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Biomedical subjects

J M Castilla

Publications and source records attributed to J M Castilla.

At least 19 recordsLinked to original sources
PubMed2004

[Multifocal motor neuropathy with conduction blocks and prurigo nodularis. A paraneoplastic syndrome in a patient with non-Hodgkin B-cell lymphoma?].

Multifocal motor neuropathy with conduction blocks (MMNCB) is a peripheral demyelinating neuropathy. The etiology of this disease is unknown, but an autoimmune origin is postulated. Prurigo nodularis (PN), a chronic dermatosis also having an unknown etiology and many peripheral neuropathies of different nature are associated to hematological tumors. We have found no cases in the literature in which MMNCB was presented as a paraneoplastic syndrome of a non-Hodgkin B-cell type lymphoma (NHL-B). We present the case of a 67 year old man who simultaneously developed PN and MMNCB in upper limbs and who was diagnosed of a NHL-B 19 months later. We raise the hypothesis that both prurigo and neuropathy are a paraneoplastic syndrome for lymphoma with a possible common autoimmune pathogenic mechanism.

Aged↗
PubMed2003

[First steps in neuronavigation].

INTRODUCTION: We try to evaluate the introduction of a neuronavigation system widely used in a neurosurgical department. MATERIAL AND METHODS: We analyze the surgical procedures performed since the introduction of a neuronavigator in our hospital, the advantages and the problems related with its use. RESULTS: From 21/12/00 to 31/12/01, 64 cranial and 5 spinal procedures were performed in our centre with the aid of the BrainLAB neuronavigation system. They were 19.37% of the elective surgeries: 45.7% of cranial and 2.8% of spinal procedures. The accuracy of registration was 1.6 mm; the number of trials for registration was 2.8 on average, although in 3 cases it was not possible; there were disarrangements during 9 surgical procedures (two of them after the lesions were reached). Magnetic resonance imaging (MRI) was used in 54 instances, computerized tomography (CT) in 5, fluoroscopy (Rx) in 1, CT plus MRI in 8, CT plus Rx in 1. Since Z-Touch localization system and software was available, it was used exclusively, disregarding the use of external fiducials. DISCUSSION AND CONCLUSIONS: In our experience, neuronavigation needs extra time, but it helps in the election of the best position for the surgical approach, reduces the time required for scalp incision and craniotomy planning, and is useful for the opening of the dura and the corticectomy. As the operation proceeds, we found it less truhstworthy and necessary. The Z-touch system frees the imaging from the surgery. Its use in spinal operation is scarce and with limited results in our practice. We found the neuronavigation useful, and we employ it on a regular basis in every cranial procedure whenever it is possible.

Humans↗
PubMed2002

[Giant aneurysm of fast development].

The percentage of aneurysms measuring more than 2'5 cm in diameter ranges from 3 to 13%, and occur more commonly in females. They come to clinical attention later than nongiant aneurysms, but 20% of them appear in patients 20 years of age or younger. Its natural history is incompletely understood. We present the case of a 24-year-old female admitted following a generalized seizure with postictal dysphasia and right hemiparesis caused by a subarachnoid hemorrhage due to a ruptured giant aneurysm located in the left temporal fossa, who died few hours later because of rebleeding. This patient had been followed during the last seven years at our unit because of untreated frontal osteomas, without evidence of any intracranial lesion in the computerized axial tomography (CT). Some months before her death, she had suffered a left micotic otitis, and she was studied because of the reappearance of her left cephalalgia without neurological deficit. This case is another evidence of quick appearance of a giant aneurysm, "silent" until the fatal outcome.

Adult↗
PubMed2002

[Surgical treatment of patients with spinal infection].

INTRODUCTION: The surgical treatment of spinal infection, relegated because of the development of more effective antibiotherapy and the fear of associated morbidity, is springing up again with the increase of new patients with weakening pathology. MATERIAL AND METHODS: The clinical records of 27 patients submitted to surgery because of spinal infection between January 1990 and December 1999 at our service have been retrospectively studied. They were assessed with the Frankel and Karnofsky clinical scales, and the radiological angulation of the spine. RESULTS: Male (n = 17) and dorsal lesions (n = 14) predominate. Most of patients presented with pain, and 13 had neurological compromise. 29 operations were performed on the 27 patients. One of them was previously operated upon before the period considered, that procedure has been excluded. The total surgeries performed were 5 simple and 4 instrumented laminectomies, 6 simple corpectomies, 10 corpectomies with anterior instrumentation and 4 with posterior instrumentation. One patient died, there was not definitive morbidity and any patient deteriorated on clinical scales although radiology was not always improved. DISCUSSION AND CONCLUSIONS: The aggressive treatment of spinal infection is indicated when conservative means are insufficient. Surgery permits a better recovery of the neurological deficit, and prevents spinal deformity and pain produced by the disease.

Adolescent↗
PubMed2002

[Intradural cervical lipoma without neurologic involvement; report of a case].

Lipomas are masses composed of mature adipose tissue, usually affecting lumbosacral levels, often associated with neural tube defects. Spinal lipomas at more rostral levels are usually unassociated with congenital abnormalities, but may produce a more severe neural compromise. Rare reports of cervical lipoma without neurological deficit have been described. We present the case of a 10-years-old girl who complained of cervical pain and stiff neck related to a C7-T1 intradural lipoma, without neurological affectation. The lipoma was partially resected without postoperative deterioration.

Cervical Vertebrae↗
PubMed1999

[Warthin's tumor in the neck].

