[Prophylaxis of chronic daily headache with a simplified regimen of subcutaneous administration of botulinum toxin type A]. / Profilaxis de la cefalea crónica diaria con una pauta simplificada de administración subcutánea de toxina botulínica tipo A.

INTRODUCTION: Primary headaches are one of the most prevalent conditions in neurology. Botulinum toxin type A (TBA) has been used for years as a prophylactic measure for chronic daily headache (CDH) with varying infiltration regimens and outcomes. AIM: To demonstrate the speed, convenience and safety of a subcutaneous regimen of TBA as a prophylactic for CDH, and also to determine how effective it is as a preventive therapy. PATIENTS AND METHODS: A total of 843 patients were infiltrated subcutaneously with 100 U of TBA (Botox) using a 'fixed dose-fixed site' technique in six pericranial points in periods of at least three months. We evaluated the reduction in the mean frequency of crises and days with headaches and the intake of analgesics, as well as the percentage of patients with a reduction of over 50% in the mean frequency of headache crises. RESULTS: Subcutaneous infiltration of TBA brought about a reduction of 78.91+/-6.81% in the frequency of monthly crises (p<0.001) and a reduction of 62.38+/-12.8% in the number of days per month with headache after three months' infiltration. Reports from patients indicated that 92.8% of them had reduced the number of days with headache per month by at least 50%. Mean frequency and total intake of analgesics decreased from 21.48+/-2.47 to 1.96+/-1.27 (p<0.001) and from 126.01+/-24.7 to 6.65+/-2.27 doses, respectively. There were few side effects, none of which were severe. CONCLUSION: Simplified subcutaneous infiltration of TBA is very effective, convenient, fast and safe as a means of preventing CDH.

Profilaxis de la cefalea crónica diaria con una pauta simplificada de administración subcutánea de toxina botulínica tipo A / Prophylaxis of chronicdaily headache with a simplified regimen of subcutaneous administration of botulinum toxin type A

Las cefaleas primarias constituyen una de las afecciones más prevalentes en neurología. La toxinabotulínica tipo A (TBA) se utiliza desde hace años en la profilaxis de la cefalea crónica diaria (CCD) con pautas de infiltración y resultados variables. Objetivo. Determinar la eficacia preventiva y demostrar la rapidez, comodidad y tolerabilidad de una pauta subcutánea de TBA en la profilaxis de la CCD. Pacientes y métodos. 843 pacientes fueron infiltrados subcutáneamente con una técnica ‘dosis fija-sitio fijo’ de 100 U de TBA (Botox) en seis puntos pericraneales en períodos de al menos tres meses. Se valoró la reducción de la frecuencia media de crisis y días con cefalea, y del consumo de analgésicos y porcentaje de pacientes con reducción de más del 50% de la frecuencia media de crisis de cefalea. Resultados. La infiltración subcutáneade TBA produjo una reducción del 78,91 ± 6,81% en la frecuencia de crisis mensuales (p < 0,001) y una reducción del 62,38 ± 12,8% en los días mensuales con cefalea a los tres meses de la infiltración. El 92,8% de los pacientes refirió una reducción de al menos un 50% de los días con cefalea mensuales. La frecuencia media y el total de consumo de analgésicos se redujo de 21,48 ± 2,47 a 1,96 ± 1,27 (p < 0,001), y de 126,01 ± 24,7 a 6,65 ± 2,27 dosis, respectivamente. Hubo pocos efectosadversos, ninguno grave. Conclusión. La infiltración simplificada subcutánea de TBA es muy eficaz, cómoda, rápida y segura en la prevención de la CCD

Primary headaches are one of the most prevalent conditions in neurology. Botulinum toxin type A(TBA) has been used for years as a prophylactic measure for chronic daily headache (CDH) with varying infiltration regimens and outcomes. Aim. To demonstrate the speed, convenience and safety of a subcutaneous regimen of TBA as a prophylactic for CDH, and also to determine how effective it is as a preventive therapy. Patients and methods. A total of 843 patients wereinfiltrated subcutaneously with 100 U of TBA (Botox) using a ‘fixed dose-fixed site’ technique in six pericranial points in periods of at least three months. We evaluated the reduction in the mean frequency of crises and days with headaches and theintake of analgesics, as well as the percentage of patients with a reduction of over 50% in the mean frequency of headache crises. Results. Subcutaneous infiltration of TBA brought about a reduction of 78.91 ± 6.81% in the frequency of monthly crises (p < 0.001) and a reduction of 62.38 ± 12.8% in the number of days per month with headache after three months’ infiltration. Reports from patients indicated that 92.8% of them had reduced the number of days with headache per month byat least 50%. Mean frequency and total intake of analgesics decreased from 21.48 ± 2.47 to 1.96 ± 1.27 (p < 0.001) and from 126.01 ± 24.7 to 6.65 ± 2.27 doses, respectively. There were few side effects, none of which were severe. Conclusion. Simplified subcutaneous infiltration of TBA is very effective, convenient, fast and safe as a means of preventing CDH

[Neurology in the court of the Learned King]. / Neurología en la corte del Rey Sabio.

