Therapeutic hypothermia: critical review of the molecular mechanisms of action.

Therapeutic hypothermia (TH) is nowadays one of the most important methods of neuroprotection. The events that occur after an episode of ischemia are multiple and hypothermia can affect the various steps of this cascade. The mechanisms of action of TH are varied and the possible explanation for the benefits of this therapy is probably the multiple mechanisms of action blocking the cascade of ischemia on many levels. TH can affect many metabolic pathways, reactions of inflammation, apoptosis processes, and promote neuronal integrity. To know the mechanisms of action of TH will allow a better understanding about the indications for this therapy and the possibility of searching for other therapies when used in conjunction with hypothermia will provide a therapeutic synergistic effect.

Epilepsy and multiple sclerosis: Increased risk among progressive forms.

Multiple sclerosis (MS) patients are at higher risk for epilepsy. Epilepsy was frequent among our MS patients (6.55%). Progressive MS forms were associated with higher incidence of epilepsy (p=0.021). Partial motor seizures were observed in five patients (62.5%) and generalized tonic-clonic in three (37.5%). Electroencephalogram (EEG) revealed epileptic activity in 62.5%. A high percentage of MS patients with epilepsy (37.5%) reported intoxication as the most severe form of adverse effect of antiepileptic therapy.

[Excessive daytime sleepiness in Mexico city]. / Somnolencia excesiva diurna en la ciudad de México.

OBJECTIVE: To determine the prevalence of excessive daytime somnolence (EDS) in a sample of residents from Mexico City. METHODS: A cross-sectional survey was done using a randomized telephone survey. A structured questionnaire (including demographic and clinical data) and Epworth Sleepiness Scale, a valid and reliable instrument for the detection of EDS, were administered. RESULTS: A total sample of 200 subjects was obtained, with a mean age of 37 +/- 16.24 years. EDS was found in 31.5% of the subjects; 12.5% considered that EDS interfered in a significant way with daily activities, and 9% with work related abilities. Subjects with EDS were older, came from lower socio-economic status, and had a significantly higher body mass index. DISCUSSION: Our results indicate that EDS is more frequent in Mexico City residents than in other populations. Notwithstanding, the association between EDS with advanced age, lower socio-economic status and high body mass index requires further investigation.

Somnolencia excesiva diurna en la ciudad de México / Excessive daytime sleepiness in Mexico city

Objetivo: Determinar la prevalencia de somnolencia excesiva diurna (SED) en una muestra de habitantes de la ciudad de México. Material y métodos: Se realizó un estudio transversal analítico mediante una encuesta telefónica al azar; la entrevista estructurada se aplicó con la finalidad de obtener datos demográficos y clínicos. Así mismo se utilizó la escala de Epworth, que es un instrumento confiable y válido para el diagnóstico de la SED. Resultados: Se estudiaron 200 habitantes de la ciudad de México, con una media de edad de 37±16 años. De ellos 31.5% cursaba con SED. En 12.5% de los sujetos la SED interfería de manera significativa con sus actividades cotidianas y 9% admitía que interfería con sus actividades laborales. Los sujetos con SED tenían mayor edad, pertenecían con mayor frecuencia al nivel socioeconómico bajo y presentaban un índice de masa corporal significativamente más alto. Discusión: Estos resultados indican que la SED es más frecuente en la ciudad de México que en otras poblaciones estudiadas. Se requieren estudios posteriores que permitan establecer la participación de la edad, nivel socioeconómico y el índice de masa corporal en el desarrollo de la SED.

OBJECTIVE: To determine the prevalence of excessive daytime somnolence (EDS) in a sample of residents from Mexico City. METHODS: A cross-sectional survey was done using a randomized telephone survey. A structured questionnaire (including demographic and clinical data) and Epworth Sleepiness Scale, a valid and reliable instrument for the detection of EDS, were administered. RESULTS: A total sample of 200 subjects was obtained, with a mean age of 37 +/- 16.24 years. EDS was found in 31.5% of the subjects; 12.5% considered that EDS interfered in a significant way with daily activities, and 9% with work related abilities. Subjects with EDS were older, came from lower socio-economic status, and had a significantly higher body mass index. DISCUSSION: Our results indicate that EDS is more frequent in Mexico City residents than in other populations. Notwithstanding, the association between EDS with advanced age, lower socio-economic status and high body mass index requires further investigation.

Aripiprazole in psychosis associated with Parkinson's disease.

Aripiprazole is an agent for treating schizophrenia. The authors assume that aripiprazole as a dopamine receptor partial agonist may be useful in treating PD patients. Three cases are presented in this study. All patients were evaluated by the same clinician, a neuropsychiatrist well trained in the use of Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI). Aripiprazole was effective for reducing psychosis in each case.

Severe impulsiveness as the primary manifestation of multiple sclerosis in a young female.

Severe impulsiveness in the absence of apparent neurological signs has rarely been reported as a clinical presentation of multiple sclerosis (MS). An 11-year-old female developed progressive and sustained personality disturbances including disinhibition, hypersexuality, drug abuse, aggressiveness and suicide attempts, without neurological signs. She was given several unsuccessful psychopharmacological and psychotherapeutic interventions. At age 21, a diagnosis of MS was made, confirmed by imaging, laboratory and neurophysiological studies. Although unusual, MS may produce pure neurobehavioral disturbances. In the present case, widespread demyelinization produced a complex behavioral disorder, with features compatible with orbitofrontal and Klüver-Bucy syndromes.