Subject(s)
Leg/physiology , Reflex , History, 20th Century , Humans , Infant, Newborn , Neurology/historyABSTRACT
No disponible
Subject(s)
Humans , History, 20th Century , Neurocognitive Disorders/etiology , Neurocognitive Disorders/history , Encephalitis/complications , Encephalitis/history , Syndrome , SpainSubject(s)
Neurology , Philosophy, Medical , Diagnosis, Differential , History, 20th Century , Humans , Psychosomatic MedicineABSTRACT
No disponible
Subject(s)
Animals , Humans , History, 19th Century , History, 20th Century , Neuralgia , Central Nervous System/anatomy & histology , Central Nervous System/physiology , Hyperalgesia , Peripheral Nervous System/anatomy & histology , Peripheral Nervous System/physiologyABSTRACT
No disponible
Subject(s)
Humans , Cerebral Cortex/physiopathology , Neurology/history , Attitude of Health Personnel , Neurophysiology/history , Parietal Lobe/physiopathology , Spain , Vision Disorders/etiology , Vision Disorders/history , Vision Disorders/physiopathology , Visual Cortex/physiopathology , Visual Pathways/physiopathology , Brain MappingABSTRACT
DEVELOPMENT: In this paper, we briefly review the characteristics of the how the human psychobiological unit progresses in the early ages. The pre-eminence of the affective axis is underlined, the shades of narcissism, egocentrism and pseudo-omnipotence present in such early stages are highlighted, and emphasis is placed on how the morbid persistence of such shades throughout adult life can distort the subject's evaluations. This is more specifically so if they badly taint the subject's image of God. The author briefly analyzes the organic stratum underlying emotional affective life and discusses the relationships of the joint integration between the brain and the visceral world. The study also includes contributions by leading Spanish thinkers about the serene conception of the omnipotence of God and finishes by comparing the complexity of the brain with the interaction of the galaxies in the universe. CONCLUSIONS: The paper describes the psychobiological structure of the human personality, from its most archaic and childish positions, steeped in egocentrism and pseudo-omnipotence, and points out how they extend into adulthood. The frequency and the risk of projections of God (not abstract, not 'all-embracing') are also stressed, and the most up to date and serene theology is followed. It is pointed out that the complexity of the brain is greater than that of a system of galaxies.
Subject(s)
Christianity , Terminology as Topic , Theology , Humans , NeurologyABSTRACT
Introducción. Se pretende exponer el valor de la historia y del examen clínico en la orientación diagnóstica de una probable esclerosis múltiple (EM). Caso clínico. Se aporta el estudio de una mujer de 42 años que en el curso de los últimos 10 años ha presentado tres episodios de parestesias, tipo hormigueos, en la extremidad inferior izquierda y algunas otras zonas del mismo hemicuerpo, nunca en el cuello ni en la cabeza, así como fatigabilidad. El examen clínico ambulatorio pone de manifiesto un síndrome de afectación de los segmentos altos de la médula espinal, lateralizado en gran parte a derecha, que dibuja un cuadro de Brown-Séquard, bien notoriamente imperfecto: exaltación de los reflejos musculares clínicos -o profundos-, el más elevado de los cuales era el deltoideo derecho (C5), signo de Babinski bilateral en abanico, Barré de la pierna positivo a derecha, hormigueos con disestesia a izquierda sin nivel preciso. Rendimiento funcional bien conservado comparativamente a la signología. Se orienta clínicamente el caso como una probable EM `monotópica'. Una RM espinal confirma esta impresión clínica. Conclusiones. Se resalta el valor del estudio clínico cuidadoso dirigido al diagnóstico de EM probable. Se resalta el valor de la disociación signología grave frente al rendimiento funcional desproporcionadamente bien conservado, así como la originalidad de la presencia de un signo del abanico bilateral como apoyo de una EM, tratándose de un proceso de la edad adulta (AU)
Subject(s)
Adult , Female , Humans , Reflex, Babinski , Spinal Cord , Multiple SclerosisABSTRACT
Starting from Babinski's original description, the author carries out a revision of semeiological value of the sign "fanning of the toes". It is considered that there are two clinical variants. The first, present in most cases of connatal encephalopathy, is due to involvement of the premotor area, which is usually accompanied by pyramidal, dystonic or athetoid signs. The second variant is present in cases of multiple sclerosis presumably attributable to involvement of the lateral spinal tracts including the reticulospinal one. The author proposes the need of using modern neuroimaging and electrophysiological techniques for further pathophysiological investigation of both clinical variants of the sign.