During the reign of Alfonso X of Castile one of the most flourishing cultural periods of European history was reached. The so-called Learned King contributed to this development by promoting the use of Castilian as the language of scientific discovery instead of Latin, and favoring the recovery of Arabic origin manuscripts in the Toledo Translators' School. Where the wise men from the "three cultures" (Christian, Islamic and Jewish) worked together in harmony to perpetuate classical knowledge. The aim of this paper is to analyze neurological pathology in the period concerned. The Learned King suffered from several neurologic syndromes including delirium and coma. He also showed chronic maxillary sinusitis with orbital involvement, trigeminal neuralgia and visual loss. Furthermore, in the "Cantigas" he described miraculous treatments of several disorders including seizures, leprous neuropathy, dementia, rabies, and ergotism.

Neurología en la corte del Rey Sabio / Neurology in the court of the Learned King

Durante el reinado de Alfonso X de Castilla se alcanzó uno de los períodos culturales más florecientes de nuestra historia. El llamado Rey Sabio contribuyó a este desarrollo promoviendo el uso del castellano como lengua de transmisión científica en lugar del latín en la Escuela de Traductores de Toledo, donde sabios de las «tres culturas) (cristiana, islámica y judía) colaboraron en armonía para perpetuar el conocimiento heredado de los clásicos. En el presente trabajo se estudia historiográficamente la neurobiopatología alfonsí y la idea de enfermedad neurológica durante la época medieval hispana.En la obra generada por la corte alfonsí (Cantigas, documentos de su cancillería y cronicones de la época) se desprende que el Rey Sabio padeció procesos que cursaron con semiología neurológica y se reconocen cuadros de nuestra especialidad que afligieron a las gentes medievales. Alfonso X padeció afecciones que cursaron con coma y delirio, estando su propia vida seriamente comprometida en varias ocasiones. Asimismo, sufrió una lesión inflamatoria maxilar crónica con afectación orbitaria progresiva que produjo una grave neuralgia trigeminal, afectación del nervio óptico, pérdida progresiva de la función visual y enucleación ocular. En las Cantigas se relatan «curaciones milagrosas» de traumatismos craneales, neuropatías leprosas (mal de San Lázaro), demencias, hemiplejías, rabia (mal de San Huberto), crisis convulsivas (endemoniados). diversas tipologías de padecimientos psiquiátricos y el ergotismo (mal de San Antón)

During the reign of Alfonso X of Castile one of the most florishing cultural periods of European history was reached. The so-called Learned King contributed to this development by promoting the use of the Castilian as the language of scientific transmission instead of latin, and favouring the recovery of arabic origin manuscripts in the Toledo Translators' School. Where the wise men from the «three cultures» (Christian, Islamic and Jewish) worked together in harmony to perpetuate classical knowledge. The aim of this paper is to analyze the neurological pathology in the period concerned.The Learned King suffered from several neurologic syndromes including delirium and coma. He also showed chronic maxillary sinusitis with orbital involvement, trigeminal neuralgia and visual loss. Furthermore, in the Cantigas he described miraculous treatments of several disorders including seizures, leprous neuropathy, dementia, rabies, and ergotism

[The examination of men's wits by Juan Huarte de San Juan, and the dawn of the neurobiology of intelligence in the Spanish renaissance]. / Examen de ingenios, de Juan Huarte de San Juan, y los albores de la Neurobiología de la inteligencia en el Renacimiento español.

INTRODUCTION: The Spanish renaissance doctor Juan Huarte de San Juan (1529-1588) was the author of a unique and immortal work, The Examination of Men's Wits, the edition princeps of which was printed in Baeza in 1575. Since then it has been reprinted at least 80 times and translated into seven languages, which makes it the most influential Spanish contribution to medicine ever published. DEVELOPMENT: In this paper we review the unjustly little-known figure of Huarte as the founder of Neuropsychology, and we also analyse his works from a historical and neuroscientific point of view. Huarte's writings deal with the problem of the organic relations between the brain and understanding, and accept the possible influences exerted by temper on the will within the field of the Neurobiology of Intelligence. Thus, over four centuries ago Huarte became the founder of Differential or Physiological Psychology, Neuropsychology, Eugenics and Career Guidance. CONCLUSIONS: Huarte's work not only played a fundamental role in the history and development of the body of neuroscientific knowledge, but has also been a clear (although not always cited) influence on scientists, philosophers and men of letters such as Alarcón, Bacon, Cabanis, Cervantes (whose Don Quixote was inspired by him), Charron, Chomsky, Gall, Goethe, Hume, Kant, Kretchmer, Lessing, Lope de Vega, Montaigne, Montesquieu, Nietzsche, Quevedo, Rousseau, Schopenhauer, Thomasius, Tirso de Molina and Ziegler. In the middle of the 16th century, Huarte and his Examination of Men's Wits, together with the works of the naturalist philosophers Gómez Pereira (Antoniana Margarita, 1554) and Miguel Sabuco (New Philosophy, 1587), constituted the prestigious triumvirate of Spanish Renaissance scholars who, for the first time in history, contemplated the workings of the brain from a point of view that had more to do with science than the supernatural.

