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Síndrome de Down y COVID-19: Una Breve Perspectiva. Down Syndrome And COVID-19: A Brief Perspective
Palabras clave: COVID-19,
síndrome de down,
Un Ejemplo del Factor Bayes Para el Contraste de Hipótesis en la Investigación de Neurología. An Example Of The Bayes Factor In Hypothesis Contrasting In Neurology Research
Palabras clave: factor bayes,
Ronquido, Eventos Respiratorios y Cardíacos Después de la Colocación de un Dispositivo de Avance Mandibular. Snoring, Respiratory And Cardiac Events After The Placement Of A Mandibular Advancement Device.
Objective: To compare snoring levels, respiratory and cardiac events before and after the placement of a new mandibular advancement device (MAD) designed for snoring control, placed as an option for the control of pathological mechanisms respiratory disorders that have been associated with cognitive dysfunction, excessive daytime sleepiness and as an aggravator of the development of Alzheimer’s and Parkinson’s.
Methodology: Study of a case series that considered 12 snoring adults initially identified with the Roncolab® App. A clinical history of sleep and initial (A) and final (D) polysomnography (PSG) was performed. A new design of intra-oral mandibular advancement device for snoring control was placed, which was reviewed every 20 days for two months. Neurophysiological, cardio-pulmonary and sleep parameters were analyzed. The statistical differences between the variables were established according to the distribution of the data with tests of t-student or Mann-Whitney U.
Results: The average snoring events according to PSG were (A: 198; D: 260) with p> 0.05; according to Roncolab® (A: 73.6; D: 22.6) with a p <0.05. There were no differences between the oximetry averages (A: 0.84; D: 0.83) or heart rate (A: 65; D: 66.9).
Conclusions: There was no statistically significant difference in respiratory, cardiac events, oximetry nor apnea episodes according to PSG, after the placement of the manufactured DAM. Roncolab® registered a significant decrease in snoring events.
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Evaluación de la Utilidad de las Escalas Pronósticas del Status Epiléptico Convulsivo en el Status Epiléptico no Convulsivo. Usefulness Of Status Convulsive Score In Prognosis Of Non-Convulsive Status Epilepticus
Introduction: The Non-Convulsive Status Epilepticus (NCSE) is a rare clinical entity. As of today, a predictive mortality scale has not been developed. Moreover, the risk factors that contribute to the prognosis have not been clearly defined. The aim of this study was to evaluate the usefulness of the prognostic scores for status epilepticus (SE): the epileptic status severity score (STESS), the modified RANKIN scale STESS (mRSTESS) and the epileptic status mortality score based on epidemiology (EMSE-EACEG) applied in patients diagnosed with NCSE.
Results: The sample analyzed for this study consisted of 66 patients with an average age of 59 years (SD 18.5).
The STESS and mRSTESS were significantly associated with higher odds for poor prognosis at the time of discharge in patients with NCSE (p<0.05 and p<0.05, respectively). However, none of the three was associated with mortality.
Conclusion: Considering that the scores used to predict prognosis in patients with SE have not shown equal diagnostic accuracy in the NCSE, we believe that a validated predictive scale of morbidity and mortality would be of great help for these patients.
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Estructura Factorial del Funcionamiento Neuropsicológico en la Discapacidad Intelectual Leve en Niños. Factorial Structure Of Neuropsychological Functioning In Mild Intellectual Disability In Children.
An exploratory factor analysis was performed to establish the factor structure of neuropsychological functioning in mild intellectual disability in children. It was a quantitative, descriptive and cross-sectional study. Eighty children with a diagnosis of mild intellectual disability were included. An extensive battery of neuropsychological tests was applied. An Exploratory Factor Analysis was performed to identify the main factors. The results showed that mild intellectual disability in children has a structure in which the neuropsychological functions associated with executive functioning explain 56% of the variance and have a factor priority over 13%, which explains the variables associated with two traditional tests for assess intelligence. Each factor is analyzed and discussed from clinical and experimental neuropsychology. The study findings have theoretical and clinical implications for differential diagnosis.
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Palabras clave: discapacidad intelectual leve,
Funciones Ejecutivas,
inteligencia,
neuropsicología,
Niños,
Epilepsia Como Factor Pronóstico de Refractariedad y Funcionalidad en Estado Epiléptico en Pacientes Mexicanos. Epilepsy As Prognostic Factor Of Refractoriness And Functionality In Status Epilepticus In Mexican Patients.
