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1.
Mult Scler Relat Disord ; 83: 105422, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38219299

RESUMO

BACKGROUND AND PURPOSE: Although more common than in the general population, seizures are an atypical manifestation of multiple sclerosis (MS) and their pathophysiology is not well understood. This study aims to examine the prevalence, clinical characteristics, brain imaging findings and course of epilepsy, presenting in patients with MS. METHODS: Observational retrospective study of MS patients evaluated at a single MS reference center in Buenos Aires, Argentina, between 2011 and 2022, focusing on those who developed epilepsy (EMS). Clinical, demographic, and prognostic factors were evaluated and compared to a control group of non-epileptic MS patients (NEMS). To analyze specific epilepsy characteristics, a second control group of patients with non-lesional focal epilepsy (FNLE) was also included. RESULTS: Twenty-five patients (18 women), were diagnosed with epilepsy, corresponding to a prevalence of 1.95%. Comparison of brain imaging characteristics between EMS and NEMS patients showed brain atrophy (32% vs 6.1%, p<0.01), as well as cortical (26% vs 4%, p=0.03) and juxtacortical lesions (84% vs 55%, p=0.05), were more frequent in EMS patients. However, after multivariate analysis, cortical atrophy was the only variable linked to a significant increase in risk of epilepsy (OR 24, 95%CI=2.3-200, p<0.01). No significant differences in clinical characteristics, disease activity, disability levels, response to disease modified treatment (DMT) or lack of DMT efficacy were observed between MS patients with or without epilepsy. Most patients received anti-seizure medication (ASM), and seizure control was better in EMS than in FNLE patients (92% vs 58%, p=0.022) with no differences found in drug resistance. We did not find predictors of seizure recurrence in the population studied. CONCLUSION: We observed a lower prevalence of epilepsy in this group of MS patients, compared to other reported cohorts. Although epilepsy seems to have a benign course in MS patients, cortical atrophy appears to be an important contributor to the development of secondary epilepsy in MS patients. Further investigations will be necessary to identify risk factors or biomarkers predicting increased epilepsy risk in MS.


Assuntos
Epilepsia , Esclerose Múltipla , Humanos , Feminino , Estudos de Casos e Controles , Estudos Retrospectivos , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico por imagem , Esclerose Múltipla/epidemiologia , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Epilepsia/etiologia , Prognóstico , Atrofia/epidemiologia , Atrofia/complicações , Convulsões/tratamento farmacológico , Anticonvulsivantes/uso terapêutico
2.
Pediatr Neurol ; 44(5): 385-8, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21481750

RESUMO

Epilepsia partialis continua is defined as a spontaneous regular or irregular clonic muscular twitching affecting a limited part of the body, occurring for a minimum of 1 hour and recurring at intervals of less than 10 seconds. Levamisole is used as an immunomodulating medication in patients with recurrent aphthous ulcers. Evidence suggests that it can induce multifocal inflammatory leukoencephalopathy. We describe the clinical neuroimaging and ictal electroencephalographic findings in an adolescent with epilepsia partialis continua caused by the administration of levamisole with cortical and subcortical lesions. To our knowledge, this is the first report that describes the association of epilepsia partialis continua cortical lesions detected by magnetic resonance imaging and levamisole that were not previously described.


Assuntos
Adjuvantes Imunológicos/efeitos adversos , Epilepsia Parcial Contínua/induzido quimicamente , Levamisol/efeitos adversos , Adolescente , Epilepsia Parcial Contínua/diagnóstico , Epilepsia Parcial Contínua/tratamento farmacológico , Feminino , Lobo Frontal/efeitos dos fármacos , Lobo Frontal/patologia , Humanos , Imageamento por Ressonância Magnética , Estomatite Aftosa/tratamento farmacológico
3.
Rev. argent. cir ; 87(1/2): 13-17, jul.-ago. 2004. ilus
Artigo em Espanhol | LILACS | ID: lil-391473

RESUMO

Antecedentes: El tumor sólido-papilar representa menos del 2 por ciento de todas las neoplasias pancreáticas y afecta predominantemente al sexo femenino durante la infancia y juventud. Se presenta característicamente en la tomografía axial computada (TAC) como un gran tumor, con áreas de densidad correspondiente a tejidos sólidos y líquidos en proporciones variables. Otros patrones tomográficos "no característicos" son poco conocidos y motivo de interpretaciones erróneas. Objetivo: Investigar la incidencia de los distintos patrones tomográficos del tumor sólido-papilar de páncreas. Lugar de aplicación: Hospital Público afiliado a la Universidad de Buenos Aires. Diseño: Estudio prospectivo en una serie consecutiva de pacientes. Población: 13 pacientes operados entre enero de 1988 y marzo de 2003 por tumor sólido-papilar. Método: Se analizaron las TAC de acuerdo a los valores densitométricos del tumor. Estos fueron clasificados en tres patrones: Sólido, Líquido y Mixto. Se definió como "sólido" a aquel que presenta áreas con valores densitométricos mayores a 50 Unidades Hounsfield (UH) y "líquido" con valores menores a 15 UH...


