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Biomedical subjects

A Iranzo

Publications and source records attributed to A Iranzo.

26 records · Page 2Linked to original sources
PubMed1996

[Movement disorders and AIDS].

We describe the clinical characteristics, causes and response to treatment in 6 patients with AIDS who presented with abnormal movement disorders between January 1987 and July 1993 in our hospital, 3 with hemiballismus-hemichorea, 1 with athetosis, 1 myoclonia and 1 with "rubric" tremor. Brain imaging showed lesions in the corpus striatum in all the patients. Suspected diagnoses were cerebral toxoplasmosis in 4, cerebral lymphoma in 1 and progressive multifocal leukoencephalopathy in 1. The toxoplasmosis patients showed improvement (2 cases) or disappearance (2 cases) of movements with antiparasitic therapy. Treatment provided no benefit to the patients with leukoencephalopathy and lymphoma. Hemiballismus-hemichorea was the most common movement disorder in AIDS patients. The underlying cause is usually lesions in the basal ganglia arising from toxoplasmosis. If the lesions are so caused, movements may improve with antiparasitic therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Cerebral toxoplasmosis in patients with human immunodeficiency virus (HIV) infection. Clinico-radiological and therapeutic aspects in 63 patients].

We have retrospectively reviewed 63 cases of encephalic toxoplasmosis (ET) in HIV-infected patients in order to determine clinical and radiological characteristics, the diagnostic value of serologic determinations, and the response to antioxoplasmic therapy. ET was the AIDS-defining condition in 44% of the patients. Eighty of the patients had a CD4 cell count < 100/microliters when ET was diagnosed. Only 4.8% of the patients had been taking anti-Pneumocytis carinii prophylaxis with cotrimoxazol. The most frequent clinical presentation was focal neurologic signs in 80.9% of the patients, with headache and fever in 53.3% and 42.4%, respectively. The most frequent cerebral CT finding was hipodense lesions (92%) with ring enhancement (68.9%). They were most frequently had a hemisferic location. Seroconversion was detected in two patients (6%), whereas 55 patients had serologic evidence of latent infection by Toxoplasma gondii (87.3%). Ninety eight percent of the patients were treated with sulphadiazine plus pyrimethamine. However, such therapy should be discontinued in 22% of them and switched to clindamycin plus pyrimethamine. The overall mortality rate during the acute phase of the disease was 7.9%, but 41.4% of the survivors exhibited neurologic sequelae. Relapsing ET was detected in 33.3% of the patients, and it was usually due to discontinuation of treatment. The mean survival time after the diagnosis of ET was 11.5 months. ET is the most common opportunistic infection of the central nervous system among our AIDS patients. Primary prophylaxis for toxoplasmic infection seems advisable in our epidemiologic environment, when CD4 cell count is less than 200/microliters and there is serologic evidence of latent infection. Acute ET usually has a good response to therapy, and the acute mortality rate is low. However, most of the survivors will remain with neurologic sequelae. The high frequency of adverse effects to sulphamide therapy with clindamycin make the need of alternative treatment strategies urgent.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Visual and central oculomotor disorders in patients with acquired immunodeficiency syndrome].

A clinical evaluation of visual and central oculomotor defects are presented in a series of 56 patients who were HIV carriers, of whom 47 fulfilled criteria for AIDS. Changes were detected in 22% of the asymptomatic patients (2/9), in 36% of the AIDS patients with no neurological complications and in 93% (15/16) of the AIDS patients with neurological involvement. Some changes were seen in 55% of the patients with AIDS. The commonest defects were alterations of saccadic movements and visual pursuit (35% respectively) and of opticokinetic nystagmus (28%). Only one homonymous visual defect was found. No brain stem syndromes were seen, except for one case of bilateral internuclear ophthalmoplegia. The commonest neurological complications were toxoplasmosis, the AIDS dementia complex (ADC) and multifocal leukoencephalopathy (MLP). Neuro-ophthalmological changes are described, in the literature, in 2-12%. Central oculomotor disorders, including supranuclear, nuclear and internuclear ophthalmoplegias are frequent and probably underestimated. Nystagmus is a common sign and there are isolated descriptions of flutter, opsoclonus and ocular dipping. The causes of visual and oculomotor changes reflect the incidence of parenchymatous neurological complications of AIDS. MLP is the commonest cause of change in the retrogeniculate optic pathways. Oculographic studies show changes in saccadic movements and ocular pursuit and signs of unstable visual fixation. These changes are seen in all ADC patients, in a large proportion of those without dementia and also in asymptomatic carriers, suggesting that oculography may be useful for prognosis.

AIDS Dementia Complex↗
PubMedDate not supplied

[Nocturnal eating syndrome].

AIM: A clinical and polysomnographic study of two patients with nocturnal eating syndrome (recurrent awakenings associated with the need to eat and difficulty in returning to sleep it the patient does not eat). PATIENTS AND METHODS: Two patients, one 36-year-old male and one 41-year-old woman underwent clinical tests (including a psychopathological study based on a structured interview and a series of psychometric tests) and polysomnographical tests with audiovisual recording. RESULTS: The two patients presented a history since adolescence and insidious, progressive course of multiple nocturnal episodes associated with the need to eat and difficulty in returning to sleep if they did not do so. The polysomnographic study with video demonstrated awakenings in all the phases of sleep which were rapidly followed by food intake discarding other diseases. The biochemical, hormonal and neuroimaging studies were normal. The two patients showed alterations in alimentary habits characterized by gorging and a psychiatric profile of obsessive and compulsive traits. Bulimia and anorexia nervosa were excluded. CONCLUSIONS: The association of nocturnal eating syndrome with a compulsive alimentary pattern and the presence of obsessive-compulsive features in exception and suggests a common mechanism characterized by compulsive acts. Polysomnographic recording allows confirmation of the clinical diagnosis of nocturnal eating syndrome and discards other diseases.

Adult↗
PubMedDate not supplied

[Sleep disorders in multiple system atrophy].

Sleep disorders are so common in multiple system atrophy that they should be considered an integral part of the disease. Sleep fragmentation occurs in more than half of the patients, with sleep onset and sleep maintenance insomnia. Periodic leg movements of sleep are also common, although they are generally asymptomatic. REM sleep behavior disorder, a parasomnia in which the patient presents vigorous movements associated with intense dreaming dreaming during REM sleep, is detected polysomnographically in almost all the patients with variable severity. Nocturnal stridor is produced by obstruction on the glottis level. The cause of stridor is unknown but two alternative explanations have been proposed: paralysis of the muscles opening the vocal chords and excessive contraction of the muscles that close them. A combination of both, however, is the most likely explanation. Nocturnal stridor is associated with decreased survival and its treatment is based on continuous positive air pressure (CPAP) when it occurs only during sleep or tracheostomy when it worsens and becomes also diurnal.

Humans↗
PubMedDate not supplied

[Adie's tonic pupil].

Explore the source record for details and available documents.

Adie Syndrome↗
PubMedDate not supplied

[Post-radiotherapy brachial plexopathy and cervical myelopathy].

The case of a 58-year-old male who, after 47 months of treatment with cervical radiotherapy for labial carcinoma, developed brachial plexopathy and six months later cervical myelopathy is herewith presented. Involvement of both the brachial plexus and the spinal cord in the same patient secondary to radiotherapy is exceptional.

Brachial Plexus↗