use of antibiotic.therapy. Results: Altered LCR, RNM encephahis with hypersignal in T2 in bridge and ganglia of the basis. Conclusion: Behcet disease with recurrent meningoencephalitis presence.

1612 ADEM (Acute Dissenlinated Eneephalo Myelites)

Gomes, S z, Pizzato, R, Valle, ELR, Dantas, TN, Campanella, CAD, Luna, AST, Rodrignes, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 1Hospital Real e Benern&ita Sociedade Portuguesa de Beneficidncia HRBSPB; 2Faculdade de Medicina da Universidade de Sdo Paulo FMUSP, Sao Paulo, Brazil; 3Hospital Geral Ex(rcito de Sdo Paulo HGESP, Brazil

The acute disseminated encefalomyelites is a rare, monophasic dismyelinating disease, which affects the central nervous system and that appears shortly after either a exanthematous, non-exanthematous or vaccination. It attacks mainly clffldren and young adults. The severe form has great importance due to the lffgh rate of mortality or morbidity on those who pull through.

The clinical scenario is constituted of: convulsion, confusion, sleepiness, cephalea, temperature, nuchalgia, para or tetraplegia; para or tetraparestesia, hyperreflexia, splffncterial disturbance among others. Therefore, it is, in certain cases, very hard to differentiate from multiple sclerosis. Case Report: T.E.V. 15 years old, male, caucasian, born in Silo Paulo. Clinical Scenario: Patient presented paresthesia on the feet planta which evolved ascending to the perineal region and evolved after ten days, with paresthesia on upper limbs. Personal Background: Denies other diseases, as well as medication use; refers to viral infection episode on past fortnight.

Physical examination: temperature, tetraparesthesia, preserved mus- cular strength, overexcited reflexes in upper and lower limbs, sensitive level on T4, and unaltered cutaneous planta reflex.

LCR with protein electroforese: unaltered. Encephalic RMN presenting dismyelinating lesions in right fi'ont

region, smaller than 1 cm. Cervical spine RMN showing 2cm cephalo-caudal intramedullar

lesion on the medulla's rear portion at the level of c3-cd with contrast captioning with minimum medulla broadening at this level, suggesting acute dismyelinating lesion. Conclusion: the clinical signals and the exams that took place are compatible with ADEM (Acute Disseminated Encephalo Myelites) according to the researched worldwide literature.

1613 Multiple Cavernoma: case report

C-OIIlOA;, S 2, Luna, AST, Pizzatto, R, Valle, ELR, Dantas, TN, Campanella, CAD, Rodrigues, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benem~rita Sociedade Portuguesa de Benefieidneia - HRBSPB," 2Faeuldade de Medicina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Germ Ex&cito de S~.o Paulo - HGESP, Brazil

Background: With the advent of magnetic resonance, the differential diagnosis of expansive behavior pathologies has been more specific and in many cases precise. We have discussed the case of a female patient of 30 years of age with Epyleptic Syndrome associated with cephalea and behavior disturbance. Her tomography showed expan- sive left front temple lesion, and the magnetic resonance evidentiated countless lesions difusedly spread. After surgery submission, it was concluded that a cavernoma was the case. Our aim is to show how tiffs pathology incidence has increased and in tiffs case it is about nmltiple lesions.

1614 Precocious surgical treatment for post brain Aneurism Subaraehnoid Haemorrhage. Service Casuistry

Goines, S z, Pizzato, R, Valle, ELR, Dantas, TN, Campanella, CAD, Luna, AST, Rodrigues, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benemdrita Sociedade Portuguesa de Benefieidncia - HRBSPB; 2Faeuldade de Medicina da Universidade de Sdo Paulo - FMUSP, Sao Paulo, Brazil," 3Hospital Geral Ex&cito de Sdo Paulo HGESP, Brazil

Background: The precocious surgical treatment for post-subaradmoid- haemorrhage aneurism dipping is still controversial. The risk of intra- operative aneurismatic rupture, a greater necessity of the encephalic tissue contraction and the presence of solid clots, are limiting factors for the frequent employ of this operative technique. Aiming to prevent re-bleeding, the easing to the treatment of the vasoespasm and the intra-operative cleansing of vasoespasmogenic agents, we present the service casuistry in precociously approached ruptured brain aneurisms. The cases with ictus under 48hs and grading by Hunt and Hess scale under three were retrospectively analysed, in which it was opted for the precocious surgical treatment. The present study has as aim to show the acquired experience in service concerning the indication of tiffs operative tedmique.

1615 Deeompressive Craniectomy in Isdleinic Brain Vascular accident advantages of the Magnetic-Resonance-Oriented Precodous treahnent: comparative study and service casuistry

Gomes, S z, Luna, AST, Pizzatto, R, Valle, ELR, Dantas, TN, Campanella, CAD, Rodrigues, LC, Cassis, R, Sassine, S, Godoy, R, Oliveira, PGD, Montanaro, AC. 2Hospital Real e Benem~rita Sociedade Portuguesa de BeneficiCncia HRBSPB; 2Faculdade de