Neurology has always been a complex discipline in which every consultation, every complementary study, and each patient challenges us to interpret the signs and symptoms of the physical examination, arrive at a diagnosis, and ultimately determine the appropriate treatment. In recent years, artificial intelligence (AI) has been added, and its presence continues to grow in our field, already becoming part of our daily practice. When used properly, these tools help neurologists shorten the time required to search for differential diagnoses while maintaining clinical depth.
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La Simulación Como Metodología de Aprendizaje Fundamental para la Enseñanza de la Neurología. Simulation as a Fundamental Learning Methodology for the Teaching of Neurology
Reading the article by Castellanos-Ruiz et al. on the application of virtual reality for the treatment of hemiplegia invites reflection on the relevance of simulation in healthcare. Accordingly, the aim of this letter is to highlight the importance of simulation in neurology training.
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Prevalence of Dehydration at Acute Ischemic Stroke Onset and the Impact of Dehydration Subtypes on Severity: A Prospective Observational Study. Prevalencia de la Deshidratación al Inicio del Ictus Isquémico Agudo y el Impacto de los Subtipos de Deshidratación en la Gravedad: Un Estudio Observacional Prospectivo
Background: Dehydration has been suggested to influence stroke severity and recovery through mechanisms like increased blood viscosity and thromboembolism risk. This study aims to estimate the prevalence of dehydration at acute ischemic stroke (AIS) onset and assess the impact of different dehydration subtypes on stroke severity.
Methods: This prospective observational study was conducted at a tertiary care center over a period of one year. Dehydration was assessed using specific biomarkers to check for intracellular dehydration (Group A using urine osmolarity, plasma osmolarity, urine/plasma osmolarity ratio >1.5) and mixed dehydration (Group B using BUN/creatinine ratio >0.20 ) parameters. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS).
Results: Out of 177 AIS admissions, 71 patients met the inclusion criteria (49 males, 22 females; average age: 61.1 years for males, 62.8 years for females). Dehydration was present in 65% of patients at stroke onset. Among dehydrated patients, 33.3% had abnormal Group A parameters, 30% had abnormal Group B parameters, and 36% had abnormalities in both groups. A significant correlation was found between the presence of multiple dehydration markers and increased stroke severity (p < 0.005).
Discussion: The high prevalence of dehydration in AIS patients at onset suggests it may be a potential trigger for stroke and exacerbates stroke severity. Dehydration subtypes, categorized into intracellular, mixed, and extracellular dehydration, have distinct physiological implications requiring specific management strategies. Further research into standardized protocols and innovative biomarkers for dehydration assessment is recommended to enhance patient outcomes.
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Análisis de Redes de Adherencia al tratamiento farmacológico, Calidad de vida y síntomas no Motores en pacientes con Parkinson de Azogues, Biblián y Déleg. Network analysis of adherence to pharmacological treatment, quality of life and nonmotor symptoms in Parkinson’s patients from Azogues, Biblián and Déleg
This study aims to analyze medication adherence, quality of life, and non-motor symptoms in Parkinson’s disease patients in Azogues, Biblián, and Déleg. A descriptive and correlational approach was used, collecting data on various variables such as Age, Age at Diagnosis, Mobility, Daily Activity, Emotional Well-Being, Stigma, Social Support, Cognitive Status, Communication, Physical Discomfort, Medication Adherence, and Non-Motor Symptoms. The normality of variable distributions was assessed, and Pearson correlations were applied to examine their relationships. The results showed significant correlations between Age and other variables, such as Mobility, Daily Activity, and Emotional Well-Being. The relationship between Mobility and Daily Activity was extremely strong, and non-motor symptoms notably impacted quality of life, particularly Cognitive Status and Communication. The Gaussian graphical model revealed direct interactions between the variables. In conclusion, the research highlights how mobility, emotional well-being, and social support influence the quality of life of Parkinson’s patients, while non-motor symptoms negatively affect their overall well-being, suggesting key areas for intervention and improvement in the treatment of these patients.
