Desert dust intrusions and their incidence on airborne biological content. Review and case study in the Iberian Peninsula.

Desert dust intrusions cause the transport of airborne particulate matter from natural sources, with important consequences for climate regulation, biodiversity, ecosystem functioning and dynamics, human health, and socio-economic activities. Some effects of desert intrusions are reinforced or aggravated by the bioaerosol content of the air during these episodes. The influence of desert intrusions on airborne bioaerosol content has been very little studied from a scientific point of view. In this study, a systematic review of scientific literature during 1970-2021 was carried out following the standard protocol Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After this literature review, only 6% of the articles on airborne transport from desert areas published in the last 50 years are in some way associated with airborne pollen, and of these, only a small proportion focus on the study of pollen-related parameters. The Iberian Peninsula is affected by Saharan intrusions due to its proximity to the African continent and is seeing an increasing trend the number of intrusion events. There is a close relationship among the conditions favouring the occurrence of intrusion episodes, the transport of particulate matter, and the transport of bioaerosols such as pollen grains, spores, or bacteria. The lack of linearity in this relationship and the different seasonal patterns in the occurrence of intrusion events and the pollen season of most plants hinders the study of the correspondence between both phenomena. It is therefore important to analyse the proportion of pollen that comes from regional sources and the proportion that travels over long distances, and the atmospheric conditions that cause greater pollen emission during dust episodes. Current advances in aerobiological techniques make it possible to identify bioaerosols such as pollen and spores that serve as indicators of long-distance transport from remote areas belonging to other bioclimatic and biogeographical units. A greater incidence of desert intrusion episodes may pose a challenge for both traditional systems and for the calibration and correct validation of automatic aerobiological monitoring methods.

Osteoprotegerin and zoledronate bone effects during orthodontic tooth movement.

OBJECTIVES: To assess the effects of local delivery of recombinant fusion protein osteoprotegerin (OPG-Fc) and bisphosphonate zoledronate on bone and periodontal ligament in a rat tooth movement model. MATERIALS AND METHODS: Maxillary first molars of 36 male Sprague-Dawley rats were displaced mesially using a calibrated spring connected to an anterior mini-screw. Two different drugs were used: a single dose of Zoledronate (16 µg) and a twice-weekly dose of OPG-Fc (5.0 mg/kg) were injected. Tooth movement was measured on scanned plaster casts. Structural and immunohistochemical analysis of the orthodontic-induced changes in bone included receptor activator of nuclear factor ĸ (RANK), Runx, type 1 collagen, matrix metalloproteinases (MMPs) 2 and 9, tissue inhibitors of metalloproteinases (TIMPs) 1 and 2, and vimentin. RESULTS: Both groups showed a reduction in mesial molar displacement. Animals receiving OPG-Fc demonstrated only 52%, 31%, and 21% of the total mesial molar displacement compared to control rats at 7, 14, and 21 days, respectively (*p < 0.001). For rats receiving zoledronate tooth displacement decreased significantly with 52%, 46% and 30%, respectively (*p < 0.001). At 14 and 21 days, OPG-Fc group showed significantly less molar displacement than the zoledronate group (*p < 0.001). RANK, Runx, vimentin, MMP-9 and tissues-inhibitor metalloproteinase 1 immunoreactivity were reduced in zoledronate treated animals and even more in OPG treated animals. CONCLUSION: Local delivery of OPG-Fc or zoledronate inhibits bone resorption and therefore tooth movement. OPG-Fc was more effective than zoledronate in blocking the action of osteoclasts.

Neuromodulation of the posterolateral hypothalamus for the treatment of chronic refractory cluster headache: Experience in five patients with a modified anatomical target.

