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P J Serrano-Castro

Publications and source records attributed to P J Serrano-Castro.

At least 19 recordsLinked to original sources
PubMed2005

[Vasomotor reactivity throught the voluntary apnea test can be measured without calculating the apnea index].

INTRODUCTION: Vasomotor reactivity (VR) is the capability of the cerebral arterioles to dilate and to constrict in response to determined stimuli. Using transcranial doppler (TCD), there are various test to evaluate it, including the breath holding test. With this test, VR can be calculated two ways: using the increment percentage of the mean velocity with respect to the basal velocity (PIV) or by quantifying the apnea time to obtain what is call the breath holding index (PIV/apnea seconds). The objective of our study is to study the linear correlation between the PIV and the breath holding index. METHODS: This was an observational study performed in a neurology ambulatory setting. A total of 128 subjects, age 16 to 50 years old, were included. We assessed VR using the breath holding test described by Markus and Harrison on the middle cerebral artery. The linear correlation between the two quantitative variables was analysed using Pearson's correlation coefficient. RESULTS: Pearson's correlation coefficient between the PIV and the breath holding index was 0.75 for a significance level of p < 0.0001. CONCLUSION: Given the good linear correlation between these two methods for calculating the VR using the breath holding test, we consider it is not necessary to calculate breath holding test time when using this test.

Adolescent↗
PubMed2004

[Descriptive analysis of the e-mail list "Neurología-RedIRIS" (http://listserv.rediris.es/neurologia.html): an active, plural instrument having scientific quality at the reach of the Spanish speaking neurology sector].

INTRODUCTION: In recent years, professional mailing-lists (PML) have experienced wide diffusion in the field of the medicine thanks to their educational and academic potential. In neurology and in Spanish, Neurología list belonging to RedIRIS has played the lead in the history of PML. Since the year 1997, it has maintained approximately 200 persons related with neurology in communication and has exceeded more of 7,300 messages. MATERIAL AND METHODS: We analyzed retrospectively the activity recorded in the Neurología PML between January and December 2003, recording variables related to the activity and scientific quality of the PML and to the origin and content of the messages. RESULTS: 758 messages were registered (2.07 messages/day; 3.73 messages/subscriber). 93 of 203 subscribers (45.81 %) participated on at least one occasion. 83 % of the messages came from Spain, there being an inverse relationship between the neurologists relative endowment and degree of participation in the PML. The most frequent messages referred to clinical cases followed by debate of topics of management and scientific consultations. The scientific quality of Neurología PML is comparable to other English language based PML analyzed based on the number of publications in Index Medicus and of the impact factor of its subscribers. CONCLUSION: Neurología PML has reached a level of maturity and enjoys a critical mass and a number of subscribers of high scientific level that assures its immediate future. Besides its educational and consultation functions, it may become an opinion forum for the Spanish neurologists without their losing their independence or Latin-American vocation.

Electronic Mail↗
PubMed1998

[Mesial temporal sclerosis (II): clinical features and complementary studies].

OBJECTIVE: To collect clinical data and diagnostic characteristics of the mesial temporal sclerosis syndrome (MTS). Development. CLINICAL FEATURES: In MTS repeated temporal lobe seizures, difficult to control pharmacologically, are seen in patients with neuropsychological defects which can be shown by appropriate tests. There is no pathognomonic clinical data. However, there is frequently: 1. Onset of seizures during childhood (6-10 years old). 2. Presence of some type of aura. The only significantly related types are visceral, olfactory and uncinate. 3. A pattern of conduct typical of ictus, although this is nonspecific: Early ipsilateral manual automatism and contralateral tonic posture. 4. Infrequent generalization. Surface EEG: Acute elements and/or slow waves in interictal recordings localized to the anterior temporal region, either unilateral or bilateral and with independent expression. MR of encephalum: Two typical ipsilateral findings at the electric focus of independent presentation and not mutually exclusive: a) Hippocampal hyperdensity in T2 sequences. b) Atrophy of hippocampal structures. FDG-PET: Interictal pattern of ipsilateral temporal hyperperfusion with typical maximal involvement of the polar region. SPECT-HMPAO: Early ictal and post-ictal pattern of ipsilateral temporal hyperperfusion. CONCLUSIONS: MTS is a clinical syndrome with its own identity from the clinical and diagnostic point of view. Results of the non-invasive tests currently available make invasive tests unnecessary in the preoperative guidelines for these patients.

