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Caracterización histológica de las dendritas de la amígdala por alto consumo de fructosa en un modelo experimental de isquemia cerebral. Histological features of dendrites in the amygdala due to high fructose consumption in an experimental model of cerebral ischemia
SummaryIntroduction. High fructose consumption has been shown to magnify cerebral ischemic injury in the ischemic focus and penumbra region. However, ischemia also produces changes in exofocal areas such as the amygdala, an important structure in emotional processing. Therefore, the objective of the investigation was to characterize the histological changes of the amygdala dendrites caused by high fructose consumption in an experimental model of cerebral ischemia.
Method. Wistar rats fed with standard food were used; the control group was given water and the fructose (HDF) group was given add libitum 20% fructose in water for 11 weeks. Some rats were subjected to cerebral ischemia. Therefore, there were four experimental groups: Sham control, Sham HDF, Ischemia control, Ischemia HDF. 50 um coronal sections of the brains were made and microtubule-associated protein 2 (MAP2) immunohistochemistry was performed. Images were captured and processed in Image J software.
Results. Loss of dendrite immunoreactivity was found in ischemic groups, and also cluster-type MAP2 immunoreactivity in HDF groups.
Conclusion. According to the above, both ischemia and high fructose consumption generate dendritic alterations in the amygdala.
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Relación entre factores de riesgo y la distribución topográfica en niños con parálisis cerebral. Relationship between etiological factors and topographic distribution in children with cerebral palsy
SummaryIntroduction: Cerebral palsy is a health condition that seriously impacts the life condition of children and their family. Different risk factors are becoming increasingly important in its etiology.
Objective: The aim of this study was to analyze the most frequent risk factors for cerebral palsy and their association with topographic distribution in children aged 0 to 15 years in the city of Barranquilla.
Methods: An analytical observational cross-sectional survey type study was conducted with a sample of 78 children diagnosed with cerebral palsy in the city of Barranquilla, where the association of the most frequent risk factors of this condition with the topographic distribution was analyzed.
Results: The risk factors associated with cerebral palsy in order of importance were: perinatal hypoxia, gestational history of maternal infections, maternal trauma and congenital malformations. There was statistically significant association between gestational weeks at birth and GMFCS level (p<0.05) and between gestational weeks and topographic distribution.
Conclusions: Subjects with higher gestational age presented greater involvement at the level of motor function and a more extensive topographic distribution.
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Hipernatremia como factor pronóstico de mortalidad en trauma encefalocraneano severo. Hypernatremia as a prognostic factor of mortality in patients with severe traumatic brain injury
SummaryBackground: A severe traumatic brain injury is a frequent pathology, it implies a non-negligible morbidity and mortality. Hypernatremia could be considered a factor associated with poor prognosis in order to optimize treatment in the group of high-risk patients. We aim to determine if hypernatremia is a prognostic factor of mortality in patients with severe traumatic brain injury in a public hospital which is a local reference center in trauma.
Material and Methods: We performed a non-probabilistic sampling of adult patients of both sexes with severe traumatic brain injury from the Intensive Care Unit of the Hospital Regional Docente de Trujillo, Perú during the 2015–2018 period.
Results: Mortality in the group with and without hypernatremia was 38% and 6% respectively (p=0.001). The difference in natremia mean values between the group with and without mortality was 21,86 (95% CI 18.2-25.5) (p=0.000). In the multivariate analysis, we found hypernatremia with adjusted OR of 16.73 (95% CI 1.96-142.82) (p=0.01). The ROC curve showed adequate performance to predict mortality, with an AUC 0.878 (95% CI 0.77-0.97) (p=0.00).
Conclusion: Hypernatremia is a prognostic factor of mortality in patients with severe traumatic brain injury.
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Psychiatrists available in the Ecuadorian public health system and psychiatry residency programs in Ecuador – A cross-sectional analysis. Psiquiatras disponibles en el sistema de salud público y programas de residencia en psiquiatría del Ecuador – Un análisis transversal
SummaryIntroduction: In 2008, Ecuador’s mental health profile displayed deficiencies due to the lack of psychiatrists and psychiatry residency programs. The same year, access to universal health care, was instituted as a right in the Constitution. There are no studies on the Public Health System’s capacity to provide mental health services, hence an updated analysis of the number of psychiatrists and psychiatry training programs available is required.
Objective: To determine the number of psychiatrists available through the Public Health System and to calculate the ratio of psychiatrist per 10,000 population; to establish the number of residency programs available.