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Criança , Neoplasias Pancreáticas , Estudos Prospectivos , Tomografia Computadorizada por Raios X/normas
4.
Rev. argent. cir ; 87(1/2): 13-17, jul.-ago. 2004. ilus
Artigo em Espanhol | BINACIS | ID: bin-3131

RESUMO

Antecedentes: El tumor sólido-papilar representa menos del 2 por ciento de todas las neoplasias pancreáticas y afecta predominantemente al sexo femenino durante la infancia y juventud. Se presenta característicamente en la tomografía axial computada (TAC) como un gran tumor, con áreas de densidad correspondiente a tejidos sólidos y líquidos en proporciones variables. Otros patrones tomográficos "no característicos" son poco conocidos y motivo de interpretaciones erróneas. Objetivo: Investigar la incidencia de los distintos patrones tomográficos del tumor sólido-papilar de páncreas. Lugar de aplicación: Hospital Público afiliado a la Universidad de Buenos Aires. Diseño: Estudio prospectivo en una serie consecutiva de pacientes. Población: 13 pacientes operados entre enero de 1988 y marzo de 2003 por tumor sólido-papilar. Método: Se analizaron las TAC de acuerdo a los valores densitométricos del tumor. Estos fueron clasificados en tres patrones: Sólido, Líquido y Mixto. Se definió como "sólido" a aquel que presenta áreas con valores densitométricos mayores a 50 Unidades Hounsfield (UH) y "líquido" con valores menores a 15 UH...(AU)


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Criança , Neoplasias Pancreáticas/diagnóstico por imagem , Estudos Prospectivos , Neoplasias Pancreáticas/classificação , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Tomografia Computadorizada por Raios X/normas
5.
Medicina (B.Aires) ; 61(1): 53-6, 2001. tab
Artigo em Espanhol | LILACS | ID: lil-286379

RESUMO

Magnetic Resonance Imaging (MRI) is the method of choice to search for epileptogenic lesions. We correlated MRI findings with the epileptogenic zone (EZ) depicted by clinical and electroencephalographic (EEG) data. We studied 400 clinical records of patients who had been submitted to MRI studies and we analyzed, retrospectively, their ictal semiology, EEG characteristics and response to treatment. They were classified into 3 groups: A) temporal lobe epilepsy, B) frontal lobe epilepsy and C) parieto-occipital epilepsy. We included 155 patients: Group A) 68 cases (43.9 per cent), 28 men (41.1 per cent), mean age 32 +/- 11 years old, abnormal IMR in 44 (64.7 per cent), refractory to treatment 48 (70.5 per cent). Group B) 68 cases (43.9 per cent), 38 men (55.8 per cent), mean age 30 +/- 15 years old, abnormal IMR in 26 (38.2 per cent), refractory to treatment 30 (44.1 per cent). Group C) 19 cases (12.2 per cent), 13 men (68.4 per cent), mean age 27 +/- 11 years old, abnormal IMR in 11 (57.8 per cent), refractory to treatment 12 (63.1 per cent). Results showed that there were higher possibilities of detecting lesions which correlate with EZ in temporal than in frontal or parieto-occipital lobes epilepsy. The chances to find abnormalities on the MRI were 5 times higher in refractory patients than in those who were non-refractory.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Eletroencefalografia/métodos , Epilepsias Parciais/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/tratamento farmacológico , Estudos Retrospectivos
6.
Medicina [B.Aires] ; 61(1): 53-6, 2001. tab
Artigo em Espanhol | BINACIS | ID: bin-10516

RESUMO

Magnetic Resonance Imaging (MRI) is the method of choice to search for epileptogenic lesions. We correlated MRI findings with the epileptogenic zone (EZ) depicted by clinical and electroencephalographic (EEG) data. We studied 400 clinical records of patients who had been submitted to MRI studies and we analyzed, retrospectively, their ictal semiology, EEG characteristics and response to treatment. They were classified into 3 groups: A) temporal lobe epilepsy, B) frontal lobe epilepsy and C) parieto-occipital epilepsy. We included 155 patients: Group A) 68 cases (43.9 per cent), 28 men (41.1 per cent), mean age 32 +/- 11 years old, abnormal IMR in 44 (64.7 per cent), refractory to treatment 48 (70.5 per cent). Group B) 68 cases (43.9 per cent), 38 men (55.8 per cent), mean age 30 +/- 15 years old, abnormal IMR in 26 (38.2 per cent), refractory to treatment 30 (44.1 per cent). Group C) 19 cases (12.2 per cent), 13 men (68.4 per cent), mean age 27 +/- 11 years old, abnormal IMR in 11 (57.8 per cent), refractory to treatment 12 (63.1 per cent). Results showed that there were higher possibilities of detecting lesions which correlate with EZ in temporal than in frontal or parieto-occipital lobes epilepsy. The chances to find abnormalities on the MRI were 5 times higher in refractory patients than in those who were non-refractory. (Au)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Imageamento por Ressonância Magnética/métodos , Eletroencefalografia/métodos , Epilepsias Parciais/fisiopatologia , Epilepsias Parciais/diagnóstico , Epilepsias Parciais/tratamento farmacológico , Estudos Retrospectivos
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