Examen de ingenios, de Juan Huarte de San Juan, y los albores de la Neurobiología de la inteligencia en el Renacimiento español / The examination of Men's Wits by Juan Huarte de San Juan, and the dawn of the neurobiology of intelligence in the spanish renaissance

Introducción. El médico renacentista hispanoconverso Juan Huarte de San Juan (1529-1588) fue autor de una única e inmortal obra, Examen de ingenios, cuya edición prínceps, impresa en Baeza (1575), ha tenido al menos 80 reediciones y traducciones a siete idiomas, lo que constituye la contribución médica española de mayor influencia de todos los tiempos. Desarrollo. En el presente artículo se revisa la injustamente poco conocida figura de Huarte como fundador de la Neuropsicología, y se analiza su obra desde un punto de vista histórico y neurocientífico. El texto huartino aborda el problema de las relaciones orgánicas entre cerebro y entendimiento, y acepta posibles influencias del temperamento sobre el albedrío en el campo de la Neurobiología de la inteligencia, lo que convierte a Huarte en fundador -hace más de cuatro centurias- de la Psicología diferencial o fisiológica, la Neuropsicología, la Eugenesia y la Orientación profesional. Conclusiones. La obra de Huarte no sólo fue fundamental en la historia y desarrollo del cuerpo de conocimientos neurocientíficos, sino que también ha influido de forma clara -aunque no siempre citada- en científicos, filósofos y literatos como Alarcón, Bacon, Cabanis, Cervantes -a quien inspiró Don Quijote-, Charron, Chomsky, Gall, Goethe, Hume, Kant, Kretchmer, Lessing, Lope de Vega, Montaigne, Montesquieu, Nietzsche, Quevedo, Rousseau, Schopenhauer, Thomasius, Tirso de Molina y Ziegler. En pleno siglo XVI, Huarte y su Examen de ingenios, junto con las obras de los filósofos naturalistas Gómez Pereira (Antoniana Margarita, 1554) y Miguel Sabuco (Nueva Filosofía, 1587), establecieron el prestigioso triunvirato de sabios renacentistas españoles que, por primera vez en la Historia, contemplaron las funciones del cerebro desde un punto de vista más científico que sobrenatural (AU)

Introduction. The Spanish renaissance doctor Juan Huarte de San Juan (1529-1588) was the author of a unique and immortal work, The Examination of Men’s Wits, the editio princeps of which was printed in Baeza in 1575. Since then it has been reprinted at least 80 times and translated into seven languages, which makes it the most influential Spanish contribution to medicine ever published. Development. In this paper we review the unjustly little-known figure of Huarte as the founder of Neuropsychology, and we also analyse his works from a historical and neuroscientific point of view. Huarte’s writings deal with the problem of the organic relations between the brain and understanding, and accept the possible influences exerted by temper on the will within the field of the Neurobiology of Intelligence. Thus, over four centuries ago Huarte became the founder of Differential or Physiological Psychology, Neuropsychology, Eugenics and Career Guidance. Conclusions. Huarte’s work not only played a fundamental role in the history and development of the body of neuroscientific knowledge, but has also been a clear (although not always cited) influence on scientists, philosophers and men of letters such as Alarcón, Bacon, Cabanis, Cervantes (whose Don Quixote was inspired by him), Charron, Chomsky, Gall, Goethe, Hume, Kant, Kretchmer, Lessing, Lope de Vega, Montaigne, Montesquieu, Nietzsche, Quevedo, Rousseau, Schopenhauer, Thomasius, Tirso de Molina and Ziegler. In the middle of the 16th century, Huarte and his Examination of Men’s Wits, together with the works of the naturalist philosophers Gómez Pereira (Antoniana Margarita, 1554) and Miguel Sabuco (New Philosophy, 1587), constituted the prestigious triumvirate of Spanish Renaissance scholars who, for the first time in history, contemplated the workings of the brain from a point of view that had more to do with science than the supernatural (AU)

[Treatment of chronic tension type headache with mirtazapine and amitriptyline]. / Tratamiento de la cefalea tipo tensión crónica con mirtazapina y amitriptilina.

INTRODUCTION: The mechanisms at play in the production of tension type headaches (TTH) are partially unknown. Some of the aspects that have been discussed in connection with this issue include genetic, vascular and biochemical factors and even a predisposition of certain personalities to suffer from this kind of pain. Yet, the relation between neurotransmitters like noradrenalin (NAd) and serotonin (5 HT) and chronic TTH (CTTH) seems to be quite clear and hence the use of antidepressants that act on these substances in the pharmacological treatment of CTTH. In this study, the qualitative and quantitative efficiency of amitriptyline is compared with that of mirtazapine (two antidepressants that act on NAd and 5 HT) in the prophylaxis of CTTH. PATIENTS AND METHODS: A sample of 60 patients with CTTH criteria was divided into two groups, and subjects were administered one of the drugs at 50% random for six months. Group I was administered 25 mg of amitriptyline and group II received 30 mg of mirtazapine, both given in a single night time oral dose. Later, the two groups were compared before and after treatment, taking into account the following aspects: objective and subjective improvements, depression criteria according to the Hamilton 17 coefficient, reduction in the amount of pain killers taken, and the side effects produced by the two drugs. RESULTS: Both groups of patients presented depression criteria, which improved after taking the drugs, without any objective differences between the two forms of therapy, although the subjective feeling of improvement was greater with mirtazapine. In both groups there was a significant reduction in the usual consumption of analgesics after the prophylaxis. Side effects with both antidepressants were relatively frequent, but well tolerated, and the most common were a dry mouth and drowsiness. There were significantly fewer in the group of patients treated with mirtazapine than in those who received amitriptyline. CONCLUSIONS: First, depression and CTTH clearly coexist and that there is a certain dysphoric component associated to suffering chronic headache. Second, mirtazapine has proved to be as efficient in the treatment of CTTH as amitriptyline, but has significantly fewer side effects, probably because it acts more selectively on the brain receptors. It could, therefore, be a drug worth considering for use in the prophylaxis of chronic TTH.

