RESUMEN
We present a case of a patient with focal non-motor emotional seizures with dacrystic expression in the context of drug-resistant magnetic resonance imaging negative epilepsy. The pre-surgical evaluation suggested a hypothesis of a right fronto-temporal epileptogenic zone. Stereoelectroencephalography recorded dacrystic seizures arising from the right anterior operculo-insular (pars orbitalis) area with secondary propagation to temporal and parietal cortices during the dacrystic behavior. We analyzed functional connectivity during the ictal dacrystic behavior and found an increase of the functional connectivity within a large right fronto-temporo-insular network, broadly similar to the "emotional excitatory" network. It suggests that focal seizure, potentially, from various origins but leading to disorganization of these physiological networks may generate dacrystic behavior.
Asunto(s)
Epilepsia Refractaria , Epilepsias Parciales , Humanos , Electroencefalografía/métodos , Convulsiones , Lóbulo Parietal , Imagen por Resonancia Magnética/métodosRESUMEN
Caffeine is an alkaloid which belongs to the family of methylxanthines and is present in beverages, food and drugs. Caffeine competitively antagonizes the adenosine receptors (AR), which are G protein-coupled receptors largely distributed throughout the body, including brain, heart, vessels and kidneys. Caffeine consumption has a well-known diuretic effect. The homeostasis of salt and water involves different segments of the nephron, in which adenosine plays complex roles depending on the differential expression of AR. Hence, caffeine increases glomerular filtration rate by opposing the vasoconstriction of renal afferent arteriole mediated by adenosine via type 1 AR during the tubuloglomerular feedback. Caffeine also inhibits Na(+) reabsorption at the level of renal proximal tubules. In addition, caffeine perturbs the hepatorenal reflex via sensory nerves in Mall's intrahepatic spaces. Here, we review the physiology of caffeine-induced natriuresis and diuresis, as well as the putative pathological implications.