Introduction: Status epilepticus is a medical condition which could lead to a great disability and be mortal. Background of epilepsy could prevent a progression to a refractory status epilepticus and predict a good functional prognosis. Nevertheless, in Mexican population there are no studies about that.
Materials and methods: An observational, analytic, retrospective, cohort study was performed with patients with status epilepticus in Specialities Hospital of “Siglo XXI” National Medical Center, in Mexico. It was evaluated the probability of presenting refractory status epilepticus and a good functional outcome in patients with a background of epilepsy, performing Pearson Chi-square.
Results: 40 patients with status epilepticus were included, 32 with refractory status epilepticus and 14 with a background of epilepsy. The probability of presenting a refractory status epilepticus with a background of epilepsy was OR 1.29 (p 0.53), and for a good functional outcome was OR 3.63 (p 0.10).
Conclusions: Background of epilepsy is not a protective factor for preventing the progression to a refractory status epilepticus, neither a factor for predicting a good functional outcome in our study with Mexican population. Nevertheless, further studies with a bigger sample are needed in order to prove these results.
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Palabras clave: Epilepsia,
estado epiléptico,
factor de riesgo,
funcionalidad,
Pronóstico,
refractariedad,
Magnetic Resonance Poor Prognostic Factors In Mexican Multiple Sclerosis Patients. Factores de Mal Pronóstico Por Resonancia Magnética en Pacientes Mexicanos Con Esclerosis Múltiple.
Introduction: Multiple sclerosis is one of the main causes of disability in young people. It has characteristic lesions in magnetic resonance images which are part of diagnosis criteria, and some of them could predict a long-term disability. In mexican population there is no description about multiple sclerosis imaging characteristics.
Materials and methods: We performed an observational, descriptive, cross-sectional, and retrolective study at the Neurology Service of Specialties Hospital of Siglo XXI National Medical Center of Mexican Social Security Institute, in Mexico, evaluating magnetic resonance images characteristics of patients with multiple sclerosis diagnosis between January 2017 and January 2020.
Results: 75 patients were included, 8% had 1-3 T2-weighted lesions, 18.6% had 4-9 T2-weighted lesions, and 73.3% had 10 or more T2-weighted lesions. 50.6% had infratentorial lesions and 61.3% had spinal cord lesions. Gadolinium enhancing lesions were found in 48%, with a median of lesions 2 (IQR 1,3).
Conclusions: Mexican patients with multiple sclerosis have a great incidence of magnetic resonance image poor prognosis factors, which should lead to a closer follow-up and influence treatment options.
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Keywords: Disability,
epidemiology,
magnetic resonance,
mexican patients,
multiple sclerosis,
Prognosis,
Prescription Patterns Of Antimigraine Drugs. Patrones de Utilización de Antimigrañosos.
Introduction: The objective was to determine the prescription patterns of antimigraine drugs in a Colombian population.
Methods: A cross-sectional study of a population database that recorded all patients diagnosed with migraine and the drugs used for crisis and prophylaxis treatment for at least three months during 2018. Multivariate analysis was performed to identify variables associated with the use of prophylaxis.
Results: A total of 5973 patients diagnosed with migraine were identified, with a mean age of 37.7±14.5 years and female predominance (81.3%). The most common diagnosis was migraine without aura (36.9%), followed by migraine with aura (28.4%). Overall, 7.3% of patients were treated by neurologists and 92.8% by general practitioners, and 85.4% (n=5101) received treatment for acute episodes. Nonsteroidal anti-inflammatory drugs (52.1%) were the most prescribed drugs, followed by ergotamine (42.1%). The 46.3% of patients were receiving prophylactic therapy. Women older than 35 years and patients treated by neurologists were more likely to receive prophylactic therapy.
Conclusions: The use of medications for acute migraine management prevailed, with a very low proportion of triptans. Despite the significant undesirable effects, ergotamine continues to be used frequently. Physicians should evaluate the need for prophylaxis, focusing on finding an effective therapy that reduces disabilities.
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Prevalence Of Major Depressive Disorder In Portoviejo, Ecuador. Prevalencia del Trastorno Depresivo Mayor en Portoviejo, Ecuador.
