Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

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Estatus epiléptico no convulsivo por Lupus Eritematoso Sistémico y Síndrome Antifosfolípido. Non convulsive status epilepticus due to Systemic Lupus Erythematosus and Anti- phospholipid syndrome

Summary

Systemic Lupus Erythematosus is a chronic disease, with the presence of autoantibodies and lymphocyte hyperactivity. The presence of antiphospholipid antibodies is associated with seizures and vasculocerebral disease. We present the case of a patient with atypical absence seizures and mild cognitive impairment.


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Instrumentos que evalúan la inteligencia emocional en estudiantes universitarios: Una revisión sistemática. Instruments that assess emotional intelligence in college students: A systematic review

Summary

Objective: To identify the studies that have applied Emotional Intelligence instruments in university students in the last 20 years (2001 to 2020).

Methodology: A desk study (systematic review) was carried out. The selection of primary studies was carried out in the Scopus and Scielo databases. The range of years systematized was from 2001 to 2020. The studies are published in English, Spanish, Portuguese and French. The keywords in English were used: Instruments, emotion intelligence, evaluation; in Spanish: instruments, emotional intelligence, evaluation. The observation technique was used to record the information, and the instrument was an observation record.

Results: 75% (n = 12) of the primary studies were published in English, 18.8% (n = 3) in Spanish and 6% (n = 1) in French. Also, it is highlighted that 81.3% (n = 13) of the articles were published in the Scopus database, 18.8% (n = 3) in the Scielo database. The highest number of publications were in the last 5 years (62.5%, n = 10). The instruments that were used to evaluate EI were MSCEIT, Bar-On and TMMS.

Conclusion: It was verified that the Emotional Intelligence (EI) instruments that were most applied to university students were the MSCEIT, the Bar-On and TMMS, in addition, the studies from 2001 to 2020 were gradually increasing. The results suggest the use and application of these instruments for samples of young university students.


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Un año después. A year later

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Demencia en Tiempos de COVID-19. Dementia in the time of COVID-19

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Riesgos Para el Desarrollo Neuropsicofisiológico de los Adolescentes: Impacto de la Pandemia por COVID-19. Risks For The Neuropsychophysiological Development Of Adolescents: Impact Of The COVID-19 Pandemic

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Síndrome de Down y COVID-19: Una Breve Perspectiva. Down Syndrome And COVID-19: A Brief Perspective

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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

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Alternativas Para Navegar Hasta Que se Calme el Mar. Alternatives To Sailing Until The Sea Calms Down

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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

Summary

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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Encefalopatía Hipóxico-Isquémica Por Anfetaminas. Hypoxic-Ischemic Encephalopathy Due To Amphetamines

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Calcificaciones en Ganglios de la Base en un Caso de Hipoparatiroidismo Primario. Basal Ganglia Calcification In A Case Of Primary Hypoparathyroidism

Summary

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

Summary

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

Summary

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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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

Summary

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.


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Síndrome de Joubert Asociado a Apnea Central del Sueño en un Adulto de Colombia. Joubert Syndrome Associated With Central Sleep Apnea In An Adult From Colombia

Summary

Introduction: The Joubert syndrome is an autosomal recessive disorder, classified as a ciliopathy. The primary cilia have a role in neuronal proliferation and axonal migration in the cerebellum and brainstem. Marie Joubert and colleagues in 1969 pu- blished four cases with partial or total agenesis of the cerebellar vermis and apnea-hyperpnea neonatal episodic disorder. From an early age the principal manifestations are: abnormal breathing pattern, nystagmus, swallowing alterations, hypotonia, ataxia and intellectual disability. Classically, the neonatal breathing disorder improve with age.

Clinical case: A 39 years old, with intellectual disability and a history of a movement disorder involving a lower extremity, snoring, episodes of central apnea, hypotonia and nystagmus. He was the second child, with an uncomplicated, full-term gestation. In the clinical exam was found dysarthria, short term and semanticmemory loss, Epworth scale: 9/24. Brain magnetic resonance imaging (MRI) showed cerebellar vermis hypoplasia and elongation of the hemispheres as the “molar tooth sign.” Moreover, a polysomnography study found a central sleep apnea disorder.

Discussion: It is fundamental to recognize this syndrome to establish a prenatal or an early age diagnosis, for a multidisciplinary approach and an early genetic counseling. The treatment of the sleep disorder in these patients is crucial for a better quality of life.


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Cómo Reconocer el Meningioma Intraóseo: Etiología y Hallazgos por Imagen. How To Recognize Intraosseous Meningioma: Etiology And Imaging Findings

Summary

Meningiomas are the most common primary brain tumors. Primary intraosseous meningioma is a rare extradural meningioma subtype. They are usually asymptomatic but may cause proptosis or neurological symptoms depending on size and location. The most common finding in imaging tests is hyperostosis although a lytic or even mixed pattern can also be observed, so it should be considered in the differential diagnosis of cranial sclerotic bone tumors. Although most are benign, they are more likely to develop malignancy than intradural meningiomas. Imaging techniques (CT and MRI) are very useful in preoperative diagnosis and evaluation of adjacent anatomical structures. Surgical resection followed by cranial reconstruction is the treatment of choice.


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Razonamiento Clínico: Mujer de 38 Años de Edad en Puerperio Alejado con Debilidad Muscular en Hemicara Derecha. Clinical Reasoning: 38-Year-Old Woman In Remote Puerperium With Weakness In Right Side Of The Face

Summary

A case of 38-year-old woman is presented with muscular weakness in right side of the face during her remote puerperium. We reviewed the history, physical examination, and analyze the differential diagnosis, etiology and the final diagnosis.


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Tuberculosis Meníngea en un Paciente Pediátrico: Reporte de un Caso Clínico. Meningeal Tuberculosis In A Pediatric Patient: A Case Report

Summary

Tuberculosis is a global public health problem. In pediatric ages it represents between 3% and 40% of the total disea- se. In countries with high incidence, such as Ecuador, the presence of cases of childhood tuberculosis always indicates the circulation of Mycobacterium tuberculosis or contact with an untreated patient or undiagnosed. In our country there is a high percentage of underdiagnosis of childhood tuberculosis and a lower burden than expected, mainly in children under 5 years of age. Meningeal tuberculosis is the most serious form of presentation of infection by M. tuberculosis in pediatric age since it causes many deaths and disability. The diagnosis of tuberculous meningitis is achieved considering epidemiological criteria, laboratory studies in blood, cerebrospinal fluid, and neuroimaging. Early treatment improves the prognosis, but the problem lies in making an early diagnosis, since it has different forms of clinical presentation ranging from nonspecific symptoms to severe neurological involvement.


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