[Sabuco's suco nerveo and the origins of neurochemistry in the Spanish Renaissance]. / El suco nerveo sabuceano y los orígenes de la neuroquímica en el Renacimiento español.

INTRODUCTION: In the 16th century, at the height of the Spanish Renaissance, Bachiller Miguel Sabuco revolutionised medical theories about brain physiology with the publication of his work Nueva Filosof a in 1587. This work, which is mysteriously attributed to his daughter Luisa Oliva, presents a surprisingly gynocentric ideology for its time and has been reprinted on numerous occasions since its first edition saw the light. Sabuco s ideas have been plagiarised by such renowned authors as Descartes, Willis and Glisson. DEVELOPMENT: In stark contrast to the Arabized galenism based on the criterion of authority that predominated the medical practice of his time, Nueva Filosof a empirically promoted a modern approach to neurophysiology. This becomes even more worthy of merit if we bear in mind that Sabuco was not trained as a doctor but instead worked as an apothecary in Alcaraz (Albacete, Spain). The Bachiller granted the brain a commanding role over the organisation of the body for the first time in the history of medicine. He not only developed the surprising theory of succo nervoso (the nervous sap, or original neurotransmitting substance), but also an elegant digression on human nature that puts forward solid arguments about the dualist relation between mind and brain. He examined the association between emotional and physical health and explained how the emotions can impair health and lead to early death, which means he was also a pioneer in the development of psychosomatic medicine. CONCLUSIONS: Besides constituting the most illustrious forerunner of modern day neurochemistry, Sabuco s work also encourages doctors to treat their patients in an integral manner, with equal attention being given to the body, mind and soul. It comes as no surprise, then, that many aspects of his work can still be compared to modern medical and philosophical thought.

Tratamiento de la cefalea tipo tensión crónica con mirtazapina y amitriptilina / Treatment of chronic tension-type headache with mirtazapine and amitriptyline

Introducción. Los mecanismos por los que se produce la cefalea tipo tensión (CTT) se desconocen en parte; se ha hablado de factores genéticos, vasculares y bioquímicos, incluso de la predisposición de ciertas personalidades a padecer este tipo de dolor. Sin embargo, la relación entre neurotransmisores como la noradrenalina (NAd) y la serotonina (5-HT) y la CTT crónica (CTTC) parece clararse, por lo que los antidepresivos que actúan sobre éstos se usan actualmente en el tratamiento farmacológico de la CTTC. En el presente trabajo se ha estudiado cualitativa y cuantitativamente la eficacia comparada de amitriptilina frente a mirtazapina, dos antidepresivos que actúan sobre NAd y 5-HT, en la profilaxis de la CTTC. Pacientes y métodos. Se administró de forma aleatorizada al 50 por ciento uno de ambos fármacos, durante seis meses, a una muestra de 60 pacientes con criterios de CTTC, que se dividieron en dos grupos: al grupo I se le administraron 25 mg de amitriptilina, y al grupo II, 30 mg de mirtazapina con toma diaria nocturna en monodosis por vía oral. Posteriormente, se valoraron comparativamente los dos grupos, antes y después del tratamiento, y se tuvo en cuenta las mejorías objetivas y subjetivas de los pacientes, los criterios de depresión según el coeficiente de Hamilton-17, la disminución en la toma de analgésicos y los efectos secundarios producidos por ambos fármacos. Resultados. Ambos grupos de pacientes presentaron criterios de depresión, que mejoró tras la toma de los fármacos, sin diferencias objetivas entre ambos tratamientos, aunque la sensación de mejoría subjetiva fue mayor con mirtazapina. En ambos grupos hubo una significativa reducción en el consumo habitual de analgésicos tras la profilaxis. Los efectos secundarios con ambos antidepresivos fueron relativamente frecuentes, pero bien tolerados, y predominó globalmente la xerostomía y la somnolencia. Fueron significativamente menores en el grupo de pacientes tratados con mirtazapina frente a los tratados con amitriptilina. Conclusiones. En primer lugar, existe una coexistencia clara de depresión y CCTC y que se asocia cierto componente disfórico en el padecimiento de la cefalea crónica. En segundo lugar, la mirtazapina ha demostrado ser un tratamiento tan eficaz para la CCTC como amitriptilina, pero con significativamente menos efectos secundarios, probablemente por su acción más selectiva sobre los receptores cerebrales; por ello, podría utilizarse como un fármaco a tener en cuenta en la profilaxis de la CCT de tipo crónico (AU)

