GIANT CELL ARTERITIS AND CHARLES BONNET SYNDROME. THE CASE OF SAINT MARTIN OF LEON

Santo Martino de León fue un clérigo leonés del siglo XII. Se conocen algunos detalles de su vida porque fueron descritos por su coetáneo Lucas de Tuy en el Liber de Miraculis Sancti Isidori. Santo Martino era un anciano venerable que padecía fuertes dolores de cabeza, notables dificultades para elevar o mantener elevados los brazos, cansancio y anorexia. Además, aparece representado en su obra Concordia con una inusual hiperpigmentación de las sienes que sugiere alguna intervención terapéutica sobre las arterias temporales. Estos datos nos llevan a pensar que podría ser el primer caso descrito de arteritis de células gigantes con alguna información clínica. Por otra parte, sufrió una singular y curiosa aparición de San Isidoro de Sevilla que le hizo tragar un librillo, que pudiera corresponder a una alucinación visual compleja o síndrome de Charles Bonnet asociado. Se comentan los datos históricos de la enfermedad, así como su evolución y tratamiento antes de los corticoides.Saint Martin of Leon was a monk who lived in the 12th century. The details of his life are known because they were described by his contemporary, Lucas de Tuy, in the Liber de Miraculis Sancti Isidori. Saint Martin of Leon was a venerable old man who suffered from severe headaches, considerable difficulties in raising or maintaining his arms raised, asthenia, and anorexia. In addition, he is represented in his codex Concordia with an unusual hyperpigmentation of the temples suggesting a therapeutic intervention on temporal arteries. These data lead us to think that this could be the first described case of giant cell arteritis with some clinical information. Moreover, he experienced a singular and curious appearance of Saint Isidore of Seville, who made him swallow a booklet, which might correspond to a complex visual hallucination or associated Charles Bonnet syndrome. Historical data on the disease are reviewed and discussed, as well as its evolution and treatment before giving steroids

Long-Term V-EEG in Epilepsy: Chronological Distribution of Recorded Events Focused on the Differential Diagnosis of Epileptic Seizures and Psychogenic Non-Epileptic Seizures

Differential diagnosis in epilepsy is sometimes challenging. Video-electroencephalography (V-EEG) is an essential tool in the diagnosis and management of epilepsy. The prolonged duration of V-EEG recording increases the diagnostic yield of a conventional V-EEG. The right length of monitoring for different indications is still to be established. We present a retrospective descriptive study with a sample of 50 patients with long-term V-EEG monitoring, with a mean age of 36.1 years, monitored from 2013 to 2019 at the Burgos University Hospital. The mean monitoring time was 3.6 days. Events were obtained in 76% of the patients, corresponding to epileptic seizures (ES) in 57.9% of them, with psychogenic non-epileptic seizures (PNES) in 39.5%, and with episodes of both pathologies in 2.6% of the patients. We found that the first event was highly representative, and it correlated with the rest of the events that would be recorded. Moreover, 92% of the first PNES had been captured at the end of the second day, and 89% of the first ES by the end of the third day. V-EEG for differential diagnosis between ES and PNES can be performed in hospitals without specialized epilepsy surgery units. For this indication, the duration of long-term V-EEG can be adjusted individually depending on the nature of the first event