Abstract

REGAL RAMOS, Raúl Jesús. Valuation of work disability of the Arnold Chiari malformation. Med. segur. trab. [online]. 2011, vol.57, n.222, pp.95-100. ISSN 1989-7790.

Introduction: The recent publication of a consensus document by the Research Institute of Rare Diseases, the increased incidence of Arnold-Chiari malformation (by the increased demand of cervical MRI) and, simultaneously, the increased presence of these patients in hospitals where doctors can assess their functional capacity, invites us to reflect on the assessment of the working disability of these patients. Objectives: This review pretends to make an approach to various relevant aspects on the assessment of these patients' working disability. Material and methods: The following bibliographical database have been reviewed until May 2010: Medline, Embase, Cochrane. Results: The intensity of the symptoms (mostly pain) is not directly related to the severity of the lesions observed in the imaging tests. The clinical symptoms may fluctuate, with periods of exacerbation and remission. The symptoms that best respond to surgery are those due to compression of the brainstem (especially cervical headache), disappearing in some cases. The presence of atrophy, ataxia, scoliosis in the pre surgery tests, and more than two years between the beginning of the symptoms and the surgery are poor post surgery evolution factors. Those clinical manifestations that do not disappear in the post surgery period or in the follow-up period could be related to permanent damage of the neural pathways or their nuclei. Despite being a congenital disease, it could be treated as a working accident, if symptoms appear after trauma. Evidence of the effectiveness of pain treatment is low. Conclusions: These patients' evaluation should always be individualized, considering the organic and or functional limitations and relating them to the requests of their job. Nevertheless, there exists a series of common relevant aspects in these patients' working assessment.

Keywords : Chiari I malformation; Work disability; Functional impact.

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