Cognition Disorders↗
PubMed1996

[Non-giant cell temporal arteritis as a manifestation of Churg-Strauss syndrome. Presentation of a case and review of literature].

Most cases of temporal arteritis are of the giant cell variety, with cases involving other histologic patterns occurring rarely. There are only 4 descriptions in the literature of non giant cell temporal arteritis as a manifestation of Churg-Strauss syndrome. We report the case of a 74-year-old man with a history of bronchial asthma who presented with systemic symptoms and right temporal cephalea with diplopia, diffuse muscle pain and transient skin lesions on the extremities. The right temporal artery was enlarged and painful but pulsatile. Tests showed a high erythrocyte sedimentation rate and leukocytosis with relative and absolute eosinophilia. Biopsy of the temporal artery revealed polymorphic inflammatory infiltration throughout the vas, with numerous eosinophils and non giant cells, confirming a diagnosis of Churg-Strauss syndrome with extension to the temporal artery. Temporal arteritis should be considered a syndrome with variable substrate pathology; the possibility that it is a rare manifestation of systemic necrotizing vasculitis should not be ruled out.

Aged↗
PubMed1996

[Callosotomy in the treatment of drug-resistant epilepsy].

At the present time corpus callosotomy is a valuable option in the management of some patients with drug-resistant epilepsy who are not candidates for resective procedures. The records of six patients who underwent callosotomy at 'Hospital Virgen de las Nieves' (Granada, Spain) in the past four years were retrospectively analyzed. The patients all had intractable primary or secondarily generalized seizures, were severely handicapped by its frequency and nature (especially with drop attacks and multiple injuries) and were not suitable for other surgical procedure. The results of surgery (five anterior callosotomies and one subtotal section) are described after an average follow-up period of 2.5 years. Overall, four patients achieved significant improvement (at least 50% reduction in seizure frequency, severity, or both, affecting quality of life), with a marked reduction (> 75%) in two of them. There was no clinical deterioration, significant surgical complication nor relevant additional long-term neuro-psychological deficit in any case. Previous studies have been reviewed mainly to find those prognostic factors associated with a better seizure outcome or with the occurrence of complications. The best results are obtained in those patients with drop attacks (including atonic seizures) as the most frequent and disabling seizure type. According to the type of epilepsy, patients with localization-related epilepsy (especially when symptomatic of a focal brain damage) and those with the Lennox-Gastaut syndrome are the most likely to benefit from the procedure. It is suggested that, in the first place, a two-thirds anterior callosotomy should be performed particularly with atonic seizure are the most frequent seizure type. We may proceed with completion of callosal division as a second stage in those patients in whom a significant improvement has not been observed. In severely retarded patients with multiple seizure types, one-stage complete section may be performed. The procedure is relatively safe, with a low incidence of morbidity and clinically significant long-term neuro-psychological deficits. Further larger clinical studies are necessary to elucidate many aspects which are still unresolved. More uniformity would be desirable in the evaluation of patients, surgical technique, follow-up and presentation of results.

Adult↗
PubMedDate not supplied

[Parry-Romberg progressive facial hemiatrophy: pathogenic and evolutionary considerations with regards to a case followed up for a long period of time].

