Polymicrogyria: An Unusual Case of Secondary Mania.

BACKGROUND: Secondary mania refers to a manic episode that arises during a medical illness other than bipolar disorder or in response to a drug or medication. As the psychopathological features of secondary mania resemble those of mania due to bipolar disorder, misdiagnosis is frequent. PURPOSE AND BASIC PROCEDURES: We present the case of a 20-year-old woman who developed a manic episode with psychotic symptoms, in whom polymicrogyria, a malformation of the cortical development with abnormal electroencephalographic activity, was documented. After initiating antiepileptic management, the affective symptoms completely subsided. MAIN FINDINGS: To date, no specific recommendations are available concerning when to perform advanced studies in patients with a manic episode; however, as our case shows, these are much needed. PRINCIPAL CONCLUSION: Because the treatment of secondary conditions largely depends on finding the underlying cause, patients with a new-onset mania should undergo a thorough assessment for secondary causes.

The role of short-term video electroencephalogram monitoring for epilepsy and psychogenic seizures: Experience from a Latin American referral center.

Short-term VEEG represents an affordable option in limited resources environments. There are few reports on its use. Its diagnostic yield is variable (7-57%) and can be related to the differences in recording time. The present study analyzes possible predictive factors to support the indication of a short-term VEEG. We analyzed short-term VEEG studies (<24 h) throughout a period of 5 years (2013-2017). The patients were clustered according to the date of last epileptic seizure and the frequency of epileptic events per month and subcategorized depending on the frequency found. Chi square univariate analysis was performed looking for predictive variables to obtain an epileptic short-term EEG. A multivariate logistic regression analysis was performed with statistically significant variables. A total of 1092 VEEG were analyzed from 832 patients. 34.5% were reported as epileptic VEEG. In the multivariate analysis, 3 predictors of epileptic short-term VEEG were identified: The use of 2 or more antiepileptic drugs (AEDs) (OR 1.67, CI 1.23-2.25, p = 0.001), the presence of an epileptic event in the last month (OR 1.53, CI 1.07-2.17, p = 0.018) and daily seizures (OR 1.84, CI 1.21-2.78, p = 0.004). Six-month seizure free subjects predict a non-epileptic VEEG (OR 0.58, CI 0.30-0.89, p = 0.013).

[Consensus conference of the Mexican Association for the Study of Climateric on veralipride prescription for patients with vasomotor symptoms]. / Consenso de la Asociación Mexicana para el Estudio del Climaterio para la indicación de veraliprida a pacientes con síntomas vasomotores.

Vasomotor symptoms are one of the main reasons for climateric women to consult a physician. Hormone therapy is the first treatment choice, but it is not indicated to all patients. Veralipride is an option for those who cannot or will not try hormone treatment. The Mexican Association for the Study of Climateric (AMEC) assembled an interdisciplinary group of medical experts so that they revised the medical literature on the subject and reached a consensus on veralipride indication, doses, counterindications and safety. The recommendations of the consensus conference on veralipride are: (1) Physicians must be familiar with its indication, side effects, pharmacokinetics and dosage. (2) Patients must be informed on other therapeutical options. (3) Patients' mental and neurological state must be evaluated, in particular to identify movement disorders, extrapyramidal symptoms (tremor or dystonia), anxiety and depression that can be mistaken for climateric symptoms. (4) Any adverse effect associated with the drug must be reported. (5) A random multicenter trial must be carried out in order to identify the frequency and severity of side effects, and (6) Written information on possible health risks when using the drug must be provided.

Manejo de las mordeduras de serpientes venenosas en pacientes atendidos en el servicio, de medicina interna en el Hospital Escuela Oscar Danilo Rosales, durante el período de enero 1997-noviembre 1999

En el presente estudio se encontro que el grupo de edad más afectado con mordeduras de serpientes correspondió de 12 a 20 años lo cual coincide con estudios internacionales, donde se reporta que las edades mas afectadas por accidente ofídico es la comprendida entre 10 y 19 años lo cual esta en correspondencia a la actividad laboral ya que la gran mayoría se dedica a la agricultura y pertenece al área rural y es campesino. Con respecto a los tipos de serpientes, la más frecuente que ocasionó accidentes ofídico fue serpiente cascabel con un 41.7 porciento, seguido de serpientes desconocidas en un 38.9 porcientos, sólo se presentó un caso de mordedura de coral. Podemos observar que en relación al tiempo transcurrido entre la mordedura de serpiente y la atención hospitalaria fue en promedio de 8 horas con una desviación estándar de 9.1 horas. Se presentaron los resultados clínicos de la familia de serpientes viperidae, en donde se observa que los datos de laboratorio hubo una prolongación en tiempo de protombina siendo en promedio de 15.4 +- 10.3 segundos. Un 44 porciento de los accidentes correspondió a persona que deambulaban y un 43.1 porciento durante el trabajo en el campo. El área anatómica más frecuente afectada correspondió a miembro inferior izquierdo en un 38.9 porciento. Del total de pacientes 89 porciento recibieron suero antiofídico polivante, 96 porciento tratamiento con penicilina cristalina, en un 14 porciento gentamicina y se utilizó un tercer antibiótico en un 8.3 porciento de los pacientes. Recibieron terapia analgésica con diclofenac sódico en un 8.3 porciento. Se indicó el uso de hidrocortisona en 18.1 porciento de los pacientes y en un 7 porciento de dichos pacientes no se aplicó toxoide cuando estaba indicada. El 62.5 porciento de los pacientes recibió hidroterapia y se aplicó inmunoglobulina antitetánica humana en un 82 porciento. Hubo complicaciones hemorrágicas y se reportó un caso de amputación