Major depressive disorder (MDD) is a debilitating neuropsychiatric disorder that affects more than 300 million people, causing enormous socioeconomic burden. Little data has been known about prevalence of MDD in Ecuador. Thus, the aim of this study was to describe the prevalence of MDD in the population in a highly populated city in Ecuadorian Coast. This population-based study was accomplished in Portoviejo, Manabí. Here, we analyzed 114.239 records about MDD using Structured Clinical Interview for the Diagnosis of DSM-IV Disorders in younger, adults, and older peoples. We observed that the MDD score of 8.6% of the studied population. There was a suitable agreement between mild MDD and residence location scores (urban or rural zone). Both models had a good standard of fit (R2 = 0.91 and 0.95) and a mean p-value of 0.04 for both locations. A significant positive correlation between marital status and MDD scores, particularly for single (p = 0.001361, r = 0.94), and education levels (p = 0.00102, r = 0.95) was also demonstrated. Moreover, both age (p = 0.001067, r = -0.94) and widowed (p = 0.009662, r = -0.87) were negatively correlated with MDD scores. Collectively, our results revealed a high prevalence of MDD in the Portoviejo population, an effect more prominent in man, living alone, young and resident of the urban zone.
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Adaptación Lingüística de la Batería de Evaluación Neuropsicológica “BREV” en Una Población de Escolares Ecuatorianos. Linguistic Adaptation Of The Neuropsychological Evaluation Battery “BREV” In A Population Of Ecuadorian Schoolchildren.
This article reports the process followed for the linguistic adaptation of the Neuropsychological Assessment Battery “BREV” in a population of Ecuadorian school children. The translation-back-translation method was used. The final version of the test was applied to a pilot sample of 100 schoolchildren from the city of Cuenca – Ecuador. The piloting revealed results similar to the original version in most of the subtests, however, there are still certain adaptation errors at the level of some terms and stimuli of the test that must be corrected. The statistical results demonstrated a significance of 5% (p <0.05) in the correlations between the performance of each subtest and the age of the Ecuadorian children. It was concluded that the final version of the linguistic adaptation of the Battery “BREV” obtained in this first part of the investigation similar results to the original version; but a statistical analysis by retest is necessary to ensure the equivalence and reliability of the adapted instrument with respect to the original French test.
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Correlación Entre Calidad de Sueño y Calidad de Vida en Estudiantes de Medicina. Correlation Between Quality Of Sleep And Quality Of Life In Medical Students.
Introduction: Sleep is important for the proper performance of the individual since it participates in many biological processes. Medical students often do not get the recommended amount of sleep per day, this affects their quality of sleep, with repercussions on their quality of life.
Objective: To identify the association between sleep quality according to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and quality of life according to the World Health Organization Quality of Life (WHOQOL–BREF) questionnaire of the World Health Organization (WHO) and describe the most prevalent risk factors for sleep disorders in medical students from the Catholic University Santiago de Guayaquil (UCSG).
Methods: Cross-sectional observational study in UCSG medical students.
Results: The questionnaires were completed by 211 students; the mean age was 20,8 ± 2,6 years; 62,1% were women. The mean BMI was 23,1 ± 3,8, 20,4% of the students were overweight and 4,3% were obese. The mean score in the PSQI obtained in the study population was 7,2 ± 3,1 and in the WHOQOL – BREF was 60,9%. Pearson’s correlation coefficient, r2, between both variables was -0.33 (p: <0.01).
Conclusion: Poor quality of sleep is inversely correlated with quality of life. The quality-of-life domain most associated with poor sleep quality was the physical domain. The most frequent risk factor for poor quality sleep was snoring.
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Palabras clave: calidad,
estudiantes,
medicina,
Pittsburgh Sleep Quality Index,
Sueño,
WHOQOL- BREF,
Empatía: Medidas Cognitivas y Psicofisiológicas en Población Infantil Empathy: Cognitive And Psychophysiological Measures In The Child Population
Empathy has an important research trajectory since the last century in cognitive neurosciences. From the definition as a concept, the construction of evaluation instruments for different ages and the search for domains and aspects that address this component are still in force. This review aims to collect representative findings in the history of the conceptualization of the term and the development of measurement in empathy in populations, with special emphasis on the work carried out with the child population with self-report tools and psychophysiological measures. The review showed that there is a promising research horizon with psychophysiological techniques such as the EEG for the evaluation of the construct. The need to deepen the search for patterns in the ontogeny of empathy in childhood is discussed, as well as the design of new forms of measurement through self-report for research practice in Spanish-speaking countries that involve social dynamics and demographics of these populations.