INTRODUCTION: Deep brain stimulation (DBS) of the posterior hypothalamus has been found to be effective in the treatment of refractory chronic cluster headache (CCH). METHODS: We report the long-term outcomes of five patients with refractory CCH on whom stimulation of a modified target of approximately 3 mm in radius, which included the posterolateral hypothalamus, the fasciculus mammillotegmentalis, the fasciculus mammillothalamicus and the fasciculus medialis telencephali, was performed. The stereotaxic coordinates were 4 mm from the third ventricle wall, 2 mm from behind the mid-intercommissural point and 5 mm from under the intercommissural line. RESULTS: All patients became pain-free for 1-2 weeks after the procedure, but then needed an average of 54 days to optimize stimulation parameters. After a mean follow-up of 33 months, two remain pain-free, two have an excellent response (>90% decrease in attack frequency) and in one the attacks have been reduced by half. There were no serious adverse events. Permanent myosis and euphoria/well-being feeling were seen in three patients. Other adverse events, such as diplopia, dizziness, global headache of cervical dystonia, were seen transiently related to an increase in stimulation parameters. Attacks reappeared transiently in two patients as a result of cable rupture and when the stimulator was disconnected. CONCLUSIONS: Our results supports the efficacy of DBS in very refractory CCH with a slightly modified hypothalamic target conceived to avoid the lateral ventricle wall so as to extend the stimulated brain area and to decrease the morbidity of potential haemorrhagic complications.

[Review of the target for the deep brain stimulation of chronic cluster headache]. / Revision de la diana para la estimulacion cerebral profunda de la cefalea en racimos cronica.

Cluster headache is included in the group of trigeminal autonomic cephalalgias. Although the pathophysiology of cluster headache has not yet been sufficiently established, the theory of a central origin tells us that this headache is produced by hypothalamic dysfunction. More than 50 patients have been treated with deep brain stimulation of the posterior nucleus of the hypothalamus from 2001. The results show clinical improvement in more than 60% of the cases, opening a promising issue for the treatment of the cluster headache persistent after medical treatment. The surgical target that have been used until now is based on the origin of the cluster headache in the hypothalamic dysfunction. Nevertheless, It has still some open questions as the lack of proving the posterior nucleus of the hypothalamus is the real origin of the cluster headache, the lack of consensus about the anatomy of the surgical target and the variability of the structures stimulated with the surgery. The aim of this article is a review of the target used and propose another surgical target based on physiopathological concepts to explain the improvement with the deep brain stimulation in these patients.

Revisión de la diana para la estimulación cerebral profunda de la cefalea en racimos crónica / Review of the target for the deep brain stimulation of chronic cluster headache

La cefalea en racimos pertenece al grupo de las cefalalgias trigeminales autosómicas. Aunque su fisiopatología no está suficientemente clara, se cree que una disfunción hipotalámica es la causante de este tipo de cefaleas. Desde 001 se ha tratado a más de 50 pacientes con estimulación cerebral en el hipotálamo posterior. Los resultados obtenidos hasta la fecha son de mejoría en más del 60% de los casos y se ha abierto un camino prometedor para el tratamiento de la cefalea en racimos crónica rebelde a tratamiento farmacológico. La diana quirúrgica utilizada hasta ahora se basa en la disfunción del hipotálamo posteroinferior como origen de la cefalea en racimos; sin embargo, hay varias cuestiones no resueltas como son, entre otras, la falta de demostración de que el hipotálamo posteroinferior es el generador de las cefaleas, no existe un consenso sobre la anatomía de la diana quirúrgica y la variabilidad de estructuras anatómicas neuroestimuladas en estos pacientes. El objetivo de este artículo es hacer una revisión crítica de la diana utilizada en esta patología y proponer, sobre la base de conceptos fisiopatológicos, otra diana que explique el efecto beneficioso de la estimulación cerebral profunda en estos pacientes (AU)

