Revisão dos instrumentos de diagnóstico médico-forense no alcoolismo
Palavras-chave:
Alcoolismo, Testes psicológicos, Tomografia computadorizada, Ressonância magnética, Doença mental.Resumo
A elevada prevalência mundial do alcoolismo, associada às graves conseqüências orgânicas do consumo etílico, fazem dessa doença um grande problema social com significativas repercussões no Direito. Nas mais diversas áreas do Direito, a atividade jurisdicional depende do preciso dimensionamento da extensão e magnitude das lesões nos órgãos e sistemas, cabendo à Medicina Forense sistematizar os critérios e instrumentos diagnósticos da doença. Os exames de investigação mais adequados para esse estudo são discutidos no presente trabalho, com destaque para suas indicações e limitações.
Downloads
Referências
ABEL, E. L.; KRUGER, M. L.; FRIEDL, J. How do physicians define “light”, “moderate”, and “heavy” drinking? Alcoholism: Clinical and Experimental Research, Baltimore, MD, v. 5, n. 22, p. 979-984, 1998.
ACKESON, S.; STEIN, R. M.; SWANTZWELDER. Impairment of semantic and figural memory by acute ethanol age dependent effects. Alcoholism: Clinical and Experimental Research, Baltimore, MD, v. 22, n. 7 p. 1437-42, 1998.
ALLEMANN, P. I. Marker fur ubermassigen alkoholkonsum (screening) / Markers for excessive alcohol use (screening). Ther Umsch, v. 57, n. 4, p. 185-90, abr. 2000.
ANDRADE, A. G.; HIRATA, E. S. Avaliação psiquiátrica de alcoolistas. Revista da Associação Brasileira de Psiquiatria, v. 7, n. 24, p. 17-22, 1985.
BÄCKMAN, C.; WEST, J. R.; MAHONEY, J. C.; PALMER, M. Electrophysiological caracterization of cerebellar neurons from adult rats exposed to ethanol during development. Alcoholism: Clinical and Experimental Research, Baltimore, MD, v. 22, n. 5, p. 1137-1145, 1988.
BAIRD, T. J.; VANECEK, S. A.; BRISCOL, R. J.; VALLET, M.; CARL, K. L.; GAUVIN, D. V. Moderate, long-term, alcohol consumption potentiates normal, age-related spatial memory deficits in rats. Alcoholism: Clinical and Experimental Research, Baltimore, MD, v. 22, n. 3, p. 628-36, 1998.
BEGLEITER, H.; PORJESZ, B. Persistence of brain hyperexcitability following chronic alcohol exposure in rats. Advances in Experimental Medicine and Biology, New York, n. 85, p. 209-222, 1977.
BEGLEITER, H.; PORJESZ, B.; CHOU, C. L. Auditory brain stem potentials in chronic alcoholics. Science, n. 211, p. 1064-1066, 1981.
BEGLEITER, H.; PORJESZ, B.; KISSIN, B. Brain dysfunction in alcoholism with and without a family history of alcoholism. Alcoholism: Clinical and Experimental Research, Baltimore, MD, v. 6, n. 136, 1982.
BERGMAN, H.; AXELSSON, G.; IDESTROM, C. M.; BORG, S.; HINDMARSH, T.; MAKOWER, J.; MUTZELL, S. Alcohol consumption, neuropsychological status and computer-tomographic findings in a random sample of men and women from the general population. Pharmacology Biochemisty and Behavior, New York, v. 18, n. 1, p: 501-505, 1983.
BERGMAN, H., HINDMARSH, T. Alcohol and brain damage: neuropsychological and computer-tomographic findings. Lakartidningen, v. 84, n. 46, p. 3828-33, nov. 1987.
BIERLEY, R. A.; CANNON, D. S.; WEHL, C. K.; DUSTMAN, R. E. Effects of alcohol on visually evoked responses in rats during addiction and withdrawal. Pharmacology Biochemisty and Behavior, New York, n. 12, p. 909-915, 1980.
BRAZIER, M. A. B. The electrical activity of the nervous system. Science, v. 146, p. 1.423-1.428, 1964.
CHARNESS, M. E. Brain lesions in alcoholics. Alcoholism: Clinical and Experimental Research, Baltimore, MD, v. 17, p. 2-11, 1993.
