ABSTRACT
La causa más frecuente de complicaciones visuales enel postoperatorio de cirugía no oftalmológica es la neuropatía óptica isquémica. La incidencia es variabledependiendo de las series publicadas, en la mayoría deellas, la cirugía de raquis realizada en decúbito pronoaparece implicada.Exponemos el caso de una mujer de 47 años que trasuna artrodesis lumbar, con unas pérdidas hemáticas deunos 900 mL, desarrolló una ceguera prácticamentetotal en el ojo izquierdo. En el examen oftalmológicorealizado, fondo de ojo, angiofluoresceingrafía, campimetría y potenciales evocados visuales se diagnosticó una neuropatía óptica retrolaminar, que evolucionó desfavorablemente
Ischemic optic neuropathy is the most common cause ofvisual complications after non-ophthalmic surgery. Theincidence has varied in different case series, but prone-position spine surgery appears to be involved in most of the reports.We present the case of a 47-year-old woman whodeveloped near total blindness in the left eye followinglumbar spine fusion surgery involving the loss of 900 mLof blood. An ophthalmic examination including inspectionof the ocular fundus, fluorescein angiography, and visualevoked potentials returned a diagnosis of retrolaminaroptic neuropathy. Outcome was poor (AU)
Subject(s)
Humans , Female , Arthrodesis/adverse effects , Optic Neuropathy, Ischemic/etiology , Blindness/etiology , Postoperative Complications , Evoked Potentials, Visual , Fluorescein Angiography , Fundus OculiABSTRACT
Ischemic optic neuropathy is the most common cause of visual complications after non-ophthalmic surgery. The incidence has varied in different case series, but prone-position spine surgery appears to be involved in most of the reports. We present the case of a 47-year-old woman who developed near total blindness in the left eye following lumbar spine fusion surgery involving the loss of 900 mL of blood. An ophthalmic examination including inspection of the ocular fundus, fluorescein angiography, and visual evoked potentials returned a diagnosis of retrolaminar optic neuropathy. Outcome was poor.
Subject(s)
Optic Neuropathy, Ischemic/etiology , Postoperative Complications/etiology , Prone Position , Spinal Fusion , Evoked Potentials, Visual , Female , Humans , Lumbar Vertebrae/surgery , Middle Aged , Obesity/complications , Risk Factors , Vision, Low/etiology , Visual Acuity , Visual FieldsABSTRACT
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Subject(s)
Male , Adult , Humans , Anesthesia, Inhalation/adverse effects , Paraparesis/etiology , Nitrous Oxide/adverse effects , Vitamin B 12 Deficiency/bloodABSTRACT
INTRODUCTION: Migraine is a frequent and disabling pathological condition with important socioeconomic repercussions. Recent studies have explored the use of antiepileptic drugs in the prophylactic treatment of migraine. Preliminary studies have shown that gabapentin is a drug that is effective and well tolerated by patients. AIM. To evaluate the effectiveness and safety of gabapentin in the prophylactic treatment of migraine. PATIENTS AND METHODS: A prospective, open, multicentre, random clinical study, carried out according to IHS criteria, which compares the effectiveness and safety of gabapentin in 1,200 mg/day and 2,000 mg/day doses as a preventive treatment for migraine over a 16 week period. RESULTS: Significant differences were found in patients treated with gabapentin, as compared with their basal state, in the following: a lower number of attacks (reduction in weeks 4, 10 and 16: 2.4 2.8, 2.9 2.9 and 3.1 2.9 attacks/month on a basal rate of 5.3 3.5 attacks/month), lower intensity (on a scale of 0 3 of increasing pain intensity: basal rate: 2.7 0.4, week 4: 1.8 0.9, week 10: 1.7 0.9, week 16: 1.4 1.0) and how long the pain lasts (basal rate 390 hours/month, week 4: 180 hours/month, week 10: 180 hours/month, week 16: 120 hours/month). No statistically significant differences were found between doses of 1,200 or 2,000 mg/day. Mild adverse effects were seen in 62 patients (37.8%): drowsiness (22.6%), asthenia (7.9%), dizziness (4.9%), abdominal pain (3.7%) and dazedness (3.7%). No serious adverse events occurred. CONCLUSIONS: Gabapentin can be considered an effective and safe drug in the preventive treatment of migraine.
Subject(s)
Acetates/therapeutic use , Amines , Calcium Channel Blockers/therapeutic use , Cyclohexanecarboxylic Acids , Migraine Disorders/prevention & control , gamma-Aminobutyric Acid , Adult , Female , Gabapentin , Humans , Male , Prospective StudiesABSTRACT
Introducción. La migraña es una patología frecuente e incapacitante con grandes repercusiones socioeconómicas. Recientemente se estudia el uso de fármacos antiepilépticos en la profilaxis de la migraña. Estudios preliminares han demostrado que la gabapentina es un fármaco efectivo y bien tolerado por los pacientes. Objetivo. Evaluar la eficacia y la seguridad de la gabapentina en la profilaxis de la migraña. Pacientes y métodos. Estudio clínico prospectivo, abierto, multicéntrico y aleatorio, con 164 pacientes migrañosos, según criterios de la IHS, que compara la eficacia y seguridad de gabapentina en dosis de 1.200 mg/día y 2.000 mg/día, como tratamiento preventivo de la migraña, durante 16 semanas. Resultados. Se encontraron diferencias significativas en los pacientes tratados con gabapentina, respecto a su estado basal, en: reducción del número de crisis (reducción en las semanas 4, 10 y 16: -2,4ñ2,8, -2,9ñ2,9 y -3,1ñ2,9 crisis/mes sobre un basal de 5,3ñ3,5 crisis/mes), disminución de la intensidad (sobre una escala 0-3 de intensidad ascendente de dolor: puntuación basal: 2,7ñ0,4, semana 4: 1,8ñ0,9, semana 10: 1,7ñ0,9, semana 16: 1,4ñ1,0) y de la duración de dolor (basal de 390 horas/mes, semana 4: 180 horas/mes, semana 10: 180 horas/mes, semana 16: 120 horas/mes). No se encontraron diferencias estadísticamente significativas entre dosis de 1.200 o 2.000 mg/día. Se registraron efectos adversos de carácter leve en 62 pacientes (37,8 por ciento): somnolencia (22,6 por ciento), astenia (7,9 por ciento), mareo (4,9 por ciento), dolor abdominal (3,7 por ciento) y aturdimiento (3,7 por ciento). No hubo ningún acontecimiento adverso grave. Conclusiones. La gabapentina puede considerarse un fármaco eficaz y seguro en la profilaxis de la migraña (AU)