Subject(s)
Brain Diseases/physiopathology , Motor Cortex/physiopathology , Reflex, Babinski , Efferent Pathways/physiopathology , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Infant , Infant, Newborn , Multiple Sclerosis/physiopathology , Reflex, Babinski/historyABSTRACT
Partiendo de la descripción por Babinski del fenómeno de la abduction des orteils, el autor procura precisar el valor semiológico del "signo del abanico", en el que tal abducción acompaña a una extensión (flexión dorsal) del dedo gordo. Sugiere considerar dos variantes clinicofisiopatológicas de este signo: 1. Una presente en muchos casos de encefalopatía infantil de instauración connatal o prenatal, con compromiso del área premotora o de sus proyecciones, con la adjunción al síndrome piramidal de rasgos distonicoatetósicos -siquiera mínimos- de índole extrapiramidal.2. Otra, mucho menos frecuente, de aparición en el adulto, casi privativa de algunos casos de esclerosis múltiple, atribuible a la afección difusa de los cordones espinales, incluyendo el compromiso del haz reticuloespinal dorsal, con intensa liberación de los reflejos de defensa.El autor señala la oportunidad de aplicar las metodologías exploratorias actuales a la investigación de tales hipótesis clinicofisiopatológicas (AU)
Subject(s)
Infant , Infant, Newborn , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Reflex, Babinski , Multiple Sclerosis , Motor Cortex , Efferent Pathways , Brain DiseasesABSTRACT
INTRODUCTION: We wish to discuss the value of the clinical history and examination in orientation of the diagnosis of probable multiple sclerosis (MS). CLINICAL CASE: We report the two year study of a woman who over the previous ten years had had three episodes of paraesthesia, with pins and needles in her left leg and other parts of the left side of her body, although never affecting head or neck. She also complained of tiring more than usual. In an outpatient clinic she was found to have a syndrome affecting the upper segments of the spinal cord, mainly involving the right side and resembling an incomplete Brown Sequard type syndrome. There were increased clinical muscle and deep reflexes. The most marked was that of the right deltoid (C5), bilateral fanning of the toes when the Babinski reflex was tested, Barré positive in the right leg, pins and needles and dysaesthesia on the left to an undetermined level. Function was well preserved when compared with the clinical signs found. The case was considered to be of monotopical MS. Spinal magnetic resonance findings confirmed the clinical diagnosis. CONCLUSIONS: We emphasise the value of careful clinical investigation directed towards the diagnosis of probable MS. We draw attention to the diagnostic value of the dissociation between the severe clinical alterations and the functional performance, which was surprisingly well maintained. Also we report the originality of the presence of bilateral fanning sign supporting the diagnosis of MS, occurring in a disease of adult life.
Subject(s)
Multiple Sclerosis/diagnosis , Reflex, Babinski , Spinal Cord/pathology , Adult , Female , Humans , Multiple Sclerosis/physiopathologyABSTRACT
OBJECTIVE: To describe the current basic functional neuroanatomy of the frontal lobes and complex cognitive processes associated with this wide brain zone. DEVELOPMENT: We reviewed recent studies with neurofunctional interest. We structured the frontal zones and the cognitive functions more specifically humans, named 'executive functions'. We classified the frontal syndrome into more specific syndromes; and, we reviewed the fronto-cortical and subcortical connections, which are the basis of the frontal zones and functions. CONCLUSIONS: The frontal lobe is not a single anatomical and functional brain region. Regions and fronto-cortical and subcortical circuits within the frontal lobe are associated with motor functions and cognitive processes highly specialized, which may be differently affected.