CHELUNE, G. J.; PARKER, J. B. Neuropsychological deficits associated with chronic alcohol abuse. Clinical Psychology Review, Arlington, n. 1, p. 181-195, 1981.
CHU, N. S.; SQUIRES, K. C.; STARR, A. Auditory brain stem potentials in chronic alcohol intoxication and alcohol withdrawal. Archives Neurology, Chicago, n. 35, p. 596, 1978.
CHURCH, M. W.; WILLIAMS, H. L. Dose and time-dependent effects of ethanol brains stem auditory evoked responses in young adult males. Electroencephalography and Clinical Neurophysiology, Limerick, n. 54, p. 161-174, 1982.
CLARREN, S. K.; SMITH, D. W. The fetal alcohol syndrome: A review of the world literature. The New England Journal of Medicine, Walthan, n. 298, p. 1063 1067, 1978.
CORBETT, C. E. Hipnóticos. In: CORBETT, C. E. Farmacodinâmica. 6. ed. Rio de Janeiro: Guanabara Koogan, 1982.
DANO, P.; LE GUYADER, J. Atrophie cerebrale et alcoolisme chronique / Cerebral atrophy and chronic alcoholism. Revue Neurologique, Paris, v. 144, n. 3, p. 202-208, 1988.
DE LA MONTE, S. M. Disproportionate atrophy of cerebral with matchs chronic alcoholics. Archives Neurology, Chicago, v. 45, p. 990-992, 1988.
DIAMOND, I.; GORDON, A. S. Cellular and molecular neuroscience of alcoholism. Physiological Review, n. 77, p. 1-20, 1997.
DOM ZAL, T.; KOTOWICZ, J.; WALECKI, J. et al. Clinical, CT and eletrophysiologic studies of alcoholics with special reference to the cerebellum. Neurol. Neurochir. Pol., v. 23, n. 1, p. 17-20, jan. 1989.
ECKARDT, M. J.; MARTIN, P. R. Clinical assessments of cognition on alcoholism. Alcoholism: Clinical and Experimental Research, Baltimore, n. 10, p. 123-127, 1986.
ELKIS, H. Definições e critérios para o diagnóstico de alcoolismo. Jornal Brasileiro de Psiquiatria, Rio de Janeiro, v. 34, p. 319-322, 1985.
EXNER JN., J. Manual de classificação de Rorschach. São Paulo: Casa do Psicólogo, 1999. 322 p.
FORTES, J. R. A.; GATTO, B. C. F. Alcoolismo. São Paulo: Savier, 1975. 322 p.
GALLUCCI, M.; AMICARELLI, I.; ROSSI, A. et al. MR imaging of white matter lesions in uncomplicated chronic alcoholism. Journal of Computer Assisted Tomography, New York, v. 13, n. 3, p. 395-398, maio/jun. 1989.
GANANÇA, M. M. Vertigem tem cura? São Paulo: Lemos Editorial, 1998. 301 p.
GLASS, A. Mental arithmetic and blocking of the occipital alpha rhythm. Electroencephalography and clinical neurophysiology, Limerick, v. 16, p. 595-603, 1964.
GUEBALY, N.; GUEBALY, A. Alcohol in ancient Egypt: the recorded evidence. Addict., v. 16, p. 1027-1221, 1981.
HALL III, J. W. Handbook of auditory evoked responses. Allyn and Bacon: Ed. Needham Heights, 1990.
HAMMERSCHLAG, S. B.; WOLPERT, S. M.; CARTER, B. L. Computed coronal tomography. Radiology, v. 120, p. 219-220, 1976.
HARPER, C.; KRILL, J.; DALY, J. Does a moderate alcohol intake damage brain? Journal of Neurology Neurosurgery & Psychiatry, v. 51, p. 909-913, 1988.
HARPER, C.; KRIL, J. If you drink your brain will shrink; neuropathological considerations. Alcohol and Alcoholism: supplement, Oxford, v. 1, p. 375-80, 1991.
HOUNSFIELD, G. N. Computerized transverse axial scanning (tomography); 1. description of system. The British Journal of Radiology Archives, London, v. 46, p. 1.016-1.022, 1973.
