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Biomedical subjects

M Noya

Publications and source records attributed to M Noya.

137 records · Page 8Linked to original sources
PubMedDate not supplied

[Paramedian bithalamic infarct syndrome: report of five new cases].

Five patients were examined suffering from bilateral paramedian thalamic infarction, caused by occlusion of the posterior paramedian thalamo-subthalamic arteries, when they begin from one single pedicle. All cases began with obnubilation or transitory coma, followed by hypersomnia. Four patients showed vertical gaze paralysis, and the fifth vertical nystagmus. In three cases, nuclear lesion of the III cranial nerve was observed along with alteration of the photomotor reflexes, and there was miosis in one case. All were suffering from weakness in one or another limb or facial paresis and generalised acute hypotonia: only one patient had hemihypostesia. All five had dysarthria, ataxy and dysmetria, one had asterixis and two spasmodic crying. Between 5 and 12 months later, one had akinetic mutism and vertical gaze paralysis as the most noteworthy signs. The neuroradiological images show a bilateral ischemic lesion in the paramedian thalamic region, which extends in some cases to the anterior nucleus and in one case to the pulvinars; the lesion continues through the subthalamic regions and the medial part of the mesencephalic tegmentum, with a clear extension to the medial region of the cerebral peduncles in three cases and to the tectum in one case.

Adult↗
PubMedDate not supplied

[A headache and ischemic infarction of middle cerebral artery: a prospective study of 100 patient].

The frequency and clinical characteristics of headache were assessed in a prospective study carried out among 100 patients suffering from ischaemic infarct in the area of the middle cerebral artery. Headache was found in 28 out of the 100 patients studied and proved to be significantly more frequent in those infarcts located in the superficial branches (p < 0.001) and in the dominant hemisphere (p < 0.05). We found no relationship between the existence of headache and the type of infarct, its extension or level of neurological affectation. Severe headache preceded stroke in 28.5% of cases, was simultaneous in 57.1% and followed in 14.2%. The average intensity of headache was 2.14 +/- 1.69 headache units. It was bilateral in 46.4% of patients, generalized in 14.2%, unilateral on the side of the infarct in 28.5% and counterlateral in the remaining 10.7%.

Adult↗
PubMedDate not supplied

[Migraine and histamine: determining histidine in plasma and cerebrospinal fluid during migraine attacks].

We studied the plasma levels and cerebrospinal fluid (CSF) levels in twenty-nine patients suffering from migraine without aura and in eighteen others with aura. The samples were obtained during migraine attacks. We compared the results obtained with those from twenty-seven control subjects. Histidine levels in plasma were 1.18 +/- 0.51 mg/dl for the control group, 1.75 +/- 0.39 mg/dl in those suffering from migraine without aura and 2.07 +/- 0.64 mg/dl in those cases of migraine with aura. In both plasma and in cerebrospinal fluid concentrations of histidine were greater in patients with migraine than in controls (p < 0.001). Histidine is an amino acid precursor of histamine and its abnormalities may be demonstrative of the participation of this amine in migraine attacks, possibly within the state of neuronal hyperexcitability.

Adolescent↗
PubMedDate not supplied

[Subcutaneous sumatriptan in the treatment of migraine attacks. An analysis of its long term efficaciousness and tolerance].

We present the results of treatment with subcutaneous sumatriptan in migraine attacks. The study comprised forty-two patients suffering from migraine both with and without aura, with migraine attacks not susceptible to analgesics, non-steroid anti-inflammatory drugs (NSAID), ergotics or else intolerance to the same. Two groups were independently analyzed, one consisting of ten patients who had menstrual migraine continually for twelve months, the other consisting of thirty-two patients suffering from migraine with and without aura for six months. We assessed the effectiveness of the drug (reduction in the intensity and duration of the attack, action, speed, recurrence) and tolerance (adverse effects). The effectiveness of sumatriptan in relieving headache was 75.9% (80% in the case of the menstrual migraine group and 71.8% in the case of the migraine with and without aura group). This effectiveness was maintained in a similar fashion by analyzing independently the first and last months of treatment. Adverse effects were noted in 38.7% of patients treated (40% for the menstrual migraine group, 37.5% for those with migraine with and without aura). The most frequent effects were pain at the point of injection, a feeling of general tiredness, nausea and a sensation of tension in the neck or chest. These effects were largely slight and short lived. No serious adverse effects were reported. A long term analysis carried out on the menstrual migraine group shows the efficacy of sumatriptan is kept up, with improved tolerance of the drug and a decrease in the number of negative side effects noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The evaluation of the temporal lobe size by magnetic resonance in Alzheimer's disease].

