Revista de neurologia
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Revista de neurologia · May 2003
Review Meta Analysis[Effectiveness of flunarizine in the prophylaxis of migraine: a meta-analytical review of the literature].
Migraine is a common and disabling health problem among young and middle aged adults. Flunarizine have been used as a prophylactic medication in its management for more than two decades. ⋯ Based on a small number of trials, flunarizine, at a daily dose of 10 mg lightly reduces the frequency of migraine attacks.
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Revista de neurologia · May 2003
Case Reports[When should a brain scan with HMPAO be performed to diagnose brain death?].
Current Spanish law defines the criteria to be met in the case of brain death (BD) and the complementary tests to confirm it, although they do not always need to be carried out. In Spain one of the most frequently used methods is the electroencephalogram (EEG), which has its shortcomings in patients who are under sedation with barbiturates. Transcranial Doppler (TCD) offers a number of advantages in the diagnosis of BD, but it also has certain limitations. In these cases, a cerebral perfusion scan (CPS) with HMPAO can be very useful. ⋯ Although it has obvious advantages, TCD cannot always be performed to confirm BD diagnosis. In these cases, CPS can be an extremely valuable tool
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Revista de neurologia · May 2003
[Monitoring dermatomal somatosensory evoked potentials at the ERB point, the cervical spinal cord and the cerebral cortex in the diagnosis of cervical radiculopathy].
Recording at various levels of the somatosensory pathway is often used in somatosensory evoked potentials to mixed nerve stimulation (SEP), but not in dermatomal somatosensory evoked potentials (DSEP) in which only the cortical potential is usually recorded. The aim of our study was to compare the recordings of upper limb DSEP at Erb point, cervical cord, and subcortical and cortical levels with SEP recordings in healthy subjects and patients with cervical radiculopathy. ⋯ We found that it is possible to record and to identify all the potentials in DSEP as observed in the SEP. On cervical radiculopathy, DSEP with the present technique increase the sensitivity and give some additional and useful information regarding the extension and localization of the pathology. Besides, DSEP recording is a non invasive technique, non traumatic and well tolerated for our patients.
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Revista de neurologia · May 2003
Review[Modern day psychosurgery: a new approach to neurosurgery in psychiatric disease].
To obtain an up to date review of the different possible surgical approaches in the management of certain psychiatric disorders that are refractory to conservative treatment (pharmacotherapy, psychotherapy, electroconvulsive therapy). ⋯ The most noteworthy progress in psychosurgery in recent years has been the combination of a more rigorous selection of patients and the higher degree of specificity with which treatment is performed on the brain structures involved in psychiatric disease. The most widely employed psychosurgical procedures at present are cingulotomy, anterior capsulotomy, subcaudate tractotomy, limbic leucotomy and postero medial hypothalamotomy, with favourable responses in about 35 70% of cases. The psychiatric diagnoses where the best results are to be found are obsessive compulsive disorder, chronic anxiety states and major depression. Current progress in neuroimaging techniques, increased neurophysiological knowledge and the revolutionary neuromodulation techniques, especially deep brain stimulation, offer an even more promising future for psychiatric neurosurgery.