Imagen clínica
Mioclonias laríngeas
Laryngeal myoclonus
Unidad de Endoscopia Per Oral, Hospital Francisco Muñiz , Ciudad Autónoma de Buenos Aires, Argentina
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Roberto Duré" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Daniel" "apellidos" => "Samolski" "email" => array:1 [ 0 => "dsamolski@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Roberto" "apellidos" => "Duré" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Endoscopia Per Oral, Hospital Francisco Muñiz , Ciudad Autónoma de Buenos Aires, Argentina" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Laryngeal myoclonus" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Paciente varón de 42 años de edad con antecedente de tabaquismo (20 paquetes/año), que presentó un accidente cerebrovascular (ACV) isquémico de cerebelo, por obstrucción de la arteria basilar. La resonancia magnética nuclear mostró lesiones multifocales hiperintensas (T2 y FLAIR) localizadas en ambos hemisferios cerebelosos y vermis.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Requirió la realización de traqueostomía por asistencia respiratoria mecánica prolongada, situación que se mantuvo durante su estancia en un centro de cuidados crónicos y rehabilitación. Tres meses después de su ACV se realizó una fibrobroncoscopía para evaluar estructural y funcionalmente su vía aérea. En este estudio se observaron movimientos mioclónicos de las estructuras laríngeas<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>, especialmente epiglotis y cuerdas vocales. Estos movimientos tenían idéntica frecuencia de oscilación que los movimientos involuntarios de las extremidades (véase el vídeo [anexo]).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Las mioclonias son movimientos involuntarios, breves, cortos y repentinos. La mayoría afecta a las extremidades, pero pueden, también, observarse en músculos faciales, tronco y otras partes del cuerpo. Las mioclonias secundarias a otras enfermedades son las más frecuentes. Esto puede deberse a daño estructural, insultos isquémicos o desórdenes tóxico-metabólicos del sistema nervioso central. Los movimientos mioclónicos de la laringe son una rara expresión de afectación neurológica de sus músculos<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>, y suelen asociarse a mioclonias del velo del paladar y faringe como expresión de lo que se denomina «mioclonias palatinas sintomáticas»<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Actualmente, el paciente continúa recibiendo rehabilitación respiratoria, motora, del habla y de la deglución.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0030" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Anexo A" "titulo" => "Material suplementario" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 9191693 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Palato-pharyngo-laryngeal myoclonus… an unusual cause of dysphagia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.G. Juby" 1 => "P. Shandro" 2 => "D. Emery" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ageing/afu066" "Revista" => array:6 [ "tituloSerie" => "Age Ageing." "fecha" => "2014" "volumen" => "43" "paginaInicial" => "877" "paginaFinal" => "879" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24950689" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Palatal myoclonus (syn. Palatal Tremor)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Pearce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000159929" "Revista" => array:6 [ "tituloSerie" => "Eur Neurol." "fecha" => "2008" "volumen" => "60" "paginaInicial" => "312" "paginaFinal" => "315" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18832845" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000012/v1_201611260110/S0300289616000806/v1_201611260110/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000012/v1_201611260110/S0300289616000806/v1_201611260110/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289616000806?idApp=UINPBA00003Z" ]
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