Cluster headache is included in the group of trigeminal autonomic cephalalgias. Although the pathophysiology of cluster headache has not yet been sufficiently established, the theory of a central origin tells us that this headache is produced by hypothalamic dysfunction. More than 50 patients have been treated with deep brain stimulation of the posterior nucleus of the hypothalamus from 2001. The results show clinical improvement in more than 60% of the cases, opening a promising issue for the treatment of the cluster headache persistent after medical treatment. The surgical target that have been used until now is based on the origin of the cluster headache in the hypothalamic dysfunction. Nevertheless, It has still some open questions as the lack of proving the posterior nucleus of the hypothalamus is the real origin of the cluster headache, the lack of consensus about the anatomy of the surgical target and the variability of the structures stimulated with the surgery. The aim of this article is a review of the target used and propose another surgical target based on physiopathological concepts to explain the improvement with the deep brain stimulation in these patients (AU)

Histopathological findings in oral lichen planus and their correlation with the clinical manifestations.

OBJECTIVES: To highlight the most characteristic histopathological findings of oral lichen planus and their correlation with the clinical manifestations and forms. STUDY DESIGN: We performed a retrospective study of 50 biopsied and diagnosed cases of oral lichen planus obtained over a period of 11 years, spanning from May 1998 to April 2009. We analyzed the age and sex of the patient, type of lichen planus, location and different histopathological findings, comparing them with the clinical lesions. RESULTS: Seventy eight percent of the patients are female and 22% are male, with an average age of 56.06 years for both sexes. The most frequent clinical form is reticular, present in 78% of the cases, and the most common location is the buccal mucosa, present in 70% of the patients. Hydropic degeneration of the basal layer and lymphocytic infiltration in the subepithelial layer are observed in the entire sample. Signs of atypia were identified in 4% of the cases, but without dysplasic features. Other common histological findings were the presence of necrotic keratinocytes (92%), hyperplasia (54%), hyperkeratosis (66%), acanthosis (48%), and less frequently, serrated ridges (30%) and the presence plasma cells (26%). CONCLUSIONS: Oral lichen planus is a disease that is more common in women, usually appearing in the fifth and sixth decades of life. The most common clinical form is reticular, manifesting mainly in the buccal mucosa. Histological findings characteristic of oral lichen planus include hydropic degeneration of the basal layer, lymphocytic infiltration in the subepithelial layer and the absence of epithelial dysplasia; however, it is also frequent to observe hyperplasia phenomena at the epithelial level, hyperkeratosis, acanthosis and the presence of necrotic keratinocytes.

[The physiopathology and management of sexual dysfunction in epileptic patients]. / Fisiopatología y abordaje de la disfunción sexual en pacientes epilépticos.

AIM: To review sexual dysfunction in epileptic patients, which is an aspect of the disease that is often deemed as being of little importance, but which exerts a decisive influence on the quality of life of these patients. DEVELOPMENT: The alterations in sexual functioning in epilepsy have a complex physiopathology, can be of different types and occur during seizures, the aura or in the intercritical periods. Their clinical expression depends on the sex and age of the patient. The severity and incidence of sexual dysfunction are influenced by the treatment being used, the psychosocial adjustment of the individual, and certain aspects of epilepsy such as the age at onset, time to progression, location of the focus, the type of seizures and the degree of control the patient has over them. The therapeutic strategy is based on adjusting or modifying the antiepileptic therapy and then treating the sexual dysfunction and/or possible hormonal upsets. CONCLUSIONS: Sexuality is a fundamental human right and as a health provider, the physician must take this aspect of the disease into account when dealing with epileptic patients by attempting to detect and characterise the disorder. The patient must be informed of the possible effects of epilepsy and its treatment on sexual functioning, and also the therapeutic options the physician considers to be best suited to the patient's particular case. He or she should also be encouraged to play an active role in making decisions on the matter and it is necessary to carry out developmental monitoring that takes into account the impact that improved sexual functioning is going to have on the patient's psychosocial and family adjustment.