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Palabras clave: adherencia a la medicación,
calidad de vida,
enfermedad de Parkinson,
síntomas no motores,
IMPACT Score as a Predictor of Mortality in Patients with Severe Traumatic Brain Injury in The Intensive Care Unit. Puntaje IMPACT como Predictor de Mortalidad en Pacientes con Traumatismo Craneoencefálico Severo en la Unidad de Cuidados Intensivos
Objective: To assess whether the IMPACT score predicts mortality in patients with traumatic brain injury (TBI).
Design: Cohort study.
Setting: A total of 260 patients with moderate and severe TBI were enrolled from the Intensive Care Unit (ICU) of Hospital Regional Docente de Trujillo, a trauma referral hospital in northern Peru. The data collection period spanned from 2018 to 2023.
Patients: Patients with moderate and severe TBI admitted to the ICU.
Interventions: Patients with TBI in whom the predictive performance of the IMP ACT score for mortality was assessed.
Main Outcome Measure: In-hospital mortality.
Results: A total of 260 patients with moderate and severe TBI were included. When evaluating the IMPACT score and its models (core, extended, and laboratory), we found adequate predictive values expressed by their respective ROC AUCs (0.74, 0.83, and 0.84). Additionally, upon constructing a predictive model utilizing the IMPACT score laboratory model, an increased risk of mortality was observed (adjusted RR 1.21; 95% CI 1.12–1.31). Furthermore, the variables: mechanism of TBI (adjusted RR 5.6; 95% CI 3.03–10.85), Glasgow Coma Scale (GCS) (adjusted RR 1.35; 95% CI 1.15–1.58), and use of vasopressors (adjusted RR 2.2; 95% CI 1.14–4.42) behaved as independent predictors of in-hospital mortality.
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La Autorregulación en el Espectro Autista: Una Visión Sobre su Influencia en la Intervención del Proceso Enseñanza-Aprendizaje. Self-Regulation in the Autism Spectrum: A View of its Influence on the Intervention of the Teaching-Learning Process
The aim of this study is to describe the emotional and behavioral management capacity of autistic people under various conditions or scenarios and its influence on the teaching-learning process. The methodology, according to the source, is cross-sectional documentary, where scientific articles were explored in Google Scholar. Among the most important conclusions, it can be mentioned that emotional management is a vital factor for the development of skills and abilities, learning and memorization are enhanced when the autistic person focuses on aspects of his or her interest, and self-regulating his or her emotions and behaviors allows for a balanced environmental interaction whether or not he or she has comorbidities.
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Prevalencia de Depresión y Ansiedad en Adultos Ecuatorianos: Una Revisión Sistemática Narrativa. Prevalence of Depression and Anxiety in Ecuadorian Adults: A Narrative Systematic Review
The present narrative systematic review aims to estimate the prevalence of depression and anxiety in the Ecuadorian adult population, a field little explored despite the growing global burden of these mental disorders. The importance of this review lies in the need to synthesize scattered evidence on the prevalence of these disorders in Ecuador, where there is no previous systematic review. The methods included an exhaustive search in five electronic databases and complementary sources, selecting 33 observational studies. The results reveal wide variability in prevalence rates, influenced by methodological heterogeneity and the characteristics of the studied populations. Depression figures reported in the included studies ranged from 5.6% to 86.81%, while the prevalence of anxiety showed an even more extreme range, from 0.02% to 77.1%. Consistently higher prevalences are observed in vulnerable groups such as health professionals, hospitalized patients, and university students, which underscores the urgency of standardizing research methodologies and strengthening mental health policies in Ecuador, focusing on early detection and psychosocial interventions.
