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Biomedical subjects

C H Lahoz

Publications and source records attributed to C H Lahoz.

33 records · Page 2Linked to original sources
PubMed1992

[Acute meningoencephalitis caused by Coxiella burnetii with periodic EEG complexes].

Q fever is a zoonosis found worldwide and is produced by Coxiella burnetii. It may be acute or chronic with neurological manifestations being infrequent. Several cases of acute encephalitis or meningoencephalitis have been described, generally with an evolution towards cure regardless of the use of selective antibiotic treatment. Recently the authors had the opportunity to study a 33 year old male presenting acute meningoencephalitis in which the clinical manifestations, CSF findings (increase in cellularity with lymphocytic predominance and excess proteins ) and neurophysiological findings (appearance of periodic bilateral complexes in the EEG) suggested the diagnosis of herpetic meningoencephalitis. Treatment with acyclovir was initiated. However, serologic studies demonstrated, a posteriori, that the germ responsible had been Coxiella burnetii. The patient evolved satisfactorily with no specific treatment and the EEG anomalies disappeared within a few days. The authors insist on the need to include Q Fever in the diagnostic differential of acute meningoencephalitis and emphasize the possibility that germs of a non viral nature may produce periodic EEG complexes in all that similar to those found in herpetic encephalitis.

Acute Disease↗
PubMed1992

[Ischemic ictus in a young woman with fibromuscular dysplasia of the basilar artery].

Fibromuscular dysplasia (FMD) is a vasculopathy of unknown etiology generally presented in young women and preferentially found in the renal arteries. The second site of frequency of appearance corresponds to the cervical-cephalic arteries with cases of the intracranial vessels being exceptional. We recently had the opportunity to study a female patient of 29 years of age admitted following an acute progressive cerebrovascular event. Cranial computerized tomography (CT) demonstrated multiple ischemic lesions bilaterally affecting the basilar-vertebral territory. Angiographic study established the diagnosis of FMD upon observing "pearl-like" lesions located in the distal part of the basilar artery. Anticoagulant treatment was initiated and the patient evolved satisfactorily although some neurologic deficits persisted. The authors insist on the need to consider FMD as a cause of ictus in young, specially female, patients.

Adult↗
PubMed1990

Benign myoclonic epilepsy of infancy.

We present a case of benign myoclonic epilepsy of infancy and analyze the characteristic electroclinical findings. We wish to emphasize the usefulness of recognizing this entity among myoclonic epilepsies in children to enable early treatment and to obtain a good prognosis.

Child, Preschool↗
PubMedDate not supplied

Somatosensory evoked potentials in juvenile myoclonic epilepsy.

We analyzed the somatosensory evoked potentials (SEP) of 35 patients with juvenile myoclonic epilepsy (JME), 26 patients with idiopathic generalized epilepsy (IGE), and a control group consisting of 24 healthy people. The N19-P25 interval was significantly prolonged in the IGE group both as compared with the JME and control groups. This finding may be related to antiepileptic drug (AED) treatment, principally phenytoin (PHT). No differences were noted in N19 amplitude in any group. The P25 and N33 amplitudes were significantly higher in the JME group. In 5 patients of the JME group (14%) "giant SEP" were observed, but no differences were evident in the electroclinical characteristics with respect to the other JME patients. JME is one of the causes of giant-SEP.

Adolescent↗
PubMedDate not supplied

[Nuclear syndrome of the oculomotor nerve caused by a mesencephalic infarction confirmed by MRI].

The nuclear syndrome of the third nerve was first described in 1981. It has the very characteristic disturbance of an ophthalmoplegia with complete ipsilateral third nerve palsy associated with paresis of elevation in contralateral eye. This particularly presentation is due to the innervation of the superior rectus which comes mainly from the contralateral oculomotor nucleus. As associated signs were described contralateral cerebellar and or pyramidal syndromes, uni or bilateral parasympathetic disfunction and sometimes gaze disorders. The etiology es usually a vascular damage (ischemic most frequently) located in mesencephalon. We report on a case of a 60 years old man who developed acute nuclear ophthalmoplegia of the third right nerve accompanied with cerebellar and pyramidal syndrome and focal asterixis in left extremities. MRI showed an ischemic lesion in right paramedial mesencephalic territory with extension to the ipsilateral thalamic region. Pyramidal and cerebellar syndromes and asterixis disappeared in a few weeks, while ophthalmoplegia remained unchanged. Semiologic characteristics and anatomic basis of the nuclear oculomotor syndrome which allow to make the differential diagnosis between this syndrome and intra-axial fascicular disturbances of the third nerve (Weber, Claude and Benedikt syndromes) are discuss.

