Assuntos
Mononucleose Infecciosa/complicações , Oftalmoplegia/complicações , Adulto , Feminino , HumanosRESUMO
Dementia is an infrequent and little known manifestation of giant cell arteritis or temporal arteritis (GCA-TA). The cases of 2 women with histologically proven GCA-TA are presented in which, together with the most classical symptoms, they presented a brusque mental deterioration on initiation of the disease. One patient developed a severe irreversible dementia which coincided with a rapid reduction in the doses of corticoids; while the other patient demonstrated improvement in cognitive function with steroid treatment and control of the disease. Magnetic resonance studies revealed multiple areas of infarction in both hemispheres in the two patients. The importance of treating multi-infarct dementia is underlined in the context of GCA-TA with high doses of corticoids. It is also emphasized that GCA-TA should be considered in the evaluation of older patients with mental alterations.
Assuntos
Demência por Múltiplos Infartos/etiologia , Arterite de Células Gigantes/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Demência por Múltiplos Infartos/tratamento farmacológico , Feminino , Arterite de Células Gigantes/complicações , HumanosRESUMO
The malignant neuroleptic syndrome (MNS) is an idiosyncratic reaction to neuroleptic drugs. Although it was described in the sixties, it is still a poorly known condition. Controversy still exists about its conceptual frame, and its true incidence is still unknown. We have evaluated 9 cases of MNS seen in a 37 month period. There were 5 females, with a mean age of 50 years. Haloperidol, either single or in association, was the most commonly implicated drug. The estimated frequency of MNS in our population at risk was 1.5%. Eight patients had complications and 5 died from them (55%). We discuss the pathogenetic mechanisms, the conceptual characterization and the current diagnostic criteria. We evaluate the causes of the high mortality in our series. We think that a higher suspicion index of this condition would be desirable, and we recommend early treatment with vigorous supportive measures and drug therapy. We think that prospective studies are required to assess the true incidence of MNS.
Assuntos
Síndrome Maligna Neuroléptica , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Maligna Neuroléptica/complicações , Síndrome Maligna Neuroléptica/diagnóstico , Síndrome Maligna Neuroléptica/epidemiologia , Síndrome Maligna Neuroléptica/etiologia , Síndrome Maligna Neuroléptica/mortalidade , Psiquiatria , Espanha/epidemiologiaAssuntos
Anticoncepcionais Orais Combinados/efeitos adversos , Etinilestradiol/efeitos adversos , Síndrome Maligna Neuroléptica/etiologia , Norgestrel/efeitos adversos , Adulto , Combinação Etinil Estradiol e Norgestrel , Feminino , Humanos , Levanogestrel , Esquizofrenia Paranoide/tratamento farmacológicoRESUMO
We have studied the electrically evoked blink reflex (R1 and R2 components) in 40 parkinsonian patients with levodopa-induced dyskinesia (15 with facial dyskinesia, 13 with limb-truncal dyskinesia and 12 with mixed dyskinesia). R2 latencies (both ipsilateral and contralateral) were significantly prolonged in dyskinetic patients. These findings are indicative of decreased excitability of brainstem interneurones in the dyskinetic parkinsonians. We found no correlation between the neurophysiological pattern of blink reflex and the localization of dyskinesia.
Assuntos
Piscadela , Discinesia Induzida por Medicamentos/fisiopatologia , Levodopa/efeitos adversos , Doença de Parkinson/fisiopatologia , Idoso , Feminino , Humanos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/tratamento farmacológico , Tempo de ReaçãoRESUMO
An electrophysiological study of the blink Reflex was undertaken in 40 dyskinetic and 20 nondyskinetic patients with Parkinson's disease, who were matched for age, stage of disease, duration of illness and amount and nature of antiparkinsonian medication. We found that latencies of R2 responses (both ipsilateral and contralateral) were prolonged in the dyskinetic group compared to the nondyskinetic group. Moreover, the late response was more easily inhibited by conditioning stimulation in dyskinetic patients. This behavior of late response in dyskinetic parkinsonians may be attributed to the reinstatement of dopaminergic suppressive control over the segmental multisynaptic systems belonging to the reflex.
Assuntos
Piscadela/efeitos dos fármacos , Discinesia Induzida por Medicamentos/fisiopatologia , Doença de Parkinson/fisiopatologia , Adulto , Idoso , Discinesia Induzida por Medicamentos/complicações , Estimulação Elétrica , Eletromiografia , Feminino , Humanos , Levodopa/farmacologia , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicaçõesRESUMO
An electrophysiological study of the blink reflex was undertaken in 25 control subjects and in 57 patients with Parkinson's disease. An increase in the ipsilateral and contralateral late response was the most evident finding. The excitability cycle of recovery of the R2 component of the blink reflex after a prior conditioning shock was enhanced in the patients. A statistically significant correlation was established between the increase in the late response and the severity of akinesia and rigidity.
Assuntos
Piscadela , Doença de Parkinson Secundária/fisiopatologia , Adulto , Idoso , Estimulação Elétrica , Eletromiografia , Lateralidade Funcional/fisiologia , Humanos , Pessoa de Meia-Idade , Tempo de Reação/fisiologiaRESUMO
A patient developed weakness in the upper limbs, eventually causing brachial diplegia with only slight paresis of the legs after rapid correction of severe hyponatraemia. Pseudobulbar palsy, mental confusion and urinary incontinence were also present. CT scan showed a zone of lucency in the pons. Clinical recovery occurred and the zone of lucency had disappeared 12 months after the appearance of the neurological signs.