[ChatGPT: a novel tool for writing scientific articles, but not an author (for the time being)]. / ChatGPT: una novedosa herramienta de escritura para artículos científicos, pero no un autor (por el momento).

TITLE: ChatGPT: una novedosa herramienta de escritura para artículos científicos, pero no un autor (por el momento).

Adaptación cultural y validación al español de España del MSTCQ© (Multiple Sclerosis Treatment Concerns Questionnaire) / Cultural adaptation and validation of a peninsular Spanish version of the MSTCQ© (Multiple Sclerosis Treatment Concerns Questionnaire)

Introducción: A pesar de la efectividad de los tratamientos inyectables para la esclerosis múltiple (EM), las reacciones adversas y el dolor pueden implicar problemas de satisfacción y adherencia. Se presenta la validación de la versión española del Multiple Sclerosis Treatment Concerns Questionnaire (MSTCQ)©, que evalúa la satisfacción con el dispositivo de autoinyección (DA), 4 dimensiones: sistema de inyección (A), efectos secundarios (B) (síntomas pseudogripales, reacciones, satisfacción), experiencia con el tratamiento (C) y beneficios (D). Métodos: Dos fases de estudio: 1) Adaptación cultural con expertos (n = 6) y pacientes (n = 27). 2) Estudio observacional, transversal y multicéntrico de validación. Se evaluaron 143 pacientes adultos con EM que utilizaban el DA Extavijec(TM) 30G. Cuestionarios: MSTCQ©; Patient-Reported Indices for Multiple Sclerosis (PRIMUS©), y Treatment Satisfaction Questionnaire for Medication (TSQM©). Propiedades psicométricas: factibilidad (% casos válidos y distribución de puntuaciones); fiabilidad (α-Cronbach) y test-retest (n = 41, coeficiente correlación intraclase [CCI]), y validez de constructo (análisis factorial A y B, [AF]) y convergente (Spearman-rho MSTCQ© versus TSQM©). Resultados. Edad media (DT) 41,94 (10,47) años, 63% mujeres, 88,11% con EM remitente-recurrente, media (DT) EDSS 2,68 (1,82) puntos. Alta cumplimentación del MSTCQ© (perdidos 0-2,80%). Alta consistencia interna: puntuación total (A + B) α = 0,89, por dimensiones (A, B y C) α = 0,76, 0,89 y 0,92, respectivamente. Excelente concordancia test-retest en las puntuación total (CC I= 0,98), por dimensiones (A, B y C) CCI = 0,82, 0,97 y 0,89, respectivamente. El AF corroboró la estructura interna del cuestionario original. Correlación moderada (Rho = 0,42-0,74) y significativa (p < 0,05 y p < 0,01) entre las puntuación total y por dimensiones del MSTCQ© y el TSQM©. Conclusiones. Se constatan adecuadas propiedades psicométricas de la versión española del MSTCQ

Introduction: Although subcutaneous treatments for multiple sclerosis (MS) have been shown to be effective, adverse reactions and pain may adversely affect treatment satisfaction and adherence. This study presents an adapted and validated Spanish version of the Multiple Sclerosis Treatment Concerns Questionnaire© (MSTCQ), which evaluates satisfaction with the injection device (ID) across 4 domains: injection system (A), side effects (B) (flu-like symptoms, reactions, and satisfaction), experience with treatment (C) and benefits (D). Methods: Two study phases: 1) Cultural adaptation process with input from experts (n = 6) and patients (n = 30). 2) Validation obtained by means of an observational, cross-sectional, multi-centre study evaluating 143 adult MS patients using an ID. Tools employed: MSTCQ©, Patient-Reported Indices for Multiple Sclerosis (PRIMUS©), and Treatment Satisfaction Questionnaire for Medication (TSQM©). Psychometric properties: Feasibility (percentage of valid cases and floor/ceiling effects); Reliability (Cronbach α) and test-retest correlation (n = 41, intraclass correlation coefficient, ICC); and construct validity (factor analysis of domains A and B) and convergent validity (Spearman rank-order correlation for MSTCQ© vs TSQM©). Results: Mean age (SD) was 41.94 (10.47) years, 63% of the group were women, and 88.11% presented relapsing-remitting MS. Mean (SD) EDSS score was 2.68 (1.82) points. MSTCQ© completion was high (0%-2.80% missing data). Internal consistency was high at α=0.89 for the total score (A+B) and α = 0.76, 0.89, and 0.92 for domains A, B, and C, respectively. The version demonstrated excellent test-retest reliability for the total (ICC = 0.98) and for domains A, B, and C: ICC = 0.82, 0.97, and 0.89, respectively. Factor analysis corroborated the internal structure of the original questionnaire. The association between total and domain scores on both the MSTCQ© and the TSQM© was moderately strong (Rho = 0.42-0.74) and significant (P < .05 and P < .01). Conclusion: The Spanish version of MSTCQ© demonstrates appropriate psychometric properties