Cerebral Infarction↗
PubMedDate not supplied

[Epilepsy with myoclonic absences].

Within generalized epilepsy, the syndrome of epilepsy with myoclonic absences is considered as intermediate between idiopathic and symptomatic forms. This syndrome is characterized by developing in childhood with a male predominance. Critical EEG shows paroxysms of PO at 3 Hz, and in the polygraphic recording rhythmic 3 Hz myoclonus is observed with a strict correspondence between EEG spike and myoclonus. The response to therapy is generally poor, and 18% develop generalized symptomatic epilepsy. We report 3 patients with epilepsy with myoclonic absences and good outcome, to emphasize the importance of a precise diagnosis by means of the polygraphic recording of the attack, the fact the association of sodium valproate and ethosuximide is the most useful therapy and, finally, the possibility that some patients with epilepsy with myoclonic absence may develop Janz's juvenile myoclonic epilepsy.

Adult↗
PubMedDate not supplied

[Nodular subependymal heterotopia and epilepsy].

Neuronal migration disorders may manifest as epilepsy alone and this is usually the case in nodular subependymal heterotopia, of which we present 5 cases. We consider this entity to be a well-defined epileptic syndrome because it is found nearly exclusively in women and is characterized by nearly constant seizures which start in the second or third decade of life, familial aggregation of cases, a clinical and EEG profile that suggests a temporal focus and the absence of associated cognitive or motor deficits. Seizures are usually controllable with medication.

Adult↗
PubMedDate not supplied

[Recurrent confusional states and periodic lateralized epileptiform discharges: a new type of non-convulsive status epilepticus?].

Periodic lateralized epileptiform discharges (PLEDs) in an EEG usually indicate the presence of an underlying structural lesion (of vascular origin in most cases). PLEDs are also sometimes observed in certain types of infections (mainly viral), in which they may even constitute a characteristic finding useful for diagnostic purposes. In recent years cases have been reported in which PLEDs are linked to recurring confusional states that do not fit in with established classifications and that may be epileptic in nature. We discuss the cases of 2 patients who were repeatedly admitted to our hospital in confusional states, in whom PLEDs were observed in EEG readings. Clinical evolution in both cases paralleled EEG alterations. We were able to perform both critical and intercritical single proton emission tomography on 1 patient, finding, respectively, hyper- and hypoabsorption foci. Symptoms resolved with antiepileptic treatment.

Aged↗
PubMedDate not supplied

[Prognosis of supratentorial parenchymal hemorrhages].

The prognostic value of a group of parameters recorded upon hospital admission was assessed in a series of 135 supratentorial hemorrhages. The patients were divided into 3 groups based on survival < 30 days, between 30 days and 1 year, or > 1 year. Patients in the group with the shortest survival period were older; had more Glasgow scale scores < or = 10 and more Canadian scale scores < or = 5; had more hematomas > or = 4 cm in diameter revealed in computerized tomography with frequent midline shift and frequent ventricular hemorrhagic invasion; had higher stress reaction (hyperglycemia, leukocytosis and heart arrhythmia). Cholesterinemia, however, was lower in the shortest survival group. A range of quality of life was observed in the group (44%) with survival longer than 1 year. The subgroup with motor independence (Rankin < 3) (19%) differed from those with less motor independence (Rankin > or = 3) in that they were younger, more often had mean scores > or = 5 on the Canadian scale and normal blood pressure levels. We conclude that prognostic value of the clinical evaluation scales used, along with age and size of hematoma, was good.

Adolescent↗
PubMedDate not supplied

[Prognostic factors of supratentorial cerebrovascular accidents].

Our aim was to delimit prognostic factors in supratentorial stroke based on data obtained upon hospitalization. We studied two series of patients, the first being 150 with brain infarct and the second 135 having intracerebral haemorrhage. We analyzed: age, Glasgow and Canadian scales, glucose and urgence haemogram and the size of the lesion across its greatest diameter using computerized tomography (CT). Follow-up time was until death or one year after the stroke. Those who lived longer than one year after were subclassified according to the Rankin scale as < 3 and > or = 3. There was a significant difference between those who survived for less than one month and those surviving more than one year: their age (p < 0.01), average score on the scale (p < 0.001) and size of infarct (p < 0.05) or haematoma (p < 0.001). The Rankin subgroups < 3 and > or = 3 also differed significantly with regard to age. Noteworthy were the unfavourable data: Glasgow < 10 points and Canadian < 5 points, in infarcts > 6 cm and haematomas > 4 cm in diameter. We comment on other evolutionary variables which may influence prognostic assessment such as clinical deterioration or CT sensitivity of the infarct depending on the carry-out time.

Adolescent↗