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M Amorín

Publications and source records attributed to M Amorín.

8 recordsLinked to original sources
PubMed2006

[Cerebellar hemorrhage after spinal anesthesia].

Cerebellar hemorrhage is a rare complication of spinal anesthesia. We report a case in a 51-year-old woman with a history of hypertension who underwent uterine dilatation and curettage with spinal anesthesia. During recovery she vomited and complained of headache. Postdural puncture headache was diagnosed. When there was no response to conventional treatment, computed tomography and magnetic resonance scans of the head were performed. The scans confirmed cerebellar hemorrhage due to rupture of a cavernous angioma. The patient recovered fully without surgical decompression. We review the pathogenesis of headache and cerebral hemorrhage after spinal anesthesia and propose differential diagnosis between spontaneous rupture related to hypertension and cerebrospinal fluid hypotension syndrome caused by trauma from lumbar spinal puncture. Patients with prolonged severe headache after spinal anesthesia require neurologic and radiologic monitoring to rule out the possibility of intracranial complications.

Anesthesia, Spinal↗
PubMed2000

[Drop attacks in patients with partial epilepsy].

BACKGROUND: It is known the presence of sudden falls or epileptic drop-attacks (DA) in patients with partial epilepsy. OBJECTIVE: To review the clinical and electroencephalographic manifestations in our patients with partial epilepsy and DA. PATIENTS AND METHODS: Fifteen patients (9 males/6 females) over 18 years with partial epilepsy and epileptic falls were selected. RESULTS: The mean age was 39 years (24-56 years). The mean age at seizure onset were 13 years (8 months-49 years) for partial seizures and 26 years (2-54 years) for DA. Secondary generalized or not, all patients had complex partial seizures, associated with simple partial seizures in five (34%). All were treated with politherapy, but a good control was not achieved. EEG recordings showed frontal focus in 7, temporal focus in 8, secondary bilateral synchrony in 9, and increase of electroencephalographic abnormalities during sleep in 9. Cognitive and emotional disorders were observed in 8 and 6 patients, respectively. Nine patients suffered from status epilepticus. The causal lesions were connatal encephalopathy in 8 and criptogenic in the other 7. The main consequence of DA was recurrent craneal trauma in 9 patients. CONCLUSIONS: The presence of DA is considered an ominous change in the evolution of a partial epilepsy. It's associated with mental deterioration and emotional disturbances and with drug resistance.

Adult↗
PubMed2000

[Reflex epilepsies].

INTRODUCTION: Reflex seizures are provoked by a specific sensory stimulus. Approximately 6% of all epileptic patients have reflex seizures. For identification of these seizures it is necessary to take a directed history and make an EEG study whilst the patient is being exposed to the stimulus, which will confirm the diagnosis. DEVELOPMENT: Many stimuli are effective in provoking reflex seizures, the commonest are visual. Amongst the various epileptic syndromes there are different types of epilepsies with reflex seizures which generally correspond to idiopathic generalized epilepsies. The physiopathogenic mechanisms are usually complex. The cerebral cortex corresponding to the function which induces the epileptic crisis is hyperexcitable, and is the cause of an identifiable lesion or dysfunction without an underlying lesion. CONCLUSION: The diagnostic importance of reflex seizures is that when some formerly drug-resistant patients can control the mechanism which triggers off their seizures they attain good control of them.

Brain↗
PubMed1999

[Rational choice of antiepileptic treatment].

The choice of the adequate antiepileptic treatment is based on the clinical experience more than rationality. During some decades, the combination of two antiepileptic drugs was considered the initial treatment but monotherapy showed more advantages (effectiveness, fewer adverse events, fewer teratogenic effects and better compliance). New antiepileptic drugs have increased our interest and knowledge of the epilepsies. They have changed some of our therapeutical schemes. Sodium valproate continues to be considered the choice treatment for all the idiopathic, cryptogenic and symptomatic generalized epilepsies. Lamotrigine and topiramate are two valid alternatives in these epileptic syndromes. In West's syndrome vigabatrin is considered the initial treatment. Carbamacepine, vigabatrine and tiagabine are not indicated in the treatment of generalized idiopathic epilepsies especially in patients with absence seizures. In focal epilepsies, both cryptogenic and symptomatic all the antiepileptic drugs have shown efficacy and the choice treatment is based on the adverse events and the teratogenic power. Prospective studies in patients with the same type of seizures and epileptic syndromes will allow us to determine the more adequate antiepileptic treatment.

Anticonvulsants↗
PubMedDate not supplied

[Use of extra-hospital emergency systems in the treatment of acute stroke in the region of Murcia. Possible repercussions on the urgent care of stroke patients].

AIM: To examine the use of extra-hospital emergency systems in the urgent care of stroke patients in our region and their influence on the time required to reach hospital, the time needed to perform an urgent computerised axial tomography (CAT) scan and the delay in receiving attention from the specialist. PATIENTS AND METHODS: Samples were collected from 232 stroke patients out of the total number admitted to our hospitals. Data about the stroke were collected prospectively, and included the arrival time, the time required to perform the CAT scan and the time the specialist devoted to attending the patient. Data were also gathered about the different extra-hospital transport and emergency systems. A statistical analysis was performed to determine the effect of using the extra-hospital emergency procedures on the different variables. RESULTS: A total of 53.6% of patients arrived within the first three hours. 38.7% went straight to hospital, 25% visited extra-hospital Emergency Services first, and 18.5% made a prior visit to Primary Care. 51.5% found their own way to the hospital and 46.7% arrived by ambulance. Mean time taken to perform an urgent CAT scan: 190.4 minutes; mean time required for specialist attention: 25.65 hours. The only statistically significant relation was the use of extra-hospital emergency systems and health care transport according to the type of stroke: both were more likely to be used in cases of haemorrhagic stroke. CONCLUSIONS: In hospitals in the Murcia region, the use of the extra-hospital emergency system and the means of transport utilised do not affect the time stroke patients take to reach hospital or the time needed to perform an urgent CAT scan or the delay in receiving attention from a specialist; the aetiology of the stroke does, however, influence the use of such services.

Emergency Medical Services↗