Introduction. The mechanisms at play in the production of tension-type headaches (TTH) are partially unknown. Some of the aspects that have been discussed in connection with this issue include genetic, vascular and biochemical factors and even a predisposition of certain personalities to suffer from this kind of pain. Yet, the relation between neurotransmitters like noradrenalin (NAd) and serotonin (5-HT) and chronic TTH (CTTH) seems to be quite clear and hence the use of antidepressants that act on these substances in the pharmacological treatment of CTTH. In this study, the qualitative and quantitative efficiency of amitriptyline is compared with that of mirtazapine (two antidepressants that act on NAd and 5-HT) in the prophylaxis of CTTH. Patients and methods. A sample of 60 patients with CTTH criteria was divided into two groups, and subjects were administered one of the drugs at 50% random for six months. Group I was administered 25 mg of amitriptyline and group II received 30 mg of mirtazapine, both given in a single night-time oral dose. Later, the two groups were compared before and after treatment, taking into account the following aspects: objective and subjective improvements, depression criteria according to the Hamilton-17 coefficient, reduction in the amount of pain-killers taken, and the side effects produced by the two drugs. Results. Both groups of patients presented depression criteria, which improved after taking the drugs, without any objective differences between the two forms of therapy, although the subjective feeling of improvement was greater with mirtazapine. In both groups there was a significant reduction in the usual consumption of analgesics after the prophylaxis. Side effects with both antidepressants were relatively frequent, but well tolerated, and the most common were a dry mouth and drowsiness. There were significantly fewer in the group of patients treated with mirtazapine than in those who received amitriptyline. Conclusions. First, depression and CTTH clearly coexist and that there is a certain dysphoric component associated to suffering chronic headache. Second, mirtazapine has proved to be as efficient in the treatment of CTTH as amitriptyline, but has significantly fewer side effects, probably because it acts more selectively on the brain receptors. It could, therefore, be a drug worth considering for use in the prophylaxis of chronic TTH (AU)

El suco nerveo sabuceano y los orígenes de la neuroquímica en el Renacimiento español / Sabuco's suco nerveo and the origins of neurochemistry in the spanish Renaissance

Introducción. En el sigloXVI, en pleno Renacimiento español, el bachiller Miguel Sabuco revolucionó las teorías galénicas de la fisiología cerebral con la publicación en 1587 del texto Nueva Filosofía.Misteriosamente atribuido a su hija Luisa Oliva, con una ideología sorprendentemente ginocéntrica para su época, el texto sabuceano ha tenido numerosas impresiones desde su edición princeps; sus ideas han sido plagiadas por autores tan relevantes como Descartes, Willis y Glisson.Desarrollo. Nueva Filosofía, en abierta oposición con el galenismo arabizado predominante en la medicina de su época, basada en el criterio de autoridad, promueve empíricamente una aproximación moderna a la neurofisiología, lo cual resulta más meritorio si tenemos en cuenta la falta de formación médica de Sabuco, que ejerció la profesión de boticario en Alcaraz (Albacete). El bachiller otorgó al cerebro el papel de órgano rector de la economía por primera vez en la historia de la medicina; desarrolló no sólo la sorprendente teoría del suco nerveo (sustancia neurotransmisora primigenia), sino también una elegante digresión sobre la naturaleza humana que aporta argumentos sólidos sobre la relación dualista entre mente y cerebro. Escrutó la relación entre la salud emocional y física, y explicó cómo las emociones menoscaban la salud y causan la muerte prematura, por lo que fue pionero en el desarrollo de la medicina psicosomática. Conclusiones. Además de constituir el más preclaro antecedente de la moderna neuroquímica, la obra sabuceana invita a los médicos a tratar a sus pacientes de un modo integral, y a atender al unísono cuerpo, mente y ánima, por lo que muchos aspectos de su obra siguen siendo compatibles con el pensamiento médico y filosófico modernos (AU)

[Pareidolia in Beato de Liébana's illuminated Visigothic codes]. / Pareidolia en los códices visigóticos iluminados de Beato de Liébana.

The visual perception alterations constitute a characteristic etymological field in some neurological and psychiatric processes (such as hallucinations, hallucinosis, etc.) that can also appear in healthy people (metamorphosias, pareidolias). The pareidolia is a phenomenon characterized by the non auto-provoked visualization of a perception in which reality and daydream are combined. It constitutes a source of inspiration for different artistic manifestations, is the basis of some common psychological explorations (such as Rorcharch test) and it even can be the explication to some situations considered as paranormals, for example the vision of faces in the Moon or in Mars or the apparition of sacred figures either in spots or shades... Beato of Liébana was a cantabrian presbyter, author in the eight century of the Comments of the Apocalypse exegesis, copied and illuminated repeated times all through the following centuries. Given the marked revealing and eschatological component of the Apocalypse, starting from the Leon's School (known also as Mozarabic since the Ninth Century), the original was enriched adding another texts with their own illustrations. From them, the Comments to Daniel's Book, from Saint Jeronimus, stands out. The whole of the illuminated Hispanic manuscripts constitutes a "corpus" of amazing codices international known today as Beatos. We have demonstrated that the first History's graphic representation of a pareidolia phenomenon is found in the miniature Visigoth Hispanic manuscripts known as Beatos; we have arrived to this conclusion studying two facsimiles from the x Century (Beato of Valcavado and Beato of Gerona) specially the miniature called Baltasar's Feast; in both codices, is illustrated how this Babylon king perceives the way a phantasmagoric hand spurts up from a candlestick flame and writes in the adjacent wall three mysterious words: MANE, TECEL, FARES, which were only interpreted by Prophet Daniel, requested ad hoc. Baltasar mixed up unintentionally the perceived and the daydreamed starting from a visual field barely structured, we conclude that he suffered from a pareilolia phenomenon, graphically represented by the first time in History in the Beatos.