The estimation of the size of the structures of the temporal lobe using magnetic resonance (MR) can be of assistance when diagnosing early degenerative dementia. We have carried out a survey on 17 patients with Alzheimer type dementia (ATD). They were classified in clinical stages according to the Reisberg global deterioration scale. As diagnostic criteria for ATD we used those developed by DSM-III-R and NINCDS-ADRDA. We carried out axial sequences of 10 mm thickness in protonic density and in T2, and crown sequences of 5mm in T1 perpendicular to the axis of the hypofield. We selected the crown incisions at the level of the interpeduncular cistern. We determined the areas of the temporal lobe, hypocampus and ventricular and two linear measurements (the interhypocampus distance and the maximum transverse diameter between internal layers of the craneum). The images were processed by means of a computer programme. The average area of both hypofields in patients at stages 3-5 on the Reisberg scale was 378.6 +/- 86.1 mm2 and in stages 6-7 was of 364.7 +/- 62.2 mm2. The average area of both temporal lobes in patients at stages 3-5 was of 2,177.03 +/- 411.4 mm2 and in stages 6-7, was of 1,945.0 +/- 303.3 mm2. The shrinkage in size of the temporal lobe and the hypocampus in patients with Alzheimer's disease was not found to be related with the degree of dementia.

Aged↗
PubMedDate not supplied

[Clinical diagnosis of dementia associated with cortical Lewy bodies].

8 cases of dementia associated with cortical Lewy bodies are dealt with, that were diagnosed in 1993 in examinations for dementia, using the Nottingham's clinical criteria. They make up 15.4% of primary degenerative dementias diagnosed in this examination. All developed a predominantly cortical dementia with variable bradiphrenia and a parkinsonian syndrome which was predominantly of the rigid-bradikinetic type. The dementia established itself rapidly -between 1 and 3 weeks- in 3 cases (37.5%). 50% of patients (4 cases) showed marked psychiatric symptoms. In 2 cases stiffness was predominantly axial and another had supranuclear paralysis of vertical gaze. 3 patients had no tremor, and 2 of the 5 remaining patients showed postural tremor. CT and axial MR images of the encephalon were similar to those observed in dementia of the Alzheimer type. The coronal MR carried out on 3 patients revealed less atrophy of the hypocampus than is normally observed in patients with dementia of the Alzheimer type who are at the same stage of development.

Aged↗
PubMedDate not supplied

[Adding lamotrigine to the treatment of epilepsy which is difficult to control].

We studied the effect of adding Lamotrigine to the medication of 36 patients with refractory epilepsy (ten with Lennox-Gastaut syndrome and ten with partial epilepsy with or without secondary generalization), who were resistant to optimized treatment with other drugs and who suffered at least four attacks per month. Lamotrigine was administered progressively, the final dose varying between 25 and 400 mg per day, the average being 192.3 mg. Lamotrigine was suspended in four cases (11%) as a result of behavioural abnormalities; three further patients showed slight secondary effects; no exanthemata were observed. The average age of the 32 patients who continued with treatment was 36.25 years and the average duration of epilepsy was 22.41 years. Average follow-up time was 26.9 weeks. In the case of two patients (5.55%) the attacks disappeared during follow-up time; 25 patients (69.4%) experienced at least a 50% objective reduction in the number of attacks. In no case was treatment suspended for lack of effect. Two patients gave up other drugs and continued monotherapy using Lamotrigine. In nine of the ten Lennox-Gastaut syndrome patients the frequency of attacks went down by more than 50% and in seven such cases by more than 75%.

Adolescent↗