Biomedical subjects

F Villanueva-Gómez

Publications and source records attributed to F Villanueva-Gómez.

6 recordsLinked to original sources

PubMed2002

[Society, law and epilepsy].

INTRODUCTION: Epilepsy is an important problem from a medical, social and legal point of view. Proof of this is the fact that it constitutes the second most commonly alleged cause for absolution of responsibility in Spain, according to the jurisprudence from the Supreme Court (1976 1995). METHOD: Throughout history it has been classified as a magical, supernatural disease and has been studied within psychiatry as an endogenous psychosis. It has therefore been considered a form of madness, which has led to court decisions that have taken this concept into account. The supposed dangerousness of suffers from epilepsy must be the exception, and their supposed epileptic characters and personalities that drive them to commit atrocious murders are no longer of any relevance. The problems stemming from epileptic seizures are to be seen in civil, penal, military, canonical and labour law, very often in an exclusive fashion. CONCLUSION: We think it is worthwhile reviewing these concepts with a view to their undergoing a later modification, which would lead to the full integration of these patients and to their being considered as suffering from a neurological illness.

Crime↗

PubMed2000

[Video-EEG description of epileptic seizures].

INTRODUCTION: Digital electroencephalography with simultaneous video-EEG recording gives invaluable information for the diagnosis of epileptic seizures, so that motor episodes which seem to be of cerebral origin may not show electrical correlation or on the other hand, electroencephalographic seizures may not be accompanied by clinical changes. DEVELOPMENT: The differential diagnosis between the different types of epileptic seizures and between these and non-epileptic motor episodes, have, in this technique, great application as does the monitoring of doubtful seizures. We have recorded a large number of epileptic seizures with electrical correlation. In some of these cases it may be seen that the start of the episode, which clinically appeared to be generalized, showed an initial focal discharge although it became secondarily generalized. CONCLUSIONS: We believe that this is not an expensive investigation when rationally used for a specific purpose, knowing what we are looking for (when this is possible). We particularly recommend synchronized recordings in neonatology, where the identification of seizures is difficult.

Diagnosis, Differential↗

PubMed2000

[A video-EEG description of non-epileptic paroxysmal seizures].

INTRODUCTION: Paroxystic disorders, especially of motor type, mean that sometimes interpretation and classification as epileptic or non-epileptic is difficult. In these cases a recording of the episodes synchronized with an EEG may help diagnosis. DEVELOPMENT: By means of digital EEG and video we have recorded various episodes similar to epileptic seizures, in which lack of correlation between the absence of paroxysms on the recording and the clinical anomalies is well seen, and therefore this investigation is more than justified. In some cases it has allowed medication to be stopped in patients who were being treated as though they were epileptics when in fact they were not. In others, such as a case of syncope with subsequent convulsions, we showed that on the EEG there was slowing followed by reduction in the amplitude representing cortical extinction, far from paroxystic hypersynchrony. Hypnagogic nocturnal episodes are differentiated from true myoclonic epilepsies. We have shown pseudo-seizures which were very similar to the automatisms of epileptic complex partial crises, without electrical changes apart from the extracerebral artefacts due to the patient's movements. CONCLUSION: In every patient in whom there is reasonable doubt as to whether the motor disorders are of cerebral origin or not, a long duration synchronized video-EEG is essential, done both whilst awake and asleep.

Child, Preschool↗

PubMed1998

[Epilepsy, society and rights].

Although from the medical point of view epilepsy is considered to be a neurological disorder, this has not always been so. It was once included in the group of psychiatric disorders by the medical profession and others. In the case law of the Supreme Court, epilepsy is defined as a typical endogenous psychosis, and therefore as insanity. This would lead to its inclusion in the grounds for exoneration from criminal responsibility and has therefore been invoked as grounds for immunity from prosecution by many offenders. This has proved to be a two-edged sword, since the concept of insanity has led to these patients suffering social rejection. Medicine and Law have never found it easy to understand each other. However, now more than ever, some degree of mutual understanding is necessary when passing judgement on a person, since the Law progresses more slowly than Medicine does. Thus, today we would question a series of offences referred to in this paper, which used to be classified as insanity due to epilepsy. From a legal point of view we advocate a clear classification of epilepsy as a neurological disorder. This would doubtless lead to epileptics being more socially acceptable.

Attitude to Health↗

PubMed1997

[Informed consent in neurology].

Informed consent has remained in the medical tradition but the scale of values and human rights have changed. Today the emphasis is on a human being's right to autonomy, his personality and power to make decisions. At the same time, the doctor-patient relationship has undergone considerable changes. It has evolved from one of paternalism based on the old idea of charity, to one in which the principle of freedom is prevalent whereby it is the patient who has the right to decide the type of medical procedures to be used on him. This idea is recognized as such in the General Health Act of 1986. It has therefore become obligatory for the medical profession to abide by this Act. To do so the patient must be given sufficient information regarding the medical procedures to be applied in his case in particular, including all the risks and advantages as well as any possible alternatives, so that the patient is able to play a part in choosing the most suitable treatment. By law this information must be written down. This is essential to create protocols or medical guide-lines to orientate both the patient and the judge in the event of a demand action as to whether the medical procedure was in accordance with the lex artis or not in each case (lex artis ad hoc). We wish to encourage our colleagues to create a model such as we present, indicating what we consider to be essential points to be included in guide-lines in order to achieve uniform criteria throughout the country thereby facilitating the work of medical assessors and judges. We encourage the scientific societies involved and the corresponding medical departments to form a working party to draw up these medical guide-lines in order to achieve the maximum agreement possible.

Humans↗

PubMedDate not supplied

[Epilepsy and permission to drive].

INTRODUCTION: At the present time it has become a social necessity for most people to be able to drive a motor vehicle. For this reason, obtention of a driving license is continuously regulated so as to be adapted to the psychophysical aptitudes required at any given moment, since these vary with medical and social advances. DEVELOPMENT: We review the doctrine on this subject in some of the major countries, finding that far from having similar criteria, there is disparity even between different jurisdictions of the same country. In Spain epilepsy is regulated regarding the difficulty in obtaining a driving license in the General Regulation for Drivers (RD 772/1997). We consider this in detail. CONCLUSIONS: We try to unify criteria regarding the periods free of seizures, modifying the language with respect to some of these, validity of the license, analysis of the medical report and its responsibility in case of third party injury in a road accident. We propose open debate to clarify these terms.

Accidents, Traffic↗