Pareidolia en los códices visigóticos iluminados de Beato de Liébana / Pareidolia in Beato de Liébana's illuminated Visigothic codes

Las alteraciones perceptivas visuales constituyen un peculiar campo semiológico en determinados procesos neurológicos y psiquiátricos (alucinaciones, alucinosis) que pueden aparecer asimismo en sujetos sanos (metamorfopsias, pareidolia).La pareidolia es un fenómeno caracterizado por la visualización no autoprovocada de una percepción combinada entre lo real y lo fantaseado. Constituye una fuente de inspiración para diversas manifestaciones artísticas, es la base de algunas exploraciones psicológicas (test de Rorcharch) e incluso supone la explicación de algunas situaciones supuestamente paranormales (visión de rostros en la Luna o Marte, caras y figuras sagradas en manchas o sombras, etc.).Beato de Liébana fue un presbítero cántabro, autor en el siglo VIII de los Comentarios al Apocalipsis, exégesis copiada e iluminada repetidas veces a lo largo de los siglos siguientes. Dado el marcado componente revelatorio y escatológico del Apocalipsis, a partir de los manuscritos de la escuela leonesa o mozárabe (desde el siglo IX) el original beatense fue enriquecido añadiendo otros textos con sus propias ilustraciones, entre los que destacan los Comentarios al Libro de Daniel de San Jerónimo. El conjunto de manuscritos iluminados constituye un corpus de extraordinarios códices hispanos hoy conocidos internacionalmente como Beatos. Hemos demostrado que la primera representación gráfica de la historia de un fenómeno de pareidolia se encuentra en los manuscritos visigóticos miniados hispanos denominados Beatos, estudiando dos facsímiles de códices mozárabes del siglo X (Beatos de Valcavado y de Gerona), concretamente la miniatura denominada El festín de Baltasar. En ambos códices se ilustra cómo este rey babilónico percibe una fantasmagórica mano que surge del fuego de un candelabro y escribe en la pared adyacente tres misteriosas palabras (MANE, TECEL, FARES), que únicamente fueron interpretadas por el profeta Daniel, requerido ad hoc. Dado que Baltasar mezcló involuntariamente lo percibido con lo fantaseado a partir de un campo visual escasamente estructurado, concluimos que sufrió un fenómeno de pareidolia, representado gráficamente por primera vez en la historia en los Beatos. (AU)

[Santiago Ramón y Cajal: his activity as a military doctor (1873-1875)]. / Santiago Ramón y Cajal: su actividad como médico militar (1873-1875).

Santiago Ram n y Cajal entered the Medical Corps after graduating in Medicine in 1873. His marked Spanish nationalist character and his excellent physical condition led him to serve in the third Carlist war as a medical lieutenant and later in the Cuban War as a captain. His stay in Cuba, however, was marked by hardship and illness. The decline of Spain s colonialist policy, the war that was fought in a hostile climate and atmosphere, and the corruption of the military officers led to Santiago being posted to the frontlines on a fixed logistics system of trails. All this was to end in military failure and the subsequent loss of the colony. Disillusioned and seriously ill from malaria, which nearly killed him, he returned to Spain after being discharged for illness. Shortly afterwards, thanks to Dr. Jenaro Casas, he became a university lecturer, which put an end to his military career

[Neuroscience in ancient Egypt and in the school of Alexandria]. / Neurociencia en el Egipto faraónico y en la escuela de Alejandría.

INTRODUCTION: About five thousand years ago, one of the most ancient, important and enduring civilisations in the history of Mankind flourished on the banks of the Nile. In Egypt, all the branches of human knowledge attained a high degree of development and today it is considered the mother of medicine. Despite the marked religious component that affected all its activities, the medicine of the Pharaohs was practised in a rational and deductive manner, and the Egyptians were the inventors of clinical observation. METHOD: The desert climate of the Nile Valley has preserved monuments, mummies and papyruses which have enabled us to get a certain idea of the degree of development reached in medical matters. The aim of this work is to analyse them from a neuroscientific point of view. The anatomical discoveries of the Egyptians originated in the inspection of wounds and the practice of embalming. They came to know a large number of diagnoses and were able to prescribe many different forms of treatment. They also attained a certain proficiency in dealing with neurotraumatological patients. They practised anamnesis, prognostics and a regulated surgery that infrequently included trephination. Their conservatism meant that, after the Macedonian domination, the traditional Egyptian medicine was replaced the Greek medicinal arts, which reached their maximum period of splendour in the School of Alexandria, where Herophilus and Erasistratus, pioneers in the study of anatomy and brain circulation, were especially renowned. CONCLUSIONS: From the point of view of the neurosciences, the Egyptians were the first to describe the brain, migraine, epilepsy, strokes, tetanus, Bell s palsy and the sequelae of head injuries and of spinal transection. Their artwork sometimes shows neurological patients and, according to Herodotus, there were doctors who were specialised in head diseases and could therefore be considered the precursors of our present day neurologists.

[Neuroscience in Al Andalus and its influence on medieval scholastic medicine]. / La neurociencia en Al Andalus y su influencia en la medicina escolástica medieval.