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Intervention methods for working memory: A systematic review. Métodos de intervención para la memoria de trabajo: Una revisión sistemática
Working memory refers to storing and manipulating information to achieve a specific goal or completing a task at a high cognitive level. This component is part of the executive functions and is essential for daily life. A quantitative systematic review aims to identify the intervention methods currently developed to rehabilitate and improve working memory. The articles were obtained from SCOPUS, ScienceDirect, PubMed, and Scielo databases. Initially, 550 articles were found, and after applying the inclusion and exclusion criteria, 65 articles were selected and included in the data extraction process and used for the descriptive statistical analysis. The main results found that computerized treatments prevailed in 41 studies, transcranial electrical stimulation in 16, and sport and cognitive stimulation in two, respectively. These findings will be analyzed to develop new proposals that can contribute to clinical practice and offer mental health professionals a selection of intervention methods helpful in carrying out intervention plans aimed at working memory deficits.
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Reto Diagnóstico en Enfermedad del Espectro de Neuromielitis Óptica Asociado a Bandas Oligoclonales Tipo 2 Positivas: Reporte de Caso. Diagnostic Challenge in Neuromyelitis Optica Spectrum Disease Associated with Type 2 Positive Oligoclonal Bands: Case Report
Neuromyelitis Optica spectrum disorder, formerly known as Devic’s disease, is characterized by an autoimmune-mediated pathology of the central nervous system. This pathology generates an inflammatory process directed against the channels of the protein Aquaporin 4, located mainly in the membrane of astrocytes. Aquaporin-4 is a protein related to water transport, which plays a crucial role in brain inflammation through mechanisms that involve the release of cytokines and astrocytic inflammation. These pathological changes cause demyelination and secondary axonal damage, with diverse clinical manifestations in the brain, spinal cord, and optic nerve sheaths. The detection of antibodies against the protein Aquaporin 4, the analysis of oligoclonal bands in the cerebrospinal fluid, and radiological findings by magnetic resonance imaging of the brain and spinal cord must be carefully evaluated to reach an accurate diagnosis in challenging clinical cases. This report reviews the differential etiologies of this disease and the challenge of comprehensive analysis of the corresponding diagnostic tests.
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Insonation of the Posterior Cerebral Artery Via the Transforaminal Window: An Unusual but Feasible Observation. Insonación de la Arteria Cerebral Posterior a Través de la Ventana Transforaminal: Una Observación Inusual pero Factible
Transcranial Doppler (TCD) ultrasonography typically visualizes the posterior cerebral arteries (PCAs) through the transtemporal window, while the basilar and vertebral arteries are assessed via the suboccipital approach. This report describes an unusual technical finding: visualization of PCA flow through the suboccipital window. During routine TCD in a patient with excellent acoustic access, two vascular structures arising from the distal basilar artery were identified at a depth of 92 mm, with flow characteristics consistent with PCAs. Favorable bone transmission and vascular alignment likely enabled this alternative insonation route. This observation suggests that, in exceptional anatomical conditions, suboccipital PCA assessment is feasible and may expand posterior circulation evaluation.
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Bilateral Globus Pallidus T1 Hyperintensity in Hepatic Cirrhosis. Hiperintensidades de Globos Pálidos en Cirrosis Hepática
Bilateral symmetric T1 hyperintensities in the globus pallidus on MRI are a hallmark of manganese deposition secondary to hepatic dysfunction, reflecting portosystemic shunting and subclinical hepatic encephalopathy. A 60-year-old man with history of diabetes mellitus type 2, and chronic liver disease, presented with troubling gait. The rest of the neurological examination was unremarkable.
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Palabras clave: cirrosis hepática,
Hiperintensidades de Globos Pálidos,
Keywords: Bilateral Globus Pallidus,
Hepatic Cirrhosis,
Técnica de Doble Stent Retriever para Trombectomía Mecánica en Ictus: Primera Experiencia en Ecuador. Double Stent Retriever Technique for Mechanical Thrombectomy in Acute Ischemic Stroke: First Experience in Ecuador
Endovascular treatment of acute ischemic stroke has become established as an effective and safe technique for reperfusion in selected cases. Although early studies did not demonstrate superiority over intravenous thrombolysis, the development of advanced devices, such as aspiration catheters and stent retrievers (SR), made it possible to show significantly improved outcomes.