Cultural adaptation and validation of a peninsular Spanish version of the MSTCQ© (Multiple Sclerosis Treatment Concerns Questionnaire). / Adaptación cultural y validación al español de España del MSTCQ© (Multiple Sclerosis Treatment Concerns Questionnaire).

INTRODUCTION: Although subcutaneous treatments for multiple sclerosis (MS) have been shown to be effective, adverse reactions and pain may adversely affect treatment satisfaction and adherence. This study presents an adapted and validated Spanish version of the Multiple Sclerosis Treatment Concerns Questionnaire© (MSTCQ), which evaluates satisfaction with the injection device (ID) across 4 domains: injection system (A), side effects (B) (flu-like symptoms, reactions, and satisfaction), experience with treatment (C) and benefits (D). METHODS: Two study phases: 1) Cultural adaptation process with input from experts (n=6) and patients (n=30). 2) Validation obtained by means of an observational, cross-sectional, multi-centre study evaluating 143 adult MS patients using an ID. Tools employed: MSTCQ©, Patient-Reported Indices for Multiple Sclerosis (PRIMUS©), and Treatment Satisfaction Questionnaire for Medication (TSQM©). Psychometric properties: Feasibility (percentage of valid cases and floor/ceiling effects); Reliability (Cronbach α) and test-retest correlation (n=41, intraclass correlation coefficient, ICC); and construct validity (factor analysis of domains A and B) and convergent validity (Spearman rank-order correlation for MSTCQ© vs TSQM©). RESULTS: Mean age (SD) was 41.94 (10.47) years, 63% of the group were women, and 88.11% presented relapsing-remitting MS. Mean (SD) EDSS score was 2.68 (1.82) points. MSTCQ© completion was high (0%-2.80% missing data). Internal consistency was high at α=0.89 for the total score (A+B) and α=0.76, 0.89, and 0.92 for domains A, B, and C, respectively. The version demonstrated excellent test-retest reliability for the total (ICC=0.98) and for domains A, B, and C: ICC=0.82, 0.97, and 0.89, respectively. Factor analysis corroborated the internal structure of the original questionnaire. The association between total and domain scores on both the MSTCQ© and the TSQM© was moderately strong (Rho=0.42-0.74) and significant (P<.05 and P<.01). CONCLUSION: The Spanish version of MSTCQ© demonstrates appropriate psychometric properties.

Folletos de información educativa en migraña: satisfacción percibida en un grupo de pacientes / Migraine education brochures and patient-perceived satisfaction