INTRODUCTION: Since the application of technical medicine by the Greeks, modern neurology has been based on a body of knowledge and cultural heritage from ancient times. In this paper we review the contribution made by Al Andalus to neuroscience during the Middle Ages and its repercussions on modern neurology. DEVELOPMENT: Following the death of Mohammed in the vii century AD, Islam enjoyed one of the most spectacular periods of expansion in the history of mankind. Occupation of the cities of Alexandria and Gundishapur put the Arabs into contact with original Greco Latin manuscripts, which were assimilated and divulged by Islamic scientists in the middle eastern caliphates of Damascus and Bagdad as well as the western caliphates of Al Andalus (Spain) and Kairwan (Tunis). This classical hippocratico galenico medicine was refashioned into the so called arabized galenism, which markedly influenced the Scholastics and the cultured world of the lower Middle Ages and became the basis of European medicine until well into the Renaissance period. There was a first Spanish cultural Renaissance in Al Andalus during the ix xii centuries, which led to a flowering unheard of in the Middle Ages before then. Andalusian doctors made major contributions to the body of knowledge about neuroscience and developed major philosophical concepts of human understanding. Thus, Abulcasis (936 1013), the father of modern surgery, developed material and technical designs which are still used in neurosurgery. Averroes suggested the existence of Parkinson s syndrome and attributed photoreceptor properties to the retina. Avenzoar described meningitis, intracranial thrombophlebitis, mediastinal tumours and made contributions to modern neuropharmacology. Maimonides wrote about neuropsychiatric disorders and described rabies and belladonna intoxication. CONCLUSION: Aside from the political, religious and cultural differences between Al Andalus and the Christian kingdoms of the Iberian peninsula, the historical Andalusian period (711 1492) forms one of the most brilliant periods of Spanish neuroscience.

Santiago Ramón y Cajal: su actividad como médico militar (1873-1875) / Santiago Ramón y Cajal: his activity as a military doctor (1873-1875)

Santiago Ramón y Cajal opositó a Sanidad Militar tras finalizar su licenciatura de Medicina en 1873. Su carácter marcadamente españolista y su excelente forma física le hicieron participar en la tercera guerra carlista con el empleo de teniente médico, y en la guerra de Cuba con el de capitán. Sin embargo, su estancia en Cuba estuvo marcada por las penalidades y la enfermedad. El declive de la política colonialista de España, la guerra en un clima y ambiente hostiles y la corrupción de los mandos militares hicieron que Santiago estuviera destinado en pleno teatro de operaciones dentro de un rígido sistema logístico de `trochas', que acabaría en un fracaso militar y a la posterior pérdida de la colonia. Desencantado y gravemente enfermo de malaria, que estuvo a punto de causarle la muerte, regresó a España con licencia por enfermedad. Poco después ingresó como docente universitario de la mano del Dr. Jenaro Casas, lo cual supuso el fin de su carrera castrense (AU)

Neurociencia en el Egipto faraónico y en la escuela de Alejandría / Neuroscience in ancient Egypt and in the school of Alexandria

Introducción. A orillas del Nilo floreció hace cinco milenios una de las civilizaciones más antiguas, importantes y duraderas de la historia de la humanidad. En Egipto se alcanzó un alto grado de desarrollo en todas las ramas del saber humano y hoy se considera la civilización madre de la medicina. A pesar del marcado componente religioso que afectaba a todas sus actividades, la medicina faraónica se practicó de una forma racional y deductiva, y los egipcios fueron los creadores de la observación clínica. Desarrollo. El clima desértico del valle del Nilo ha preservado monumentos, momias y papiros cuyo estudio permite hacerse cierta idea del grado de desarrollo alcanzado en los saberes médicos. Su análisis desde el punto de vista de los conocimientos neurocientíficos constituye el objetivo de este trabajo. Los hallazgos anatómicos de los egipcios derivaron de la inspección de heridas y de la práctica del embalsamamiento. Llegaron a conocer un gran número de diagnósticos y a prescribir muchos tratamientos, y alcanzaron cierto desarrollo en el manejo del paciente neurotraumatológico. Practicaron la anamnesis, el pronóstico y una cirugía reglada que incluía infrecuentemente la trepanación. Su conservadurismo hizo que, tras la dominación macedónica, la medicina griega suplantara a la tradicional egipcia, que alcanzó su máximo esplendor con la escuela de Alejandría, donde destacaron Herófilo y Erasístrato, pioneros de los estudios de anatomía y circulación cerebrales. Conclusiones. Desde el punto de vista de la neurociencia, los egipcios describieron por primera vez el cerebro, la jaqueca, la epilepsía, los ictus, el tétanos, la parálisis de Bell y las secuelas de los traumatismos craneales y de la sección medular. En sus manifestaciones artísticas se aprecian pacientes neurológicos y, según refiere Heródoto, había medicos especializados en las `enfermedades de la cabeza' que podrían considerarse precursores de los actuales neurólogos (AU)

La neurociencia en Al Ándalus y su influencia en la medicina escolástica medieval / Neuroscience in Al Andalus and its influence on medieval scholastic medicine

