Crises Oculógiras: uma condição subdiagnosticada
DOI:
https://doi.org/10.34024/rnc.2025.v33.20100Palavras-chave:
distonia, Dopamina, Receptores, Agentes antipsicóticosResumo
Introdução. A distonia é um distúrbio do movimento hipercinético caracterizado por posturas anormais de natureza torcional ou movimentos repetitivos. A crise oculógira (COG) é um tipo específico de distonia que compromete músculos extraoculares. Embora rara, COG pode gerar grandes dificuldades diagnósticas. Objetivo. Realizar uma revisão narrativa sobre COG para chamar atenção dos neurologistas para essa condição debilitante. Método. Realizamos uma revisão não sistemática de artigos publicados em inglês ou português por meio do Google Scholar, de 2000 a 2025, utilizando os termos “oculogyric crises/oculogyric crisis” ou “crises oculógiras”. Resultados. Obtivemos 239 manuscritos sobre COG. Trinta e dois artigos foram selecionados para esta revisão. A COG é uma distonia focal ou segmentar infrequente que afeta os músculos extraoculares. Classicamente atribuída ao uso agudo de antagonistas dos receptores de dopamina, também pode persistir com o uso crônico de fármacos antidopaminérgicos. Novos casos continuam sendo relatados, apesar do uso de novos agentes antipsicóticos atípicos. Além dos antipsicóticos, a COG pode surgir com uso de fármacos antieméticos e terapias medicamentosas para o parkinsonismo. Outras condições neurometabólicas, genéticas e estruturais são responsáveis por alguns casos. Representa um desafio diagnóstico devido à sua curta duração e à semelhança com outras condições graves, como crises epilépticas e encefalite. O tratamento baseia-se na administração de fármacos anticolinérgicos ou benzodiazepínicos. Conclusões. A COG é uma doença infrequente que pode ser causada por fármacos de uso rotineiro na Neurologia. Neurologistas devem estar atentos à sua ocorrência e etiologias para realizar um diagnóstico rápido e suprimir o agente causador.
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Referências
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