Introducción: Los folletos informativos son una herramienta educativa habitual en la práctica neurológica diaria; mediante este mecanismo se pretende incrementar de primera mano los conocimientos que la población tiene sobre una enfermedad concreta, además de evitar fuentes de información erróneas. Las encuestas son el medio más empleado para conocer la satisfacción de los usuarios con los servicios recibidos. Objetivos: Evaluar la satisfacción percibida y establecer una retroalimentación informativa que valore la comprensión y la utilidad global de un folleto educativo sobre migraña. Material y métodos: Estudio abierto, prospectivo y multicéntrico sobre una población de pacientes diagnosticados de migraña en diversas consultas de neurología de la provincia de Alicante. En la visita basal se les entrega un folleto informativo de migraña confeccionado por el grupo de estudio para la cefalea de la Sociedad Valenciana de Neurología (CEFALIC). En la visita control se les solicita la cumplimentación de una encuesta personal y por escrito sobre la calidad global de la información incluida en el folleto. Resultados: Se incluye a un total de 257 pacientes diagnosticados de migraña (83% migraña episódica; 17% migraña crónica), con una edad media de 37,6 años. Confirmaron la lectura del folleto 207 paciente (80,5%) y no lo habían leído 50 pacientes (19,5%), bien por olvido bien por desinterés. Al 90% de los pacientes la lectura del folleto les pareció interesante y comprensible. El 76% de los encuestados opina que la lectura del folleto incrementa sus conocimientos sobre migraña. El 50% de los pacientes opina que el folleto resultó de utilidad para mejorar el control de su migraña. Conclusiones: La utilización de un folleto educativo sobre migraña resultó comprensible, además incrementó el conocimiento global de la enfermedad y en opinión de los pacientes resultó útil para mejorar el control de su migraña. La evaluación de la información educativa que prestamos a nuestros pacientes con migraña debe ser medida para descubrir las causas de descontento, determinar el nivel de calidad del servicio e investigar las posibilidades de mejora de calidad

Introduction: Brochures are commonly used as educational tools in daily neurological practice. They are provided to increase the general population's knowledge of a specific disease and also to combat sources of erroneous information. Surveys are the most commonly used method of ascertaining user satisfaction with services received. Objectives: This study will assess patient-perceived satisfaction and provide feedback to measure the comprehensibility and overall utility of an educational brochure on migraine. Material and methods: Open prospective multicentre study of a group of patients diagnosed with migraine in neurology clinics in Alicante province. During the initial visit, each patient received a migraine brochure prepared by the Valencian Society of Neurology's study group for headaches (CEFALIC). During a follow-up visit, they were then asked to fill out a personal survey on the overall quality of the information in the brochure. Results: We included a total of 257 patients diagnosed with migraine (83% episodic migraine; 17% chronic migraine); mean age was 37.6 years. Two hundred seven patients confirmed having read the brochure (80.5%); 50 patients (19.5%) either forgot to read it or had no interest in doing so. The brochure seemed interesting and easy to understand according to 90% of the patients. Seventy-six per cent of the respondents stated that reading the brochure increased their overall knowledge of migraine, while 50% of the patients found the brochure useful for improving migraine control. Conclusions: Patients found the migraine educational brochure to be comprehensible, a means of increasing overall knowledge of the disease, and useful for increasing control over migraines. Evaluations of the educational brochures that we provide to our patients with migraine should be studied to discover the causes of dissatisfaction, determine the level of quality of service, and investigate potential areas for improvement

Eyelid myokymia in patients with migraine taking topiramate.

OBJECTIVE: Although ocular side effects of topiramate are common, neuroophthalmologic manifestations such as blepharospasm, myokymia and oculogyric crisis are scarcely reported. METHODS: We present a serie of 8 patients with migraine who developed eyelid myokymia after treatment with topiramate. We reviewed all patients with migraine treated with topiramate attending the headache outpatient clinic of our hospital from January 2008 to December 2012. RESULTS: During the study period, a total of 140 patients with migraine were treated with topiramate in our headache clinic. Eight presented eyelid myokymia after beginning treatment with topiramate (5,7%). Topiramate was stopped and myokymia disappeared in all patients, it was prescribed again and eyelid myokymia reappeared with their previous characteristics in all patients. CONCLUSIONS: Eyelid myokymia is an underreported side-effect of topiramate in patients with migraine, of unknown cause, so that in future, further studies are need to examine whether patients with migraine are predisposed or not to this adverse effect.

Migraine education brochures and patient-perceived satisfaction.