Fisiopatología y abordaje de la disfunción sexual en pacientes epilépticos / The physiopathology and management of sexual dysfunction in epileptic patients

Revisar la disfunción sexual en epilépticos, un aspecto de la enfermedad a menudo infravalorado, peroque puede influir decisivamente sobre la calidad de vida de estos pacientes. Desarrollo. Las alteraciones de la función sexual en la epilepsia tienen una fisiopatología compleja, pueden ser de diferentes tipos y acontecer durante las crisis, el aura o los períodos intercríticos. Su expresión clínica depende del sexo y la edad de los pacientes. El tratamiento utilizado, el ajuste psicosocial del individuo y determinados aspectos de la epilepsia, como la edad de comienzo, el tiempo de evolución, la localización del foco, el tipo de crisis y el grado de control de las mismas, influyen sobre la gravedad y la incidencia de la disfunción sexual. La estrategia terapéutica se basa en ajustar o modificar la terapia antiepiléptica y abordar después la disfunción sexual y/o las posibles alteraciones hormonales. Conclusiones. La sexualidad es un derecho fundamental del ser humano, y ante un paciente epiléptico es obligación del médico, como proveedor de salud, atender este aspecto de la enfermedadtratando de detectar y caracterizar la alteración, informando al paciente de los posibles efectos de la epilepsia y su tratamiento sobre la función sexual, exponiéndole las opciones terapéuticas que considera más adecuadas, animándole a participar activamente en la toma de decisiones al respecto, y realizando un control evolutivo que tenga en cuenta el impacto que la mejoría de la función sexual va a producir sobre el ajuste psicosocial y familiar del paciente

To review sexual dysfunction in epileptic patients, which is an aspect of the disease that is often deemed asbeing of little importance, but which exerts a decisive influence on the quality of life of these patients. Development. The alterations in sexual functioning in epilepsy have a complex physiopathology, can be of different types and occur during seizures, the aura or in the intercritical periods. Their clinical expression depends on the sex and age of the patient. Theseverity and incidence of sexual dysfunction are influenced by the treatment being used, the psychosocial adjustment of the individual, and certain aspects of epilepsy such as the age at onset, time to progression, location of the focus, the type of seizures and the degree of control the patient has over them. The therapeutic strategy is based on adjusting or modifying the antiepileptic therapy and then treating the sexual dysfunction and/or possible hormonal upsets. Conclusions. Sexuality is a fundamental human right and as a health provider, the physician must take this aspect of the disease into account whendealing with epileptic patients by attempting to detect and characterise the disorder. The patient must be informed of the possible effects of epilepsy and its treatment on sexual functioning, and also the therapeutic options the physician considers tobe best suited to the patient's particular case. He or she should also be encouraged to play an active role in making decisions on the matter and it is necessary to carry out developmental monitoring that takes into account the impact that improved sexual functioning is going to have on the patient’s psychosocial and family adjustment

Etiología neurógena en pacientes con disfunción eréctil / Neurogenic etiology in patients with erectile dysfunction

Objetivo: La disfunción eréctil (DE) es una alteración cuya prevalencia es elevada y aumenta con la edad. Se estima que en España afecta al 18,9% de los varones de 25 a 70 años. En la mayor parte de los casos es de origen multifactorial y en su patogenia se admite la influencia de enfermedades sistémicas, fármacos de diferentes tipos, factores psicógenos, patologías cardiovasculares, endocrinopatías y alteraciones neurológicas. La disfunción eréctil de causa neurológica puede tener su origen a nivel del Sistema Nervioso Central o Periférico. Entre las posibles causas de disfunción eréctil neurógena de origen central estarían tumores, accidentes cerebrovasculares, encefalitis, Enfermedad de Parkinson, Esclerosis Múltiple y otras enfermedades desmielinizantes, demencias, degeneración olivo pontocerebelosa y epilepsia. Las mielopatías de cualquier etiología, pueden ser dependiendo de su localización o extensión, causas de disfunción eréctil. A nivel periférico pueden ser causa de DE las alteraciones de las vías sensitivas que constituyen el brazo aferente del reflejo espinal de la erección y las de las vías eferentes vegetativas o somáticas que median en la vasodilatación arterial, la relajación del músculo liso cavernoso o la contracción de la musculatura estriada del suelo de la pelvis. La finalidad de este trabajo es revisar detalladamente las causas más relevantes de DE de origen neurógeno, sus mecanismos etiopatogénicos y los abordajes terapéuticos que en la actualidad se consideran más adecuados para cada caso particular. Conclusión: La correcta aproximación diagnóstica al paciente con DE pasa por identificar, en la medida de lo posible, los factores etiopatogénicos implicados su origen. En este sentido, la detección e identificación, de la posible presencia del factor de riesgo neurógeno, contribuirá a un mejor entendimiento de sus mecanismos fisiopatológicos y con ello a una aproximación diagnóstica, pronóstica y terapéutica más adecuada especialmente en aquellos pacientes refractarios a la terapia de primera línea (AU)