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Ethnic Variations Are Still Underrepresented In Neuropharmacogenomics: A Systematic Review. Las Variaciones Étnicas Todavía Están Infrarrepresentadas en la Neuro Farmacogenómica: Una Revisión Sistemática
Context: There is a growing amount of evidence suggesting that specific medication responses can be linked to everyone’s genetic makeup. The advent of fast genomics and more accurate genetics has only fueled the research in understanding that link. This situation has opened exciting research fields, namely, pharmacogenetics and pharmacogenomics. Studies regarding treatment response to mental health conditions using new tools have caught much attention, especially for conditions such as bipolar disorder (BP), schizophrenia (SP), mania, and hypomania, in which the treatment response can vary significantly among patients. One-way to associate a patient’s genetics and his/her treatment response is by recalling the patient’s ethnicity. Exciting results have been found for different ethnic groups where Asian and Caucasian populations are the most studied. However, there is a profound lack of studies on African and Latin-American populations. This paper aims to show some pharmacogenetics/genomics studies of mental health disease and contrast the significant difference between population studies in this regard.
Methods: We follow the PRISMA methodology, a systematic search was performed on PubMed, Medline, Web of Science, Scopus, and Google Scholar, taking into consideration any type of studies published up to November 30, th 2019. The search contained the following terms: pharmacogenetics, pharmacogenomics, ethnicity, and ethnic groups combined with their respective treatment (antidepressants, lithium, anticonvulsant, and various types of antipsychotics) and the condition (bipolar disorder (BP), schizophrenia (SP), mania, hypomania, and major depressive disorders (MDD). In each database, an input contained terms as pharmacogenetics OR pharmacogenomics AND ethnicity OR “ethnic groups” AND “bipolar disorders” AND “lithium.”
Results: We found only 29 studies on studies on pharmacogenetics/pharmacogenomics and ethnicity/ethnic groups, 14 related to schizophrenia, 7 related to mania and major depressive disorder and, 8 with bipolar disorders. These research fields have continuously explored the link between an individual’s genetics and the treatment side effects. Even though nearly twenty genes were associated with treatment response, small changes such as a single nucleotide polymorphism can also influence the treatment response. Clozapine was the most used drug to explore its pharmacogenetics/genomics. More than half of the studies found were done on Europeans and more than three-quarters on Asians.
Conclusion: We found only five studies on pharmacogenetics of mania and major depressive disorder linked to ethnicity that involve the genes SLC6A4, ABCB1, NTRK2, SLC6A2, BDNF, PDE11A, and PDE9A, genes related to the use of fluoxetine and desipramine. Some studies suggest that the precision of using Single Nucleotide Polymorphisms (SNPs) as pharmacogenomics markers of treatment outcome, if appropriately used, could represent a significant advance in personalized medicine as two SNPs found in the same gene can yield different treatment outcomes. One expected result was that the vast amount of information found mainly reflected studies performed in Europe and Asia. However, we observed that the studies in Latino or Hispanic ethnic groups are very few, which constitutes a strong bias when choosing the appropriate drug in treating neuropsychiatric diseases, especially to understand any ethnic drug responses and take advantage of this growing and exciting field.
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Memoria Episódica en las Etapas Preclínicas de la Enfermedad de Alzheimer Genética. Episodic Memory In The Preclinical Stages Of Genetic Alzheimer’s Disease
Introduction: Episodic memory (EM) allows us to recall events or lived experiences. EM is associated to the medial temporal lobe (MTL) activity, which has circuits integrated by different cortical association areas. EM impairment is the first symptom of Alzheimer’s disease (AD), which is explained by the abnormal beta amyloid (βA) and phosphorylated tau protein (PTF) deposition in the MTL.
Development: A review about EM components and its assessment is done, especially related to preclinical stages of genetic AD. The relationship of EM components to βA and TFP deposition and the activity of MTL networks, using positron emission tomography (PET) of the brain, particularly in asymptomatic members of families at genetic risk for early AD, caused by the E280A mutation in preseniline 1 (PSN1), is revised.
Conclusions: The reviewed studies trend to validate the hypothesis, which would suggest that EM allows us to consolidate and recalling lived subjective experiences, which also allows us learning from the past. EM has been assessed with verbal declarative memory tasks. The asymptomatic members, carrying the E280A PSN1 mutation for genetic AD, have showed lower scores than asymptomatic non carriers on these memory tasks, which significantly correlates to PET-amyloid and PET-tau of MTL signals, up to 20 years before dementia onset.
