Biomedical subjects

M de Entrambasaguas

Publications and source records attributed to M de Entrambasaguas.

3 recordsLinked to original sources

PubMed2003

Sleep disorder in alien hand syndrome.

A 63-year-old right-handed woman developed an alien hand syndrome (AHS) after an acute infarction in the territory of the left anterior cerebral artery. The uncontrolled hand movements were present during the daytime and eventually disturbed sleep. Polysomnography revealed that these motor actions only appeared when the patient was awake. These awakenings emerged mostly from NREM sleep stage 2 during the first half of the night. There was no evidence of any epileptiform activity, dyssomnia or parasomnia. These movements were controlled making her wear an oven mitt during sleep. The temporal distribution of this motor activity seems to follow the progressive hyperpolarization of anterior horn neurons that occurs when sleep deepens. The accommodation of the grasp reflex in AHS probably helps control this unwanted motor activity.

Anterior Horn Cells↗

PubMed1996

Lithium-induced Creutzfeldt-Jakob syndrome.

a 67-year-old man with bipolar disorder developed a Creutzfeldt-Jakob like syndrome during lithium carbonate treatment. Lithium serum level was within the therapeutic range. Complete clinical-electroencephalographic recovery was achieved after lithium therapy was discontinued. Several cases of lithium-induced Creutzfeldt-Jakob syndrome have been reported to date; all of them were elderly patients and a half had "therapeutic" lithium serum levels. Patients in this age group receiving antimanic maintenance treatment should keep lithium serum levels as low as possible. Lithium neurotoxicity should be considered in Creutzfeldt-Jakob disease differential diagnosis, serial electroencephalograms being the most valuable.

Aged↗

PubMedDate not supplied

[Malignant catatonia].

INTRODUCTION: Malignant catatonia is thought to be due to a severely decreased central dopaminergic activity of a medical, psychiatric, toxic-pharmacologic or idiopathic origin. CLINICAL CASE: A 24 year-old man presented with a generalized tonic-clonic seizure of focal onset. Within the following 48 hours, he developed agitation and paranoid ideation, which evolved into a severe catatonic syndrome complicated by aspiration pneumonia requiring transfer to Intensive Care Unit (ICU). Complementary tests (CT scan MRI, CSF, blood and urine studies) were negative or could not provide an etiological diagnosis. Initial EEG showed theta and delta waves, originating in the right frontal regions which later generalized. He stayed in ICU for the following three months in a state of catatonic stupor with frequent medical complications. During this time, he was given 27 sessions of electroconvulsive therapy (ECT) that eventually led to a remission of the catatonic syndrome. He was discharged from hospital one month later, fully asymptomatic except for a residuary amnesia, with a final diagnosis of idiopathic malignant catatonia. CONCLUSIONS: The authors have reviewed the management of this syndrome, which can be challenging for the physician because of the wide array of possible etiologies and its potentially lethal nature. A favorable outcome can be expected when ECT is started early, provided the underlying pathological process is treatable and there are no structural lesions in the central nervous system.

Adult↗