Objectives: Erectile dysfunction (ED) is a disorder with a high prevalence that increases with age. It is estimated that 18.9% of men’s between 25 and 70 years suffer it in Spain. Most cases have a multifactorial origin and it is admitted the influence on its pathogenesis of systemic diseases, different kind of drugs, psychogenic factors, cardiovascular, endocrinological and neurological diseases. Neurologic cause erectile dysfunction may have its origin in the central or peripheral nervous system. Among possible process of neurogenic erectile dysfunction of central origin would be tumors, cerebral vascular accidents, encephalitis, Parkinson disease, multiple sclerosis and other demyelinization diseases, dementias, olivopontocerebellar degeneration and epilepsy. Myelopathies of any etiology may be, depending on their localization and extension, cause of erectile dysfunction. At the peripheral level, disorders of the sensitive tracts constituting the afferent limb of the erection spinal reflex, and the efferent vegetative or somatic tracts mediating arterial vasodilatation, cavernous smooth muscle relaxation or pelvic floor striated muscle contraction. The aim of this work is to review in detail the most relevant causes of neurogenic erectile dysfunction, their etiopathogenic mechanisms and therapeutic approaches currently considered more adequate for each particular case. Conclusions: The correct diagnostic approach to patients with erectile dysfunction passes through identification, if possible, of the etiopathogenic factors implied. Regarding this, detection and identification of a possible neurogenic risk factor will contribute to a better understanding of the physiopathology mechanisms, and more adequate diagnostic, prognostic and therapeutic approaches, mainly in those patients refractory to first line therapy (AU)

[A proposed new target for deep brain stimulation in obsessive-compulsive disorder]. / Propuesta de una nueva diana para la estimulación cerebral profunda en el trastorno obsesivo-compulsivo.

INTRODUCTION: The obsessive-compulsive disorder (OCD) has an incidence in general population of 1.5-3%. If we consider as a positive respond a diminution of the 25-35% in the symptoms of OCD according to the Y-BOCS, and we add the cognitive-behavioral therapy to the pharmacological treatment, only a 40-60% of treated patients would have significant improvement and a 10% of patients with OCD, would be refractory to all type of medical treatment. DEVELOPMENT: Current neurosurgical techniques for resistant cases of OCD interrupt the connections between the frontal lobes and subcortical structures (cingulotomy, capsulotomy). These techniques are ablative and irreversible. It shows the importance of finding a less aggressive technique with better clinical results. Deep brain stimulation (DBS) is an alternative to traditional neurosurgery based in neuromodulation methods. It's considered that the physiopathology of the OCD consists of a dysfunction of the direct and indirect vias that control the extrapiramidal limbic circuit. On the other hand, it had been obtained positive results after DBS of the subthalamic nucleus of three patients with Parkinson's disease and OCD. CONCLUSION: This article has as target the demonstration that bilateral DBS of the limbic part of the subthalamic nucleus is an alternative for the treatment of refractory OCD.