INTRODUCTION: Brochures are commonly used as educational tools in daily neurological practice. They are provided to increase the general population's knowledge of a specific disease and also to combat sources of erroneous information. Surveys are the most commonly used method of ascertaining user satisfaction with services received. OBJECTIVES: This study will assess patient-perceived satisfaction and provide feedback to measure the comprehensibility and overall utility of an educational brochure on migraine. MATERIAL AND METHODS: Open prospective multicentre study of a group of patients diagnosed with migraine in neurology clinics in Alicante province. During the initial visit, each patient received a migraine brochure prepared by the Valencian Society of Neurology's study group for headaches (CEFALIC). During a follow-up visit, they were then asked to fill out a personal survey on the overall quality of the information in the brochure. RESULTS: We included a total of 257 patients diagnosed with migraine (83% episodic migraine; 17% chronic migraine); mean age was 37.6 years. Two hundred seven patients confirmed having read the brochure (80.5%); 50 patients (19.5%) either forgot to read it or had no interest in doing so. The brochure seemed interesting and easy to understand according to 90% of the patients. Seventy-six per cent of the respondents stated that reading the brochure increased their overall knowledge of migraine, while 50% of the patients found the brochure useful for improving migraine control. CONCLUSIONS: Patients found the migraine educational brochure to be comprehensible, a means of increasing overall knowledge of the disease, and useful for increasing control over migraines. Evaluations of the educational brochures that we provide to our patients with migraine should be studied to discover the causes of dissatisfaction, determine the level of quality of service, and investigate potential areas for improvement.

Linfoma cerebral primario con remisión espontánea / Primary cerebral lymphoma with spontaneous

No disponible

[Prevention of migraine: a pharmacoepidemiological study]. / Prevención de la migraña: un estudio farmacoepidemiológico.

INTRODUCTION: This study aims to perform a descriptive analysis of the usage patterns of migraine prophylactic medications by various neurologists in our setting. MATERIAL AND METHODS: The first preventive treatment prescribed for migraine in patients not associated to other diagnoses of primary headache was recorded in three outpatient neurology clinics and one headache specific clinic. RESULTS: A total of 235 prophylactic treatments out of 669 patients were initiated. The patients were aged 37 +/- 12 years (mean +/- standard deviation) and 84.45% were women. Migraines with aura accounted for 18.9% of migraines. By order of frequency, the prophylactic treatments administered were topiramate (43%), beta-blockers (18%), flunaricine (17%), amitriptyline (14%), selective serotonin reputake inhibitors (6%) and others (2%). Beta-blockers and flunaricine were used much more frequently in men (29.7% and 27% versus 15.9% and 14.4%, respectively) and antidepressants were used more in women (21.87% versus 5.4%). The most frequently used antidepressant was amitriptyline, and its use increases with the age of the patient, it being the most frequently used treatment in over 60-year-old patient group. CONCLUSIONS: At present, topiramate has become the first preventive treatment option for migraine in our setting, especially in young women. There is greater variability in the choice of an alternative treatment. Amitriptyline is the first choice within the antidepressants and is almost exclusively prescribed in women with migraine and elderly age.

Prevención de la migraña: un estudio farmacoepidemiológico / Prevention of migraine: a pharamacoepidemiological study

Introducción. Se realiza un análisis descriptivo de los tratamientosprofilácticos empleados para el tratamiento de la migrañapor varios neurólogos de nuestro medio.Material y métodos. Se registró el primer tratamiento preventivopautado para migraña en pacientes que no asociaban otro diagnósticode cefalea primaria. Se reclutaron durante 1 año en tres consultasde neurología ambulatoria y una específica de cefalea de laprovincia de Alicante.Resultados. De 669 pacientes totales, se iniciaron 235 tratamientosprofilácticos, con una edad de los pacientes de 37±12años (media±desviación estándar) y un 84,45 % de mujeres. Un18,9% de migrañas eran con aura. Por orden de frecuencia, los profilácticosempleados fueron el topiramato (43 %), los betabloqueantes(18%), la flunaricina (17%), la amitriptilina (14 %), inhibidoresselectivos de la recaptación de serotonina (6 %) y otros(2 %). Los betabloqueantes y la flunaricina se emplearon muchomás en el hombre (29,7 y 27 % frente a 15,9 y 14,4%, respectivamente)y los antidepresivos en la mujer (21,87 frente a 5,4 %). Elantidepresivo más empleado fue la amitriptilina, y su empleo aumentacon la edad del paciente, siendo el tratamiento más frecuenteen el grupo de más de 60 años.Conclusiones. El topiramato en la actualidad y en nuestro medioes la primera opción en el tratamiento preventivo de la migraña,sobre todo en la mujer joven. La variabilidad es mayor en la eleccióndel tratamiento alternativo. La amitriptilina es la primera opcióndentro de los antidepresivos y se prescriben casi exclusivamente en lamujer con migraña y en edades avanzadas (AU)