Methods: Cross-sectional analysis of the data available from the Ecuadorian Public Health System and the Higher Education Council of Ecuador. Ratios were calculated using data from the National Institute of Statistics and Censuses.
Results: Ecuador’s psychiatrists ratio is 0.08:10,000 and the adjusted ratio (psychiatrists and psychologists) is 0.65:10,000. The Public Health System has 138 psychiatrists, concentrated in Pichincha (n=51) and Guayas (n=27). Three provinces had no psychiatrists available. There are two psychiatry training programs in Quito.
Conclusion: Ecuadorian Public Healthcare holds a shortage of psychiatrists which inhibit the minimum ideal ratio fulfillment, along with a noticeable lack of psychiatric training programs availability.
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Alteraciones en el sistema nervioso producido por la obesidad. Alterations in the nervous system produced by obesity
SummaryIntroduction: The central nervous system as well as the cardiovascular system are target organs, susceptible to endogenous and exogenous injuries. In this sense, the role that obesity has in relation to the direct or indirect affection towards the nervous tissue is little known, however, there is evidence that suggests that the decrease in cerebral blood flow as well as the exaggerated production of pro-inflammatory cytokines could be associated with damage to cellular tissue including gray matter and white matter.
Objective: The objective of our study was to review the available scientific literature on the macro and microstructural changes caused by obesity in the nervous system.
Methodology: Searches were made in English and Spanish in PubMed, GoogleSchoolar and Scielo using the following search terms: “OBESITY” OR “OVERWEIGHT” AND “BRAIN STRUCTURE” OR “GRAY MATTER” OR “WHITE MATTER” OR “BRAIN VOLUME”. We included articles since 2000 to 2021.
Results: The results show that obesity is associated with a decrease in brain tissue volume, possibly at the expense of a decrease in white and gray matter, which also causes demyelination and diffuse axonal damage in patients with body mass index > 30.
Conclusions: There are different mechanisms that affect the nervous system, producing macro and microscopic changes in obese patients, among which are decreased blood flow, alteration of the blood-brain barrier, production of proinflammatory cytokines, production of reactive oxygen species, among others, which lead to nerve cell apoptosis, decreased white matter volume white and gray matter volume, axonal damage among others.
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Construcción teórica neuropsicológica de las funciones ejecutivas. Theoretical neuropsychological construction of executive functions
SummaryExecutive functions (EF) constitute a large conglomerate of cognitive abilities that, as their name indicates, carry out decisive actions in decision-making and human behavior. They are of a cognitive and socio-emotional nature, they coordinate the input and output information to regulate the behaviors, thoughts, and emotions of a task to be performed. Alexander Luria raises its conceptualization at the beginning of the seventies, being Muriel Lezak the one in charge of its scientific dissemination. In this article, a bibliographic compilation on EFs, their best known theoretical models, their neuropsychological evaluation process, the most common disorders and the most relevant studies in recent years is made.
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Calcificaciones ganglio basales simétricas bilaterales (Enfermedad de Fahr) en pediatría: Reporte de caso. Bilateral symmetric basal ganglia calcifications (Fahr’s disease) in pediatrics: Case report
SummaryIntroduction: Fahr syndrome is defined as the presence of predominantly bilateral symmetric calcifications in the basal ganglia (mainly striated nucleus). It is considered primary when the etiology is genetic, which is also known as Fahr’s disease; and secondary if metabolic alterations, endocrine alterations, exposure to radiation, infections, vascular disorders, mitochondrial diseases or others, are found, being the most frequent: hypoparathyroidism and pseudo-hypoparathyroidism. Fahr’s disease is a pathology of genetic origin, rare in pediatrics, that is associated with movement, neuropsychiatric and cognitive disorders.
Clincal case: We present the case of a 9-year-old boy with evidence of bilateral symmetric basal ganglia calcifications on brain computed tomography (CT) scanning. In the literature there are very few descriptions of this finding in pediatrics. Clinically, the child presented WITH epilepsy, right hand dystonia, mild cognitive deficit and progressive impairment of speech and gait. He was clinically diagnosed as a Fahr’s disease, given the abscense of other metabolic or endocrinological alterations, without genetic studies, and treatment with Levodopa-carbidopa was started for the management of dystonia with clincal evidence of improvement, an a comprehensive rehabilitation program was indicated.