Propuesta de una nueva diana para la estimulación cerebral profunda en el trastorno obsesivo-compulsivo / A proposed new target for deep brain stimulation in obsessive-compulsive disorder

La incidencia del trastorno obsesivo-compulsivo (TOC) en la población general es del 1,5-3%, y secalcula que sólo un 40-60% de los pacientes tratados farmacológicamente tiene mejoría significativa, y un 10% de ellos es refractario a dicho tratamiento. Actualmente, el TOC tiene dos tipos de tratamiento neuroquirúrgico: uno ablativo (cingulotomía,capsulotomía) y otro neuromodulador –estimulación cerebral profunda (ECP)–. Desarrollo. Partiendo del hecho de que la fisiopatología del TOC consiste en una disfunción de las vías directa e indirecta que regulan el circuito límbico extrapiramidal,y de los resultados clínicos de tres pacientes con enfermedad de Parkinson y TOC que, tras recibir ECP en el núcleo subtalámico, han mejorado de las dos patologías, proponemos el área límbica del núcleo subtalámico como diana quirúrgicapara la ECP en el TOC. Las coordenadas estereotáxicas sugeridas serían: x, 8-9 mm lateral a la línea media comisura anterior-comisura posterior; y, 1 mm por delante del punto intermedio comisural; z, 3 mm por debajo de la línea media comisuraanterior-comisura posterior. Conclusión. Este artículo tiene como objetivo demostrar que la ECP bilateral de la parte límbica de los núcleos subtalámicos puede ser una alternativa para el tratamiento del TOC refractario a tratamiento farmacológico

The obsessive-compulsive disorder (OCD) has an incidence in general population of 1.5-3%. If we consider as a positive respond a diminution of the 25-35% in the symptoms of OCD according to the Y-BOCS, and we add thecognitive-behavioral therapy to the pharmacological treatment, only a 40-60% of treated patients would have significant improvement and a 10% of patients with OCD, would be refractory to all type of medical treatment. Development. Current neurosurgical techniques for resistant cases of OCD interrupt the connections between the frontal lobes and subcortical structures (cingulotomy, capsulotomy). These techniques are ablative and irreversible. It shows the importance of finding a less aggressive technique with better clinical results. Deep brain stimulation (DBS) is an alternative to traditional neurosurgery based in neuromodulation methods. It’s considered that the physiopathology of the OCD consists of a dysfunction of the direct and indirect vias that control the extrapiramidal limbic circuit. On the other hand, it had been obtained positiveresults after DBS of the subthalamic nucleus of three patients with Parkinson’s disease and OCD. Conclusion. This article has as target the demonstration that bilateral DBS of the limbic part of the subthalamic nucleus is an alternative for the treatmentof refractory OCD

[Psychiatric symptoms of Parkinson's disease following deep brain stimulation surgery on the subthalamic nucleus]. / Manifestaciones psiquiátricas de la enfermedad de Parkinson tras la cirugía de estimulación cerebral profunda del núcleo subtalámico.

AIM: To review the increasing number of papers that report diverse neuropsychiatric disorders that happen in patients diagnosed of Parkinson's disease submitted to brain deep stimulation of subthalamic nuclei with high frequency current. DEVELOPMENT: It is a fact the need to evaluate carefully all the patients who have to submit to this surgical procedure analyzing previous psychiatric history, and the possible appearance of psychiatric sphere symptoms after surgery. The acute depression and the euphoric moods (than can occur immediately after surgery) and major depression, obsession, widespread anxiety and substance abuse (among those of more delayed appearance) constitute examples of this pathology. The treatment of previous psychiatric disorders is forced in all cases and specially relevant in the major depression when suicide ideas coexist. CONCLUSIONS: Information that allow to predict the risk of developing depressive disorders in the postoperative period does not exist at present time, though it is more predictable that it happens in those patients with previous severe depressive history. In general, euphoric moods, apathy and depression, usually are transient and of multifactorial origin that includes the existence of endogenous predisposition, the change to an independence pattern after surgery, the psychotropic effect of levodopa, and the high frequency current stimulation effect on the non motor structures target and in the adjacent regions. It must be outlined that it is possible the appearance of psychotic symptoms after brain deep stimulation of subthalamic nuclei in patients with ideal results on motor disability.

