Revista de neurologia
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The neurosciences have developed at a stunningly fast rate. Key points accounting for this progression include the introduction of functional neuroimaging techniques and the boost resulting from the Decade of the Brain project. This expansion has also allowed new disciplines such as neuroethics to appear. ⋯ Neuroethics is a discipline that, prior to the year 2002, was understood only as an ethics of neuroscience (a branch of bioethics). As of that date, however, it is also understood as a neuroscience of ethics (a new discipline). Neuroreductionism proposes that all ethical life has a basis in the brain that determines ethical actions; neuroscepticism holds that neuroscience cannot be considered a normative function; and neurocriticism considers that the neuroscientific advances cannot be ignored and must be taken into account in some way in order to draw up ethical theories.
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Revista de neurologia · Oct 2013
Multicenter Study Observational Study[Adaptation and validation of CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and others with intellectual disabilities) in Spanish population with intellectual disabilities].
Dementia caused by Alzheimer's disease commonly affects the adult population with Down's syndrome. This population presents two characteristic clinical features: a semiologic pattern that differs from the typical Alzheimer's disease, and previous intellectual deficits that may confound the clinical diagnosis. There is a clear need to validate specific instruments adapted to Spanish population. ⋯ The Spanish version of CAMDEX-DS is a valid instrument with high applicability for people with intellectual disability. It shows good psychometric properties. The Cambridge Cognitive Examination for Older Adults with Down's Syndrome (CAMCOG-DS) can set two key points by the level of intellectual disability on the suspicion of cognitive impairment in people with Down's syndrome.
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Revista de neurologia · Oct 2013
Case Reports[CLIPPERS syndrome with atypical distribution of lesions in magnetic resonance imaging of the brain].
CLIPPERS syndrome (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) is an inflammatory process of the central nervous system whose distinguishing features are the enhancing punctiform lesions in the brainstem that appear in the magnetic resonance images. Clinically, it is accompanied by dysarthria, ataxia and diplopia, and usually responds to treatment with corticoids. Pathologically, T lymphocytes appear infiltrated in the perivascular spaces of the brainstem. ⋯ Diplopia and ataxia, as in our case, are practically always present. The MR findings consist of punctiform enhancing lesions located in the pons extending towards the cerebellum, basal ganglia and corpus callosum, the enhancement gradient becoming lower as the distance increases rostrally away from the cortex, and caudally towards the spinal cord. In the case of our patient, this gradient is not respected, and the density found was similar to that of lesions at the supratentorial level. The differential diagnosis is wide-ranging and justifies an extensive diagnostic study with, in certain cases, a biopsy study of brain tissue. The disease courses in a relapsing-remitting pattern and the earlier steroid therapy is established and the more prolonged it is, the better the prognosis will be.
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Revista de neurologia · Oct 2013
Observational Study[Analysis of a series of cases with an initial diagnosis of acute disseminated encephalomyelitis over the period 2000-2010].
Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease that essentially affects the white matter of the central nervous system. The diagnosis is based on clinical-imaging and developmental findings. Magnetic resonance imaging of the brain is the most useful diagnostic tool. The disease course is usually monophasic and the preferred initial treatment is with corticoids. ⋯ ADEM may present at any age, including in infants. There are a number of conditions that can mimic ADEM in the early stages.
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Revista de neurologia · Oct 2013
Case Reports[Lacosamide as an alternative in the treatment of post-surgery neuropathic pain in an allergic patient].
Neuropathic pain is a condition that is still not well understood, although it affects a significantly high percentage of the population. The main problem lies in the fact that it can become a fairly disabling pathology. The most frequent treatment is based essentially on two drugs: gabapentin and pregabalin. Other pharmaceuticals, such as antidepressants, opioids or N-methyl-D-aspartate receptor antagonists can also be employed in combination with the primary drugs. All the same, treatment remains unsatisfactory. Furthermore, it must be borne in mind that there may be patients who are allergic to the two main drugs. ⋯ Lacosamide is a third-generation antiepileptic drug that has been proven to be effective, safe and with few side effects. It has been considered a good therapeutic option for the treatment of neuropathic pain in patients who are allergic to pregabalin.