Biomedical subjects

J M López-Agreda

Publications and source records attributed to J M López-Agreda.

3 recordsLinked to original sources

PubMedDate not supplied

[Surgery unit for epilepsy].

INTRODUCTION: Only few medically refractory epileptic patients are evaluated for surgical treatment, in spite of the good results obtained at the Centers where epilepsy surgery is performed. OBJECTIVE: We are presenting the way the Gregorio Marañón Hospital Epilepsy Surgery Unit functions and their casuistry. PATIENTS AND METHODS: This Unit is composed by members of the Services of Neurosurgery, Neurology, Neurophysiology, Neuroradiology, Psychology, Neuropediatry, Nuclear Medicine and Neuroanestesiology. Patients are studied by means of protocols. RESULTS: Twenty cases were operated upon. The procedures were temporal lobectomy in 9 cases, amygdalo-hipocampectomy in 4, frontal lobectomy in 3, frontal topectomy in 2, partial hemispherectomy in 1 and vagal nerve stimulation in 1. In 16 of the 19 surgery specimen there were some pathological abnormalities. In the short follow-up 13 patients are seizures free experience significant improvement.

Epilepsy↗

PubMedDate not supplied

[The association between post anoxic encephalopathy and startle epilepsy].

INTRODUCTION: The startle is a variant of primitive physiological reflex, present in developed animals. It could be defined as a sudden defensive reaction triggered by an adequate sensorial stimulus, most effective if auditory, consisting under a clinical basis on the sudden and sequential contraction of some muscular groups, in first place affecting the facial territory (orbicularis oculi bilaterally), followed by the rest of the cranial nerves, the axial musculature and finally the limbs, predominantly proximal and flexor regions of superior extremities. The pathological startle is that which is precipitated by inadequate stimulus and excessive in response to it (under a low level of intensity or duration). It appears on account of different causes and mechanisms, among them a peculiar form of reflex epilepsy, the startle epilepsy. This form of epilepsy commonly present on infant postanoxic encephalopathy, shares its clinical features with other causes of pathologic startle, even though it presents a very characteristic electroencephalographic semiology. CASE REPORT: We present the case of a child with a startle epilepsy clinically presented as a form of subintrant status epilepticus under the context of a postanoxic encephalopathy secondary to drowsiness. With an adequate treatment it was possible to eliminate the epileptic phenomena, thus notoriously improving his quality of life (vigil and asleep). CONCLUSION: We review the characteristics and classifications of a variant of reflex epilepsy, the startle epilepsy.

Child, Preschool↗

PubMedDate not supplied

[Nocturnal paroxysmal dystonia, movement disorder and epilepsy].

INTRODUCTION: Nocturnal paroxysmal dystonia (NPD) is a disorder which appears during sleep. It is characterized by generally brief paroxysmal motor events which are complex when clinically expressed and are often repetitive. The origin of this disorder has been a matter for discussion for some time. Initially it was considered a specific movement disorder, but recently it has been suggested that it is epileptic in nature. CASE REPORT: In this study we present the case of a patient who is hospitalized in the Unit for epileptic surgery, suffering from epilepsy which does not respond to medical treatment and requires surgery. The patient is treated with conventional methodology, prolonged and continuous presurgical videoelectroencephalographic monitoring. EEG registers were used via electrodes placed in the scalp and skull, electrodes placed in the skull on adequate indication. Two types of perfectly defined electroclinical events occurred: some not epileptic and others clearly epileptic. On one occasion a convulsive tonic clonic epileptic crisis was recorded typical of frontal focal origin preceded by non epileptic motor phenomena. CONCLUSION: The presence of paroxysmal motor episodes during sleep, atypical as a form of epilepsy, the absence of unquestionable specific data in the EEG, and in the light of our discoveries, force us to consider the possibility that NPD is in fact a form of epilepsy caused in a reflex manner by a specific type of movement disorder during sleep, and whose origin should be more widely discussed.

Adult↗