Introduction. This study aims to perform a descriptiveanalysis of the usage patterns of migraine prophylactic medicationsby various neurologists in our setting.Material and methods. The first preventive treatment prescribedfor migraine in patients not associated to other diagnosesof primary headache was recorded in three outpatient neurologyclinics and one headache specific clinic.Results. A total of 235 prophylactic treatments out of 669patients were initiated. The patients were aged 37±12 years(mean±standard desviation) and 84.45% were women. Migraineswith aura accounted for 18.9% of migraines. By order of frequency,the prophylactic treatments administered were topiramate(43%), beta-blockers (18%), flunaricine (17%), amitriptyline(14%), selective serotonin reputake inhibitors (6 %) and others(2 %). Beta-blockers and flunaricine were used much more frequentlyin men (29.7% and 27% versus 15.9% and 14.4%, respectively)and antidepressants were used more in women(21.87% versus 5.4%). The most frequently used antidepressantwas amitriptyline, and its use increases with the age of the patient,it being the most frequently used treatment in over 60 yearold patient group.Conclusions. At present, topiramate has become the firstpreventive treatment option for migraine in our setting, especiallyin young women. There is greater variability in the choiceof an alternative treatment. Amitriptyline is the first choice withinthe antidepressants and is almost exclusively prescribed inwomen with migraine and elderly age (AU)

Clinical characteristics associated with psychosocial functioning among patients with uncomplicated epilepsy in Spain.

OBJECTIVE: To identify the clinical characteristics associated with poor psychosocial functioning among Spanish patients with epilepsy but no other neurological or psychiatric disorder. METHODS: Between May and September 2001 a survey among patients with epilepsy was carried out in 32 Spanish health care centres. The selection criteria of patients were attendance to a routine neurologist visit, to be aged between 25 and 64 and not having another additional neurological handicap (n=812). Psychosocial function was elicited through six indicators: educational level, marital status, unemployment status, restricted car driving, self-perception of epilepsy as an important limiting factor in the educational level achieved and, among unemployed, as the cause of their unemployment. Multiple logistic regression models were fitted in order to calculate adjusted odds ratios (aOR) and their 95% confidence intervals. RESULTS: After simultaneously adjusting for socio-demographic variables and clinical characteristics, the six outcomes analysed increased with seizure frequency. Moreover, all the outcomes except low educational level were also related to early age at onset of epilepsy. Although no relation with objective educational level was found, there was a strong association between early age at onset of symptoms and self-perception of epilepsy as an important limiting factor of educational achievement. CONCLUSION: These findings emphasize the need for more effective treatment of epilepsy and also highlight the importance of a psychosocial approach to management of epilepsy for patients with an early onset of symptoms in order to prevent social limitations in adult life.

[Quality of the health care to the epileptic patients in Spain]. / Calidad asistencial en epilepsia. Situación de la asistencia a los pacientes epilépticos en España.