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Parálisis Cerebral en Pediatría: Problemas Asociados. Cerebral Palsy In Pediatrics: Associated Problems
Introduction: Cerebral palsy is the most frequent cause of childhood disability. Children with CP will associate, in addition to neurological problems, other non-neurological disorders that will be more frequent with a greater degree of CP involvement.
Objective: To address the clinical manifestations of children with cerebral palsy and their diagnostic and therapeutic management in order to provide a comprehensive approach to these patients in a single document.
Development: A review is made of the clinical manifestations of the child with cerebral palsy including neurological disorders, orthopedic problems, digestive disorders, respiratory problems, bone health, visual and hearing problems, urological and sexual disorders, oral health, hypersalivation, sleep disorder and pain.
Conclusions: The approach to the patient with CP has changed in recent years. Care provided by an specialized multidisciplinary team is essential. However, from our experience, the role of a pediatrician who knows all the associated problems seems essential to coordinate all the follow-up.
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Palabras clave: diagnóstico,
Discapacidad,
parálisis cerebral,
trastornos neurológicos,
Tratamiento,
Revisión Sistemática de Literatura sobre Evaluación Neuropsicológica Infantil en Ecuador. Systematic Review Of The Literature On Child Neuropsychological Evaluation In Ecuador.
The objective of this study is to identify the cognitive functions evaluated and the tests used in child neurocognitive screening. Through a systematic review of the literature, the academic databases Pubmed, Scopus, ScienceDirect, Redalyc, Scielo and APA Psycnet were examined between the years 2014 and 2019. The results show that the functions considered for the evaluation are: language, memory, visual perception, attention, executive functions and learning abilities. In addition, the studies identify cognitive profiles based on the Wechsler, Kaufman Batteries and Infant Neuropsychological Assessment (ENI) scales.
In Ecuador, the Ministry of Public Health has not developed an instrument to carry out neurocognitive screening for children, so postgraduate thesis investigations were identified with the use of tests for specific situations such as violence, attention deficit, learning prob-lems and screening Infant highlights the use of the BREV Rapid Neurocognitive Function Assessment Battery model as a recommendation for a child neurocogitive screening instrument.
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Aterosclerosis Carotidea: Una Causa Frecuente Pero Prevenible de Ictus Isquémico. Carotid Atherosclerosis: A Common But Preventable Cause Of Ischemic Stroke
Carotid atherosclerosis is responsible for 10-20% of all ischemic strokes and is characterized by a high risk of stroke recurrence, as well as by its preventable nature through the control of vascular risk factors, intensive medical management, and surgical revascularization in cases of severe stenosis. Pivotal studies in the 90’s showed significant benefit of carotid endarterectomy in patients with severe symptomatic carotid stenosis (>70%), whereas the benefit in patients with moderate stenosis (50-69%) and those with asymptomatic disease was modest. Active areas of research in the field include the identification of novel non-traditional risk factors directed to the early diagnosis and primary prevention of carotid atherosclerosis, the efficacy of intensive medical management to decrease to the risk of stroke among patients with asymptomatic disease, and the development of new surgical revascularization techniques with lower complication rates. Through this revision manuscript we aim to summarize the current knowledge on carotid atherosclerosis and expose a practical approach for its diagnosis and treatment.
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Temporal Squama Pneumatization: An Under-Recognized Limitation Of Transcranial Doppler. Pneumatización de las Escamas Temporales: Una Limitación Poco Reconocida Del Doppler Transcraneal
Transcranial Doppler (TCD) is a non-invasive procedure that is increasingly used for diagnostic and prognostic purposes in patients with an acute stroke. In addition, TCD enhances the effect of thrombolysis by exposing thrombi surfaces to circulating rTPA. However, insonation problems through acoustic windows limit the diagnostic efficiency of TCD.
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Keywords: pneumatization,
Transcranial Doppler,
Encefalopatía Hipóxico-Isquémica Por Anfetaminas. Hypoxic-Ischemic Encephalopathy Due To Amphetamines
Palabras clave: anfetaminas,
Encefalopatía,
El Uso de Programas Computarizados y su Efectividad en la Rehabilitación de Funciones Ejecutivas en Daño Cerebral Adquirido. The Use Of Computer Programs And Their Effectiveness In The Rehabilitation Of Executive Functions In Acquired Brain Damage.
