Revista de neurologia
-
Revista de neurologia · Aug 2018
Observational Study[APACHE II and SAPS II as predictors of brain death development in neurocritical care patients].
To assess the prognostic value of APACHE II and SAPS II scales to predict brain death evolution of neurocritical care patients. ⋯ Transplant coordinators might use the APACHE II score as a tool to detect patients at risk of progression to brain death, minimizing the loss of potential donors.
-
Revista de neurologia · Jul 2018
[Outpatient establishment and initial management of treatment with intraduodenal levodopa-carbidopa infusion in advanced Parkinson's disease].
Treatment with intraduodenal levodopa-carbidopa infusion is one of the three therapies currently available for advanced Parkinson's disease. It optimizes the benefit of antiparkinsonian treatment by counteracting the negative effect of erratic gastric emptying on the absorption of oral levodopa. The purpose is to describe our outpatient protocol of treatment establishment. ⋯ The outpatient onset install of this treatment saves costs and avoids the negative impact of admission on the patient with advanced Parkinson's disease, in the same way that favors their adaptation and tolerability to it.
-
Revista de neurologia · Mar 2018
Case Reports[Lacosamide associated with high-degree block in a patient with trigeminal neuralgia].
Lacosamide is an antiepileptic drug whose exact mechanism of action remains unknown. It acts by increasing the slow inactivation of the voltage-dependent sodium channels of the cell membranes. It is indicated in the treatment of focal seizures with or without secondary generalisation and is occasionally used as adjunct treatment in neuropathic pain. Although the most frequent side effects are mild (dizziness, diplopia, blurred vision, headache, tremor, etc.), others such as supraventricular tachyarrhythmias, changes in repolarisation, atrioventricular blocks and even cardiac arrest or sudden death have been reported. ⋯ Voltage-dependent sodium channel blockade mainly affects non-sinusal cardiac tissue. An alteration in the atrioventricular or infrahisian node is more consistent with its mechanism of action. Other cases of atrioventricular block in this kind of polytherapy have been reported. Precaution is advised in the concomitant use of antiepileptic drugs, above all among those that prolong the PR interval, and they should be contraindicated in patients with a history of atrioventricular block, ischaemic heart disease or heart failure. Before starting, a baseline electrocardiogram and regular electrocardiographic monitoring are advised during the first few weeks.
-
Revista de neurologia · Mar 2018
[Neurobiological bases of autistic spectrum disorder and attention deficit hyperactivity disorder: neural differentiation and synaptogenesis].
To know the neural processes linked to the activity of brain circuits in order to understand the consequences of their dysfunction and their role in the development of neurodevelopmental diseases, such as autistic spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). ⋯ ASD and ADHD are functional alterations of the cerebral cortex, which present structural anomalies in the arrangement of neurons, in the pattern of connections of cortical columns and in the structure of dendritic spines. These alterations affect mainly the prefrontal cortex and its connections.
-
Revista de neurologia · Oct 2017
[Transcranial direct current stimulation for the treatment of fibromyalgia: a systematic review].
Fibromyalgia is a multisymptomatic diffuse chronic musculoskeletal pain syndrome with evidence of central nervous system dysfunction. Accordingly, non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) may be a complementary therapeutic resource to reduce pain perception. ⋯ The experience with tDCS in fibromyalgia is still limited. However, the anodal tDCS in the left primary motor cortex can be recommended with level B (probable therapeutic efficacy) and appears to act through the modification of the sensorial processing of the pain of thalamic inhibitory circuitry.