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La Sociedad Médica Ecuatoriana de Neurología (SEN) a la Comunidad Médica
Times have always been difficult for the SEN, from the initial efforts to constitute it involving all the neurologists of that era, to the present day. I can imagine the tremendous and arduous task faced by the neurologists of that time, as it was first necessary to dissolve the former SENNCA (Ecuadorian Society of Neurology, Neurosurgery, and Related Sciences). This event took place on October 28, 1981, within the context of the VII Latin American Congress of Neurosurgery and the XIII Latin American Congress of Electroencephalography and Neurophysiology. I can envision the intense level of that dialectic and the maieutics applied to give birth to our society in March 1983.
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Disfagia Orofaríngea y Ataque Cerebrovascular: Implicaciones de un nuevo Síndrome Geriátrico
Dear Editor:
Oropharyngeal dysphagia (OD) is a condition that increases in frequency with aging. It is multifactorial, resulting from the accumulation of deficits across various systems, and is associated with adverse health outcomes in older adults (OA). Consequently, it has been recognized over the last decade as an emerging geriatric syndrome.
Prominent among its causes is ischemic stroke, which caused approximately 14,000 deaths and 246,400 disability-adjusted life years among older adults in Colombia during 2021, ranking as the leading cause of disability. This burden is largely explained by swallowing disorders, which appear to be highly prevalent among older adults in Colombia; this was evidenced by a study in Medellín in which 3 out of 4 participants with stroke presented with OD, with age being identified as one of the specific factors that increased the likelihood of developing it.
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Palabras clave: Ataque Cerebrovascular,
Disfagia Orofaríngea,
Keywords: Oropharyngeal Dysphagia,
stroke,
Restaurando la Homeostasis Metálica en Alzheimer: Avances y Desafíos en la Terapia de Quelación
To the Editor:
Alzheimer’s disease (AD) continues to challenge conventional therapeutic approaches, necessitating alternative strategies based on its pathophysiology. Among these, metal chelation therapy emerges as a promising option that directly addresses the metal dyshomeostasis implicated in AD, offering disease-modifying effects beyond symptomatic relief. Copper, iron, and zinc actively participate in the progression of AD, promoting amyloid-β oligomerization, oxidative stress, and tau hyperphosphorylation. Post-mortem studies have identified elevated concentrations of these metals in the brains of AD patients, particularly copper in amyloid plaques, which reaches levels three times higher than normal.
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¿Por qué la Investigación en Astrobiología, Astroquímica y Ciencias del Espacio es Relevante para la Neurología y Ciencias Relacionadas?
To the Editor:
Modern neurology faces the major challenge of understanding the plasticity and vulnerability of the nervous system (NS) under extreme conditions, such as the space environment. Therefore, the interrelationships between astrobiology, astrochemistry, neuroscience, and space medicine must be discussed.
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Desafíos, Inequidades y Oportunidades en la Atención Pre Hospitalaria de la Enfermedad Cerebrovascular en América Latina
To the Editor:
Cerebrovascular disease (CVD) constitutes a leading cause of both acquired disability and mortality in Latin America. Although notable advances have been made in areas such as neuroimaging, thrombolysis, and thrombectomy, the reality in the region reveals marked disparities that hinder the provision of timely and effective care. Among these limitations, prehospital care remains a vulnerable link and, in many countries, is given low priority in health policies.