INTRODUCTION: The objective of the study was to evaluate the quality of the health care to the epileptic patient in Spain including recently diagnosed patients, controlled patients and medically refractory patients. METHODS: Throughout years 2001-2002 a questionnaire of consensus was agreed by neurologists from surgical epilepsy units, epilepsy units, community hospitals and outpatient clinics. RESULTS: A total of 139 questionnaires were analysed. Only one third of the hospitals had a specialized epilepsy clinic. The longest waiting lists for diagnostic procedures were video EEG and Holter EEG, with 175 and 97.6 days, respectively. Clear differences between autonomous communities as far as availability of neurologists on duty, availability of diagnostic tests and number of epilepsy units are stated, existing, in general, more resources in the autonomous communities with health transferred before 2002 and Madrid. CONCLUSIONS: As much the lack of resources as the inequalities indicate that we are still far from the quality standards recommended by the International League Against Epilepsy (ILAE), lacking a suitable lanning that eliminates the inequalities and it so approaches us a system of assistance integrated in different levels as it is set out by the international scientific community.

Calidad asistencial en epilepsia. Situación de la asistencia a los pacientes epilépticos en España / Quality of the health care to the epileptic patients in Spain

Introducción. El objetivo de este estudio es conocer la realidad asistencial al paciente epiléptico en España y valorar la calidad de la asistencia en el paciente epiléptico de reciente diagnóstico, controlado y refractario al tratamiento. Métodos. A lo largo de los años 2001-2002 se realizó una encuesta cuyo contenido fue elaborado mediante consenso entre especialistas de neurología que procedían de unidades de cirugía de la epilepsia, consultas de epilepsia en hospitales de referencia y especialistas de hospitales comarcales y centros de especialidades. Resultados. Se recogieron 139 cuestinarios (76 % de los enviados). Un tercio de los hospitales dispone de consulta especifica dedicada a la epilepsia. Respecto a la disponibilidad de las pruebas (EEG) diagnósticas, el vídeo y el Holter electroencefalográficos soportan los mayores tiempos de demora, 175 y 97,6 días, respectivamente. Se constatan claras diferencias entre comunidades autónomas en cuanto a realización de guardias de neurología, pruebas diagnósticas disponibles y número de consultas especificas, existiendo, en general, más recursos en las comunidades autónomas con sanidad transferida antes de 2002 y Madrid. Conclusiones. Tanto las carencias como las desigualdades encontradas indican que estamos todavía lejos de los estándares de calidad recomendados por la International Ligue Against Epilepsy (ILAE), faltando una planificación adecuada que elimine las desigualdades y nos acerque a un sistema de asistencia integrada en diferentes niveles, tal y como se propone por la comunidad científica internacional

Introduction. The objective of the study was to evaluate the quality of the health care to the epileptic patient in Spain including recently diagnosed patients, controlled patients and medically refractory patients. Methods. Throughout years 2001-2002 a questionnaire of consensus was agreed by neurologists from surgical epilepsy units, epilepsy units, community hospitals and oupatient clinics. Results. A total of 139 questionnaires were analysed. Only one third of the hospitals had a specialiced epilepsy clinic. The longest waiting lists for diagnostic procedures were video EEG and Holter EEG, with 175 and 97,6 days, respectively. Clear differences between autonomous communities as far as availability of neurologists on duty, availability of diagnostic tests and number of epilepsy units are stated, existing, in general, more resources in the autonomous communities with health transferred before 2002 and Madrid. Conc1usions. As much the lack of resources as the inequalities indicate that we are still far from the quality standards recommended by the International League Against Epilepsy (ILAE), lacking a suitable lanning that eliminates the inequalities and it so approaches us a system of assistance integrated in different levels as it is set out by the international scientific community

Fármacos antiepilépticos clásicos y de nueva generación: diferencias de sexo en la efectividad y en las reacciones adversas / Classic antiepileptic and new generation antiepileptic drugs: gender differences in effectiveness and adverse drug reactions

