Using Intravenous Inmunoglobulin in an Atypical Case of Lambert Eaton Síndrome.

A 48 year-old hypertensive, smoker patient who started presenting a generalized weakness, pait instability,visual disorders and uncontrolled blood pressure is presented. At physical examination quadriparesis and weakness extraocular muscles were found. A repetitive estimulation test of low frequency was performed among other lab tests that had compatlbility with gravis myasthenia which was treated and improved. After this, an acute worsening of the condition was found and was treated with intravenous inmunoglobulin which produce a signifcant quantitative improvement. Days after this the patient stated to have some other disorders and, Lambert Eaton myasthenic syndrome was suspected. An electromyography test with 30 Hz was performed proving it. In spite of suffering a Lambert Eaton myasthenic syndrome this patient presented an acute state making a crisis which was improved with the use of intravenous inmunoglobulin. This result make us consider the usage of this medication as a therapeutic option in similar cases.</strong

An approach to the differential diagnosis of the epileptic crisis.

There are many kinds of epileptic crisis, for they are the most frequent cerebral crisis, but there are other events known as not epileptic paroxysmal events that may lead to confusion and that, sometimes, are very hard to distinguish from the first ones; to do it one should first detail at the clinic, and the best diagnostic means is the video-electroencephalogram. The frequency rate of these events and also of epilepsy, the approach by several medical specialties, and the complexity of the diagnostic means and the anti-epileptic treatment give this topic a great practical significance suggesting its opportune consultation

The neurosyphilis is not history. A case presentation.

The syphilis is a sexual transmitted disease, caused by the pal Treponema that has had an increment with the appearance of the syndrome of acquired immunodeficiency disease starting from 1980. In 1906 this germ was observed in the human cerebrospinal fluid, in this way it opened up the neurosiphilis diagnosis. Is presented the case of a patient who began in a sudden way with a two-phase convulsive square followed by a state of coma of several days, then appeared fever, astenia, left hemiparesis. He was entered and disorientation stigmas, nape rigidity and fever emerged of up to 39oC, twelve days later He was received in neurology room where, after a series of studies, he was diagnosed with neurosyphilis.<strong><br /></strong

Prognostic Value of Transcranial Doppler in the Survival of Patients with Spontaneous Cerebral Intraparenchymal Hemorrhage

Background: transcranial doppler is a technique which is constantly being developed and constitutes an indirect measure of intracranial pressure. Objective: to demonstrate the prognostic value of transcranial doppler in patients with spontaneous cerebral intraparenchymal hemorrhage. Method: a prospective study was carried out on 50 patients admitted with the diagnosis of intraparenchymal cerebral hemorrhage of non-traumatic cause in the first 12 hours of admission, the pulsatility rate and average velocity in the middle cerebral artery was determined bilaterally. A univariate study was performed at age, presence of intraventricular blood, average speed, hematoma volume and transcranial doppler values. The existence of correlation between the pulsatility index values and average speed with the average speed was evaluated. The values of transcranial doppler were found their predictive values. Results: a significant association was obtained among hematoma volume, transcranial doppler values and electrocardiogram with survival. In addition, a correlation was found between this last parameter and the transcranial doppler. The area under the operating characteristic curve of the transcranial doppler receptor in the affected hemisphere was highly predictive of mortality with high sensitivity and specificity for cut-off points of the pulsatility index at 1.85 and average speed at 32.3 cm/s. Conclusions: glasgow coma scale and hematoma volume are the main prognostic indicators of survival in patients with spontaneous intraparenchymal hemorrhage

Quantification of the usage of symptomatic treatment in patients suffering from multiple sclerosis.

<p><strong>Background:</strong> Multiple sclerosis is a chronic demyelinated disease which constitutes de first cause of neurological handicaps in young adult patients and has no curative treatment. There are other options in which treatment of great importance can be applied for each of the so many symptoms that may appear. <strong><br />Objective:</strong> To show the insufficient utilization of symptomatic treatment in patients with multiple sclerosis. <br /><strong>Methods:</strong> 47 patients were studied in a national consultation of multiple sclerosis in a two-year period. They were interviewed and examined. The data were collected in a survey and statistically processed opposing the specific signs and symptoms to the treatments used. <strong><br />Results:</strong> High percentages of patients with clinical manifestations and without the proper treatment for rigidity, weakness, ataxia, urinary retention and incontinence, sexual dysfunction, constipation, fatigue, pain and depression were found. <br /><strong>Conclusions:</strong> It was already proved that there is an insufficient utilization of symptomatic treatment in patients suffering from multiple sclerosis.</p

Ethiologic diagnosis of dementia syndrome.

Dementia prevalence is between 4,5 and 18,5%, the inferior numbers are in the underdeveloped countries. Studies carried out in Cuba, shows approximately a 10% for more than 60 year old persons, what makes consider dementia as a health problem of huge importance. That is why the existence of a practical guide for its etiological diagnosis is of supreme necessity. This study engulfs diverse criteria to reach the diagnosis of dementia syndrome, as well as the diseases that may cause it, foretell it or accelerate it. Numbers are presented, and a series of valuations about dementia, the slight cognitive aggravation, Alzheimer disease, vascular dementia, dementia by Lewy bodies, and front temporal dementia, as well as other kinds of dementia. <strong><br /></strong