Diagnóstico y tratamiento del trombo móvil carotídeo. A propósito de un caso / Diagnosis and treatment of a mobile carotid thrombus. A case report

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Encefalopatía epiléptica de inicio precoz en un paciente con mutación en SCN8A / Early onset epileptic encephalopathy in a patient with mutation in SCN8A

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Abordaje del paciente infectado por zika / Addressing patients infected by zika

El virus del Zika se cataloga como un arbovirus, perteneciente al género Flavivirus, que puede ser transmitido al ser humano por la picadura de un mosquito del género Aedes. Desde su descubrimiento en Uganda (África), en 1943, su evolución se ha producido en forma de brotes puntuales, aunque en las últimas décadas ha evolucionado hasta ser un problema a escala mundial. Su clínica es generalmente leve e inespecífica, incluso a veces asintomática, aunque puede tener complicaciones autoinmunes y neurológicas muy graves, especialmente en neonatos. Dada la proporción del problema y su limitado conocimiento en España (por su corta evolución temporal), el objetivo principal de este trabajo es informar a los profesionales de Enfermería acerca de los aspectos principales de esta nueva patología y proponer un plan de cuidados para el óptimo manejo de este tipo de pacientes desde la prevención, el diagnóstico precoz y el cuidado del paciente infectado

The Zika virus has been classified as an arbovirus, within the Flavivirus genus, that can be transmitted to human beings through the bite of an Aedes species mosquito. Since its discovery in Uganda (Africa) in 1943, its evolution has occurred as isolated outbreaks, although in recent decades it has developed into a world-wide problem. Its clinical symptoms are typically mild and unspecific, sometimes even asymptomatic, though it can present very severe autoimmune and neurological complications, particularly in newborns. Given the scale of the problem and its limited knowledge in Spain (due to its shot time evolution), the main objective of this article is to inform Nursing Professionals about the main aspects of this new condition, and to put forward a plan of care for the optimal management of this type of patients from prevention, early diagnosis, and care for infected patients

Lacosamide for epileptic seizures in patients with co-morbidities and unusual presentations of epilepsy.

Numerous patients who are prescribed antiepileptic drugs (AEDs) for epileptic seizures are already receiving other agents for the treatment of co-morbid conditions, which frequently occur alongside epilepsy. This raises additional clinical considerations and makes the use of AEDs with good safety profiles and fewer drug-drug interactions attractive. Second and third-generation anticonvulsant drugs are associated with fewer pharmacological interactions and improved tolerability compared with first-generation drugs. Furthermore, second and third-generation anticonvulsant drugs are associated with linear pharmacokinetic profiles and differing mechanisms of action, making them ideal for pluripathological and polymedicated patients. In this report, we highlight the efficacy of one such agent, lacosamide, in five patients with co-morbidities and unusual presentations of epilepsy, including a patient with paraneoplastic encephalitis caused by microcytic lung carcinoma, one with a brain tumour and one with Alzheimer's disease, as well as a case of catamenial epilepsy and one of refractory convulsive status epilepticus. In all patients, lacosamide was associated with a substantial reduction in seizure frequency and effective control of seizure episodes. Treatment was generally well tolerated in all patients, indicating that lacosamide is an effective treatment option for a variety of patients with epileptic seizures.