Conclusions: The finding of bilateral symmetric basal ganglion calcifications should lead to rule out endocrinological or metabolic alterations; In the event that they do not occur, all possible related manifestations in the cognitive, psychiatric, motor, speech and other fields should be handled in a comprehensive manner.
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Encefalitis autoinmune por anticuerpos anti Iglon5, reporte de caso clínico. Autoinmune encephalitis due to anti Iglon5 antibodies, clinical case report
SummaryIntroduction: New clinical entities related to the discovery of autoantibodies either against intracellular antigens or against cell membrane surface receptors or synapses are being identified with increasing frequency. In the latter group, patients with apnea have been described in recent years, REM and NON-REM sleep behavior disorder, respiratory failure and presence in serum and CSF of antibodies against the LON5 antigen. These antibodies appear to alter the interaction with the cytoskeletal system of the neuron and induce accumulation of TAU, conditioning a wide clinical expression.
Clinical case: 76-year-old male patient with eight years evolution of symptoms before diagnosis. He had a mixture of respiratory symptoms, parasomnias, ataxia, movement disorder, autonomic symptoms, cognitive and mood disorder, and associated a chronic demyelinating polyneuropathy. The diagnosis was confirmed by detection of antibodies against IGLON5 in cerebrospinal fluid.
Conclusion: Anti-IGLON5 antibody encephalitis is a unique entity that challenges what we know about autoimmunity and neurodegeneration, leading to a diagnostic challenge due to the wide expression of symptoms and the possibility of improvement with early treatment.
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Enfermedad de Wilson: A propósito de un caso neuropsiquiátrico de diagnóstico tardío. Wilson’s Disease: About a late-diagnosed neuropsychiatric case
SummaryThe comprehensive assessment of a psychiatric case requires evaluating the symptoms from a comprehensive perspective, without bias, and suspecting unlikely pathologies where appropriate. We emphasize this from a case of Wilson’s disease in which, as is frequent, the diagnosis was late. Clinical case: 36 year-old woman who from the age of 18 presented depressive and later psychotic symptoms, and her diagnosis was paranoid schizophrenia. The three-year diagnostic delay led to a poor evolution with permanent disabilities. The biased diagnostic attribution about parkinsonism as secondary to antipsychotics clouded the adequate diagnostic evaluation. Our case shows the need for a comprehensive neuropsychiatric perspective in the diagnostic evaluation. In a first case of psychosis, Wilson’s disease should be considered within the differential diagnosis.
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Meningioangiomatosis y displasia cortical focal. Meningioangiomatosis and focal cortical dysplasia
SummaryThe association between meningioangiomatosis (MA) with focal cortical dysplasia (FCD) has been scarcely published. We present the case of 15-year-old adolescent suffering 10 years evolving drug-resistant epilepsy without history of neurofibromatosis. Magnetic Resonance Image showed an increase in the volume of the hippocampus and the right parahippocampal region. The lesion was considered as a possible tumor. A right temporal lobectomy, guided by trans-surgical electrocorticography (EcoG) was performed. Histology of the resected tissue evidenced a FCD type IIIc (MA mainly vascular associated to FCD). The patient has been seizure free (according to the Engel IA scale) after 4 years of post-surgical evolution. When MA is suspected, we recommend trans-surgical ECoG considering the possible association with FCD in the surrounding neocortex. It could increase the incidence and knowledge about these two lesions. The histological study provides the definitive diagnosis.
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CLIPPERS (Inflamación crónica linfocítica con realce perivascular pontino y respuesta a esteroides) con compromiso longitudinalmente extenso de la médula espinal. Una presentación atípica. CLIPPERS (Chronic lymphocytic inflammation with pontine perivascular enhancement and steroid response) with longitudinally extensive spinal cord involvement. An atypical presentation
SummaryCLIPPERS (Chronic Lymphocytic Inflammation with Perivascular Pontine Enhancement and Steroid Response) is a recently described neuroinflammatory disorder in which symptoms involving the brainstem predominate, with variable pattern on neuroimaging and a perivascular infiltrate of T lymphocytes on brain biopsy. We present a case of a 50-year-old male who presented symptoms of asthenia, adynamia, weakness in lower limbs extremities, sphincter disorder and ataxia. Patient was extensively studied to rule out infectious, neoplastic, autoimmune, and demyelinating conditions. Diagnosis was made taking into account significant clinical-imaging elements, remarking the spinal cord involvement in this patient. Treatment with steroids and steroid-sparing agents, such as methotrexate, was found to be effective. Very few cases in the literature to date describe CLIPPERS-associated spinal cord involvement.
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Trombectomía mecánica eficaz en paciente con ictus e infección por SARS-Cov-2 con desenlace fatal. Effective mechanical thrombectomy in a patient with stroke and SARS-Cov-2 infection with fatal outcome
SummaryIschemic stroke has been reported in patients with SARS-CoV-2 infection. It is not clear if COVID-19 is causal or simply coexists or triggers the onset of stroke. Stroke is relatively rare in the context of COVID-19 and mostly occurs in the elderly with vascular risk factors. The underlying mechanism of stroke is multiple. We present an 84-year-old male with a stroke due to large vessel occlusion coincident with severe COVID-19 infection, that despite an initial successful mechanical thrombectomy, had a fatal outcome due to respiratory complications and contralateral massive cerebral infarction due to early recurrence. Consequently, vigilance in this type of patients should be extreme since ischemic stroke with active SARS-CoV-2 infection may have a poor prognosis.
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Neuroimagen en síndrome de desmielinización osmótica. Neuroimaging in asmotic demyelination syndrome
SummaryThe osmotic demyelination syndrome includes pontine and extrapontine myelinolysis, the first being its classic form of presentation. Usually related to rapid corrections of hyponatremia (serum sodium less than 135mEq/L), it has been described in multiple conditions that can alter plasma osmolality. The symptoms are varied and include spastic tetra paresis, pseudobulbar paralysis, coma, seizures or the characteristic “locked in” syndrome, as well as behavioral disorders such as lack of impulse control, aggressiveness, depressive syndromes, catatonia, mutism, and emotional lability. Years ago, it was a very difficult entity to diagnose, but with the introduction of magnetic resonance imaging, many oligosymptomatic or asymptomatic cases have been detected, although there is no known treatment, spontaneous recovery can occur.
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Atrofia multisistémica, estudio por imagen de un caso. Multisystem atrophy, imaging study of a case
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El chico con medio cerebro. Boy with nearly half-of-brain
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A watery eye and an enlarged trigeminal nerve. Ojo acuoso y ensanchamiento del nervio trigémino
SummaryA 45-year-old man was evaluated one week after the acute onset of pain and numbness in the right side of the face. On examination, he had a right watery eye, which has been present for several weeks. The patient denied history of eye trauma or previous episodes of inflammatory or infected conditions affecting the lacrimal drainage complex.
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Neurología fuera de la ciudad capital. Neurology outside the capital city
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Criterios de diagnóstico de la enfermedad de Alzheimer: Aplicaciones prácticas. Diagnostic criteria for Alzheimer’s disease: Practical applications
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Relación de la periodontitis con la neuroinflamación. Relationship of periodontitis with neuroinflammation
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Cefalea post COVID-19: Una nueva entidad a considerar en la consulta diaria. Post COVID-19 headache: A new entity to consider in daily consultation
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Inclusión educativa del alumnado universitario con discapacidad intelectual en Honduras. Una deuda pendiente. Educational inclusion of university students with intellectual disabilities in Honduras. A pending debt
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Limited value of blood pressure levels in predicting white matter hyperintensities progression among community dwelling older adults living in a rural setting. Utilidad limitada de los niveles de presión arterial como predictor de progresión de hiperintensidades de sustancia blanca en adultos mayores que viven en un entorno rural
SummaryIntroduction: This study aims to assess the impact of blood pressure (BP) on progression of white matter hyperintensities (WMH) of presumed vascular origin in community-dwelling older adults living in rural Ecuador.
Methods: Atahualpa residents aged ≥60 years receiving baseline and follow-up brain MRIs after a median of 6.5 years were included. Multilevel logistic regression models, which accounted for WMH severity at baseline, were fitted to assess the risk of WMH progression according to BP levels and other covariates.
Results: Analysis included 263 participants. WMH progression increased 3.45 times (95% C.I.: 1.94 – 4.96) among non-hypertensive individuals but 6.15 times (95% C.I.: 3.18 – 9.12) among those with arterial hypertension. However, overlapping of confidence intervals make such difference non-significant. Likewise, no differences in WMH progression were noticed when steady and pulsatile components of BP were used as independent variables.
Conclusions: High BP is not an independent predictor of WMH progression in the study population.
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Conducta adaptativa en estudiantes chilenos sin discapacidad intelectual: Diferencias por género y edad. Adaptative behavior in chilean students with intellectual disability: Differences by gender and age
SummaryAdaptive Behavior (CA) is a set of skills learned and performed by people in their daily lives, which are categorized in the conceptual, social and practical domains. The objective of the research was to compare the CA skills according to sex and age range (under 10, between 10 and 16 and over 16) of the participants. A comparative-correlational design was used, which evaluated 457 students (between 5 and 18 years old) with the ABAS-II questionnaire. The results report that CA does not have significant differences when compared by sex, but in age ranges. Downward associations were observed as age increases when relating conceptual skills to social and practical domains. It is concluded that there are no differences in skills according to sex, but there are differences by age ranges and high positive correlations in the younger group, which tend to decrease in the other groups as they advance in age. It is believed necessary to continue deepening the evaluation of CA in children of typical development using the four dimensions of the instrument (conceptual, social, practical, work) in order to obtain results that allow generating comprehensive support for the better development of boys and girls.
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Rehabilitación neuropsicológica en memoria declarativa y la funcionalidad en un adulto con epilepsia y lobectomía temporal izquierda. Neuropsychological rehabilitation program on declarative memory and functionality in an adult with epilepsy and left temporary lobectomy
SummaryIntroduction: Surgical intervention is a treatment option for refractory epilepsy, and after this procedure cognitive alterations may occur. Software-based intervention approaches represent an alternative to traditional approaches.
Objective: To identify the effect of a neuropsychological rehabilitation plan for declarative memory in an adult with left temporal lobectomy, on their functional abilities.
Methodology: A single-case quasi-experimental design was used; the participant was a 45-year-old woman with memory problems and difficulties in performing daily activities. The intervention was carried out using the CogniFit rehabilitation software, and the Functioning Classification Scale and the Quality of Life Questionnaire in Epilepsy were used for the measurement.
Results: A large effect (NAP; 95%) was found in both indices.
Conclusions: The implementation of a software-based program allows a comprehensive rehabilitation.
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Propiedades psicométricas del test de evaluación neuropsicológica – Neuropsi en población peruana. Psychometric properties of the neuropsychological evaluation test – Neuropsi in peruvian population
SummaryThis research aims to estimate the psychometric properties of the neuropsychological assessment instrument – Neuropsi in patients treated in the Neurology area of a public hospital in Peru. The study is of a technological, psychometric type, of a non-experimental and cross-sectional design and is oriented through a quantitative approach. We worked with a non-probabilistic sample of 432 medical records of elderly patients who were diagnosed with or without cognitive disorders or dementia, to whom the brief neuropsychological assessment instrument in Spanish – Neuropsi was applied. A factor analysis was found that reports a good fit in a 6-factor model with X2 = 2.825, CFI = 0.990, GFI = 0.986, PNFI = 0.460, AIC = 47.774, SRMR = 0.0196, RMSEA = 0.065 and the Cognitive performance differs according to the age range of the patient. In addition, it has a Cronbach’s alpha reliability of .863. These findings suggest that the instrument is valid, short, accurate, and adequate for measuring cognitive performance.
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Práctica de la neuropsicología en Ecuador. Practice of neuropsychology in Ecuador
SummaryObjectives: To explore the current state of neuropsychology practice in Ecuador through the administration of an online survey.
Methods: A total of 48 professionals working in the field of neuropsychology completed an online survey between August 2018 and December 2019.
Results: The majority of the participants were female (62.5%), with a mean age of 37.23. 87.5% report having received postgraduate neuropsychology training. Most are employed in private practice, universities and/or clinics, and report being satisfied with their work. The most commonly treated diagnoses are Attention Deficit with Hyperactivity Disorder (ADHD), learning disabilities and language disorders. The three main barriers identified for the development of neuropsychology are the lack of academic training programs, the lack of clinical training programs and the lack of willingness to collaborate among professionals.
Conclusions: The practice of neuropsychology in Ecuador is on par with that of Latin America. However, certain changes are needed, such as increasing academic and clinical training programs in the area, formalizing regulations that guarantee quality and standards in practice, and continuing to standardize and validate neuropsychological tests in the country.
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Cerebro, hormonas y genes: conocimientos biológicos de la homosexualidad y transexualidad en una muestra chilena. Brain, hormones, and genes: biological knowledge of homosexuality and transsexuality in a Chilean sample
SummaryIntroduction: Sexual orientation and gender identity have some biological bases based on genes, perinatal hormones and brain dimorphisms that have been studied in recent decades. The objectives of this study are to know the psychometric properties of a questionnaire to evaluate biological knowledge of homosexuality and transsexuality and to investigate such knowledge in a Chilean sample.
