Delayed-onset dystonia in patients with antecedents of perinatal asphyxia.

We report 27 cases of delayed-onset dystonia in patients with antecendents of perinatal asphyxia after excluding other possible causes of dystonia. The patients were 16 males and 11 females (mean +/- SD age at onset of dystonia = 13.0 +/- 9.4 yr). Adverse obstetric and/or perinatal events were presented by 20 patients, and other neurological symptoms or signs were present prior to dystonia in 15 patients. The pattern of dystonia was: generalized (eight cases), segmental (six), multifocal (three), hemidystonia (two), and focal (eight). Cranial CT or MRI were normal in 21 cases, and showed brain hemiatrophy in three cases, and periventricular demyelination, subcortical atrophy and increased ventricular size in one case each. The possible cause-effect relationship is discussed.

[Ambulatory neurological care outside of the hospital. Analysis of the demand registered during 18 months in a neurological outpatient clinic]. / La asistencia neurológica ambulatoria extrahospitalaria. Análisis de la demanda registrada durante 18 meses en una consulta jerarquizada de neurología.

The major data from the care demand in a neurological outpatient clinic in the south area of Madrid are reported. 8.9 patients per 1,000 inhabitants are seen. The frequency of visits to this clinic is higher in females and with advancing age. More than one-half of the patients are diagnosed as having conditions not necessarily representing organic neurological disease. It is concluded that a better selection of the patients referred to this clinic should be adequate, as the number of neurologists per 100,000 inhabitants available in this country is not sufficient to care for so high an outpatient care demand.