Papillar lymphomatous cystoadenoma on the neck as first stage of development. Other lesions of this nature in atypical areas as larynx, minor salivary glands or oropharynx has been described, but is not frequent on heterotopic location so peculiar. In that case the real diagnostic problem was the differential with neck masses. Description of the case and review of the literature.

Adenolymphoma↗
PubMed1998

Diagnostic yield of stimulation and voluntary single-fiber electromyography in myasthenia gravis.

Voluntary and stimulation single-fiber electromyography were performed in the extensor digitorum communis muscle of 15 myasthenic patients. The increase in mean and individual mean consecutive difference as well as the proportion of blocking in the volitional activation were greater than in the stimulation method. These differences may be explained in part by the different degree of alteration in large as compared with small motor units in patients with myasthenia gravis.

Aged↗
PubMed1998

[Pharyngeal tuberculosis: a clinical case].

A case of pharyngeal tuberculosis secondary to pulmonary tuberculosis is reported. The importance of biopsy for the histopathological and microbiological diagnosis is emphasized.

Humans↗
PubMed1997

[Berger's disease and acquired sensorineural hearing loss].

A relation between kidney and inner ear disease, specifically neurosensorial hearing loss, has been established. Likewise, the role of tonsillitis in certain glomerulonephritides is well known. A case of post-streptococcal mesangial glomerulonephritis with IgA deposit (Berger's disease) and neurosensorial hearing loss is reported. The absence of any relevant family or personal history suggests an immunological origin for both disorders.

Adult↗
PubMed1994

The carpal tunnel syndrome. Relationship between median distal motor latency and graded results of needle electromyography.

Needle Electromyography (NEMG) was performed in 228 patients who had been diagnosed by means of motor and sensory median nerve conductions of having Carpal Tunnel Syndrome (CTS). Evaluating abnormal spontaneous muscle activity (fibrillations, positive sharp waves, fasciculation potentials and myokymic discharges) and recruitment pattern, 51.7% of them showed abnormal NEMG. According to the amount of abnormality found, the studies were classified into: normal, grade 1, grade 2 and grade 3. Median Distal Motor Latency (DML) to APB was prolonged beyond the upper confidence limit in 155 (68%) hands, showing a mean value of 5.69 +/- 2.79 msec. Statistically significant difference (p < 0.001) of DML mean value among patients with a NEMG "normal", "grade 1" or "grade 2" have been found. We revise previous reports about NEMG on the CTS and discuss practical consequences of our findings.

Action Potentials↗
PubMed1991

Continuous muscle activity and distal spinal muscular atrophy.

A young man presented with myokymias, cramp-like difficulty in muscle relaxation and peroneal atrophy. EMG studies revealed continuous muscle activity (CMA) manifested as grouped potentials and high frequency discharges. Sensory nerve conduction studies and sural nerve biopsy gave normal results, and he was thought to suffer from distal spinal muscular atrophy with CMA. This association suggests that the lower motor neuron may have an important role in the generation of the continuous muscle activity.

Adult↗
PubMed1983

Facilitating myasthenic syndrome and quadriceps myopathy.

A patient presented with myasthenic syndrome apparently not related to any neoplasia. A peculiar myopathy characterized by absolute predominance (99.50%) and atrophy of type 2A muscle fibers was found in both quadriceps muscles. It is difficult to determine the relation between the myasthenic syndrome and the localized quadriceps myopathy for which a congenital nature is suggested.

Adult↗
PubMed1981

Hereditary amyotrophic lateral sclerosis.

A Spanish family transmits, as an autosomal dominant trait, a form of amyotrophic lateral sclerosis characterized by an unusually prolonged evolution of the disease in all affected members. Precocity and persistence of muscle cramps, presence of unilateral proximal segmental myoclonus and early abolition of ankle jerks are other clinical features conspicuous in this family. This type of hereditary ALS of non-chamorro origin and prolonged evolution is rare.

Adult↗
PubMed1980

Increased mechanical muscle irritability syndrome.

The patient reported here presented electrically silent rolling movements of the muscle under hand compressions, myoedema and myotonia-like muscle responses to mechanical stimulation. These muscle contractions suggest a disturbance of the function of the myofibrillar apparatus. Th neuromuscular syndrome of our case is similar to the muscular disorder described by Torbergsen (1975), but in addition histochemical and electron microscopic studies of the muscle showed morphological abnormalities not related to any specific muscle disease. Furthermore, a cerebellar syndrome attributed to a cerebellar atrophy was the patient's main complaint. Both the neuromuscular syndrome and the cerebellar disorder were semeiologically independent of each other.

Atrophy↗
PubMed1978

Hereditary distal myopathy with onset in early infancy. Observation of a family.

The study of a family affected with hereditary distal myopathy with onset in early infancy is presented. Complete neurological examination was necessary in several members of the two last generations to discover the existence of the abnormalities of which they were unaware. The propositus was the most affected member of the family iwth distal paresis of the upper and lower extremities and selective paresis of the deltoid muscles. In addition he had kyphoscoliosis, talipes valgus and limitation of mobility of several joints. The onset of the disease was estimated as before the age of 2 when the child started walking. There was no progression of the disease. Clinical examination suggested a myopathic origin of the condition. A sural nerve biopsy was normal. Light-microscopy histochemical studies disclosed a predominance of type I fibres which were at the same time hypotrophic. Subsarcolemmal deposits of mitochondria were present although they were scanty and of normal ultrastructural appearance. In view of the morphological presentation it is postulated that this disease should be classified within the groups of myopathies accompanied by disproportion of fibres and selective atrophy of type I fibres.

Adult↗