Methodology: 144 people from three regions of Chile were surveyed. A sociodemographic survey and the Biological Knowledge of Homosexuality and Transsexuality Questionnaire (BKHT) were applied. The results show that the instrument is valid and reliable for the sample used. It is also noted that 75,7% of the respondents obtained between 1 and 6 correct answers out of a maximum of 18. Of the sociodemographic variables, only religious beliefs and having dealt with homosexuality and transsexuality in their sex education classes are predictors of the BKHT scores.
Conclusions and Recommendations: BKTH is valid and reliable to be applied in Chilean population samples. The sample evaluated has low levels of knowledge about the biological basis of homosexuality and transsexuality. It is recommended to replicate this research in larger samples, in other regions of Chile and in other Latin American countries.
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Test de Lectura de la Mente a través de la Mirada: Primera aproximación a las propiedades psicométricas en población peruana. Reading the Mind in the Eyes Test: A first approximation to the psychometric properties in the Peruvian Population
SummaryTheory of mind (ToM) is a central cognitive process of social cognition, with great importance in neuroscience and neuropsychiatric disorders. One method used to evaluate advanced ToM in adults is the Reading the Mind in the Eyes Test (RMET), which despite being widely known in Peru, still lacks standardized and adequately validated measures for its application in the clinical area and not clinical. Objectives: 1. Explore the psychometric properties of RMET in Peruvians, as well as the percentage of precision for each item among the different versions of the RMET; 2. Evaluate the test-retest reliability after one year of follow-up. Two hundred eighty-eight participants between 17 and 55 years old, of both sexes, were recruited. Results: The RMET shows a medium validity and consistency according to the KR-20, Cronbach’s Alpha, and Omega tests (0.645 – 0.666). Women perform better than men (p <0.041*), and scores remain stable after one year of follow-up. Conclusions: The RMET shows good psychometric properties, similar to other versions and different countries, with women showing better mental capacity.
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Localización cerebral y actividad eléctrica del razonamiento abstracto mediante electroencefalografía cuantitativa: Una revisión sistemática. Brain localization and electrical activity of abstract reasoning using quantitative electroencephalography: A systematic review
SummaryAbstract reasoning is the ability to process and solve tasks by means of cognitive tools, based on analysis, synthesis, pattern recognition, among others, being classified as a characteristic of human intelligence. From neuropsychology it is important to know studies that have determined through neuroimaging techniques the location of the functional architecture of this cognitive ability. Therefore, the aim of this study is to identify brain areas and electrical activity using electroencephalography from abstract reasoning tasks.
Through a systematic literature review based on the criteria of the PRISMA methodology, the academic databases PubMed, Sciencedirect, Scopus, Hinari, Dialnet, EBSCOhost were examined. The studies included in the review consist of articles from studies reviewed and published in the period 2016 to 2021. Ninety-six preliminary articles were identified, from which 16 studies were selected following the research inclusion and exclusion criteria. The results show that by performing different abstract reasoning tasks, synchronous neuronal interactions in the Theta-Alpha frequency range with main activation in frontal and parietal areas are observed by means of electroencephalography.
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Abordaje prequirúrgico en epilepsia de difícil control. Presurgical approach in drug-resistant epilepsy
SummaryEpilepsy is one of the main reasons for consultation in general neurology. It is a highly prevalent pathology, with a high impact on the quality of life of these patients. There is a percentage of drug resistance between 30% and 40% of epilepsy cases, and therefore it is very important to know the surgical alternative, as well as the importance of a timely and prompt referral to a specialized surgery center of epilepsy given the high possibility of seizure remission or improvement towards less disabling seizures, with a notable improvement in quality of life. The evaluation process of a patient with drug-resistant focal epilepsy who is a candidate for epilepsy surgery is based on a set of non-invasive diagnostic techniques. The evaluation process is based on the seizure locating semiology, an adequate protocol for the imaging study, electroencephalogram, and interictal and ictal video-monitoring, and neuropsychological evaluation in all cases, and in other functional studies such as computed tomography are necessary, ictal and interictal single-photon emission, positron emission tomography, and also invasive monitoring techniques, through which it is possible to proceed to surgery. A review of the literature is made.