Given the increase in the offer of computerized programs for the neuropsychological rehabilitation of patients with acquired brain damage, it is important to know their efficacy and the advantages of their application on different processes. This article reviews the use of these programs in the neuropsychological rehabilitation of executive functions in patients with acquired brain damage.
The search was carried out in sources such as PUBMED, internet searches and some lists of bibliographic references. Controlled, randomized articles were reviewed, and due to the characteristics of the topic, quasi-experimental studies and a case study, adults, were also included, excluding only articles that included adults patients with acquired brain damage and who had executive function failure without specify one in particular and that they have received cognitive rehabilitation through computer programs. The results reflect weaknesses in the matching of the control groups, the size of their samples, and in the use of instruments for measuring executive functions to objectify efficacy. In general, the programs reviewed do not prove to be more effective than those of traditional pencil and paper interventions.
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Palabras clave: Daño cerebral adquirido,
Funciones Ejecutivas,
ordenador,
rehabilitación neuropsicológica,
Calcificaciones en Ganglios de la Base en un Caso de Hipoparatiroidismo Primario. Basal Ganglia Calcification In A Case Of Primary Hypoparathyroidism
Hypoparathyroidism is characterized by an insufficient production of parathyroid hormone, resulting in hypocalcemia and hyperphosphatemia, that without proper treatment can lead to multiple complications in different organs. We present the case of a patient with primary hypoparathyroidism, with basal ganglia calcifications as a complication of the disease and the therapeutic challenge it presents to improve the symptoms and quality of life.
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Síndrome Lumbocostovertebral Asociado a Mielomeningocele. Lumbo-Costovertebral Syndrome Associated With Myelomeningocele
Lumbo-costo-vertebral syndrome is a rare anomaly that affects the vertebral bodies, the ribs and the muscles of the abdo- minal wall, and multiple additional congenital abnormalities requiring multidisciplinary management and early surgical inter- vention to avoid complications. Case presentation: A 10-day-old male infant presents with two right lumbar tumors, one that increased in size with crying consistent with a lumbar hernia, and the other a myelomeningocele. In complementary studies, it was found that the patient had fusion of the 1st and 2nd, 3rd and 4th and 11th and 12th ribs on the right, a 13th accessory rib on the right, and a 13th and 14th accessory rib on the left in addition to multiple defects in the fusion of the lumbar and sacral vertebral bodies, and a 1cm defect in the abdominal wall with protrusion of abdominal contents. The patient was diagnosed with LCVS with an associated myelomeningocele and underwent a simple closure and repair of the abdominal defect with a bovine pericardial patch, and plasty of the myelomeningocele without complications. We present this case due to the rarity with which it is reported in the literature. Conclusions: LCVS is a rare entity that merits early surgical resolution to avoid complications, in addition to multidisciplinary management.
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Carcinoma de Células de Merkel en Paciente con Esclerosis Múltiple en Tratamiento con Fingolimod. Merkel Cell Carcinoma In A Patient With Multiple Sclerosis Treated With Fingolimod
Fingolimod is a disease-modifying therapy widely used in Relapsing-Remittent Multiple Sclerosis. It blocks the capacity of lymphocytes to leave the lymph nodes, causing lymphopenia. This increases the risk of infections, but also non-melanocytic skin tumours. We report a case of Merkel cell carcinoma in a patient treated with fingolimod and a review of the literature, which helps to understand the relation between immunosuppression, opportunistic infections and cancer.
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Palabras clave: Cáncer,
Carcinoma de células de Merkel,
Efectos adversos,
esclerosis múltiple,
Fingolimod,
Inmunosupresión,
Diferencias en la Corteza Visual Primaria Entre la Ceguera Congénita, Temprana y Tardía. Una Revisión Sistemática Differences In The Primary Visual Cortex Between Congenital, Early And Late Blindness. A Systematic Review
The loss of a sense, such as sight, promotes research on brain plasticity and the activity of the visual cortex, either with task or at resting-state. However, the activity of the primary visual area, its role in perception through cortical signals, once blindness has developed, is still being investigated. There is evidence of the differences between the changes associated with the different types of blindness, however, it is difficult to define how the anatomical and functional changes are interrelated and how they depend on, when vision is lost. That is why the main objective of this review is the clarification and definition of said modifications.