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Palabras clave: Atención Prehospitalaria,
enfermedad cerebrovascular (ECV),
Las Enfermedades Priónicas Como Amenaza Permanente a la Salud Neurológica en América Latina
To the Editor:
The article by Sánchez Espinoza et al., published in the Revista Ecuatoriana de Neurología, makes a valuable contribution by addressing the Heidenhain variant of Creutzfeldt-Jakob disease (CJD), highlighting its clinical evolution and the relevance of differential diagnosis regarding other rapidly progressive dementias. This Letter to the Editor complements that discussion by emphasizing the persistent, transmissible, and potentially zoonotic nature of prion diseases in the Latin American context, in light of recent research.
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Palabras clave: Enfermedades Priónicas,
Salud Neurológica,
Keywords: Neurological Health,
prion diseases,
Incidencia de Eventos Isquémicos en Pacientes con Arteritis de Células Gigantes: ¿Es una Complicación de Importancia Clínica?
To the Editor:
Cerebrovascular disorders represent a growing burden on health systems, particularly in aging populations. Giant cell arteritis (GCA), the most common form of systemic vasculitis in older adults, can lead to severe ischemic complications such as visual loss or stroke. However, there is a substantial gap in understanding the incidence and predictors of these ischemic complications in patients with GCA, limiting the design of preventive clinical protocols and the implementation of personalized medicine strategies based on robust evidence.
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Riesgo Cardiovascular en el Uso de Anticoagulación Oral Posterior a Hemorragia Intracerebral: ¿Qué Desenlaces Considerar?
To the Editor:
The use of oral anticoagulation in patients with atrial fibrillation has been shown to significantly reduce thromboembolic events, including ischemic stroke. However, this therapeutic strategy poses significant clinical dilemmas in survivors of intracerebral hemorrhage (ICH), where the risk of rebleeding is weighed against the potential benefit of preventing new ischemic events. Despite the advancement of direct oral anticoagulants (DOACs), a critical gap in evidence remains to guide optimal management in this high-risk subgroup, particularly regarding the selection of neurological outcomes of greatest interest.
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Tratamiento de la Migraña Durante el Embarazo y la Lactancia
To the Editor:
With reference to the excellent systematic review by Sanchez-Landers et al. regarding migraine treatment during pregnancy, we wish to emphasize several aspects. First, it should be noted that when evaluating any patient with headache, one must always suspect a secondary headache and screen for “red flags”; pregnancy is one such flag. Migraine is a risk factor for hypertensive disorders and cardiovascular complications during pregnancy, such as preeclampsia, cerebral venous thrombosis, reversible cerebral vasoconstriction syndrome, subarachnoid hemorrhage, and ischemic stroke.
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La teoría del Síndrome de Bleuler: Una investigación en respuesta a las deficiencias epistemológicas y metodológicas en el diagnóstico y tratamiento de la enfermedad mental sin neurodegeneración
To the Editor:
November 2024 marked the twentieth anniversary of the inception of a mental health research initiative conducted jointly by public and private entities in Venezuela and Ecuador. This original and unprecedented initiative focused on non-neurodegenerative mental disorders, such as Pervasive Developmental Disorders, Autism Spectrum Disorders, Recurrent Depressive Disorders, and similar conditions. The primary purpose of the research was to generate knowledge for the creation of a standardized, universally applicable method, in response to the significant epistemological and methodological deficiencies identified in the theories and processes by which Psychology and Psychiatry construct their diagnostic classifications.
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Mini Mental State Examination (MMSE): Cut-off Scores for Ecuadorian Adult Population
Background: The MMSE is one of the most widely used tests for the detection of dementia and cognitive impairment, however, cut-off points differ between countries.
Objective: To generate MMSE cut-off scores for the detection of Alzheimer’s disease in Ecuadorian population aged 55 to 85 years.
Methods: 390 subjects were evaluated, 76 had a diagnosis of Alzheimer’s disease. The level of dementia, functional autonomy, depression levels, sociodemographic and clinical variables of interest were measured. A regression model was performed to adjust the MMSE scores for the estimated values. The results were corrected using a multiple regression model. Cut-off points were obtained by ROC curve analysis.
