[Drug-induced movement disorders]. / Trastornos del movimiento inducidos por fármacos.

INTRODUCTION: Pharmaceutical preparations with the capacity to block dopamine receptors at the brain level quite often cause secondary movement disorders, but are not the only cause. These movement disorders can be due to a poor or difficult capacity to carry out movements similar to the type observed in idiopathic Parkinson's disease (parkinsonism secondary to drugs) or also because of excess movement with acute or chronic dystonic or choreic clinical pictures. Why the same drugs cause apparently opposing effects is not altogether clear, although it is supposed that individual factors related to the pharmacokinetics, pharmacodynamics and sensitivity of different types of sub-receptors play a crucial role. DEVELOPMENT: We describe the most frequent groups of symptoms, divided into two parts depending on whether the disorder is hyper- or hypokinetic, and the drugs that are most commonly responsible for those clinical pictures are also discussed. The most frequent disorders caused by excessive movement are acute dyskinesia, akathisia and tardive dyskinesia. The disorder caused by scarcity of movement is a parkinsonian picture that it may be impossible to distinguish from idiopathic Parkinson's disease. CONCLUSIONS: An awareness of the possible existence of these disorders is essential for the clinical suspicion and diagnosis. On most occasions, withdrawing the causing drug reverts the symptoms without the need for complicated or costly diagnostic studies.

[Reye's syndrome. Description of a case focused on the patient's epileptic seizures]. / Síndrome de Reye. Descripción de un caso con especial interés en sus crisis epilépticas.

INTRODUCTION: Reye's syndrome is an acute disease characterised by encephalopathy and fatty degeneration of the liver that occurs almost exclusively in children. It can cause the death of the patient in up to a third of all cases, generally due to severe cerebral oedema. The aetiopathogenesis of this condition is uncertain and is usually preceded by a viral infection, generally from the influenza or varicella virus. Some studies have shown a strong epidemiological association between the ingestion of acetylsalicylic acid (ASA) during the viral infection and development of Reye's syndrome. CASE REPORT: We describe the case of a 20-month-old female who developed Reye's syndrome within the context of a viral infection and the ingestion of ASA. A hepatic biopsy study is appropriate in this syndrome. The patient presented a non-convulsive status during the acute phase and at one year developed Lennox-Gastaut syndrome. She died from pneumonia at the age of 18 years. CONCLUSIONS: In all patients with clinical features that suggest Reye's syndrome, inborn errors of metabolism that can mimic it must be precluded. Although the incidence of this syndrome has gone down considerably in recent years, it is important to keep it in mind as an early and aggressive diagnosis and treatment of cerebral hypertension will reduce the mortality rate and the sequelae.

[Neurological sequelae following electrocution. A case report and review of the literature]. / Secuelas neurológicas tras electrocución. Presentación de un caso y revisión de la bibliografía.

INTRODUCTION: Electrocution is the cause of a large number of accidents and, of these, a considerable percentage result in death. Several factors affect the severity and distribution of the injuries. It is known that for low voltages the characteristics of alternating current make it three times more dangerous than continuous current. The high percentage of neurological sequelae can be accounted for by the fact that nerves are the tissue with the lowest resistance in the body and electricity tends to follow the path that offers the least resistance. CASE REPORT: A 16-year-old male who was accidentally electrocuted by an electric guitar and later suffered a cardiorespiratory arrest; the patient required intubation. After withdrawing sedation, the patient was found to be blind in both eyes and could not remember what had happened. FLAIR MR imaging revealed oedema in both occipital lobes and, to a lesser extent, in the junction between the parietooccipital and temporooccipital lobes. Treatment with steroids was established for three days. After approximately one month, the patient had recovered his sight and the brain injuries had disappeared. CONCLUSIONS: The neurological manifestations secondary to accidents caused by electricity are usually divided into two types -immediate and delayed. Blindness has rarely been reported as a sequela in those who have survived fulguration due to a lightning strike. The patient's recovery after administering treatment with steroids and the reversibility of the oedema could lead us to think that the mechanism producing this sequela was the damage to the nervous system caused directly by the electricity, which is known as the 'phenomenon of electroporation'.

[Respiratory stridency by larynx paralysis. Anusual beginning of miastenia]. / Estridor respiratorio por parálisis laríngea. Debut inusual de miastenia gravis.

A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized.

[Transcranial Doppler during transient global amnesia]. / Ecografía Doppler transcraneal durante una amnesia global transitoria.

INTRODUCTION: Transient global amnesia is a syndrome mainly characterised by an anterograde memory deficit, which disappears in less than 24 hours without leaving any kind of sequelae. Its aetiopathogenesis is still unclear. The ischemic theory became important after hypoperfusion was observed in the mesial region of the temporal lobe using different imaging techniques, although recently the use of diffusion-weighted magnetic resonance imaging by other authors has not revealed these alterations in the cerebral blood flow. CASE REPORT: We report on a transcranial Doppler study carried out in a female patient during the acute phase of the amnesia, with no evidence of hemodynamic alterations or significant asymmetries. Repeating the test after clinical recovery offered values that were similar to those of the previous study. CONCLUSIONS: It is posited that the basis of this process would not be related to ischemia but instead to a mechanism enabling spreading neurogenic depression that is similar to that which takes place during a migraine attack. Treatment with antiplatelet drugs would not, therefore, be recommended but calcium antagonists or beta blockers would be useful in preventing the clinical picture from being repeated.

[Encephalomyelitis due to Epstein-Barr virus]. / Encefalomielitis por el virus de Epstein-Barr.

We present a 28-year-old woman with encephalomyelitis and concomitant central nervous system infection by Epstein-Barr virus. Progression took place in 2 phases, with myelitis at the beginning and encephalitis developing later. Despite great functional impairment, recovery was good and the patient was left suffering only from urinary retention that was presumably caused by spinal lesions. The etiology of the case is unusual, particularly in adults.