[Subclinical hypothyroidism as a cause of reversible cognitive deterioration]. / Hipotiroidismo subclínico como causa de deterioro cognitivo reversible.

Hypothyroidism, which is treatable by hormone substitution, is one of the most frequent causes of symptomatic dementia. The effectiveness of hormone therapy for improving mental status is well established, but full reversibility of symptoms is unusual. We report the case of a woman whose disease began with progressive cognitive deterioration and tremor; laboratory tests revealed subclinical hypothyroidism, which was watched carefully over the next three years. When thyroid hormone therapy was begun, there was marked clinical improvement, which reversed only when the patient voluntarily withdrew treatment for a few weeks.

[Chronic polyneuropathy due to vitamin E deficiency]. / Polineuropatía crónica secundaria a deficiencia de vitamina E.

Vitamin E deficiency has been implicated as a causal factor in neurological disease for some time. Nevertheless, only in the last 10 years have we begun to understand the role this vitamin plays in the normal functioning and structure of the nervous system. Chronic fat malabsorption syndromes are the most common causes of low levels of this highly fat-soluble vitamin. We present a case of chronic polyneuropathy due to vitamin E deficiency caused by malabsorption in which a biliary-cholonic fistula was present. Plasma tocopherol levels were normalized by parenteral substitution, leading to substantial clinical improvement. We suggest that vitamin E levels be determined in cases of digestive disorders involving malabsorption of fats and in chronic neurological diseases, particularly spinal-cerebral degenerative and polyneuropathic diseases that are mainly sensory or motor-sensory in nature, given the potential reversibility of these disorders when caused by vitamin E deficiency.

[Neurological disease due to the varicella-zoster virus without a skin lesion]. / Afección neurológica por virus varicela-zoster sin lesión cutánea.

We studied three cases of inflammatory neurological disease and serological evidence of varicella-zoster viral (VZV) infection without cutaneous manifestation. They corresponded to a case of cranial multi-neuritis, a case of aseptic meningitis, and another case of meningoencephalitis. Despite the infrequency of any such association, the spectrum of the neurological diseases associated with VZV without skin lesions is quite wide. We are motivated to present our experience by the belief that it is important to think about this possible etiology based on inflammatory areas at different levels of the Nervous System in patients who are still immunocompetent.