Results: The variables Grade (T=5.2, p<0.001) and Age range (T=-7.95, p<0.001) were the only variables that had an effect on MMSE scores of 22% of the variance (R2 adjRadj2 =0.22). An education-adjusted cut-off point of 22.81 was obtained with a sensitivity of 0.97 and a specificity of 0.88.
Conclusion: This information may increase the accuracy in the use and interpretation of the MMSE in the Ecuadorian population.
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Palabras clave: demencia,
deterioro cognitivo,
Enfermedad de Alzheimer,
escala de tamizaje,
nivel educativo,
Integración Sensorial en Usuarios con Parálisis Cerebral
Humans are capable of interacting with the environment thanks to sensory integration, a process that allows the nervous system to capture, organize and interpret information to generate an adaptive response which could be affected in Cerebral Palsy. The objective is to determine the sensory profile in users with cerebral palsy from 3 to 14 years old in the Specialized and Inclusive Education Institutions of the City of Cuenca – Ecuador, 2024.
Methodology: An observational, descriptive, cross-sectional study was carried out between September 2024 and February 2025, in 61 users with Cerebral Palsy from 3 to 14 years old enrolled in the Azuay Cerebral Palsy Institute and the Stephen Hawking Educational Unit. The Brief Sensory Profile-2 questionnaire was used.
Results: Alteration was demonstrated in all sensory patterns, highlighting 100% in registration, 100% sensory state and 93.4% behavioral state. Users aged 3-5 years show 100% alteration in 3 of the 4 sensory patterns. Men show alteration in the search patterns (97.3%), sensitivity (94.6%) and registration (100%).
Conclusions: In addition to the motor component affected in Cerebral Palsy, there is an alteration in sensory integration, therefore, it is important to evaluate the sensory profile.
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Executive Functions Scale for University Students: Protocol for the Second Version (UEF-2)
Executive Functions (EFs) comprise a set of mental skills that enable university students to consciously regulate their academic performance and learning behaviors. Research has identified several EFs as critical determinants of academic success, including emotion regulation, responsibility monitoring, working memory, cognitive flexibility, metacognitive learning, study planning, and decision-making. This protocol article presents an enhanced version of a scale designed to assess EF in the university context. The principal innovation of this revised instrument lies in its incorporation of five additional EFs, thereby providing a more comprehensive evaluation of these cognitively demanding skills essential for academic achievement. Our proposed methodology follows a psychometric validation process to examine the scale’s reliability, validity, and practical utility. Through this protocol, we anticipate establishing robust measurement properties for the new scale, advancing our understanding of university students’ cognitive processes. Furthermore, we expect the findings to facilitate the development of improved assessment tools and targeted interventions to enhance executive functioning in higher education settings. This research contributes to the growing literature seeking to optimize academic outcomes through evidence-based cognitive evaluation and support.
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Palabras clave: análisis factorial confirmatorio,
Funciones Ejecutivas,
propiedades psicométricas,
validez,
Relación Entre el Desempeño en Memoria y el Funcionamiento Ejecutivo con la Funcionalidad de la Vida Diaria en Adultos de la Ciudad de Medellín: Un Estudio Observacional
Introduction: Neuropathological processes in older adults lead to changes in their independence and, therefore, in their functionality. The aim of this study was to analyze the relationship between individual characteristics, clinical history, memory performance and executive functioning, and daily life functionality.
Methods: Data from the Neuronorma-Co research project, obtained between January 2016 and January 2017, were analyzed. The database included data from clinical records and neuropsychological tests of 126 adults from the city of Medellín, between 47 and 94 years of age. The correlation between the score obtained in the Tower of London, the learning and memory task with controlled coding of Grober and Buschke, the Modified Lawton scale and the Geriatric Depression Scale was analyzed.
Results: A relationship was found between functionality and age, years of schooling, marital status, ophthalmological, neurological and cardiovascular history, risk of depression, memory and executive functions such as sequencing and problem solving.
