Brain magnetic resonance imaging findings in acute relapses of neuromyelitis optica spectrum disorders.

We studied cranial magnetic resonance imaging (MRI) lesions in three women with acute attacks of recurrent longitudinally extensive transverse myelitis (r-LETM), recurrent-optic neuritis (r-ON) and r-LETM-CNS. Neuromyelitis Optica -immunoglobulin (IgG) antibody was positive in all cases. Brain MRI (1.5 Tesla) was performed according to protocol from consortium MS centre. We described the cranial lesions in brain MRI of acute relapses. These lesions were different from MS, most had an asymptomatic course which disappeared with time, protocol from consortium of MS centre criteria for brain MRI and seropositivity of NMO-IgG are useful tools for differentiate acute lesions of NMO/MS.

[Corticospinal dysfunction in patients with primary and amyotrophic lateral sclerosis]. / Disfunción corticoespinal en pacientes con esclerosis lateral primaria y amiotrófica.

INTRODUCTION: Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS. PATIENTS AND METHODS: It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods. RESULTS: As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30% of recording from ALS patients response to TMS was absent, but only the 4.5% in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6.32, p = 0.011; and Kruskall-Wallis, H = 5.777, p = 0.0163, respectively). CONCLUSION: Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases.

Disfunción corticoespinal en pacientes con esclerosis lateral primaria y amiotrófica / Corticospinal dysfunction in patients with primary and amyotrophic lateral sclerosis

Corticoespinal dysfunction is a common finding in primary and amyotrophic lateral sclerosis (PLS and ALS). AIM. To compare the behaviour of motor evoked potentials (MEP) with transcranial magnetic stimulation (TMS) in patients with ALS and PLS. It was performed a retrospective analysis of MEP recordings of 11 patients with PLS and 10 patients with sporadic ALS. Central motor conduction time and amplitude ratio were the selected variables for the statistical analysis of MEP from abductor pollicis brevis and tibialis anterior muscle from the four limbs, using non-parametric methods. As a general observation there was a high incidence of abnormal recordings in both groups of patients; in 30 percent of recording from ALS patients response to TMS was absent, but only the 4,5 percent in the group of PLS had the same characteristic. In PLS patients abnormal central motor conduction time was the most frequent finding, as it was the low amplitude ratio in ALS patients; both variables showed statistically significant differences between groups (Kruskall-Wallis, H = 6,32, p = 0,011; and Kruskall-Wallis, H = 5,777, p = 0,0163, respectively). Corticoespinal dysfunction has different characteristics in ALS and PLS patients, and the analysis of MEP could add useful information for differential diagnosis of these diseases(AU)

[Brainstem lesions: clinicoradiological electrophysiological correlation when chronic]. / Lesiones del tronco cerebral en estadio crónico: correlación clínica, radiológica y electrofisiológica.

INTRODUCTION: The brainstem is a vital structure. Imaging and electrophysiological studies are important aids to clinical diagnosis. OBJECTIVE: To define the clinical, imaging and electrophysiological correlation in 28 patients with chronic brainstem lesions. PATIENTS AND METHODS: We analyzed the results of physical examination, imaging studies (CAT and MR) and brainstem auditory evoked potentials (BEAP) in each patient. RESULTS: There was a predominance of males in the group studied. The commonest age groups were between 25 34 and 35 44 years old. Involvement of the cranial nerves was the commonest neurological finding, and the XII cranial nerve was the one most commonly involved. The condition had persisted for 1 to 4 years in 60.8% of the patients. There was a predominance of lesions of the pons in 28.6%. In five patients classical syndromes were seen. The commonest aetiology was ischaemic cerebrovascular disease in 53.6% of the patients. The lesions were detected on MR in 86.6% of the cases and on CAT scans in only 27.3%. The BEAP was abnormal in 75% of the patients. There was close correlation between the clinical topography and results of MR (p<0.05) but little correlation with the CAT scans or PEATC. CONCLUSION: We consider that MR is the investigation of choice in these patients.

Neurological restoration of West Syndrome: presentation of a case

Introduction. West syndrome or infantile spasms, cause a retard of the severe psychomotor development, as convulsive seizures are characterized by spasms in flexion. If the evolution is not satisfactory, the deterioration is bigger. To control the epileptic crisis and to incorporate a guided neurorestorative program in the stimulation of areas of the affected psychomotor development in an intensive, integral and personalized form with a duration of 7 daily hours at the International Center of Neurological Restoration. Clinical case. Presentation of a case with West syndrome. At the beginning of the program an applied neuropsychological evaluation was applicated (Brunnet Lezine's test, that measure the psychomotor development of the early childhood), Somatosensorial Evoked Potentials of the inferior limbs comparing them over year, are treatment performed in cycles of 60, 94 and 28 days respectively this the psychomotordevelopment improved. Result. Evolution of psychomotor development of 2.27 months to 9,6 months was predicted and a retard with adeep range and cortical answer verified the function of the somestetic ways. Conclusions. The neurorestorative program is decisive in the psychomotor development due to the neuroplasticity of the nervous system. In the evolution of her psychic functions when she received an intensive, personalized and integral stimulation, changes are observed in the Somatosensorial Evoked Potentials(AU)

Hemiatrofia facial congénita. Presentación de dos casos / Congenital facial hemiatrophy. A report of two cases

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