ABSTRACT
Metronidazole can cause adverse effects both in the central and peripheral nervous system. We report a 34-year-old female who presented a reversible cerebellar syndrome and peripheral neuropathy as an adverse effect associated with the use of metronidazole. Brain magnetic resonance imaging (MRI) showed hyperintense T2 and FLAIR bilateral symmetrical cerebellar lesions, without contrast enhancement or mass effect, isointense in diffusion-weighted imaging and hypointense in apparent diffusion coefficient sequences. Also, electrophysiological evaluation was consistent with axonal polyneuropathy. She had received metronidazole for a liver abscess during 49 days. After discontinuation of metronidazole, she had rapid regression of cerebellar symptoms and normalization of MRI, with subsequent disappearance of peripheral symptoms. The brain MRI, electromyography and nerve conduction studies performed at 35 months later showed complete resolution of the lesions. Although metronidazole neurotoxicity is a rare event, it must be borne in mind because the prognosis is usually favorable after stopping the drug.
Subject(s)
Adult , Female , Humans , Antiprotozoal Agents/adverse effects , Cerebellar Diseases/chemically induced , Metronidazole/adverse effects , Peripheral Nervous System Diseases/chemically induced , Liver Abscess/drug therapy , Magnetic Resonance ImagingABSTRACT
Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available
Subject(s)
Humans , Male , Adult , Subacute Sclerosing Panencephalitis/etiology , SSPE Virus/pathogenicity , Subacute Sclerosing Panencephalitis/diagnosis , Subacute Sclerosing Panencephalitis/drug therapy , SSPE Virus/drug effects , Inosine Pranobex/therapeutic use , Myoclonus/etiology , Myoclonus/drug therapy , Valproic Acid/therapeutic use , Magnetic Resonance SpectroscopyABSTRACT
Background: The high costs of adequate pharmacological treatment for Parkinson disease preclude the universal access of patients to this medication. Aim: To assess the accessibility to pharmacological treatment of Chilean patients with Parkinson disease. Patients and methods: An inquiry about socioeconomic stratification, medical controls, disease features and costs of pharmacological therapy, was applied to 95 patients (56 male, aged 32 to 89 years old) attending the Chilean League Against Parkinson Disease. Results: Among studied patients, the disease had a mean duration of 7.9ñ6 years. There was a direct relationship between family income, the frequency of visits to physicians and the dose and cost of pharmacological therapy. Conclusions: The accessibility to pharmacological therapy among patients with Parkinson disease, depends on their socioeconomic level. Measures to correct this situation and improve the quality of life of these patients should be undertaken by health services
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Parkinson Disease/drug therapy , Parkinson Disease/epidemiology , Antiparkinson Agents/economics , Social Class , Levodopa/adverse effects , Drug Costs/statistics & numerical data , Cost of Illness , Income , Socioeconomic SurveyABSTRACT
The features of refractory epilepsies and the role of functional surgery and new antiepileptic drugs is reviewed. Among the latter, gabapentin, a drug with peculiar pharmacokinetic properties, is highlighted as a therapeutic alternative in refractory epilepsies and eventually for epileptic patients without previous treatment. A new type of relationship between the pharmaceutical industry and physicians, that privileges clinical research is discussed
Subject(s)
Humans , Epilepsy/drug therapy , Anticonvulsants/pharmacology , Drug Interactions/physiology , Epilepsy/surgery , gamma-Aminobutyric Acid/analogs & derivativesSubject(s)
Humans , Epilepsy/diagnosis , Anticonvulsants/administration & dosage , Diagnosis, Differential , Electroencephalography/methods , Epilepsy, Tonic-Clonic/diagnosis , Epilepsies, Partial/diagnosis , Epilepsy, Absence/diagnosis , Epilepsy, Generalized/diagnosis , Epilepsy/drug therapy , Epilepsy/physiopathologySubject(s)
Humans , Male , Female , Adult , Epilepsy/diagnosis , Anticonvulsants/administration & dosage , Diagnosis, Differential , Electroencephalography , Epilepsy, Tonic-Clonic/diagnosis , Epilepsies, Partial/diagnosis , Epilepsy, Absence/diagnosis , Epilepsy, Generalized/diagnosis , Epilepsy/therapy , Status Epilepticus/diagnosis , Phenytoin/pharmacokinetics , Seizures, Febrile/diagnosis , Seizures/diagnosis , Syncope/diagnosisSubject(s)
Adult , Humans , Female , Thrombosis , Cerebrovascular Disorders , Coronary Disease , Hypertension , Skin ManifestationsABSTRACT
Se revisan las características farmacológicas clínicas de la Carbamazepina y se hace hincapié en las dificultades de índole práctica que ocasiona el uso de este fármaco antiepiléptico