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A R Reyes

Publications and source records attributed to A R Reyes.

3 recordsLinked to original sources

[Benign encephalitis of the brain stem].

INTRODUCTION: The secondary encephalitis disorders are due to an immunological mechanism which causes demyelinating lesions of the central and peripheral nervous systems, with very variable clinical features. The pathogenesis and localization of benign encephalitis of the brain stem and the Miller Fisher syndrome (MFS) are still subject to debate. It is suggested that they may both belong to different extremes of the same nosological spectrum known as the ophthalmoplegia-ataxia-areflexia syndrome. CLINICAL CASE: We report the case of an 11 year old boy with encephalitis of the brain stem who had electromyographic alterations compatible with the Guillain-Barré syndrome, and MR images characteristic of an acute demyelinating disorder of the brainstem. CONCLUSIONS: The encephalitis of the brain stem is an uncommon condition in children which leads to diagnostic difficulty at its onset, since this is similar in other disorders such as MFS, tumours, cerebrovascular accidents and less often in the initial stages of multiple sclerosis. The clinical course is very useful to distinguish between these conditions. MR is the imaging technique of choice for diagnosis in these patients. Although there is currently no specific treatment for post-infectious encephalitis, the use of high doses of immunoglobulins may be justified in view of the physiopathological origin of the condition.

Bradycardia↗

[Infantile bilateral striate necrosis].

INTRODUCTION: Necrosis of the basal ganglia (NBG) is an uncommon condition in childhood. Cases of NBG have been reported in connection with metabolic disorders, infections, degenerative conditions, intoxications, head injuries and hypoxic-ischemic encephalopathies. The commonest clinical features include alteration of consciousness, chorea-athetoic or dystonic movements, spasticity, contractures of the limbs and convulsions. CLINICAL CASE: We describe the case of an eight year old girl, who after having clinical gastroenteritis, developed acute neurological dysfunction, associated with images on cranial computerized axial tomography (CAT) showing a possible intracranial tumour and magnetic resonance (MR) studies showing bilateral hypodensity of the basal ganglia. Three months later magnetic resonance showed that these lesions had almost completely disappeared. This supports the diagnosis of post-infectious lesions. CONCLUSIONS: The clinical course is very variable. Cases with a previous history of infection have a better prognosis. In our patient treatment was started with corticosteroids. She made a good recovery and was sent home with no sequelae five days later. The new imaging techniques (CAT and MR) have led to more cases of selective involvement of the basal ganglia being diagnosed. MR is the most specific technique for diagnosis in these patients. Although there is no effective specific treatment, treatment with biperidine, thyrotropic hormone and corticosteroids have been used with no apparent effect on the course of the disorder.

Basal Ganglia Diseases↗

Ergonomics.

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Ergonomics↗