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Biomedical subjects

J M Moltó

Publications and source records attributed to J M Moltó.

At least 19 recordsLinked to original sources
PubMed1998

[Late onset epileptic crisis and cerebrovascular disease].

INTRODUCTION: Stroke is the most frequent cause of epilepsy in adults, specially in those over 60 years old. Our aim was to analyze the etiologic relevance of stroke among the different etiologies of late onset seizures and to evaluate the clinical characteristics of the subgroup of patients with late onset seizures associated to stroke. PATIENTS AND METHODS: Patients aged over 20 who were admitted to the Neurology or Neurosurgery departments in our hospital for a first-ever seizure over a period of five years were identified retrospectively. The total number of patients included was 248. RESULTS: The most frequent etiologies were stroke (26.2%), tumors (26.2%), unknown (24.6%) and chronic alcohol intake (18.5%). Stroke was the most frequent etiology in patients over 60 (50%). Five of the 65 patients with stroke related seizures had suffered an intracranial hemorrhage and the rest had ischemic lesions. Seven patients had clinically silent infarctions. Seizures were generalized in 60% of the cases. Nearly in all the patients lesions were placed close to the cortex and mainly in carotid artery territory. CONCLUSIONS: Late onset seizures are due to a lesion in the brain in an important number of cases. Stroke is the most prevalent cause and this prevalence increases with age. A complete diagnostic procedures is warranted in this patients.

Adult↗
PubMed1997

[Myopathy caused by inhibitors of hydroxymethylglutaryl-coenzyme A reductase].

INTRODUCTION: Hydroxymethylglutaryl-Coenzyme A (HMG-CoA) Reductase inhibitors are a group of drugs widely used for hypercholesterolemia. They are known to originate side-effects on muscles but with a very low incidence of myopathy. CLINICAL CASE: We present two cases of myopathy induced by HMG-CoA reductase inhibitors. They are two women, who were on 20 mg daily of lovastatin and 30 mg daily of simvastatin and consulted due to weakness, myalgia and a rise in blood levels of muscle enzymes. Both of them recovered completely a few weeks after withdrawal of the drugs. COMMENTS: Usage of this group of drugs is wide. Their side effects are rare but it is important to remember their capacity to induce a myopathy, usually reversible upon withdrawal of the drug.

Electromyography↗
PubMed1997

[A case-control study of multiple sclerosis in Alcoi].

INTRODUCTION: Multiple sclerosis (EM) is a neurological disorder of great epidemiological interest. Considerable variations have been described regarding the initial description of geographical distribution. In the Alcoi health district an epidemiological study showed more cases than would be expected from the latitude. Objective. To care out an analytical study to determine which factors influence this situation. MATERIAL AND METHODS: We carried out a case-control study, pairing one case with four controls from the population, as regards age, sex and place of residence. Only current cases were included, under the control of the only Neurology Unit in the area, and which fulfilled criteria defined by EM. The control group was randomly selected from the census. RESULTS: We analyzed 37 patients and 148 controls. There were no significant differences between the cases and the controls regarding socio-educational level, order of birth within the family, blood group, toxic habits and family history. We found a significantly greater frequency of urinary infections before the age of 15, and of cystitis and pneumonia after reaching the age of 15. Contact with textiles, their finished products and dogs reached significant values. In the patient group there was a significantly higher number of immigrants than in the control group. CONCLUSIONS: The correlation found between certain factors such as contact with textiles, their finished products and dogs should be evaluated in further studies in which the immigration factor is controlled.

Adult↗
PubMed1996

[Familial paroxysmal ataxia: a new case].

Over the last years several families affected of a clinical syndrome characterized by sudden ataxia, related to physical or mental stress, and lasting a few days have been described. Intercritical exploration is otherwise normal. We describe a new case which presents the clinical, laboratory and neuroradiological data characteristic of periodic familial ataxia. The patient is a 34 year old male who from his 23 has suffered three crisis of gait inestability, ataxia of trunk and limbs and spontaneous nystagmus in every direction, which increased in association with head movement. These episodes were always in relation with fatigue and stress and have decreased in severity. Mean duration of crisis has been 4 to 6 days. After starting treatment with acetazolamide there have no new crisis. In this case we have found no family history of the disease as it was the rule in previous description.

Acetazolamide↗
PubMed1996

[Meningiomas of the lateral ventricles: a case report].

We describe the case of a patient with an intraventricular meningioma, which initially manifested as transient mental impairment. Meningiomas are slowly growing, bening tumours, which usually remain asymptomatic or show only insidious clinical manifestations for long periods. In our case the distinct localization of the tumor gives rise to a peculiar clinical picture, with special reference to the episodic nature of symptoms. In this case we want to remark the role of both the clinical and neuroradiological data in the diagnosis of this pathology.

Brain Neoplasms↗
PubMed1996

[Intraparenchymatous hemorrhagic pathology in patients aged over seventy: a comparative study with younger subjects].

