ABSTRACT
The current concept of Parkinsons disease comprises a group of non-motor symptoms: neuropsychiatric disorders, sleep disturbances and dysautonomia, among others. Orthostatic hypotension is a frequent problem that impairs the patients quality of life. We review the symptoms of this disorder, its pathogeny and the available diagnostic tools. We emphasize the early suspicion and show the treatment options, based on the available evidence and our experience.
Subject(s)
Humans , Male , Aged , Parkinson Disease/complications , Hypotension, OrthostaticABSTRACT
Introduction: Essential tremor is commonly considered as a benign and high prevalence disease; however its study is not systematized even in its definition. Methods: We did a literature review related to essential tremor enhanced with our own experience in this matter. Results: We performed a critical review of different issues of essential tremor from definition to association to others neurological diseases. We focused on controversial points and lesser known issues by a non specialist physician. Discussion: We analyzed the complexity of this disease, its association with other neurological diseases, in particular Parkinson disease and cognitive decline. We proposed different variants ofessential tremor according prognosis. Conclusion: Essential tremor is a heterogeneous disease from clinical and etiological point of view. There are variants with different long term outcome.
Introducción: El temblor esencial es habitualmente considerado una patología benigna y de alta prevalencia, sin embargo su estudio ha sido poco sistematizado, aún en la misma definición del cuadro. Método: Se realiza una revisión de la literatura, enriquecida con la propia experiencia de los autores en el tema. Resultados: Se analizan de manera crítica diversos tópicos relacionados con temblor esencial, desde su definición hasta la asociación con otras patologías neurológicas, haciendo hincapié en puntos de mayor controversia y poco conocidos por el médico no especializado en el tema. Discusión: Se analiza la complejidad del cuadro, su asociación con una serie de patologías neurológicas, en particular enfermedad de Parkinson y deterioro cognitivo, proponiéndose variantes de temblor esencial de acuerdo a su pronóstico. Conclusión: El temblor esencial es un cuadro heterogéneo tanto clínicamente como desde una perspectiva etiológica. Existen variantes con distinto pronóstico a largo plazo.
Subject(s)
Humans , Essential Tremor/diagnosis , Diagnosis, Differential , Parkinson Disease/diagnosis , Prognosis , Essential Tremor/genetics , Essential Tremor/pathology , Essential Tremor/therapy , Cognition Disorders/diagnosisABSTRACT
Background: Front temporal dementias (FTD) are neurodegenerative disorders characterized by alterations in behavior, affection and language, with relative sparing of episodic memory. There are three major forms of FTD: the frontal or behavioral form, progressive non-fluent aphasia and semantic dementia (that may begin as a fluent progressive aphasia). Aim: To report a retrospective clinical experience of patients with frontotemporal dementia. Material and methods: Review of 3,700 records of neuropsychological assessments of patients with behavioral disturbances, studied between 1981 and 2008. Of these, 63 patients (59 percent females) complied with the criteria for frontotemporal dementia. Results: There were 47 cases with the frontal variant, four with non-fluent progressive aphasia and six with fluent progressive aphasias (2 evolved to semantic dementia). The mean age of onset was 60±11 years. There were no familiar cases of FTD. Conclusions: It is clinically difficult to diagnose FTD, since evaluation of attitude or language is required. In addition to structural images, functional images were helpful in some cases, but the definitive diagnosis is anatomical.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Frontotemporal Dementia/diagnosis , Chile/epidemiology , Frontotemporal Dementia/classification , Frontotemporal Dementia/epidemiology , Retrospective StudiesABSTRACT
Aim. To assess the efficiency of topiramate (TPM), an antiepileptic medication which possesses multiple mechanisms of action, a wide therapeutic spectrum and good pharmacokinetics in the management of status epilepticus (SE), especially in refractory. Several reports have shown that TPM presents different efficacy in the management of different types of refractory status epilepticus, both adults and children. Also present our experience with two patients with SE who responded early without TPM oral complications. Conclusions. TPM oral as drug associated, is an antiepileptic medication that has shown therapeuticefficacy in cases reports and observational studies the management SE of different types and nature. This efficacy has not been contrasted with randomized controlled trials and prospective studies, therefore, future studies with larger numbers of patients are needed to confirm published reports.
Subject(s)
Humans , Male , Middle Aged , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Anticonvulsants/pharmacokinetics , Epilepsy , Status EpilepticusABSTRACT
La atención primaria es muy importante en la salud del país, pero no está exenta de falencias. Con el objetivo de priorizar y prevenir los principales problemas de salud que aquejan a nuestra población, se cuantificaron y clasificaron los diagnósticos formulados por los médicos del Centro de Salud de Dalcahue, en los meses de marzo y abril de 2007, agrupándolos de acuerdo a la Clasificación Internacional de Enfermedades y otros problemas de salud. La revisión de 2.146 casos demuestra que los problemas de salud más frecuentes en nuestro medio son los respiratorios (27 por ciento) y los digestivos (8,8 por ciento). También hallamos una cantidad de síntomas no clasificables, lo que es explicado y analizado en nuestro trabajo.