Subject(s)
Cognition/physiology , Frontal Lobe/physiology , Frontal Lobe/anatomy & histology , Humans , Nerve Net/physiology , Prefrontal Cortex/anatomy & histology , Prefrontal Cortex/physiologyABSTRACT
BACKGROUND: Fasciculation, double discharge, myokymia and neuromyotonia are different kinds of involuntary muscular activity that originate in ectopic discharges of the motor axons. Electrophysiological studies are needed in all cases for the diagnosis. Non rigorous electrophysiological studies in some cases is the cause of the historically unclear nosological delimitation of the neuromyotonic syndromes. OBJECTIVE: To report the clinical picture and electrophysiological findings in patients with congenital neuromyotonia. PATIENTS AND METHODS: Four patients with congenital neuromyotonia were studied. Electrophysiological exam included nerve conduction measurements, study of the after-discharges and conventional EMG. Spontaneous discharges were displayed after applying a low pass filter, signal trigger and delay line. RESULTS: In one case positive motor features predominate (continuous muscle fiber activity). On the contrary, two cases, showed neuropathic deficitary signs with a Charcot-Marie-Tooth type II disease phenotype; neuromyotonia was, in both cases, an electrophysiological feature. In the last patient, motor signs were limited to the facial muscles but electrophysiological study discovered generalized neuromyotonia. Treatment with carbamazepine or oxcarbazepine was useful in the four cases. CONCLUSION: Congenital neuromyotonia is a clinically heterogeneous syndrome with uniform electrophysiological features that permit its qualification.
Subject(s)
Isaacs Syndrome/congenital , Adolescent , Adult , Female , Humans , Isaacs Syndrome/diagnosis , Isaacs Syndrome/drug therapy , Male , Middle Aged , Retrospective StudiesSubject(s)
Neurology/history , Neuropsychology/history , France , Frontal Lobe/physiology , History, 20th CenturyABSTRACT
INTRODUCTION: Déjerine and Roussy reported thalamic syndrome, chronic pain after a vascular lesion in the thalamus, in 1906. Posterior clinical observations allowed know that the same clinical picture can be observed after lesions in other parts of the central nervous system. Due to the fact that the more frequent etiology is vascular, nowadays the term central poststroke pain syndrome is preferred. CLINICAL CASE: We report a patient who suffered a left subinsular hematoma when he was 62 years old. Four years later he started complaining burning constant pain in the right side of the body with crisis of lancinating pain. Also allodynia was observed in the face and right arm. MRI disclosed a necrotic lesion at the level of the left subinsular region. CONCLUSIONS: The lancinating pain and the allodynia were properly controlled by deep brain stimulation with an electrode placed stereotactically at the level of VPL nucleus of the left thalamus. Five months later there was a recurrence of the pain, a CT disclosed a tumour in the parietal region with an important shift of the midline and migration of the electrode out the thalamus. A biopsy disclosed tumoral necrosis. The pathophysiology of the central poststroke pain and effectivity of the deep brain stimulation in this cases are discussed.
Subject(s)
Brain Neoplasms/complications , Brain Neoplasms/diagnosis , Hematoma/diagnosis , Hematoma/etiology , Intracranial Hemorrhages/diagnosis , Intracranial Hemorrhages/etiology , Occipital Lobe/diagnostic imaging , Occipital Lobe/pathology , Pain/diagnosis , Parietal Lobe/diagnostic imaging , Parietal Lobe/pathology , Ventral Thalamic Nuclei/diagnostic imaging , Ventral Thalamic Nuclei/pathology , Biopsy , Electric Stimulation/methods , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Necrosis , Pain/etiology , Radiography , Stereotaxic TechniquesABSTRACT
INTRODUCTION AND DEVELOPMENT: We review the current state of learning procedures in six neurological conditions: amnesia, Alzheimer-type dementia, Huntington's disease, Parkinson's disease, progressive supranuclear paralysis and cerebellar pathology. In each condition the conservation or deterioration of different types of ability is specified: motor and percepto-motor abilities were evaluated using different tests such as following a rotating disk or signal, the labyrinth test, percepto-motor adaptation test or tests using paradigms of time of serial reaction; percepto-cognitive abilities evaluated by 'mirror-reading' and cognitive abilities evaluated by the Tower of Hanoi, of Toronto, or of London. CONCLUSION: Most of the papers published describe conservation of learning procedures in amnesic syndromes, relatively conserved in Alzheimer's disease and relatively deteriorated in Huntington's disease, in progressive supranuclear paralysis and in cerebellar dysfunction.