Conclusion: The variables with the greatest impact on functionality are related to problem-solving and cognitive reserve.
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Probable Síndrome de Vasoconstricción Cerebral Reversible como Manifestación de Feocromocitoma
Introduction: The pathophysiology of reversible cerebral vasoconstriction syndrome remains incompletely understood. However, failure of cerebral autoregulation, sympathetic overactivity, disruption of the blood–brain barrier, and glymphatic system dysfunction play a central role.
Case report: We present the case of a 35-year-old woman with a history of cerebral vasoconstriction syndrome who developed new episodes of thunderclap headache and intermittent hypertension two years after the initial event. During hospitalization, non-invasive neuroimaging suggested a high probability of recurrent vasoconstriction syndrome. Due to persistent autonomic symptoms, further evaluation revealed a pheochromocytoma.
Conclusion: In patients with recurrent or atypical symptoms of reversible cerebral vasoconstriction syndrome, secondary and potentially treatable causes should always be considered.
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Valoración por Ultrasonido del Nervio Vago en el Síndrome de Guillain-Barré: A Propósito de un Caso Clínico
Introduction: In Guillain-Barré Syndrome (GBS), an increased cross-sectional area (CSA) of the vagus nerve (VN) has been described as a diagnostic tool and as an indicator of autonomic dysfunction.
Methods and Objectives: With the presentation of a GBS case, we aim to describe the technique for assessing the CSA of the VN using ultrasound (US).
Results: The evaluation of the VN CSA by US is a diagnostic technique with several advantages for clinicians. CSA values greater than 3 mm² are associated with the demyelinating variant of GBS and a higher likelihood of autonomic dysfunction.
Conclusion: The assessment of VN CSA by US is a useful tool in the diagnostic approach to patients with suspected GBS.
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Enfermedad de Moyamoya. De la Descripción de los Síntomas a la Afectación Neurocognitiva en un Caso Clínico
Moyamoya disease (MD) is a cerebrovascular pathology. Characterized by a stenosis of the terminal segments of the internal carotid artery. Currently the etiology of MD isn’t clear. Different studies have focused their research on understanding the disease from epidemiological aspects, its pathophysiology and recently the neurocognitive alterations presented by patients. This disease has a progressive course that impacts cognitive function. To identify the neurocognitive phenotype presented by a patient diagnosed with MD. He’s 9-year-old male patient with sudden deterioration of his neurological status. With motor aphasia, right hemiplegia and increased tone of his left hemibody. An evaluation protocol was applied by clinical neuropsychology with general and specific tests aimed at assessing the neurocognitive functioning of the patient. The patient presents alterations in information registration tasks, sustained attention, visuospatial functioning and visuoconstructive skills, compatible with dysexecutive syndrome.
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Cavum Septum Pellucidum Et Vergae y Epileptogénesis
The prevalence of Cavum septum pellucidum (CSP) and Cavum vergae (CV) is unknown. Bruyn et al, observed that 30-50 % of subjects with CSP had epileptic seizures and manifested some degree of psychosis, dementia or personality disorders. The presence of CSP was higher in patients with extra-temporal epilepsy than in temporal lobe epilepsy and also higher in patients with neuronal migration disorder than without.
We present the case of a woman with focal epilepsy since childhood, who restarted seizures in adulthood, with no family history of epilepsy, whose son with chromosomopathy 18 died 21 days after birth. Cranial MRI showed a CSP and a CV, EEG (electroencephalogram) confirmed a left temporal focus and epilepsy was controlled with eslicarbazepine 800 mg.
We can conclude that the presence of CSP and CV is not a simple anatomical variation but may be related to the occurrence of epilepsy being a developmental anomaly that may contribute to epileptogenesis, as well as a marker of poor seizure control. We alert clinicians to be aware of this malformation in cases of diagnostic uncertainty. In addition, a wide CSP would justify a more detailed ultrasound examination and genetic counseling in trisomy 18 fetuses.