HURST, P. M. & BAGLEY, S. K. Acute adaptation to the effects of alcohol. Quarterly Journal of Studies on Alcohol, New Haven, n. 33, p. 358-378, 1972.
HYVARINEN, J.; LAAKSO, M.; ROINE, R.; LEINOMEN. L.; SIPPEL, H. Effects of ethanol on neural activity in the parietal association cortex of alert monkeys. Brain, Oxford, n. 101, p. 701-715, 1978.
ISHIBASHI, M.; NAKAZAWA, Y.; YOKOYAMA, T. et al. Cerebral atrophy and slow wave sleep of abstinent chronic alcoholics. Drug Alcohol Dependence, v. 19, n. 4, p. 325-332, jul. 1987.
JÄÄSKELÄINEN, I. P.; LEHTOKOSKI, A.; ALHO, K.; KUJALA, T.; PEKKONEN, E.; SINCLAIR, J. D.; NÄÄTÄNEN, R.; SILLANAUKEE, P. Low dose of ethanol suppresses mismatch negativity of auditory event-related potentials. Alcoholism: Clinical and Experimental Research, Baltimore, n. 19, p. 607-610, 1995.
JACOBSON, R. R.; LISHMAN, W. A. Cortical and diencephalic lesions in Korsakoff’s syndrome: a clinical and CT scan study. Psychological Medicine, Cambridge, v. 20, n. 1, p. 63-75, fev. 1990.
JELLINEK, E. M. Phases in drinking history of alcoholics. Quarterly Journal of Studies on Alcohol, New Haven, n. 7, p. 1-88, 1946.
JELLINEK, E. M. Drinkers and alcoholics in ancient Rome. Quarterly Journal of Studies on Alcohol, New Haven, n. 37, p. 1718-1741, 1976.
JUSTOS, H.; VANKOLCH, T. O teste das pirâmides coloridas de cores. São Paulo: Vetor, 1976.
KELLER, M. Concepções sobre o alcoolismo. Revista da Associação Brasileira de Psiquiatria, São Paulo, v. 2, p. 93-100, 1983.
KRAMER, S. N. Mesopotâmia: o berço da civilização. In: BIBLIOTECA DE HISTÓRIA UNIVERSAL LIFE. Rio de Janeiro: J. Olympio, 1983.
KRAUSS, G. L.; NIEDERMEYER, E. Electroencephalogram and seizures in chronic alcoholism. Electroencephalography and Clinical Neurophysiology, Limerick, v. 78, n. 2, p. 97-104, fev. 1991.
LEE, K. Alcoholism and cerebrovascular thrombosis in the young. Acta Neurologica Scandinavica, Copenhagen, n. 59, p. 270-274, 1979.
LEE, K.; JENSEN, E.; BECH, P. Neurophysiological and computadorized tomographic evaluations of young alcoholics. The British Journal of Psychiatry, London, n. 141, p. 282-285, 1982.
LINNOILA, M.; STAPLETON, J.; LISTER, R.; GUTHRIE, S.; ECKARDT, M. Effects of alcohol on accident risk. Pathologist, n. 40, p. 36-41, 1986.
LISHMAN, W. A. Brain damage in alcoholism: currents. Acta Medica Scandinavica: supplement, Copenhagen, n. 717, p. 5-17, 1987.
LOVINGER, D. M. Excitotoxicity and alcohol-related brain damage. Alcoholism: Clinical and Experimental Research, Baltimore, n. 17, p. 19-27, 1993.
LUZINSE, J.; ZIMBERG, S.; SMOKLER, H.; GURLEY, K. Alcoholism and cerebral atrophy: a study of 50 patients with CT-scan and psychologic testing. Alcoholism: Clinical and Experimental Research, Baltimore, n. 4, p. 405-411, 1980.
MANDER, A. J.; YOUNG, A.; CHICK, J. D.; BEST, J. J. The relationship of cerebral atrophy and T1 in alcoholics: an MRI study. Drug Alcohol Dependence, v. 24, n. 1, p. 57-59, ago. 1989.
MARQUES, M. I. B. O teste das pirâmides coloridas de Max Pfister. São Paulo: EPU, 1988.
