Mielinolisis central pontina e hiponatremia, un problema no resuelto: caso clínico / Central pontine myelinolysis and hyponatremia: report of 1 case

There is a controversy wheter central pontine myelinolysis can complicate either hyponatremia or its rapid correction. We report a 69 years old woman with a history of one month of vertigo, nausea, vomiting and diarrhea. She was admitted dehydrated ad stuporous, and initial laboratory values showed a serum sodium of 96 mEq/L She was treated with dextrose 5 percent and 3 percent NaCI. Serum sodium raised to 120 mEq/L at the next day and the level of consciousness improved. At the 4th day of admission, the patient was again stuporous and with spastic quadriplegia. A magnetic resonance imaging showed a central and symmetrical pontine lesion on T1 and T2 weighed images. Thereafter, the patient experienced a progressive improvement of her neurological condition and was discharged three months later, moving her lower limbs. Nine month later she was able to walk

Trastorno conductual del sueño REM en dos casos documentados con polisomnogragía / REM sleep behavior disorder: report of two cases

We report a 69 years old male with a parkinsonian syndrome and a 50 years old female without neurological problems who showed violent behavior during REM sleep. Polysomnography showed that both had tonic or phasic muscular activity during REM sleep and a REM sleep behavior disorder was diagnosed. Clonazepam was used in both, with good clinical response. This condition is frequently unrecognized and confused with nightmares, nocturnal delirium or other parasomnias

Evolución electroclínica del status convulsivo secundariamente generalizado prolongado / Electroclinical evolution of prolonged secondarily generalized convulsive status epilepticus

El status convulsivo secundariamente generalizado (SCSG) es la más común de las formas de status epiléptico (SE), a la vez que el más peligroso ya que con mayor frecuencia es causa de secuelas neurológicas y muerte, si no se trata adecuadamente. SCSG es un estado dinámico, las manifestaciones clínicas y electroencefalográficas varían en el tiempo si las convulsiones persisten al fracasar el tratamiento. Existe una progresión de status manifiesto a status sutil en el SCSG, y de acuerdo a reportes previos tambien existe una progresión o secuencia en la actividad eléctrica en los casos de evolución prolongada. Para verificar lo anterior analizamos las variaciones clínicas y electromagnéticas de cinco pacientes que cumplían criterios de SCSG. En ellos efectivamente pudimos confirmar la mayoría de los cambios o patrones descritos en otras publicaciones. Sin embargo no identificamos ninguna progresión o secuencia definida en estos patrones