Subject(s)
Encephalomyelitis, Acute Disseminated/etiology , Meningococcal Vaccines/adverse effects , Neisseria meningitidis, Serogroup B/immunology , Brain/diagnostic imaging , Diagnosis, Differential , Encephalomyelitis, Acute Disseminated/diagnosis , Encephalomyelitis, Acute Disseminated/immunology , Female , Humans , Middle Aged , Spinal Cord/diagnostic imagingABSTRACT
INTRODUCTION: The need for safe health care, in which the care and treatment of the patient does not cause any injuries in addition to those already arising from their baseline disease, has led to the present study. Our objective has been to determine the frequency and describe the neurological syndromes attributable to drugs, their preventability and the levels of medical care involved. METHODS: Observational study. Cohort of subjects referred from Primary and Specialized Care between December 2008 and January 2010 due to neurological symptoms attributable to drugs, and previously known neurology patients who began to have symptoms other than those of the baseline disease, also caused by drugs. The notifications were recorded in a questionnaire. Frequency distributions, central tendency measurements, X(2) or Fisher tests and non-parametric tests were performed. RESULTS: The prevalence of adverse neurological events was 0.586% of the total sample. Of the 105 patients selected, the most frequent adverse events were: 25.7%, akinetic-rigid syndrome, 18.1%, dyskinetic syndrome, 11.4% neuro-psychiatric symptoms, and 10.5% confusional syndrome. The most commonly recorded pharmacological groups were, in decreasing order: anti-epileptic, dopaminergic, antidepressant, neuroleptic, antivertiginous and prokinetic drugs. We describe the most susceptible population and the statistically significant relationships between the presence of certain pharmacological groups and neurological syndromes. CONCLUSIONS: The low prevalence detected may be due to the study design, although adverse neurological events accounted for 2.84% of the admissions to a Neurology Unit. Understanding the epidemiology should help to identify the safest approaches, apply them correctly to the population at a higher risk, and reduce healthcare needs and consumption of medical resources.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Nervous System Diseases/chemically induced , Nervous System Diseases/epidemiology , Substance-Related Disorders/epidemiology , Adult , Age Factors , Aged , Cohort Studies , Drug Therapy/statistics & numerical data , Female , Humans , Male , Middle Aged , Nervous System Diseases/psychology , Prospective Studies , Sex Factors , Spain/epidemiology , Substance-Related Disorders/psychology , Surveys and QuestionnairesABSTRACT
INTRODUCTION: Freezing of gait unresponsive to dopaminergic stimulation in patients with severe Parkinsonism. The freezing of gait episodes (FOG) normally appear during the off period and generally improve with dopaminergic stimulus, at the same time as improving other Parkinsonian symptoms. PATIENTS AND METHODS: We report a group of 10 patients with severe Parkinson's disease. All patients suffered motor fluctuations, dyskinesias and episodes of FOG during the on and off state. The patients received a subcutaneous apomorphine bolus, without other dopaminergic medication; an effective dose of apomorphine was considered as one that induced a reduction of at least a 60% in the UPDRS motor scale. RESULTS: The baseline motor UPDRS was 61.3 +/- 4.7, which dropped to 21 +/- 4.3 after the apomorphine injection. The mean dose of apomorphine was 5.5 mg (3-7 mg). The bolus of apomorphine improved the parameters of the gait related to bradykinesia and the tapping tests of the limbs, but the episodes of FOG did not vary significantly between the off and on state. CONCLUSIONS: We present a group of 10 patients with freezing of gait episodes that did not improve with treatment and persisted during the on period induced by dopaminergic stimulus with apomorphine.
Subject(s)
Apomorphine/therapeutic use , Dopamine/therapeutic use , Dyskinesias , Gait , Parkinson Disease , Aged , Antiparkinson Agents/therapeutic use , Dopamine Agents/therapeutic use , Dyskinesias/drug therapy , Dyskinesias/etiology , Dyskinesias/physiopathology , Humans , Middle Aged , Parkinson Disease/complications , Parkinson Disease/drug therapy , Parkinson Disease/physiopathology , Treatment OutcomeSubject(s)
Cerebral Veins/pathology , Endocarditis, Subacute Bacterial/complications , Vasculitis, Central Nervous System/etiology , Adult , Endocarditis, Subacute Bacterial/diagnostic imaging , Endocarditis, Subacute Bacterial/surgery , Heart Valve Prosthesis Implantation , Humans , Magnetic Resonance Imaging , Male , Radiography , Vasculitis, Central Nervous System/diagnostic imaging , Vasculitis, Central Nervous System/pathologySubject(s)
Glioblastoma/pathology , Aged , Diagnosis, Differential , Fatal Outcome , Female , Humans , Magnetic Resonance ImagingABSTRACT
No disponible
No disponible
Subject(s)
Humans , Female , Adolescent , Pseudotumor Cerebri/diagnosis , Addison Disease/diagnosis , Papilledema/etiology , Headache/etiology , Vision Disorders/etiologySubject(s)
Humans , Female , Aged , Glioblastoma/pathology , Magnetic Resonance Imaging , Diagnosis, Differential , Fatal OutcomeABSTRACT
No disponible
No disponible
Subject(s)
Adult , Humans , Male , Cerebral Veins/pathology , Endocarditis, Subacute Bacterial/complications , Vasculitis, Central Nervous System/etiology , Vasculitis, Central Nervous System/pathology , Vasculitis, Central Nervous System , Endocarditis, Subacute Bacterial , Endocarditis, Subacute Bacterial/surgery , Heart Valve Prosthesis Implantation , Magnetic Resonance ImagingABSTRACT
No disponible