[Applied neurophysiology in the deep brain stimulation treatment of multiple sclerosis tremor]. / Neurofisiología aplicada en el tratamiento con estimulación cerebral profunda del temblor severo de la esclerosis múltiple.

INTRODUCTION: Many patients with multiple sclerosis (MS) develop tremors that may involve one or both lower and/or upper extremities, head and/or voice. In the last few years, chronic high frequency deep brain stimulation of the ventral intermedious (Vim) thalamic nucleus (Vim-DBS, deep brain stimulation) seems to be gradually replacing Vim-thalamotomy in surgical treatment of tremor. The thalamotomy is a destructive procedure of the whole neural components, whereas Vim-DBS has shown to be a selective neurophysiological procedure to block a specific group of neural components, in particular large, fast and low threshold ones. MS is a disease of uncertain etiology characterized by demyelinating plaques in central nervous system. The neurophysiological intraoperative targeting applied to this pathology identifies demyelinated plaques and the functional state of Vim, reduces pitfalls and increases accuracy. Methods included spontaneous and induced multiunit activity recording, semimicroelectrode and tetraelectrode thalamic evoked potentials recording and micro/macro stimulation techniques.

Neurofisiología aplicada en el tratamiento con estimulación cerebralprofunda del temblor severo de la esclerosis múltiple / applied neurophysiology the deep brain stimulation treatment of multiple sclerosis tremor

Introducción. Los pacientes con esclerosis múltiple (EM) desarrollan temblores que pueden afectar a una o ambas extremidades inferiores y/o superiores, a la extremidad cefálica y/o a la voz.Recientemente, la estimulación cerebral profunda del núcleo ventral intermedio (Vim) del tálamo (clasificación de Hassler), utilizando estímulos eléctricos a alta frecuencia (Vim-DBS, del inglés deep brain stimulation), está reemplazando gradualmente a la talamotomía de dicho núcleo talámico. Desarrollo. Mientras que la talamotomía es un procedimiento destructivo que aniquila la totalidad de componentes neurales de un área determinada, la Vim-DBS es un método neurofisiológico selectivo que bloquea los diferentes componentes neuronales en función de la intensidad, duración y frecuencia de los pulsos eléctricos aplicados, en particular bloqueando los componentes con bajo umbral. La EM es una enfermedad caracterizada por producir placas de desmielinización en el sistema nervioso central. En este sentido, la monitorización neurofisiológica para localizar la diana (Vim) permite reducir dificultades, identificar placas, elucidar sobre el estado funcional del Vim e incrementar la precisión. Los métodos utilizados en tal monitorización son el registro espontáneo e inducido de la actividad multiunitaria neuronal, potenciales evocados talámicos registrados con semimicroelectrodo y tetraelectrodo, y las técnicas de micro y macroestimulación con dichos electrodos (AU)

Quiste aracnoideo en paciente con SIDA y clínica neurológica / Arachnoid cyst in patient with AIDS and neurologic disease

No disponible

[Neurophysiological monitoring in the treatment of pain]. / Monitorización neurofisiológica en la terapia del dolor.

INTRODUCTION: The concept of transynaptic deafferentation secondary to a lesion is the basis of the therapeutic criteria of functional neurosurgery. DEVELOPMENT: Pain due to deafferentation requires clinical neurophysiological techniques for characterization, and when appropriate, for localization of the level of the lesion and the ectopic focus or foci which cause the pain syndrome. However, monitoring therapeutic interventions in the pain clinic is an ever increasing need, and obliges the clinical neurophysiologist to master the range of techniques involved in his specialty, so that he can use the most suitable techniques and methods as required by each condition and/or case. The use of techniques such as micro-recordings of the unitary or multiunitary activity of the nerves or nuclei, intracerebral evoked potentials, nociceptive evoked potentials, reflexology, polysomnography and topography, together with techniques such as percutaneous objective localization of deep nerves, allows quantitative evaluation pre-, intra- and postoperative. CONCLUSION: The development of neuromodulation, and in particular of acute or long-term neurostimulation by use of percutaneous techniques, offers an effective therapeutic option in the field of clinical neurophysiology.

