Guidance for clinical neurophysiology examination throughout the COVID-19 pandemic. Latin American chapter of the IFCN task force - COVID-19.

On 31st December 2019, China notified the World Health Organization of an outbreak of atypical pneumonia from patients at a local seafood market in Wuhan, Hubei, China, responsible for a new coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that caused COVID-19 disease, which spread rapidly around the world. WHO declared a state of pandemic (11th March, 2020), which has caused more than 1 million infected and more than 110,000 deaths; it was observed that up to 29% of those infected were health care personnel. The main route of transmission of SARS-CoV2 is through respiratory secretions and direct contact with contaminated surfaces and material. The pandemic induced an international saturation of health care services and a rupture in the supply chain of protective equipment for healthcare personnel, which poses a high occupational risk to all. Based on the different healthcare systems, human resources, infrastructure and medical emergencies that will warrant the conduct of clinical neurophysiology studies and the lack of a guide for the management of the situation, it was decided by an expert task force of the Latin American Chapter of the International Federation of Clinical Neurophysiology to carry out these guidelines for the protection of patient and healthcare professionals conducting clinical neurophysiological studies.

Cefalea crónica tipo tensión: una nueva experiencia de tratamiento / Chronic tension-type headache: a new treatment experience

Introducción: la cefalea tipo tensión es la forma más común de dolor de cabeza y su forma crónica una de lasmás difíciles de tratar, causa gran discapacidad a pacientes y representa enormes costos socioeconómicos, estárelacionada con factores de tensión emocional y muscular. Las propuestas terapéuticas con las que se cuentaincluyen AINE, fisioterapia, infiltraciones con toxina botulínica en músculos pericraneales.Objetivo: evaluar la efectividad en el tratamiento de la cefalea crónica tipo tensión con infiltración intramuscularcon betametasona, un esteroide de depósito más lidocaína al 1%, en puntos de tensión muscular aniveles suboccipital, paraespinales cervicales y trapecio, acompañados de fisioterapia y un proceso educativoa pacientes y familiares.Materiales y métodos: estudio retrospectivo, en el que se midió la efectividad del tratamiento utilizandola escala visual análoga (EVA). Los datos fueron analizados en el programa SPSS por medio de porcentajes,frecuencias y proporciones.Resultados: de un total de 138 casos de cefalea crónica diaria tipo tensión, con edad promedio 51 años, 76,8%sexo femenino, 21% se asocia a trastorno ansioso; 8,7% a sensación vertiginosa y 8,7% síntomas depresivos;8% insomnio; 78,2% de los pacientes refirieron mejoría con el tratamiento propuesto y de estos, 85,5% delos casos se cuantificaron según la EVA, 66,8% presentaron mejoría entre 7 y 10 puntos; el mayor porcentajeestuvo asintomático durante tres meses, 22,5% libres de crisis durante el seguimiento total de siete meses y58,7% reincidieron.Conclusión: se evidencia que la combinación de infiltraciones intramusculares con betametasona más lidocaínay fisioterapia y un proceso de educación del personal médico a pacientes y familiares es un tratamiento eficaz, sinefectos adversos, en el manejo de la cefalea crónica tipo tensión, considerada una de las más difíciles de tratar.

Introduction: the tension-type headache is the most common form of headache and chronic one of the most difficult to treat form, causes severe disability to patients and enormous socioeconomic costs is related to emotional stress factors and / or muscle. Therapeutic proposals, which are considered, include NSAIDs, physical therapy, injections of botulinum toxin in pericraneal muscles.Objetives: to evaluate the effectiveness in the treatment of chronic tension-type headache with intramuscular infiltration with steroid betamethasone one deposit plus 1% lidocaine at points of muscle tension level sub-occipital, cervical paraspinal and trapezius, accompanied by physiotherapy, more an educational process to patients and families.Materials and methods: retrospective study where treatment effectiveness was measured using the Visual Analogue Scale (VAS). Data were analyzed in SPSS using percentages, frequencies and proportions.Results: total 138 cases of chronic daily headache tension type, mean age 51 years, 76.8% female, 21% is associated with anxiety disorder, 8.7% giddy feeling and 8.7% depressive symptoms, 8% type insomnia sleep disorders. 78.2% of patients reported improvement with the proposed treatment, of these, 85.5% of cases were quantified according to VAS, 66.8% showed improvement between 7 and 10 points; the highest percentage was asymptomatic for 3 months, 22.5% seizure-free for the total up of 7 months, 58.7% relapsed.Conclusion: it is evident that the combination of intramuscular injections of lidocaine plus Betamethasone more Physiotherapy and a process of education of medical staff to patients and families, is an effective treatment without adverse effects in the management of chronic tension headache, considered one of the most difficult to treat.