ABSTRACT
Hospitalized adult patients frequently have sleep complaints. The majority of studies have principally focused in ICU patients. However, many medical and surgical disorders can disrupt the normal sleep architecture. Sleep disorders in hospitalized patients are susceptible to be successfully treated with hypnotics and control of ambient factors. We reviewed papers published in the Medline between 1997 2012, those considered relevant are be discussed in this review.
Subject(s)
Humans , Male , Female , Adult , Inpatients , Sleep Apnea Syndromes , Sleep Disorders, Circadian Rhythm , Sleep Initiation and Maintenance Disorders , Sleep-Wake Transition Disorders , Sleep Wake Disorders/classification , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/prevention & control , Sleep Wake Disorders/therapyABSTRACT
Background: Celiac disease (CD) is predominant in women and young people. Atypical, non-enteric symptoms are more common among adults. There is also an association between CD and neurological disorders, especially with cerebellar ataxia, polyneuropathy and epilepsy. Aim: To study the frequency of CD in a group of adults with cryptogenic epilepsy. Material and Methods: Twenty one patients with cryptogenic epilepsy, aged 20 to 65years (14 women) were studied, measuring IgA-anti transglutaminase antibodies and deamidated gliadin peptide (DGP) IgG and IgA antibodies. Results: One patient had elevated titers of both types of antibodies. Small bowel biopsy showed villous atrophy and lymphocytic infiltration compatible with CD. Conclusions: One of 21 adult patients with cryptogenic epilepsy had a silent CD.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Anti-Idiotypic/blood , Celiac Disease/diagnosis , Epilepsy/complications , Gliadin/immunology , Transglutaminases/immunology , Celiac Disease/complications , Celiac Disease/immunology , Gliadin/blood , Immunoglobulin A/blood , Immunoglobulin A/immunology , Immunoglobulin G/blood , Immunoglobulin G/immunology , Transglutaminases/bloodABSTRACT
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
Episodic hypersomnia, compulsive excessive eating and erotic behaviour, with schizophreniclike mental symptoms are the hallmarks of the rare KleineLevin syndrome. Many patients may not necessarily fulfill minimum criteria described for diagnosis. We report a 19 years young man with incomplete presentation the KleineLevin syndrome and briefly reviewed the most relevantaspects of this disorder, its epidemiology, clinical symptoms and complementary diagnostic examinations. Known therapeutic options and prognosis are also discussed.
Subject(s)
Humans , Male , Adult , Disorders of Excessive Somnolence , Kleine-Levin Syndrome , Sleep Disorders, IntrinsicABSTRACT
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
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 , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Cerebrovascular Disorders/diagnosis , Emergency Service, Hospital , Prognosis , Aged, 80 and over , Case-Control Studies , Cerebrovascular Disorders/drug therapy , Cerebrovascular Disorders/epidemiology , Retrospective Studies , Diagnosis-Related GroupsABSTRACT
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