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J R Cano

Publications and source records attributed to J R Cano.

4 recordsLinked to original sources
PubMed2003

[Interictal basal brain SPECT versus interictal activated brain SPECT in temporal cryptogenic epilepsy].

INTRODUCTION: Interictal epileptiform activity (IEA) is a common finding in temporal epileptic patients. The nature of the IEA is not entirely understood; it may be microseizures or just a negative phenomenon expressing brain inhibition mechanisms. In order to understand how brain metabolism is during interictal activity we studied a group of patients with SPECT HMPAO during basal condition no ictal activity - and when the same patients were having interictal activity. Temporal, thalamic and cerebellar perfusion were quantified by a digital method. PATIENTS AND METHODS: Two studies were performed in 24 epileptic patients: (9/15:M/F, 36,5 14,6 years). The MRI was normal or had minimal changes. Previous EEG had showed frontotemporal foci. The patients were studied by SPECT HMPAO performed with a STARCAM 3.200 equipment, the images being obtained by high resolution collimator with circular orbit 64 images, 30 s per image. The first study was performed when there was no anomaly in the EEG (basal study). In the second study (activated study) the radioligand was injected when the EEG showed at least 10 graphoelements (spike, polispikes, or sharp waves per EEG page). RESULTS: Thalamic, temporal and cerebellar perfusion decreased significantly in the activated state compared to the basal one (p < 0.001). The statistical relationship between these three locations was studied. There was a significant relationship (p < 0.001) between thalamic, temporal, and cerebellar perfusion, both in basal state and in the activated one. The correlation index was R2 > 0.9. CONCLUSIONS: For the cases studied, temporal epilepsy is associated to a significant decrease in thalamic, temporal and cerebellar perfusion in the basal state compared to the activated one. This finding may indicate that IEA expresses a post-ictal state.

Adult↗
PubMed1998

[Neuronopathy due to cisplatin].

INTRODUCTION: Cisplatinum is a cytotoxic agent used in the treatment of different types of cancer. It often has side-effects, including a pure sensory syndrome with conservation of pain and temperature sense which is very disabling. CLINICAL CASES: We present the case of a woman with cancer of the ovary and a man with oat cell carcinoma, who were treated with cisplatinum. After the course of chemotherapy was finished, with accumulated dosages of 500 mg/m2, they both developed paraesthesia of all four extremities, reduced control of fine movements and unstable gait. On physical examination there was distal hypoaesthesia with conservation of temperature and pain sensation, areflexia and sensory ataxia. The patient with ovarian cancer also had continuous pseudo athetotic movements. On neurophysiological studies, there was absence of peripheral and central sensory potentials and of H reflexes, normal electromyogram, normal motor conduction and normal mixed silent period. DISCUSSION: The target organ in cisplatinum neurotoxicity has been identified, in experimental and human studies, as the dorsal root ganglion. Our patients had a syndrome which clinically and neurophysiologically suggested diffuse involvement of the dorsal ganglion (neuropathy) in which absence of sensory and H reflex potentials showed that the larger cells had been damaged. However, the normal mixed silent period suggested that the small myelinic cells were not altered, in accordance with the preservation of pain and temperature sensation. CONCLUSIONS: We discuss the differential diagnosis between neuropathy due to cisplatinum and to paraneoplasia. We consider that there may be a tendency for certain heavy metals to damage posterior root ganglia.

Antineoplastic Agents↗
PubMed1998

[Section of the median nerve at the wrist].

INTRODUCTION: The usefulness of neurophysiological studies of peripheral nerves depends basically on an understanding of the physiopathology, especially of the evolutionary aspects of the phenomena of reinnervation. CLINICAL CASE: We present the case of a girl with complete section and immediate anastomosis of the two cut ends of the median nerve, at the wrist. Sixty two days later she had unmistakable signs of reinnervation (response in the thenar eminence to an electrical stimulus of 300 uV in amplitude and 42 ms in latency, with denervation and reinnervation on the EMG of the abductor pollicis brevis muscle). DISCUSSION: The findings in our patient show a rather faster rate of nerve regeneration than is usually accepted in the literature. This may have been due to suitable selection of some of the parameters of the neurophysiological study, such as time of analysis and sensitivity, which when not satisfactory may lead to an impression of failure or delay in reinnervation.

Anastomosis, Surgical↗