Biomedical subjects

A García-Castiñeira

Publications and source records attributed to A García-Castiñeira.

2 recordsLinked to original sources

PubMed1998

[Clinical pseudo-peripheral presentation of cerebral lesions].

Small size cerebral lesions, located strategically, can determine the presence of sensitive and motor signs limited to a part of an extremity, clinically suggesting peripheral nervous system affectation, determining erroneous diagnostic and therapeutic decisions. We present 5 patients initially diagnosed of peripheral nervous system pathology, which were finally diagnosed of cerebral lesions (2 lacunar infarcts, multiple sclerosis, progressive multifocal leucoencephalopaty, multicentric astrocytoma). In all, clinical examination disclosed incongruous distribution of the sensitive manifestations and myotatic reflexes were present. CT studies were normal in three patients whereas MRI showed lesions in all cases. Lesions were smaller than 1.5 cm in diameter (greater in the case of multicentric astrocytoma), and were subcortically located in the opposite cerebral hemisphere to the affected extremity. Sensitivomotor signs restricted to an extremity not concordant with a nervous or radicular distribution and with presentation of myotatic reflexes, make it necessary to look for a central nervous system lesion. Lesion will be located in the opposite cerebral hemisphere and MRI will be the elective complementary exam.

Adult↗

PubMedDate not supplied

[Coma associated with migraine].

INTRODUCTION: Basilar migraine is a particular form of migraine with an aura in which crises of headache are accompanied by symptoms of dysfunction in the vertebro-basilar territory, including alteration of consciousness in the form of stupor or coma. CLINICAL CASES: We report four patients, three men of 14, 17 and 83 years of age and one woman of 21. All had previous histories of migraine and presented with transitory episodes of coma. During the coma, the woman woke up spontaneously with intense bulimia. In the three men, it was seen, on injecting flumazenil, that the state of consciousness and the EEG returned to normal transiently. Neuroimaging studies (CT and MR) were normal in all patients. CONCLUSIONS: Migraine-coma is an exceptional, emergency condition in which structural, infectious, toxic and metabolic pathology of the Central Nervous System should be ruled out. As well as in patients with basilar migraine, the association of migraine and coma may also be seen in patients with familial hemiplegic migraine and CADASIL and MELAS syndromes. It may be that gabaergic mechanisms are involved in the theoretical dysfunction of the ascending reticular activating system causing alteration of consciousness, since in the three patients in whom flumazenil was injected, there was a response.

Adolescent↗