Parálisis de las cuerdas vocales como presentación inicial de una miastenia grave / Paralysis of the vocal cords as the presenting symptom of myasthenia gravis

No disponible

No disponible

[Respiratory stridency by larynx paralysis. Anusual beginning of miastenia]. / Estridor respiratorio por parálisis laríngea. Debut inusual de miastenia gravis.

A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized.

[Hypersensitivity syndrome caused by allopurinol: report of 2 cases and review of the literature]. / Síndrome de hipersensibilidad por alopurinol: a propósito de dos casos y revisión de la literatura.

A severe adverse drug effect secondary to allopurinol ingestion has been described, characterized by fever, eosinophilia, cutaneous rash, hepatic lesion and renal failure, with a high mortality (21-26%) and unknown ethiopathogenicity. In many cases patients had a previous disorder on their renal function (53%) and more than half received allopurinol due to asymptomatic hyperuricemia. We present two new cases and review other 18 patients diagnosed in the last nine years, analyzing the ethiopathogenicity, epidemiological, clinical, therapeutical and preventive aspects.

[Nontraumatic cerebral hematoma in young adults: a study of 42 cases]. / Hematoma intracerebral no traumático en adultos jóvenes: estudio de 42 casos.

BACKGROUND: Cerebrovascular disease has particular features in young adults (15-45 years). In this context, non-traumatic intracranial hematoma (NTICH) has received little attention. Therefore, its analysis has been attempted focusing on etiology, localization and short term prognosis. METHODS: 42 patients aged 15-45 years who were admitted because of NTICH were evaluated. 41 variables were analyzed with chi-square method and Fischer's exact test. RESULTS: The localization of hematoma was as follows: basal ganglia/thalamus in 59%, lobar in 19%, posterior fossa in 12%, pure intraventricular in 2 cases and multiple in one case. The most common etiology was hypertension (HT) (32%), followed by arteriovenous malformations (12%), oral anticoagulants (10%), chronic alcohol abuse (10%), coagulation disorders and one central nervous system arteriopathy; 12 cases were idiopathic. On the basis of etiology two groups were distinguished: 15-30 years (no case with hypertension) and 30-45 years (HT as the leading cause). Survival was 89%. CONCLUSIONS: NTICH in young adults has a heterogeneous etiology. On the basis of the most common cause two groups can be considered: from 15 to 30 years (arteriovenous malformation) and from 30 to 45 years (HT). High blood pressure at the time of stroke is correlated with previous HT. The short term life prognosis is better than that of NTICH in general series. Deterioration of consciousness in the acute phase and oral anticoagulation are poor prognostic factors.