MILNER, B. Effects of different brain lesions on card sorting. Archives of Neurology, Chicago, v. 9, p. 90-100, 1963.
MONTEIRO, M. G.; MASUR, J. Monitoring alcoholism treatment: the appropriateness of choice between GGT and MCV evaluation after a short time of abstinence. Alcohol, n. 3, p. 223-226, 1986.
MORSE, R. M.; FLAVIN, D. K. The definition of alcoholism. JAMA: Journal of American Medical Association, Chicago, v. 268, n. 8, p. 1012-1014, 1992.
MUTZELL, S.; TIBBLIN, G. High alcohol consumption, liver toxic drugs and brain damage – a population study. Upsala Journal of Medical Sciences, v. 94, n. 3, p. 305-315, 1989.
NATIONAL COUNCIL ON ALCOHOLISM / AMERICAN MEDICAL SOCIETY ON ALCOHOLISM COMMITTEE ON DEFINITIONS. Definition of alcoholism. 1992. Annals of Internal Medicine, v. 85, p. 764, 1976.
NICHOLS, J. M.; MARTIN F. P300 and heavy social drinkers: the effect of lorazepan. Alcohol, v. 10, p. 269-274, 1993.
NICHOLS, J. M.; MARTIN, F. The effect of heavy social drinking on recall and event-related potentials. Journal of Studies on Alcohol, v. 57, p. 125-135, 1996.
NIXON, S. J.; KUJAWSKI, A.; PARSONS, O. A.; YOHMAN, J. R. Semantic (verbal) and figural memory impairment in alcoholics. Journal of Clinical and Experimental Neuropsychology, London, v. 9, p. 311-322, 1987.
OGURA, C., MIYAZATO, Y. Cognitive dysfunctions of alcohol dependence using event related potentials. Arukoru Kenkyuto Yakubutsu Ison, v. 26, n. 5, p. 331-340, out. 1991.
PACHECO E SILVA, A. C. Psiquiatria Clínica e Forense. 2. ed. São Paulo: Renascença, 1951.
PEEKE, S. C.; PRAEL, A. R.; HERNING, R. I.; ROGERS, W.; BENOWITZ, N. L.; JONES, R. T. Effect of disulfiram on cognition, subjective response, and cortical-event-related potentials in nonalcoholic subjects. Alcoholism, v. 3, p. 223-229, 1979.
PEKKONEN, E.; AHVENINEN, J.; JÄÄSKELÄINEN, L. P.; SEPPÄ, K.; NÄÄTÄNEN, R.; SILLANAUKEE, P. Selective acceleration of auditory processing in chronic alcoholics during abstinence. Alcoholism: Clinical and Experimental Research, Baltimore, v. 22, n. 3, p. 605-609, 1998.
PFEFFERBAUM, A.; HORVATH, T. B.; ROTH, W. T. et al. Event-related potential changes in chronic alcoholics. Electroencephalography and Clinical Neurophysiology, Limerick, v. 47, p. 637-647, 1979.
PFEFFERBAUM, A.; ROSENBLOOM, M.; CRUSAN, K. et al. Brain CT changes in alcoholics: effects of age and alcohol consumption. Alcoholism: Clinical and Experimental Research, Baltimore, v. 12, n. 1, p. 81-87, fev. 1988.
PORJESZ, B.; BEGLEITER, H. Human evoked brain potentials an alcohol. Alcoholism: Clinical and Experimental Research, Baltimore, v. 2, n. 5, p. 304-316, 1989.
REALMUTO, G.; BEGLEITER, H.; ODENCRANZ, J.; PORJESZ, B. Event-related potentials evidence of dysfunction in automatic processing in abstinent alcoholics. Biological Psychiatry, v. 33, p. 594-601, 1993.
REYNOLDS, J. N.; PRASAD, A. Ethanol enhances GABAA receptor activated chloride currents in chick cerebral cortical neurons. Brain Research, v. 564, p. 138-142, 1991.
ROMANO, J.; ENGEL, G. L. Delirium: I. Electroencephalographic data. Archives of Neurology and Psychiatry, v. 51, p. 356-377, 1944.
RON, M. A. Brain damage in chronic alcoholism. A neuropathological, neuroradiological and psychological review. Psychological Medicine, Cambridge, v. 7, p. 103-112, 1977.
RYB, G. E.; SODERSTROM, C. A.; KUFERA, J. A. et al. Use of blood alcohol concentration and laboratory tests to detect current alcohol dependence in trauma center patients. Journal of Trauma, v. 47, n. 5, p. 874-880, nov. 1999.
SALAMY, A. The effects of alcohol on the variability of the human evoked potential. Neuropharmacology, v. 12, p. 1.103-1.107, 1973.
SALAMY, A.; WILLIAMS, H. L. The effects of alcohol on sensory evoked and spontaneous cerebral potentials in man. Electroencephalography and Clinical Neurophysiology, Limerick, v. 35, p. 3-11, 1973.
SCHILDER, P. A imagem do corpo. 1. ed. São Paulo: Martins Fontes, 1981.
SCHROTH, G.; NAEGELE, T.; KLOSE, U. et al. Reversible brain shrinkage in abstinent alcoholics, measured by MRI. Neuroradiology, v. 30, n. 5, p. 385-389, 1988.
SCHUCKIT, M. A. A clinical review of alcohol, alcoholism and the elderly patient. Journal of Clinical Psychiatry, v. 43, p. 396-399, 1982.
SILVERMAN, D. Some observations on the EEG in hepatic coma. Electroencephalography and Clinical Neurophysiology, Limerick, v. 14, p. 53-59, 1962.
SILVERMAN, D. Retrospective study of the EEG in coma. Electroencephalography and Clinical Neurophysiology, Limerick, v. 15, p. 486-503, 1963.
SQUIRES, K. C.; CHU, N. S.; STARR, A. Acute effects of alcohol on auditory brainstem potentials in humans. Science, v. 201, p. 174-176, 1978b.
STOCKARD, J. J.; ROSSITER, V. S. Clinical and pathologic correlates of brainstem auditory response abnormalities. Neurology, 27: 316-325, 1977.
TEICHMAN, M.; RICHMAN, S.; FINE, E. W. “Dose/duration effect” relationship between alcohol consumption and cerebral atrophy: a psychological and neuroradiological evaluation. American Journal of Drug and Alcohol Abuse, v. 13, n. 3, p. 357-363, 1987.
THOMSON, A. D.; RON, M. A. Alcohol-related structural brain. British Medical Bulletin, v. 38, p. 87-94, 1982.
UNGER, K. W.; JOHNSTON, D. J. Red blood cellmean corpuscular volume a potential indicator of alcohol usage in a working population. American Journal of the Medical Science, v. 267, p. 281-289, 1974.
VON GOLL, M.; BECKER, H.; ARTMANN, H.; LERCH, G. Results of computer tomography on chronic alcoholics. Neurology, v. 16, p. 329-331, 1978.
WALKER, D. W.; BARNES, D. E.; ZORNEYZER, S. F.; HUNTER, B. E.; KUBANIS, P. Neuronal loss in hippocampus induced by prolonged ethanol consumption in rats. Science, v. 209, p. 711-713, 1980.
WALKER, J. I. Psychiatric emergencies. Intervention and resolution. Philadelphia: Lippincott, 1983.
WEST, L. J.; MAXWELL, D. S.; NOBLE, E. P.; SOLOMON, D. H. Alcoholism. Annals of Internal Medicine, v. 100, p. 405-416, 1984.
WIK, G.; BORG, S.; SJOGREN, I. et al. PET determination of regional cerebral glucose metabolism in alcohol-dependent men and healthy controls using 11C glucose. Acta Psychiatrica Scandinavica, v. 78, n. 2, p. 234-241, ago. 1988.
ZEIN, M.; DISCOMBE, G. Serum gamma glutamyl transpeptidase as a diagnostic aid. Lancet, v. 2, p. 748-750, 1970.
ZILM, D. H.; HUSZAR, L.; CARLEN, P. L.; KAPLAN, H. L.; WILKINSON, D. A. EEG correlates of the alcohol-induced organic brain syndrome in man. Clinical Toxicology, v. 16, p. 345-358, 1980.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2009 Revista da Faculdade de Direito, Universidade de São Paulo
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