The aim of our study was to compare a group of over 70 year-old patients suffering from spontaneous intracerebral haemorrhage with a similarly affected group under 70 years of age. With this in mind we carried out a prospective study of all patients admitted to the Neurology Service at the Virgen de la Arrixaca Hospital between March and December 1993. They totalled some 67 patients, 33 being over 70 years of age and 34 being younger than 70. Although our data clearly show that age is a factor indicative of bad prognosis, we found no other differences between these two groups which might justify these data with the exception of a greater prevalence of consciousness abnormalities at the moment of onset in those patients aged over 70. This fact, ascertained using the Canadian scale, may, we feel, be useful in dealing with patients presenting clinical pictures compatible with brain haemorrhage who attend hospitals not having computerized tomography.

Adolescent↗
PubMed1996

[Pontine hemorrhage as a cause of peripheral facial paralysis].

Bell's palsy is the most frequent type of peripheral facial nerve paralysis. Nevertheless there are other less frequent causes of peripheral facial palsy, among which, we can find lesions in the brain stem affecting the seventh cranial nerve nucleus or its fibers. These lesions of the pons which paralyze the muscles of the face are often accompanied by lesions to other structures in the vicinity of the nucleus. We present the case of peripheral facial nerve palsy caused by hemorrhage in the pons, seen both on brain CT-scan and MRI, which affected the nucleus of the seventh cranial nerve and was not accompanied by any other clinical manifestations due to lesions of structures placed in the vicinity of this nucleus.

Aged↗
PubMed1993

Cardiovascular reflexes in Parkinson disease.

We have investigated the autonomic function of 95 patients with Parkinson disease (PD) by testing their cardiovascular reflexes and compared the results with those of 53 healthy volunteers. 51.1% of the patients were on antiparkinsonian therapy. The patients showed a smaller heart rate response to deep breathing with a mean exhalation-inspiration difference of 87.73 +/- 7 (p: 0.0005), a smaller heart rate response to standing with a mean 30: 15 index of 1.18 +/- 0.25 (p: 0.01), and a smaller blood pressure rise to handgrip with a mean rise of 9.53 +/- 8.76 mmHg (p: 0.005). We found a higher percentage of patients with established sympathetic lesion (41% vs 34%) or atypical patterns of global autonomic function involvement (33% vs 26%), but the percentage of subjects with parasympathetic lesion was similar in both, patients and controls (16% vs 15%). We found no significant difference on cardiovascular performance between treated and untreated patients. The patients with autonomic impairment were older than the patients with normal autonomic function. Our findings suggest that patients with PD have a true autonomic dysfunction.

Adult↗
PubMed1992

Cardiovascular reflexes in patients with vascular headache.

We have investigated the autonomic function of 75 patients with migraine by examining cardiovascular reflex function. The results were compared with those of 78 healthy volunteers. Measurements were made between attacks. Patients with migraine showed a smaller heart-rate response to deep breathing but a greater heart-rate response and higher blood pressure to standing when compared to controls. Migraine patients had a higher percentage of established sympathetic lesions (51% vs 17%) and severe (25% vs 5%) or atypical (24% vs 11.5%) global autonomic dysfunction. No significant differences were found among patients with migraine with aura, migraine without aura, and migraine with prolonged aura. Our findings indicate that patients with migraine have sympathetic hypofunction.

Adolescent↗
PubMed1990

Multiple sclerosis in Spain: an epidemiological study of the Alcoy health region, Valencia.

Alcoy is a defined health region in eastern Spain, at 3 degrees E-38 degrees N, with a single neurology department and includes 33 towns with a total population of 133,915 inhabitants. We have evaluated the prevalence and incidence of multiple sclerosis (MS) by analysing this region. Six new cases have been detected (2.24/100,000/year) and the prevalence rate was 17.17/100,000, the highest in Spain at the moment. However, we found an irregular distribution in the different towns in so far that 15 of our 23 patients lived in a particular subregion, which means a prevalence of 44.59/100,000. Our study shows that the area of Alcoy is a medium MS risk region according to the thesis of Kurzke, although high MS areas may be found, thus confirming that MS distribution in southern Europe is not uniform.

Adult↗
PubMed1990

Ischemic stroke in young adults. II. Analysis of risk factors in the etiological subgroups.

A prospective study on 386 consecutive patients affected of ischemic stroke (IS) has been analysed in relation to etiologies, comparing them with a control group of 100 people. The atherotrombotic etiology subgroups are associated with family history of stroke, risk factors, atheromatosis, occlusive peripheral arteriopathy, previous of stroke, high levels of hematocrit and hemoglobin, impaired lipid fractions and high levels of uric acid. The cardiac embolism etiology subgroups are associated with the presence of personal history of stroke, just as the mitral valva prolapse (MVP) patients group. The migraine group is significantly related with the intake of oral contraceptives.

Adult↗
PubMed1989

Ischemic stroke in young adults. I. Analysis of the etiological subgroups.

An ischemic stroke (IS) group including 386 patients under 50 years old is analysed taking into account different etiological subgroups and comparing risk factors against a control group of 100 people. The series points out the presence of 66.1% patients included in the inconclusive-atherothrombosis group, of which 22.7% had defined criteria of atheromatosis, while 11.6% were diagnosed of lacunar infarct. 13.5% of cases were considered as cardiac origin embolisms, and 14.1% were affected of mitral valve prolapse. The migraine group includes 4.9% of the patients while 17.6% belong to the miscellaneous group. The comparison of each of these groups with the control group showed significant differences for family history of stroke, personal history of peripheral arteriopathy, tobacco, arterial hypertension and previous IS.

Adolescent↗