Sme de Miller Fisher: Presentación de un caso y revisión de la literatura / Syndrome by Miller Fisher: Presentation of a case and review of the literature

Introducción : El síndrome de Gullain Barre (SGB) constituye un grupo de polirradiculoneuropatías auto inmunes, que pueden dividirse en carios patrones de acuerdo al modo predominante de lesión nerviosa y a la fibra nerviosa involucrada: desmielinizante, axonal, motora pura, motor, sensorial, síndrome de Miller Fisher y variante bulbar. Objetivo: Presentar el caso de una paciente con Sindrome de Miller Fisher con daño axonal primario y realizar una revisión de la literatura . Presentación del caso: Paciente de 59 años que desarrollo de forma aguda diplopia, ataxia, disfagia, voz nasal y parestesias en miembros superiores; agregando posteriormente debilidad muscular arrefléxica, oftalmoplejía, y paresia facial izquierda. no requirió asistencia respiratoria mecánica . El análisis del líquido cefalorraquideo (LCR) confirmo la disociación albuminocitológica y el electromiograma evidencio daño axonal primario. Fue tratado con inmunoglobulina intravenosa durante 5 días con buena evolución clínica..(AU)

Introduction: Gullain Barre syndrome (GBS) is a group of autoimmune polyradiculoneuropathies, which can be divided into different patterns according to the predominant mode of nerve injury and the nerve fiber involved: demyelinating, axonal, pure motor, sensory, syndrome of Miller Fisher and bulbar variant. Objective: To present the case of a patient with Miller Fisher syndrome with primary axonal damage and to carry out a review of the literature. Case presentation: A 59-year-old patient who developed acute diplopia, ataxia, dysphagia, nasal voice and paresthesias in upper limbs; subsequently adding arreflexic muscle weakness, ophthalmoplegia, and left facial paresis. did not require mechanical ventilation. Cerebrospinal fluid (CSF) analysis confirmed the albuminocytological dissociation and the electromyogram showed primary axonal damage. He was treated with intravenous immunoglobulin for 5 days with good clinical evolution ..

Persistence and vulnerability: retaining biodiversity in the landscape and in protected areas.

An objective of biodiversity conservation activities is to minimize the exposure of biodiversity features to threatening processes and to ensure, as far as possible, that biodiversity persists in the landscape. We discuss how issues of vulnerability and persistence can and should be addressed at all stages of the conservation planning and implementation process. Procedures for estimating the likelihood of persistence and for measuring degrees of vulnerability at different spatial and temporal scales using subjective assessments, rules of thumb and analytical and simulation models are reviewed. The application of information on vulnerability and persistence to conservation planning and management is discussed under the headings of natural dynamics, replication of protection, levels of representation, source and sink population structures, refuges and critical resources, reserve design, habitat fragmentation and levels of management.