Linfoma primario del sistema nervioso central aparentando lesión del ángulo pontocerebeloso / Primary central nervous system lymphoma mimicking cerebellopontine angle tumour

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Blefarospasmo y espasmo hemifacial: tratamiento a largo plazo con toxina botulínica / Blepharospasm and hemifacial spasm: long-term treatment with botulinum toxin

Introducción: Nuestro objetivo es describir las características clínico epidemiológicas y terapéuticas de los pacientes con blefarospasmo (BS) y espasmo hemifacial (EH) en tratamiento con toxina botulínica tipo A (TBA). Pacientes y métodos: Se estudió retrospectivamente a los pacientes diagnosticados de BS y EH en tratamiento con TBA en la consulta de neurología del Complejo Asistencial de Segovia, desde marzo del 1991 hasta diciembre del 2009. Resultados: Se recogieron distintas variables de 34 pacientes con BS y 55 pacientes con EH, de los cuales el 44,1 y el 32,7%, respectivamente, llevaban más de 10 años en tratamiento con TBA. Desde el inicio de los síntomas hasta la consulta la mediana de tiempo fue de 24 meses en el grupo de BS, y de 59,7 meses en el grupo de EH, diagnosticándose en la primera visita el 76,5 y el 90,7%, respectivamente. El 34,6% de los pacientes con BS y el 77,6% de los pacientes con EH fueron derivados desde atención primaria. En ambos grupos, el preparado farmacológico de TBA más utilizado fue BOTOX®, sin hallarse resistencias primarias ni secundarias. La mediana de la dosis se incrementó progresivamente en ambas entidades, de forma significativa en los primeros años de tratamiento. La ptosis fue el efecto secundario más frecuente (el 47,1% en el BS, el 32,5% en el EH). Conclusiones: El BS y el ES constituyen los trastornos del movimiento faciales más comunes, recogiendo en esta serie diferentes parámetros epidemiológicos, clínicos y terapéuticos, confirmándose el beneficio y la seguridad del tratamiento con TBA a largo plazo (AU)

Introduction: Our purpose is to describe the demographic, clinical and therapeutic characteristics of patients with blepharospasm (BS) and hemifacial spasm (HFS) in treatment with botulinum toxin type A (BtA). Patients and methods: Retrospective analysis of patients diagnosed with BS or HFS and treated with BtA in the Neurology Department at Complejo Asistencial de Segovia between March 1991 and December 2009. Results: Different variables were collected from 34 patients with BS and 55 with HFS, of whom44.1% and 32.7% respectively had been undergoing treatment with BtA for more than 10 years. Elapsed time from symptom onset to the first visit was 24 months in the BS group and 59.7 months in the HFS group. Diagnosis was given on the first visit for 76.5% of the BS patients and90.7% of the HFS patients. Patients were referred by their primary care centres in 34.6% of the cases with BS and in 77.6% of the cases with HFS. The most commonly used BtA preparation was BOTOX® in both groups, and there were no cases of primary or secondary resistance. The median dose of BtA was raised gradually in both groups, and the increase was statistically significant during the early years of treatment. The most common side effect was ptosis (47.1% in BS, 32.5% in HFS). Conclusions: BS and HFS are the most common facial movement disorders. The demographic and clinical characteristics and therapeutic findings from this study show that treatment with BtA is both effective and safe over the long term (AU)

Blepharospasm and hemifacial spasm: long-term treatment with botulinum toxin.

INTRODUCTION: Our purpose is to describe the demographic, clinical and therapeutic characteristics of patients with blepharospasm (BS) and hemifacial spasm (HFS) in treatment with botulinum toxin type A (BtA). PATIENTS AND METHODS: Retrospective analysis of patients diagnosed with BS or HFS and treated with BtA in the Neurology Department at Complejo Asistencial de Segovia between March 1991 and December 2009. RESULTS: Different variables were collected from 34 patients with BS and 55 with HFS, of whom 44.1% and 32.7% respectively had been undergoing treatment with BtA for more than 10 years. Elapsed time from symptom onset to the first visit was 24 months in the BS group and 59.7 months in the HFS group. Diagnosis was given on the first visit for 76.5% of the BS patients and 90.7% of the HFS patients. Patients were referred by their primary care centres in 34.6% of the cases with BS and in 77.6% of the cases with HFS. The most commonly used BtA preparation was BOTOX(®) in both groups, and there were no cases of primary or secondary resistance. The median dose of BtA was raised gradually in both groups, and the increase was statistically significant during the early years of treatment. The most common side effect was ptosis (47.1% in BS, 32.5% in HFS). CONCLUSIONS: BS and HFS are the most common facial movement disorders. The demographic and clinical characteristics and therapeutic findings from this study show that treatment with BtA is both effective and safe over the long term.

[Dopaminergic stimulation in the non-motor symptoms of Parkinson's disease]. / Estimulación dopaminérgica en los trastornos no motores de la enfermedad de Parkinson.

INTRODUCTION AND DEVELOPMENT: The non-motor symptoms of Parkinson's disease have a great impact in terms of quality of life. They are frequently underdiagnosed and clinical experience suggests that not only is dopamine therapy ineffective but that in many cases it is also responsible for the appearance of some of these symptoms. Different studies have drawn attention to the involvement of the dopaminergic pathways in the pathogenesis of some non-motor symptoms. It has been observed that they can undergo fluctuations in relation to dopaminergic stimulation, generally in wearing off states, while displaying a significant correlation with motor fluctuations and a clinical response with continuous dopaminergic therapy. CONCLUSIONS: Although recent reviews offer insufficient evidence for treatment of non-motor symptoms with dopaminergic therapy, involvement of the dopaminergic pathways in the aetiopathogenesis of some of these disorders and the clinical observation that such symptoms undergo fluctuations in relation to pulsatile dopaminergic stimulation may lead us to reconsider the possible role of dopaminergic therapy in the treatment of these symptoms.