[Meralgia paraesthetica: a report on a series of 140 cases]. / Meralgia parestésica: a propósito de una serie de 140 casos.

INTRODUCTION: Meralgia paraesthetica is a pathology that is frequently seen in visits to extra-hospital neurology services. Nevertheless, the diagnosis, treatment and prognosis of this condition remain somewhat unclear. PATIENTS AND METHODS: A retrospective study was conducted involving 140 patients. Data were collected concerning demographic aspects, clinical picture, diagnostic study, aetiology, treatment and progression. RESULTS: There was a predominance of males, with a mean age of 54 years. The mean follow-up time was 25 months. The symptoms that were reported were as follows: numbness, burning pain, tingling or prickling in the nerve territory. Hypaesthesia was the most frequent sign found in the examination. History of another compressive neuropathy was present in 13.6% of patients. The diagnosis was based on the patient record and the neurological examination. The neurophysiological study and complementary tests were reserved for atypical cases. The most common causation was spontaneous and only three cases were found to be secondary to a structural lesion. A third of the patients were receiving pharmacological treatment. Although the clinical picture was benign, in most cases it tended to become chronic. Patients treated pharmacologically did not show a significant improvement in comparison to those who were not given treatment. The most important data for forecasting improvement of the clinical picture were the identification and correction of the factors precipitating compression of the nerve. CONCLUSIONS: Meralgia paraesthetica is a frequent, benign pathology but with a tendency to become chronic that responds poorly to pharmacological treatment. It is important to identify and correct mechanical factors and only in exceptional cases is it secondary to a structural lesion.

Meralgia parestésica: a propósito de una serie de 140 casos / Meralgia Paraesthetca: a report on a series of 140 cases

Introducción. La meralgia parestésica es una patología frecuente en la consulta de neurología extrahospitalaria. Apesar de ello, el diagnóstico, tratamiento y pronóstico de este cuadro no están bien establecidos. Pacientes y métodos. Estudioretrospectivo de 140 pacientes. Se recogen datos demográficos, clínica, estudio diagnóstico, etiología, tratamiento y evolución.Resultados. Hubo un predominio masculino, con una mediana de 54 años. El seguimiento medio fue de 25 meses. Lossíntomas narrados fueron: acorchamiento, dolor urente, hormigueo o pinchazos en el territorio nervioso. En la exploración sehalló hipoestesia como signo más frecuente. Hubo historia de otra neuropatía compresiva en el 13,6%. El diagnóstico se basóen la historia clínica y la exploración neurológica. El estudio neurofisiológico y las pruebas complementarias se reservaronpara casos atípicos. La etiología más frecuente fue la espontánea, y se hallaron sólo tres casos secundarios a lesión estructural.Un tercio de los pacientes recibió tratamiento farmacológico. Aunque el cuadro fue benigno, en la mayoría tendióa cronificarse. Los pacientes tratados farmacológicamente no mostraron una mejoría significativa frente a los que no recibierontratamiento. El dato pronóstico más importante para la mejoría del cuadro fue la identificación y corrección de los factoresdesencadenantes de compresión del nervio. Conclusiones. La meralgia parestésica es una patología frecuente, benigna,pero con tendencia a cronificarse, en la que es importante identificar y corregir factores mecánicos, con pobre respuesta altratamiento farmacológico, y sólo en casos excepcionales secundaria a lesión estructural (AU)

Introduction. Meralgia paraesthetica is a pathology that is frequently seen in visits to extra-hospital neurologyservices. Nevertheless, the diagnosis, treatment and prognosis of this condition remain somewhat unclear. Patients andmethods. A retrospective study was conducted involving 140 patients. Data were collected concerning demographic aspects,clinical picture, diagnostic study, aetiology, treatment and progression. Results. There was a predominance of males, with amean age of 54 years. The mean follow-up time was 25 months. The symptoms that were reported were as follows: numbness,burning pain, tingling or prickling in the nerve territory. Hypaesthesia was the most frequent sign found in the examination.History of another compressive neuropathy was present in 13.6% of patients. The diagnosis was based on the patient recordand the neurological examination. The neurophysiological study and complementary tests were reserved for atypical cases. Themost common causation was spontaneous and only three cases were found to be secondary to a structural lesion. A third of thepatients were receiving pharmacological treatment. Although the clinical picture was benign, in most cases it tended to becomechronic. Patients treated pharmacologically did not show a significant improvement in comparison to those who were not giventreatment. The most important data for forecasting improvement of the clinical picture were the identification and correction ofthe factors precipitating compression of the nerve. Conclusions. Meralgia paraesthetica is a frequent, benign pathology butwith a tendency to become chronic that responds poorly to pharmacological treatment. It is important to identify and correctmechanical factors and only in exceptional cases is it secondary to a structural lesion. (AU)

[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.

Isolated oculomotor nerve palsy due to dural cavernous sinus fistula.

Two patients with a dural carotid-cavernous sinus fistula presented with unilateral oculomotor nerve palsies without signs of ocular congestion or proptosis. According to this, dural carotid-cavernous sinus fistula should be included in the differential diagnosis of any case of painful ophthalmoplegia, even in the absence of other ocular signs.