Monitorización neurofisiológica en la terapia del dolor / Neurophysiological monitoring in the treatment of pain

Introducción. El concepto de desaferentización transináptica secundaria a una lesión es la base del criterio terapéutico de la neurocirugía funcional. Desarrollo. El dolor por desaferentización requiere de las técnicas de la neurofisiología clínica para su caracterización y, en su caso, para la localización del nivel lesivo y del foco o focos ectópicos que pueden estar generando el síndrome de dolor. Sin embargo, la monitorización de las intervenciones terapéuticas en la clínica del dolor constituye una demanda cada vez mayor, que obliga al neurofisiólogo clínico a dominar la globalidad de técnicas que conforman su especialidad, con la finalidad de implementar ante cada proceso y/o cada caso en particular las técnicas y metodologías apropiadas y adecuadas. La implementación de técnicas como el microrregistro de la actividad unitaria o multiunitaria de nervios o núcleos, los potenciales evocados intracerebrales, los potenciales evocados nociceptivos, la reflexología, la polisomnografía y topografía, junto a técnicas como la localización objetiva percutánea de nervios en profundidad, permiten la valoración cuantitativa pre, intra y postintervención. Conclusión. La evolución de la neuromodulación y, en particular, la neuroestimulación subaguda o crónica, mediante la utilización de técnicas percutáneas, abren un camino de impacto para el ejercicio profesional del neurofisiólogo clínico en el ámbito terapéutico (AU)

[Stereotactic target identification for neurosurgery of Parkinson disease]. / Identificación de las dianas estereotáxicas en la cirugía de la enfermedad de Parkinson.

INTRODUCTION: The use of applied neurophysiological methods to improve the stereotactic localization of devices in the deep human brain is a high and systematic technology in Parkinson's neurosurgery today. The available standard equipment for clinical neurophysiology practice may constitute the basic set for high tech functional neurosurgery. Free run and event related multiunit recording, naturalistic and electrical evoked potentials, and deep brain microstimulation responses are the basic methodological set to neurophysiological target localization. DEVELOPMENT AND CONCLUSIONS: This article is concerned with the topic: set out a high technology using low cost equipment. So our 41 cases experienced in pallidal and thalamic nucleolisis and thalamus and subthalamus DBS results suggest that the proposed equipment and methods are the required to assure accuracy and safety for target location.

[Nerve compression syndrome in the thoracic outlet]. / Síndrome de la compresión neurógena en la salida torácica.

INTRODUCTION: The nerve conduction studies, F-waves and dermatosomal and lor somatosensory evoked potential have a low level of sensitivity for Thoracic Outlet Compression Syndrome (TOCS) diagnosis. A standard negative electrodiagnostic study does not exclude the presence of TOCS. OBJECTIVE: The purpose of this neurophysiological note is that the Wright's hyperabduction, costoclavicular compression and Adson's scalenus tests important in making a clinical diagnosis of TOCS can be used as neurophysiological provocative maneuvers to determine the effect of braquial position on electrodiagnostic parameters. MATERIAL AND METHODS: Nine selected TOCS patients were evaluated previous and following provocative maneuvers for 3 and 6 minutes. RESULTS: The results showed a positive electrodiagnostic study in 7/9 patients. CONCLUSIONS: It is suggested that patients with presumptive TOCS and negative electrodiagnostic findings be reevaluated immediately after 6 minutes of Wright's, Adson's or costoclavicular compression provocative tests.