Migraine education brochures and patient-perceived satisfaction.

INTRODUCTION: Brochures are commonly used as educational tools in daily neurological practice. They are provided to increase the general population's knowledge of a specific disease and also to combat sources of erroneous information. Surveys are the most commonly used method of ascertaining user satisfaction with services received. OBJECTIVES: This study will assess patient-perceived satisfaction and provide feedback to measure the comprehensibility and overall utility of an educational brochure on migraine. MATERIAL AND METHODS: Open prospective multicentre study of a group of patients diagnosed with migraine in neurology clinics in Alicante province. During the initial visit, each patient received a migraine brochure prepared by the Valencian Society of Neurology's study group for headaches (CEFALIC). During a follow-up visit, they were then asked to fill out a personal survey on the overall quality of the information in the brochure. RESULTS: We included a total of 257 patients diagnosed with migraine (83% episodic migraine; 17% chronic migraine); mean age was 37.6 years. Two hundred seven patients confirmed having read the brochure (80.5%); 50 patients (19.5%) either forgot to read it or had no interest in doing so. The brochure seemed interesting and easy to understand according to 90% of the patients. Seventy-six per cent of the respondents stated that reading the brochure increased their overall knowledge of migraine, while 50% of the patients found the brochure useful for improving migraine control. CONCLUSIONS: Patients found the migraine educational brochure to be comprehensible, a means of increasing overall knowledge of the disease, and useful for increasing control over migraines. Evaluations of the educational brochures that we provide to our patients with migraine should be studied to discover the causes of dissatisfaction, determine the level of quality of service, and investigate potential areas for improvement.

[A descriptive study of neurocysticercosis in a tertiary care hospital]. / Estudio descriptivo de neurocisticercosis en un hospital terciario.

INTRODUCTION: Neurocysticercosis is the most frequent parasitic disease affecting the central nervous system. It is a disease that is endemic to certain countries in South America. The phenomenon of immigration, however, has increased its prevalence in developed regions due to the arrival of immigrants from endemic areas. AIM: To present the clinical and demographic characteristics of the cases of neurocysticercosis attended in a tertiary care hospital in the city of Murcia. PATIENTS AND METHODS: We conducted a descriptive, retrospective study by reviewing the medical records of patients with a hospital diagnosis of neurocysticercosis over a nine-year period (1997-2005). Demographic and clinical data on these patients were collected. RESULTS: Twenty-three patients (three under 12 years of age) were found. Mean age: 29.6 years. Countries of origin: Ecuador and Bolivia. The most frequently observed clinical manifestations were: epileptic seizures (73.9%), headache (39.1%) and neurological focus (26.1%). Albendazole was employed in 91.3% of cases and corticoids in 73.9%. The most frequently used drug in patients who received antiepileptic therapy was phenytoin. Four patients required surgical treatment. During the follow-up period, 52.8% of the patients were asymptomatic. CONCLUSIONS: Neurocysticercosis is a disease that is becoming increasingly more prevalent in Spain and we should suspect its presence in patients from endemic areas who visit because of clinical symptoms involving the central nervous system.

[Rendu-Osler-Weber disease as an infrequent cause of stroke]. / Enfermedad de Rendu-Osler-Weber como causa infrecuente de ictus.

INTRODUCTION: Hereditary haemorrhagic telangiectasia, or Rendu-Osler disease, is a congenital vascular disease that is associated with the presence of arteriovenous fistulas that cause paradoxical embolisms. CASE REPORT: An 83-year-old female with clinical signs and symptoms of convulsive attacks and multiple cerebral infarctions in the acute phase. She also presented a history of multiple haemorrhages and iron deficiency anaemia with no clear aetiological causation. A thorough examination of her medical history revealed a family history of haemorrhages and a sister who had been diagnosed with Rendu-Osler disease, which suggested the possible existence of a pulmonary arteriovenous fistula as the aetiological causation of her cerebrovascular disease. Neurovascular Doppler ultrasonography with bubble contrast test was positive, and the presence of the fistula was confirmed by a computerised axial tomographic angiography scan of the lungs. CONCLUSIONS: Rendu-Osler disease is a rare cause of stroke due to the fact that it is usually associated with arteriovenous fistulas that can cause paradoxical embolisms. Neurovascular Doppler ultrasound scanning is useful for detecting these pulmonary fistulas by means of the bubble contrast test, which is a non-invasive test that can be carried out easily by neurologists themselves.

[A descriptive study of intrahospital consultation to a neurological department]. / Estudio descriptivo de las interconsultas realizadas a un servicio de neurología.

INTRODUCTION: Intrahospital consultation (IC) is a little analyzed activity within daily neurologist hospital care. It entails an extra investment of time and resources. This study aims to describe the number and characteristics of the IC to a neurological department in our setting and to emphasize its importance within daily neurological health care. METHODS: We performed an eighteen-month retrospective study of the requests for consultations received during this period in the Neurology Service of the Hospital General Universitario. The following variables were analyzed: demographic information, number and type of IC, time of response, syndromic diagnosis, complementary tests requested and resolution of patients. RESULTS: 224 IC in 210 patients were seen. The average time of response was 1.57 days, although it was modified because of type of IC (normal: 1.7 days; for preference: 1.5 days; urgent: 0.2 days). The specialities that requested most consultations were cardiology (12.9%) and internal medicine (12.5 %). The most frequent reasons for consultation were: signs and symptoms (27.2%), focal neurological deficit (22.8%) and cognitive impairment (17.9%). CT scan and MRI were the most common complementary tests. A total of 25.4% of patients were referred to neurology outpatient clinic for follow-up. CONCLUSIONS: IC is an infrastudied activity in the literature. We consider it necessary to analyze this kind of care in every hospital in order to improve the organization and the planning of the day-to-day hospital activity

[Analysis of the patients who missed their appointments at the neurology clinic of the Marina Alta]. / Análisis de los pacientes no presentados a la consulta de neurología de La Marina Alta.

OBJECTIVES: To analyze the frequency, reasons and characteristics of patients who missed their appointments (NP) at the Neurology Clinic (CEN). To compare the characteristics of the NP with the patients who did not miss their appointment. Suggest measures to reduce avoidable causes of NP. PATIENTS AND METHODS: During the period 1/10/99 to 30/4/2000 the cases of NP were prospectively recorded and compared with a sample of patients who attended the CEN during the same period. We analyze the data on age, sex, distance of home from CEN, diagnosis, type of consultation and date of last consultation. The NP were contacted by phone and asked why they had not gone for their appointments. The reasons given were then classified as avoidable or unavoidable. RESULTS: Of the 1,842 consultations scheduled, 19% were NP. When the NP and the patients who did attend were compared we found statistically significant differences regarding the distance home/CEN. According to the diagnosis, the NP had more 'symptoms/signs' and other MIA, whilst those who attended the clinic had more 'neuropathies' and 'awaiting diagnosis'. The commonest avoidable reasons (55.8%) for NP were forgetting, administrative error and communication failure, and for unavoidable reasons (44.2%) physical disability, other priorities and improvement. CONCLUSIONS: There is a large proportion of NP in the CEN of the Marina Alta. The distance from home to CEN (over 25 km) was the main factor affecting the rate of NP. Since 56% of the NP were due to avoidable causes, strategies could be designed to reduce this percentage. In the NP group, the main causes were forgetting, administrative errors and communication failure.