Search PubMed⌕ Search

Biomedical subjects

E Tolosa

Publications and source records attributed to E Tolosa.

208 records · Page 12Linked to original sources
PubMedDate not supplied

[Thalamic neuro inhibition in the treatment of post traumatic tremor].

INTRODUCTION: Severe head trauma could be followed by a wide range of movement disorders. Usually, they appear as a moderate or severe intention tremor that causes great patient disability. Those movement disorders use to be refractary to medical treatment, although sometimes they would be spontaneusly controlled by a year. CLINICAL CASE: 14 year old boy who suffered severe head trauma at age of 8. One year after the injury he developed an action tremor and choreiform dyskinesia with hemibalistic features evocated by the movement. Medical treatment was ineffective. Due to the great patients disability, we chose the surgical treatment based on the placement of an stimulation electrode in thalamic Vop/Vim complex, obtaining a tremor abolition with an improvement in the scales of tremor and quality of life. DISCUSSION: Surgical treatment of postraumatic tremors tryes to improve in terms of function and activities of daily living, more than suppresion of a symptom. The aim of this treatment is cut the palidal thalamic cortical pathways. Anyway, target is defined by the tremor related cells and, it is more a functional target than an anatomical one. We prefer stimulation more than lesion, due to the lack of brain definitive injury because its reversibility and adjustability features.

Adolescent↗
PubMedDate not supplied

[Sleep disorders in multiple system atrophy].

Sleep disorders are so common in multiple system atrophy that they should be considered an integral part of the disease. Sleep fragmentation occurs in more than half of the patients, with sleep onset and sleep maintenance insomnia. Periodic leg movements of sleep are also common, although they are generally asymptomatic. REM sleep behavior disorder, a parasomnia in which the patient presents vigorous movements associated with intense dreaming dreaming during REM sleep, is detected polysomnographically in almost all the patients with variable severity. Nocturnal stridor is produced by obstruction on the glottis level. The cause of stridor is unknown but two alternative explanations have been proposed: paralysis of the muscles opening the vocal chords and excessive contraction of the muscles that close them. A combination of both, however, is the most likely explanation. Nocturnal stridor is associated with decreased survival and its treatment is based on continuous positive air pressure (CPAP) when it occurs only during sleep or tracheostomy when it worsens and becomes also diurnal.

Humans↗
PubMedDate not supplied

[Diagnostic usefulness of the determination of protein 14-3-3 in cerebrospinal fluid in Creutzfeld-Jakob disease].

BACKGROUND AND OBJECTIVES: A definitive diagnosis of Creutzfeldt-Jakob disease (CJD) requires histopathological examination of a brain biopsy or autopsy specimen. The detection of a normal brain protein, protein 14-3-3, in cerebrospinal fluid (CSF) appear to be sensitive and specific for the diagnosis of CJD. Our objective has been to evaluate its diagnostic value. PATIENTS AND METHODS: The presence of 14-3-3 protein in the CSF from 97 patients with neurological diseases was analyzed by immunoblot. In the analyzed results we only included patients with pathologically or genetic confirmed CJD, and those with criteria for clinically definite CJD (Brown et al). RESULTS: The 14-3-3 protein was detected in 29 of 32 cases of CJD (90.6%). The 3 false negative results were from 3 patients with familial CJD associated with the 178 codon mutation. In the 18 patients with final diagnosis of CJD tested when the degree of certainty was probable, the 14-3-3 protein was positive. The false positive results were seen in 9 patients with other neurological diseases, but only in three of them (hypoxic encephalopathy, encephalopathy associated to Hashimoto thyroiditis and cerebral amyloid angiopathy) the disease could be included in the differential diagnosis of CJD. CONCLUSIONS: The test for detection of 14-3-3 protein is highly sensitive in patients with sporadic CJD. The 14-3-3 protein can be detected early when clinical manifestations do not allow the diagnosis of clinically definite CJD.

14-3-3 Proteins↗