Neurología : publicación oficial de la Sociedad Española de Neurología
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Pain is a cognitive evaluation. Its appearance in the new functional image systems is promising. Nocioceptive pain, usually acute or persistent, is useful to prevent animals from getting injured. ⋯ Pain treatment should be physiopathologicaly orientated. Pain units, specialized in analgesic treatment and some invasive techniques, are usually competent in the treatment of nocioceptive pain. Neuropathic pain should have a neurologic diagnosis and treatment. But neurologist need to be more and more interested in the chronic pain related with memory and sensitisation: better knowledge of the cerebral mechanisms in this phenomenon can add to this pathology in our field.
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Recently it has been demonstrated safety and efficacy of treatment with intravenous recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke in Europe, however there are differences in different European countries that may have variations in the response to treatment. In this study we reviewed the experience of thrombolytic therapy in Spain in a prospective observational register. ⋯ In Spain, treatment with rt-PA for ischemic stroke is safe and effective when administered within the first 3 hours after symptom onset, and have a higher benefit than in the rest of the world.
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Osmophobia is often reported by migraine patients. This study evaluates osmophobia in connection with the diagnosis of episodic migraine with or without aura, chronic migraine and episodic and chronic tension-type headache. ⋯ Osmophobia and taste abnormalities were demonstrated to be very specific in diagnosing migraine, but very insensitive. Osmophobia frequency does not depend on migraine frequency. Osmophobia seems to be more frequent in females than in males. The lack of osmophobia in MA patients could be explained by a different pathophysiological mechanism between MA and MoA.
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Intravenous fibrinolysis in the first 3 hours from the onset of the symptoms and admission to a Stroke Unit (SU) are fundamental cornerstones of the acute ischemic stroke treatment. Intravenous fibrinolysis in Spain has been performed by the neurologists since the beginning of the century within the safety registries. The number of patients treated and accredited centers have progressively increased in recent years. ⋯ Fibrinolysis has served to dynamize the Care regarding Stroke in Spain through the creation of the Regional Health Care Plans and the SU. The SU is the best treatment of stroke since they improve the morbidity-mortality with a favorable cost/efficacy balance, reducing the complications and dependence. Most of the strokes (including transient ischemic attacks and cerebral hemorrhages) benefit from them. The SU is the basis from which the number of fibrinolyses can be increased, where general cares can be applied and where new therapeutic measures such as Neuro-Interventionism, Tele-Medicine or the development of new drugs can be implemented. The publication of the National Strategy in Stroke by the Health Care Ministry is a unique opportunity to improve neurological care of stroke. No one more than the neurologists know how to treat stroke and up to now, we are the only specialists who have demonstrated that we know how to apply intravenous fibrinolysis.
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Letter Case Reports
[Acute hyperammonemic encephalopathy in ornithine transcarbamylase deficiency].