Pure menstrual tension-type headache: demonstration of its existence.

INTRODUCTION AND OBJECTIVE: Menstrual migraine (MM) is widely recognized among the scientific community, with diagnostic criteria included in the appendix of the third edition of the International Headache Classification. However, this classification does not include other primary headaches that may occur during menstruation. Previous retrospective studies suggest the existence of menstrual tension-type headache. Our objective is to prospectively determine the existence of this type of headache and to determine its frequency relative to that of MM. METHODS: This is a descriptive, cross-sectional (case series), prospective, observational study, conducted in a hospital neurology department, using a previously validated ad hoc questionnaire. Participants were recruited by consecutive sampling, applying inclusion and exclusion criteria among women accompanying neurology outpatients, and classified into five groups: pure menstrual tension-type headache, menstrual-related tension-type headache, pure menstrual migraine, menstrual-related migraine and unclassifiable. RESULTS: Ninety-five women (median age of 38.50 years, IQR: 13) were included, with the following group distribution: 13 (13.6%) pure menstrual tension-type headache, 14 (14.7%) menstruation-related tension-type headache, 23 (24.2%) pure menstrual migraine, 44 (46.3%) menstrual-related migraine and 1 unclassifiable. Of these patients, 23% did not treat menstrual headache, but this figure rose to 30.8% in the case of pure menstrual tension-type headache. CONCLUSION: The results confirm the existence of pure menstrual tension-type headache among women who do not seek medical care for this condition. The frequency of this headache is lower than that of MM. This reduced incidence, together with its generally mild nature, may explain the lack of prior recognition.

Neurosonological Findings Related to Non-Motor Features of Parkinson's Disease: A Systematic Review.

Non-motor symptoms (NMS) in Parkinson's disease (PD), including neuropsychiatric or dysautonomic complaints, fatigue, or pain, are frequent and have a high impact on the patient's quality of life. They are often poorly recognized and inadequately treated. In the recent years, the growing awareness of NMS has favored the development of techniques that complement the clinician's diagnosis. This review provides an overview of the most important ultrasonographic findings related to the presence of various NMS. Literature research was conducted in PubMed, Scopus, and Web of Science from inception until January 2021, retrieving 23 prospective observational studies evaluating transcranial and cervical ultrasound in depression, dementia, dysautonomic symptoms, psychosis, and restless leg syndrome. Overall, the eligible articles showed good or fair quality according to the QUADAS-2 assessment. Brainstem raphe hypoechogenicity was related to the presence of depression in PD and also in depressed patients without PD, as well as to overactive bladder. Substantia nigra hyperechogenicity was frequent in patients with visual hallucinations, and larger intracranial ventricles correlated with dementia. Evaluation of the vagus nerve showed contradictory findings. The results of this systematic review demonstrated that transcranial ultrasound can be a useful complementary tool in the evaluation of NMS in PD.

[Reflex seizures, cinema and television]. / Crisis reflejas, cine y television.

In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot.

TITLE: Crisis reflejas, cine y television.En el cine y las series de television existen escasas referencias a las crisis o epilepsia refleja, a pesar de que en la vida real constituyen un subgrupo relevante del total de sindromes epilepticos. Se ha realizado una busqueda sobre el tema y se han identificado 25 documentos cinematograficos en los que aparecen crisis reflejas. La mayoria de las crisis observadas son tonicoclonicas generalizadas y los estimulos visuales son los mas numerosos, y todos se corresponden con destellos luminosos. Entre los estimulos por procesos de nivel superior destacan las emociones. En la mayoria de las ocasiones no es posible saber si el personaje padece una epilepsia refleja o bien sufre crisis reflejas en el contexto de otro sindrome epileptico. La principal conclusion es que, en el cine y la television, las crisis reflejas no son mas que un elemento visual de refuerzo y anecdotico, sin incidencia relevante en la trama argumental.

Crisis reflejas, cine y televisión / Reflex seizures, cinema and television

En el cine y las series de televisión existen escasas referencias a las crisis o epilepsia refleja, a pesar de que en la vida real constituyen un subgrupo relevante del total de síndromes epilépticos. Se ha realizado una búsqueda sobre el tema y se han identificado 25 documentos cinematográficos en los que aparecen crisis reflejas. La mayoría de las crisis observadas son tonicoclónicas generalizadas y los estímulos visuales son los más numerosos, y todos se corresponden con destellos luminosos. Entre los estímulos por procesos de nivel superior destacan las emociones. En la mayoría de las ocasiones no es posible saber si el personaje padece una epilepsia refleja o bien sufre crisis reflejas en el contexto de otro síndrome epiléptico. La principal conclusión es que, en el cine y la televisión, las crisis reflejas no son más que un elemento visual de refuerzo y anecdótico, sin incidencia relevante en la trama argumental (AU)

In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot (AU)

[Epilepsy in films. A new century and the same old perspective?]. / La epilepsia en el cine. Un nuevo siglo y... una misma perspectiva?