INTRODUCTION: The Parry-Romberg syndrome is a clinical condition in which there is progressive facial hemiatrophy which may be associated with neurological, ocular, cutaneous and auto-immune disorders. It is of unknown aetiology, although many theories have been put forward. CLINICAL CASE: We present a case of left facial hemiatrophy associated with ipsilateral lingual hemiatrophy and signs of cortico-cerebellar dysfunction, the neuroimaging findings (NMR) and clinico-radiological follow-up covered a period of over 10 years. CONCLUSION: The data on the clinical course and neuroimaging, together with our review of the literature, suggest that the Parry-Romberg syndrome may be considered to be a dysgenetic process which may originate during the first stages of CNS embryogenesis.

Atrophy↗
PubMedDate not supplied

[A historical description of the association of macro-orchidea, mental retardation and cranial dysmorphia in males (fragile X chromosome syndrome) by A.B. Richerand].

INTRODUCTION: Anthelme Baltasar Richerand practiced medicine as Chief Surgeon of the Hospital de S. Luis in Paris and was professor of the Faculty of Medicine of that city during the first quarter of the XIX century. His greatest work was titled Nouveaux Eléments de Physiologie, a book considered to be the standard work on physiology of its time and was translated into several languages, including Spanish. DEVELOPMENT: In chapter CLV of this work there is the first description of associated macro-orchidia and mental retardation in males, with respect to three cases attended by the author. CONCLUSIONS: The fragile X chromosome syndrome is the commonest cause of hereditary male mental retardation associated with macro-orchidia. It is also known as the eponymous syndrome of Martin-Bell in honour of the first description published by these authors in 1943. However, the first recognition of the association of macro-orchidia with mental retardation in males was by Richerand at the beginning of the XIX century.

Fragile X Syndrome↗
PubMedDate not supplied

[Cerebral hemodynamics in the syndrome of pseudomigraine with csf-pleocytosis:a transcranial doppler study].

INTRODUCTION: The clinical picture of the pseudomigraine with CSF pleocytosis syndrome is of intermittent headaches, sometimes accompanied by episodes of transient neurological defects and lymphocyte pleocytosis, which occur for a variable length of time, followed by spontaneous resolution. It has been suggested that the cause is immunogenic due to post-infectious activation of the humoral immune system against the leptomeningeal vascular structures, but this hypothesis does not explain the accompanying transient deficit phenomena. MATERIAL AND METHODS: We present a study of cerebral hemodynamics using transcranial Doppler in a patient diagnosed as having pseudomigraine with pleocytosis according to current criteria. RESULTS: Our results suggest the presence of cerebral vascular instability and increased vascular reactivity to induced hypocapnia and hypercapnia, similar to that reported in patients with migraine with aura. At no time was significant increase in the average rate of cerebral blood flow detected, comparable to that usually seen in patients with bacterial or viral meningitis. CONCLUSIONS: Although the cause cannot be established, from our study it would seem that headache in the pseudomigraine with pleocytosis syndrome is related to cerebral vascular instability and therefore probably to activation of the trigeminal-vascular system. It is possible that the deficit phenomena may also have a similar explanation to that of patients with migraine with aura, that is, a propagated cortical depression. Transcranial Doppler studies may be useful in the diagnosis of pseudomigraine with pleocytosis syndrome.

Adult↗
PubMedDate not supplied

[Inflammatory pseudotumor: differential diagnosis of tumors of the 4th ventricle].

INTRODUCTION: An inflammatory pseudotumour is a condition of unknown origin and inflammatory nature. It is rarely found in the CNS. We report a case of inflammatory pseudotumour localized to the IV ventricle and review the clinical characteristics of previously reported cases in order to outline the clinical profile of this condition. CLINICAL CASE: A 40 year old man was admitted to hospital complaining of a subacute condition involving difficulty in speaking and in moving his right arm and leg. On examination he had ocular deviation on initial gaze, a complete right Horner's syndrome, right supranuclear facial palsy, dyssynergy-asymmetry on the right finger-nose test and a dissociated sensitivity disorder of the left arm. On MR of the brain there was a space occupying lesion, nodular in form and fixed to the roof of the fourth ventricle. The histopathological report on the specimen removed by surgery stated it to be an inflammatory pseudotumour. On a MEDLINE search for reported cases of inflammatory pseudotumour of the CNS, 27 were found since 1967. Four cases, including ours, involved masses growing into the interior of the fourth ventricle. CONCLUSIONS: Inflammatory pseudotumour of the CNS is a condition affecting young adults, with a slight male predominance and some association with clinical and analytical data suggesting autoimmune dysfunction. The intraventricular site, particularly within the fourth ventricle, is relatively common (4/28) and is usually associated with clinical features of dysfunction of the posterior fossa and/or intracranial hypertension. We consider that inflammatory pseudotumour should be included in the differential diagnosis of tumours of the fourth ventricle.

Adult↗
PubMedDate not supplied

[Ring chromosome 20: an epileptic channel disorder?].

INTRODUCTION: The ring-shaped chromosome 20 (r20) syndrome is an infrequent chromosopathy which is associated with epileptic seizures, behaviour disorders and mental retardation. It results from the fusion of the two arms of the chromosome with deletion of the telomeric portions. CLINICAL CASE: We present a case of r20, review published cases and describe the clinical and neurophysiological characteristics. CONCLUSIONS: The r20 syndrome is the third type of epilepsy known to be of genetic basis related to chromosome 20. It has clinical and neurophysiological characteristics which give it a distinctive character and are easily identified. The fact that on locus 20q13 (telomeric portion of the long arm of chromosome 20) two genes related to epileptic channelopathies (CHRNA4 and KCNQ2) have been described, suggest the hypothesis that the subjacent deletion in cases of r20 syndrome affect one of these genes and explains the epileptogenicity. We consider this hypothesis and the possibility that r20 syndrome may be an epileptic channelopathy.

Adult↗
PubMedDate not supplied

[Epidemiological features of epilepsy in adults requiring hospital admission].

INTRODUCTION AND OBJECTIVES: There are few epidemiological studies specifically directed towards finding the features of the adult epileptic population requiring hospital admission. We proposed to analyze these features in a consecutive series of patients admitted to our department with epilepsy and find the prevalence of diagnoses classified as syndromes and epileptic seizures according to the classification of ILAE and their distribution according to age. PATIENTS AND METHODS: We made a retrospective classification of the characteristics of the patients admitted to our department with the diagnosis of epilepsy during 1999. We divided the sample into three age groups: 18 30, 31 60 and >60 years. We calculated the absolute prevalence of the different types of crises and epileptic syndromes, the specific relative prevalence according to age groups and diagnostic category expressed with confidence intervals of 95%. The degree of statistical significance was obtained using the chi squared test of Mantel Haenszel. RESULTS: The sample group contained 96 patients (51% men and 49% women). There were 65.62% partial seizures, 21.87% generalized seizures and 12.5% pseudoseizures. The syndromes found included 60.7% of epilepsies related to site, 5.95% generalized epilepsies, 7% unclassified syndromes and 26.19% special syndromes. Of the symptomatic epilepsies, the commonest etiology was vascular, followed by toxic, tumoral and degenerative. The evolution of the relative prevalence according to age corresponded to three different patterns: ascending (partial crises and special syndromes), descending (pseudocrises and generalized epilepsy) and stable with peaks in middle age (generalized seizures, partial with generalization, unclassified syndromes, symptomatic and cryptogenic partial epileptic syndromes). CONCLUSIONS: The distribution according to seizures is similar to that reported in population studies. Special syndromes are much commoner than that reported in population studies, especially in epilepsies conditioned by the environment. The diagnosis of pseudoseizures are significantly commoner in the group of young adults. Partial seizures and special syndromes tended to be more frequent in older patients, whilst pseudocrises and generalized epilepsies were commoner in younger adults. The remaining seizures and syndromes predominated in the 18 30 year age group.

Adult↗