Psychologie anormale et comportementale

Hashimoto’s encephalopathy is considered as an autoimmune encephalopathy characterized by sub-acute altered level of consciousness associated with high titers of anti-thyroid peroxidase antibodies. In steroid resistant cases, intravenous immunoglobulin, plasmapheresis and other immunotherapy may be an effective treatment. Herein, we describe a case report of 62 years old lady presented for acute onset of altered level of consciousness. All labs, lumbar puncture and imaging including MRI of brain were not significant. Thyroid function tests were normal, but anti-TPO was more than 1000. Excluding all other common causes of altered level of consciousness, elevated level of Anti-TPO lead us to think of Hashimoto encephalopathy. We treated the patient with steroid bolus therapy for 3 days and completing with dose of 1 mg/kg for a total of seven days, with no improvement. Then, we decided to do several sessions of plasmapheresis after which the patient started gaining her consciousness. This case further supports plasma exchange as a potentially beneficial treatment modality, in severe cases of Hashimoto’s encephalopathy which are completely or partially resistant to steroids.

Introduction: On senescence the gait gets worse and affects functional capacity of the elderly and, compromises independence, autonomy and increases the rates of falls in this population. The evaluation and the study of the prevalence for future falls allow the development of preventive strategies.

Objective: To analyze the results of the application of the Dynamic Gait Index (DGI) Brazilian brief proposal and establish correlation with the original version.

Methods: Study approved by the Ethics and Research Committee of the institution under number
0197.0.107000.09. We analyzed 223 files of socially active elderly, female gender, aged ranged 60 to 85 years,
mean 68.54 (± 7,61) years. The volunteers were evaluated by the DGI- Brazil. For the statistical analysis, the
Pearson Correlation Momentum Correlation Test with Spearman Correlation was used, with P<0.5 an R=1,0.

Results: Sixty-three (27.8%) of the volunteers presented an altered DGI scores. The statistical analysis indicated that T1 and T2 did not contribute to decrease the total score in the test. The worst performances occurred in Tasks 3, 5 and 6. There was founded a positive correlation between tasks 1 and 2; 1 and 8; 3 and 4; 3 and 5; 4 and 5; 2 and 4; 2 and 7. Negative correlation occurred between tasks 4 and 8, and 6 was not correlated with another Task.

Conclusion: The DGI-Brazilian brief version presented a strong correlation with the original proposal and may be perfectly applicable in clinical practice as a tool to evidence future risks of falls in the elderly people.