INTRODUCTION: Epilepsy is a neurological pathology often represented in film. The literature on the subject concludes that the image of the disease is laden with sensationalism and imbued with stereotypes such as madness or possession. DEVELOPMENT: We provide a descriptive analysis of the seizures that appear in 155 film and analyze whether productions of the new century have succeeded in changing earlier impressions. In our series, the percentage of seizures that are not epilepsy (pseudoseizures and induced symptomatic seizures) reaches 37%. The analysis by age of seizure type and etiology of these shows similar results to the true population, however it should be noted that the age distribution of the sample does not match the true population. CONCLUSIONS: Epilepsy has not shed the spiritual component that traditionally accompanies it and that seizures tend to be used as simple visual aids, without excessive diligence in its correct representation and without much reference in the plot to the disease that causes them. However, in the last decade stigmas associated with this disease such as insanity, uncontrolled violence or victimization tend to normalize.

TITLE: La epilepsia en el cine. Un nuevo siglo y... una misma perspectiva?Introduccion. La epilepsia es una patologia neurologica ampliamente representada en el cine. En las publicaciones sobre el tema, se concluye que la imagen de la enfermedad aparece cargada de sensacionalismo e impregnada de estereotipos como la locura o la posesion. Desarrollo. Se realiza un analisis descriptivo de las crisis que aparecen en 155 peliculas y se comprueba si las producciones realizadas en el nuevo siglo han conseguido modificar las impresiones previas. En nuestra serie, el porcentaje de crisis que no constituyen epilepsia (pseudocrisis y crisis sintomaticas provocadas) alcanza el 37%. El analisis por grupos de edad del tipo de crisis y su etiologia muestra resultados similares a los reales; sin embargo, debe tenerse en cuenta que la distribucion etaria de la muestra no coincide con la de la poblacion real. Conclusiones. La epilepsia no consigue desprenderse del componente espiritual que tradicionalmente la acompaña, y las crisis suelen utilizarse como simple apoyo visual, sin excesivo celo en su correcta representacion y sin demasiado interes argumental en la enfermedad que las provoca. No obstante, en la ultima decada parecen normalizarse algunos estigmas, como la locura, la violencia descontrolada o el victimismo, que se asociaban a esta enfermedad.

La epilepsia en el cine. Un nuevo siglo y... ¿una misma perspectiva? / Epilepsy in films. A new century and the same old perspective?

Introducción. La epilepsia es una patología neurológica ampliamente representada en el cine. En las publicaciones sobre el tema, se concluye que la imagen de la enfermedad aparece cargada de sensacionalismo e impregnada de estereotipos como la locura o la posesión. Desarrollo. Se realiza un análisis descriptivo de las crisis que aparecen en 155 películas y se comprueba si las producciones realizadas en el nuevo siglo han conseguido modificar las impresiones previas. En nuestra serie, el porcentaje de crisis que no constituyen epilepsia (pseudocrisis y crisis sintomáticas provocadas) alcanza el 37%. El análisis por grupos de edad del tipo de crisis y su etiología muestra resultados similares a los reales; sin embargo, debe tenerse en cuenta que la distribución etaria de la muestra no coincide con la de la población real. Conclusiones. La epilepsia no consigue desprenderse del componente espiritual que tradicionalmente la acompaña, y las risis suelen utilizarse como simple apoyo visual, sin excesivo celo en su correcta representación y sin demasiado interés argumental en la enfermedad que las provoca. No obstante, en la última década parecen normalizarse algunos estigmas, como la locura, la violencia descontrolada o el victimismo, que se asociaban a esta enfermedad (AU)

Introduction. Epilepsy is a neurological pathology often represented in film. The literature on the subject concludes thatthe image of the disease is laden with sensationalism and imbued with stereotypes such as madness or possession. Development. We provide a descriptive analysis of the seizures that appear in 155 film and analyze whether productions of the new century have succeeded in changing earlier impressions. In our series, the percentage of seizures that are not pilepsy (pseudoseizures and induced symptomatic seizures) reaches 37%. The analysis by age of seizure type and etiology of these shows similar results to the true population, however it should be noted that the age distribution of the sample does not match the true population. Conclusions. Epilepsy has not shed the spiritual component that traditionally accompanies it and that seizures tend to be used as simple visual aids, without excessive diligence in its correct representation and without much reference in the plot to the disease that causes them. However, in the last decade stigmas associated with this disease such as insanity, uncontrolled violence or victimization tend to normalize (AU)

Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations: a multicenter study.

Continuous subcutaneous apomorphine infusion (CSAI) is, at present, an alternative option for advanced Parkinson's disease (PD) with motor fluctuations. We studied the evolution of patients with PD and severe motor fluctuations long-term treated with CSAI. We reviewed data from 82 patients with PD (mean age, 67 +/- 11.07; disease duration, 14.39 +/- 5.7 years) and severe motor fluctuations referred to 35 tertiary hospitals in Spain. These patients were long-term treated (for at least 3 months) with CSAI and tolerated the procedure without serious side effects. We compared the baseline data of these 82 patients (before CSAI) with those obtained from the last follow-up visit of each patient. The mean follow-up of CSAI was 19.93 +/- 16.3 months. Mean daily dose of CSAI was 72.00 +/- 21.38 mg run over 14.05 +/- 1.81 hours. We found a statistically significant reduction in off-hours, according to self-scoring diaries (6.64 +/- 3.09 vs. 1.36 +/- 1.42 hours/day, P < 0.0001), total and motor UPDRS scores (P < 0.0001), dyskinesia severity (P < 0.0006), and equivalent dose of antiparkinsonian therapy (1,405 +/- 536.7 vs. 800.1 +/- 472.9 mg of levodopa equivalent units P < 0.0001). CSAI is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment.