Revista de neurologia
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Over the past ten years there have been major advances in understanding the neurochemistry of the brain. This has led to better understanding of the mode of action of the classical antiepileptic drugs and the development of new drugs with better pharmacokinetic and pharmacodynamic characteristics. For this reason and also due to their wide mode of action, they have begun to be used for other clinical disorders, particularly neuropathic pain, in the prophylaxis of migraine, in psychiatric disorders and for neuroprotection. ⋯ The new antiepileptic drugs have become an excellent option for the treatment of neuropathic pain. However, for both this and other clinical indications controlled, double blind studies are necessary to determine the efficacy, tolerability and precise indications for these drugs within the therapeutic arsenal available for these disorders.
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Revista de neurologia · Jun 2001
Case Reports[Can acute disseminated encephalomyelitis progress in a deferred way?].
To report on the heterogeneity with regard to the clinical course of the acute disseminated encephalomyelitis (ADEM). ⋯ We postulate that the recurrent symptoms in our patient could be explained as a multiphasic disseminated encephalomyelitis (MDEM). Favourable outcome after simultaneous treatment with methylprednisolone and intravenous immunoglobulin is emphasized in this report.
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Revista de neurologia · Jun 2001
Case Reports[Spinal epidural abscess secondary to pharyngeal trauma due to food].
In recent years the incidence of spinal epidural abscesses has increased. Early diagnosis is very important, since once neurological deficit has become established this is often permanent. The commonest aetiological agent is Staphylococcus. Pain and fever are often the only symptoms before acute neurological deterioration. ⋯ The possibility of epidural infection must be remembered in patients with fever and nerve root pain. Early diagnosis and suitable treatment, combining both surgery and prolonged treatment with antibiotics, are essential to prevent permanent neurological damage.
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Revista de neurologia · May 2001
[Neuroprotection in acute ischemic stroke. Practicability of guidelines for treatment].
Fibrinolytic agents are effective in the treatment of acute ischemic stroke. However, logistic and clinical factors limit their use. Neuroprotective drugs pose less risks and can be used even before performance of computed tomography of the brain as they are not detrimental in hemorrhagic stroke. These aspects, in theory, will allow the use of neuroprotective drugs in larger number of patients. ⋯ A protocol of acute stroke management using neuroprotective agents presents clear logistic advantages allowing the inclusion of larger number of patients. Citicoline appears as a safe and potentially effective option.
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Revista de neurologia · Apr 2001
[Blood neuronal specific enolase in newborns with perinatal asphyxia].
Neuron-specific enolase (NSE) is a sensitive marker of brain injury after hypoxia or ischemia. There are few studies about its usefulness in asphyctic newborns. ⋯ The presence of elevated NSE values in blood after perinatal asphyxia can be a sensitive indicator of conspicuous brain damage. The combined information provided by the severity of the encephalopathy together with the blood NSE values have shown a high predictive value for neurological outcome.