Introducción. Desde la aplicación de la medicina técnica por los griegos, la neurología moderna se basa en un cuerpo de conocimientos y en un bagaje cultural heredado desde la antigüedad. En este trabajo se repasa la contribución de Al Ándalus a la neurociencia durante el medioevo y su repercusión en la neurología moderna. Desarrollo. Tras la muerte de Mahoma, en el siglo VII d.C., el Islam tuvo uno de los más espectaculares períodos de expansión en la historia de la humanidad. La ocupación de las ciudades de Alejandría y Gundishapur puso en contacto a los árabes con manuscritos grecolatinos originales, los cuales fueron asimilados y divulgados por científicos islámicos tanto en los califatos medioorientales de Damasco y Bagdad como en los occidentales de Al Ándalus (España) y Kairwan (Túnez). Esta medicina clásica hipocrático-galénica se reformuló en el denominado galenismo arabizado, que influyó notoriamente en los escolásticos y en el mundo cultural del periodo bajomedieval, y constituyó la base de la medicina europea hasta bien entrado el Renacimiento. En Al Ándalus hubo un primer Renacimiento cultural español durante los siglos IX-XII, a raíz del cual la medicina europea tuvo un florecimiento desconocido hasta entonces en el medioevo. Los médicos andalusíes hicieron importantes contribuciones en el cuerpo de conocimientos de la neurociencia y desarrollaron conceptos filosóficos importantes para el entendimiento del intelecto humano. Así, Abulcasis (936-1013), el padre de la cirugía moderna, diseñó material y técnicas de neurocirugía aún utilizadas en la actualidad. Averroes insinuó el síndrome parkinsoniano y atribuyó el papel fotorreceptor a la retina. Avenzoar describió las meningitis, las tromboflebitis intracraneales y los tumores mediastínicos, e hizo contribuciones a la moderna neurofarmacología. Maimónides escribió sobre enfermedades neuropsiquiátricas y describió la rabia y la intoxicación por belladona. Conclusión. Independientemente de las diferencias políticas, religiosas y culturales que hubo entonces entre Al Ándalus y los reinos cristianos de la península Ibérica, el período histórico andalusí (711-1492) constituye una de las páginas más brillantes de la historia de la neurociencia española (AU)

[Antoniana Margarita: Gómez Pereira, Francisco Lobato and the antecedents of cerebral mechanicism during the Spanish renaissance]. / Antoniana Margarita: Gómez Pereira, Francisco Lobato y los antecedentes del mecanicismo cerebral en el Renacimiento español.

The year 2000 is the fifth century of the birth, in Medina del Campo (Vallodolid, Spain) of licenciado Perea (Gomez Perea or Pereira). A man of the Renaissance, he was an outstanding doctor, humanist, theologist, nominalist philosopher, naturalist and practical engineer. He developed the first modern theory of behavior, based purely on mechanicistic principles, describing his ideas in a text known by the curious title of Antoniana Margarita. The objective of this paper is to pay him homage on the fifth centenary of his birth, making a historiographic study of Gomez Perea and his works, with particular emphasis on the ideological basis and its relationship with Renaissance hydraulic engineering, collaborating with his colleague Francisco Lobato, author of one of the only two pretechnological codices of sixteenth century Spain. The book Antoniana Margarita is written in Renaissance Latin and was published in Medina del Campo in 1554. It represents the first truly modern approach to brain function which excludes the providencialist concepts of Galen involving the soul and the spirit, in vogue until then, transmitted through the Arab and Scholastic tradition. Analyzing his theory of the automatism of animals Perea made the first description ever of the reflex arc and the conditioned reflex. He also established a topographical model of the brain in which he sketched the functioning of the prefrontal cortex and neurophysiology of memory. Perea was the immediate forerunner of Neuropsychology and of the methodology and organicist thought which predominates in modern Neurobiology. He was also a visionary of the Evolution of Darwin and of modern aetiology.

Antoniana Margarita: Gómez Pereira, Francisco Lobato y los antecedentes del mecanicismo cerebralen el Renacimiento español / Antoniana margarita: Gómez Pereira, Francisco Lobato and the antecedents of cerebral mechanicism during the spanish Renaissance

En el año 2000 se ha cumplido el quinto centenario del nacimiento en Medina del Campo (Valladolid, España), del `licenciado Perea' (Gómez Perea o Pereira). Hombre del renacimiento, fue médico prestigioso, humanista, teólogo, filósofo nominalista, naturalista e ingeniero práctico. Desarrolló el primer modelo teórico moderno de la conducta sobre una base puramente mecanicista, plasmando sus ideas en un texto conocido con el curioso título de Antoniana Margarita. El objetivo del presente trabajo es rendir un homenaje en el quinto centenario de su nacimiento, realizando un estudio historiográfico de Gómez Perea y su obra, haciendo especial hincapié en los antecedentes ideológicos y su relación con la ingeniería hidráulica renacentista colaborando con su paisano Francisco Lobato, autor de uno de los dos únicos códices pretecnológicos españoles del XVI. El libro Antoniana Margarita está escrito en latín renacentista y fue publicado en Medina del Campo en 1554. Representa el primer enfoque auténticamente moderno del funcionamiento cerebral que excluye los providencialistas conceptos galénicos de alma y espíritu, vigentes hasta entonces por transmisión arábica y escolástica. Analizando su `teoría del automatismo de las bestias', Perea describe por primera vez en la Historia el arco reflejo, el reflejo condicionado y establece un modelo topográfico cerebral donde se bosqueja el funcionamiento del córtex prefrontal y la neurofisiología de la memoria. Perea resulta ser el predecesor inmediato de la Neuropsicología y de la metodología y pensamiento organicista predominante en la moderna Neurobiología, además de ser un genial visionario del Evolucionismo darwiniano y de la moderna Etología (AU)