[Multifocal motor neuropathy with partial block of nerve conduction]. / Neuropatía motora multifocal con bloqueo parcial de la conducción nerviosa.

INTRODUCTION: Multifocal motor neuropathy with partial conduction block is characterized by being a chronic, demyelinating, autoimmune severely disabling neuropathy. In Cuba three cases were reported by Dr. Estrada et al in 1999. This neuropathy presents clinically in relatively young persons. The arms are predominantly affected and the typical signs are of severe asymmetrical weakness, with atrophy which is less marked than the weakness, fasciculations, cramps and myokymiae of the affected muscle. Neurophysiological study shows partial block of motor nerve conduction. Clinical interest is due to it being potentially curable. Many cases are wrongly diagnosed as motor neurone disease. CLINICAL CASES: We present five patients aged under 55 years with progressive chronic motor neuropathy mainly affecting their arms. Study of nerve conduction showed partial block of the conduction in motor nerves, in segments with no block of sensory neuroconduction. One patient had been diagnosed as having motor neurone disease; another had slight sensory involvement in the distal territory of the radial nerve; in two patients the symptoms affected all four limbs. In three patients good results were obtained with intacglobin, followed by azothroprine and prednisone. Two patients showed no improvement with this treatment so intravenous cyclophosphamide was given for nine months which stopped progression of the disorder. CONCLUSIONS: Multifocal motor neuropathy is potentially treatable. In some cases intacglobin azathioprine and prednisone may be a useful alternative to cyclophosphamide.

[Non-infectious thrombosis of the cerebral venous sinuses and veins in adults. A report of five cases]. / Trombosis no infecciosa de los senos y venas cerebrales en adultos. Presentación de cinco casos.

INTRODUCTION: Thrombosis of the veins and venous sinuses is an uncommon condition. In 1947 it was described in adults by Garcin and Pestel. It is a potentially serious disorder, in which there is severe intracranial hypertension which may be fatal or cause serious neurological sequelae. Diagnosis is made, during life, on the clinical condition and neuro-imaging features. We consider that treatment of the underlying condition is essential to improve prognosis, although this is controversial. In Cuba there are no publications reporting series of patients with this condition. CLINICAL CASES: We present five patients, four of whom were women, with a neurological disorder involving focal neurological deficits, headache and severe intracranial hypertension, of subacute onset and with convulsions in 60%. The results of imaging studies were compatible with thrombosis of veins and/or venous sinuses. The diagnosis was conformed at necropsy in two patients. The commonest risk factor was the puerperium, occurring in four cases. The patients were treated symptomatically. Two patients died. The other patients made good progress. CONCLUSIONS: The puerperium is the commonest risk factor in thrombosis of the venous sinuses and the veins draining into them. Headache, neurological focal signs and level of consciousness are the main symptoms and signs. Coma, haemorrhagic infarct and convulsions are of bad prognosis and followed by unsatisfactory progress of the disorder.