Cranial Pair 0: The Nervus Terminalis.

Originally discovered in elasmobranchs by Fritsh in 1878, the nervus terminalis has been found in virtually all species, including humans. After more than one-century debate on its nomenclature, it is nowadays recognized as cranial pair zero. The nerve mostly originates in the olfactory placode, although neural crest contribution has been also proposed. Developmentally, the nervus terminalis is clearly observed in human embryos; subsequently, during the fetal period loses some of its ganglion cells, and it is less recognizable in adults. Fibers originating in the nasal cavity passes into the cranium through the middle area of the cribiform plate of the ethmoid bone. Intracranially, fibers joint the telencephalon at several sites including the olfactory trigone and the primordium of the hippocampus to reach preoptic and precommissural regions. The nervus terminalis shows ganglion cells, that sometimes form clusters, normally one or two located at the base of the crista galli, the so-called ganglion of the nervus terminalis. Its function is uncertain. It has been described that its fibers facilitates migration of luteinizing hormone-releasing hormone cells to the hypothalamus thus participating in the development of the hypothalamic-gonadal axis, which alteration may provoke Kallmann's syndrome in humans. This review summarizes current knowledge on this structure, incorporating original illustrations of the nerve at different developmental stages, and focuses on its anatomical and clinical relevance. Anat Rec, 302:394-404, 2019. © 2018 Wiley Periodicals, Inc.

Structural and functional alterations of the heart in Parkinson's disease.

Parkinson's disease (PD) patients have most frequently heart failure. The cause of this increased prevalence is not known. We designed a study to assess the cardiac function and cardiac structure in patients with PD compared to a control group. METHODS: Cross-sectional study with 50 PD patients and 50 healthy matched controls. We performed electro and echocardiograms to all patients and controls. The measurements were blind. In addition, we performed a neurological assessment. RESULTS: PD patients had higher left ventricular mass index (114.2 ± 38.4 vs. 94.1 ± 26.4 g/m2; P = 0.003) and higher left atrial volume (30.1 ± 7.9 vs. 26.7 ± 6.2 ml/m2; P = 0.01). PD was an independent risk factor for elevated left ventricular filling pressures (OR = 2.7, CI 95% 2.2-6.3; P = 0.004). Concentric remodeling and left ventricular hypertrophy were associated with more advanced Hoehn and Yahr stages. Moreover, patients with more dysautonomia symptoms showed more left ventricular hypertrophy. Finally, PD group had longer QT interval than control group regardless of the drugs. CONCLUSIONS: PD is significantly associated with increased concentric left ventricular hypertrophy and diastolic dysfunction. Advanced stages of PD are associated with a more severe cardiac affection. These findings can explain the increase of heart failure in PD patients. Cardiomyopathy could be a non-motor parkinsonian symptom.

Síndromes conversivos en neurología: características clínicas de 16 pacientes / Conversion syndromes in neurology: clinical characteristics of 16 patients

El trastorno de conversión (término que describe lo que anteriormente se llamaba histeria) se refiere a los síntomas motores, sensitivos o ambos, que se asemejan a una enfermedad neurológica, pero que no tienen origen en una enfermedad física conocida, ni se pueden explicar por ella, dándose la particularidad de que el enfermo no es consciente de lo que le ocurre. La incapacidad funcional para los pacientes a veces es mayor que la observada en los casos en los que, con una semiología similar, hay un sustrato orgánico. Material y método: Presentamos 16 pacientes, valorados en consulta externa de neurología, con un trastorno motor o sensitivo, sin evidencia de enfermedad orgánica subyacente, con al menos un año de seguimiento. Discusión: Se comentan las características semiológicas. La fisiopatología de los síndromes conversivos está todavía en discusión. Las técnicas de neuroimágenes funcionales parecen mostrar alteraciones que nos permiten acercarnos a la fisiopatología de estos trastornos. Es importante señalar que aunque la fisiopatología de los síndromes conversivos está todavía en discusión, lo cierto es que se trata de pacientes de diagnóstico difícil, pero posible; es responsabilidad del médico intentar entender el sustrato neurológico de un problema que implica una gran incapacidad funcional e instaurar un tratamiento adecuado, buscando, si es necesario, la colaboración de un psiquiatra con experiencia en el abordaje de estos trastornos...