Revista de neurologia
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Revista de neurologia · Sep 2004
Historical Article[From empiricism to neuroscience in Alzheimer's disease].
It has been almost a hundred years since neurofibrillar degeneration in the neurones of the cerebral cortex was first described by Alois Alzheimer. This finding led to the recognition of a new disease (a presenile dementia unlike senile dementia) using the clinicopathological empirical method employed at that time. Despite Alzheimer's own opinion and the subsequent findings from many neuropathological studies, general acknowledgement of the full implications of this dichotomy has taken decades. All the cases were grouped under the eponym of Alzheimer's disease and it is now being studied with the different modern scientific methods currently available to researchers. ⋯ Alzheimer's disease has given rise to an exceptional associationist movement around the world and has become one of leading social and health problems facing the human race; its research and treatment will require the involvement of national and supranational public authorities.
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Revista de neurologia · Sep 2004
Review[Nogo-A functions during the development of the central nervous system and in the adult].
The myelin-associated inhibitors play a very important role in preventing the regeneration of the adult central nervous system. Among these inhibitors it is Nogo-A, a recently cloned protein expressed by oligodendrocytes. However, after its discovery as a myelin-associated protein, there has been described new functions for Nogo-A far from its role in the oligodendrocytes myelin. ⋯ Although Nogo-A was discovered in the context of axonal growth inhibition, in which it is indeed playing a determining role, Nogo-A has turned out to be also a neuronal protein involved in diverse processes that go from axonal fasciculation to apoptosis. As we deepened in our knowledge about the molecular mechanisms that organize the complex functioning of the CNS, it is clearer that the proteins implicated in fasciculation and axonal guidance during development also play equally important roles in mechanisms like the axonal inhibition or the regulation of the synaptic plasticity in the adult CNS.
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Revista de neurologia · Aug 2004
Review[The safety and tolerability profile of gabapentin in optimal doses].
Gabapentin (GBP) is an amino acid that is structurally analogous to GABA with the capacity to cross the blood-brain barrier and an antiepileptic action. It is indicated in the treatment of partial seizures with or without secondary generalisation. It has been suggested that the dosages used in pilot studies were not suitable to achieve optimal efficiency. ⋯ Enough evidence was found to allow us to state that the efficiency of GBP can be increased with the utilisation of higher doses than those recommended to date, without the risk of generating unacceptable side effects at the same time.
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Revista de neurologia · Aug 2004
Comparative Study[Drug-cholinesterase-inhibitors persistence patterns in treated patients with dementia of Alzheimer type: retrospective comparative analysis of donepezil, rivastigmine and galantamine].
Long term duration of treatment of the dementia of Alzheimer type, the most frequent type of dementia in our environment, is associated with delay in patient functional and cognitive impairment. The aim of the study was to determine retrospectively the persistence of treatment with donepezil, rivastigmine and galantamine in patients with dementia of the Alzheimer type in a population setting. ⋯ This retrospective study found that patients with dementia of the Alzheimer type treated with donepezil showed more persistence of treatment compared which those who received rivastigmine or galantamine.
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Revista de neurologia · Aug 2004
Case Reports[Ruptured aneurysms presenting with subdural hematoma: management without angiography].
Ruptured aneurysms on rare occasions cause subdural hematomas as described in literature. Sudden deterioration and coma is a common feature in those patients and a emergent surgical attitude is prompt required, even without confirmation with angiography. ⋯ The occurrence of a subdural hematoma caused by the rupture of an intracranial aneurysm must be suspected in spontaneous subdural hematomas, especially in association with disproportioned conscious deterioration. All the three patients we report debuted with sudden conscious deterioration. If a ruptured aneurysm causing subdural hematoma is suspected, early surgical intervention is required even if angiography is not available. Severe neurological deficit and uncal herniation might still be reversible if provided decompression can be carried out in promptly. Angiography availability should not postpone surgery. Aneurysm presence should be ruled out whether by surgical exploration or by delayed angiography. Posterior communicating aneurysm are related to formation of subdural hematoma.