Important differences have been found in terms of the thickness and volume of the visual area, and how its decrease implies a greater activity detected by overload of neurons. Therefore, it explains a greater activity in congenital and early blindness compared to late blindness. Similarly, there is greater connectivity between the ventral and dorsal pathways in congenital blindness, as well as a lesser decrease in fractional anisotropy of the white matter (FA), compared to the other two types of blindness.
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Etiología del Daño Cerebral: Un Aporte Neuropsicológico en su Construcción Teórica (Primera Parte). Etiology Of Brain Damage: A Neuropsychological Contribution In Its Theoretical Construction (First Part)
The brain is the organ responsible for all the brilliant activities that human beings perform, such as thinking, acting, speaking, solving problems, making decisions, regulating emotions and other fascinating mental abilities. Any of these brain functions can be damaged at the least expected moment, generating cognitive and behavioral problems in the patient who suffers from acquired brain damage. This article proposes a theoretical review of various etiological factors of brain damage: (a) the most frequent of them, traumatic brain injury (TBI), a condition that causes a range of cognitive and behavioral deficiencies, in addition to being the main cause of prolonged dysfunction in industrialized countries; (b) brain tumors are also an important etiological factor, since any area of the Central Nervous System (CNS) can be affected and the effects are very varied according to the location of the tumor, its level of severity, its nature and whether or not surgery was performed; (c) thirdly, epilepsy is presented as a neurological disease present in 50 million people around the world and whose consequences on the CNS are related to seizures and anti-seizure drugs; finally, (d) the neurobiology of child abuse is exposed, which can generate alterations in the brain configuration of a minor. In each of these factors, its definition, classification, associated risk factors and, finally, what is its effect on the brain and the nature of the damage will be presented.
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Palabras clave: Daño cerebral adquirido,
Epilepsia,
maltrato infantil,
traumatismo craneoencefálico,
tumores cerebrales,
Trombosis Venosa Cerebral: Consideraciones Actuales. Brain Venous Thrombosis: Current Considerations
Introduction: Cerebral venous thrombosis (CVT) is an uncommon cause of cerebrovascular disease that mainly affects children and young adults, mostly in fertile-age-women.
Objectives: A contemporary review of the epidemiological, anatomical, pathophysiological, diagnostic and treatment characteristics of CVT.
Materials and methods: A bibliographic research was performed in the PubMed / MEDLINE database and including studies published in the period 2015-2020.
Development: The estimated-annual-incidence has been increasing in last years. Its diagnosis is established by clinical studies and neuroimaging, and laboratory studies. Although, the diagnosis is generally late due to a highly variable and nonspecific clinical presentation. Treatment target is preventing potential mortal complications, followed by anticoagulant therapy. In some cases, surgical thrombolytic procedures are indicated.
Conclusions: The diagnosis is based on a combination of MRI or CT studies. The current gold-standard treatment is low molecular weight heparin and warfarin.
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Palabras clave: resonancia magnética,
tomografía computarizada,
trombosis cerebral,
Trombosis venosa,
Síndrome de Persona Rígida de Causa Paraneoplásica. Claves Diagnósticas en una Entidad Rara. Stiff Person Syndrome Of Paraneoplastic Cause. Diagnostic Keys In A Rare Entity
Introduction: Paraneoplastic disorders exert their effect through immunological mechanisms and not by direct invasion of the tumor; in this way tumors located outside the nervous system induce the production of antibodies against antigens: on the neu- ronal surface, intracellular or synaptic and affect distant sites from its location to either the central or peripheral nervous system, thus producing various clinical manifestations. One of these syndromes is the Stiff Person syndrome, which, apart from being a rare entity, occurs as a paraneoplastic syndrome in only 5% of cases.
Clinical Case: A 72-year-old male patient, a 2-month evolution that began with painful muscle spasms in the dorsal and lumbar region, evolved to rigidity with posture in axial and appendicular hyperextension, pseudospastic gait, hyperekplexia; due to the suspicion of Stiff Person syndrome a diagnostic work-up was begun finding high levels of Ab anti GAD65 and later a Non- Hodgkin’s Lymphoma. The patient received immunotherapy and cancer treatment.
Conclusion: Paraneoplastic syndromes must be identified according to the clinical phenotype and the determination of an- tineuronal antibodies. High suspicion and rapid diagnosis are necessary to achieve timely treatment and avoid permanent injury.