Introducción. Las mujeres sufren más reacciones adversas a los fármacos que los hombres y además las reacciones son diferentes según el sexo. Los fármacos antiepilépticos (FAEs) de nueva generación tienen como principal objetivo reducir los efectos secundarios de los clásicos sin perder la efectividad de éstos. Objetivos. a) Identificar las variables sociodemográficas y clínicas asociadas a recibir tratamiento de monoterapia con FAEs de nueva generación, y b) comparar la efectividad, las reacciones adversas y la calidad de vida entre pacientes tratados en régimen de monoterapia con FAEs clásicos o con nuevos, examinando las posibles diferencias de sexo. Pacientes y métodos. A partir de una encuesta realizada en 32 centros sanitarios en la que participaron 990 pacientes de 16 a 64 años con epilepsia (tasa de respuesta: 96 %). Para los objetivos de este estudio se han seleccionado los pacientes que seguían tratamiento en régimen de monoterapia (496). Las variables dependientes fueron la efectividad para el control de las crisis, los efectos adversos y tres dimensiones de calidad de vida del cuestionario SF-36 (vitalidad, salud percibida y salud mental). Resultados. El 21 % de las mujeres y el 8% de los hombres eran tratados con FAEs de nueva generación. Las mujeres recibían con mayor frecuencia FAEs de nueva generación. Además, también la edad de inicio de la epilepsia se asoció positivamente con recibir tratamiento con FAEs nuevos y se observó un gradiente. Si en los hombres no se observaron diferencias en la efectividad, las reacciones adversas y en la calidad de vida entre los dos tipos de FAEs, las mujeres las tratadas con los de nueva generación tuvieron menos efectos adversos, pero el control de las crisis fue peor. Conclusiones. Los FAEs de nueva generación se prescriben con mayor frecuencia a las mujeres. En éstas, pero no en los hombres, los FAEs de nueva generación podrían tener menos efectos adversos, pero ser menos efectivos para el control de las crisis epilépticas

Introduction. Women are more likely to suffer adverse drug reactions. Moreover adverse drug reactions differ depending on gender. The main objective of new generation antiepileptic drugs (AED) is to reduce adverse drug reactions while maintaining the same effectiveness as the classic ones. Objectives. a) To identify sociodemographic and clinical variables associated with being treated with new generation AEDs, and b) to compare effectiveness, averse drug reactions and quality of life among patients treated with monotherapy, either with classic or with new generation AEDs, examining the potential gender differences. Patients and methods. A survey among 990 patients aged 16-64 with epilepsy was carried out in 32 Spanish hospitals (response rate: 96 %). For the purposes of this study patients treated with monotherapy (n = 496) were selected. The outcome variables were: effectiveness in seizure control, adverse drug reactions and three dimensions of the SF-36 questionnaire (vitality, mental health and self-perceived health status). Results. 21 % of women and 8% of men were treated with new AEDs. Women were more likely to be treated with new generation AEDs. Moreover, age of epilepsy onset was also positively related to new AEDs and a gradient was found. Whereas no differences in effectiveness, adverse drug reactions or quality of life were observed among men, among women, those treated with new generation AEDs had less adverse drug reactions but, on the other hand, effectiveness for controlling seizures was lower. Conclusions. Women are more likely to be treated with new AEDs. Althought these new treatments seem to have less adverse drug reactions among females, their effectiveness in controlling seizures are lower than that of classic AEDs

[Classic antiepileptic and new generation antiepileptic drugs: gender differences in effectiveness and adverse drug reactions]. / Fármacos antiepilépticos clásicos y de nueva generación: diferencias de sexo en la efectividad y en las reacciones adversas.

INTRODUCTION: Women are more likely to suffer adverse drug reactions. Moreover adverse drug reactions differ depending on gender. The main objective of new generation antiepileptic drugs (AED) is to reduce adverse drug reactions while maintaining the same effectiveness as the classic ones. OBJECTIVES: a) To identify sociodemographic and clinical variables associated with being treated with new generation AEDs, and b) to compare effectiveness, averse drug reactions and quality of life among patients treated with monotherapy, either with classic or with new generation AEDs, examining the potential gender differences. PATIENTS AND METHODS: A survey among 990 patients aged 16-64 with epilepsy was carried out in 32 Spanish hospitals (response rate: 96 %). For the purposes of this study patients treated with monotherapy (n = 496) were selected. The outcome variables were: effectiveness in seizure control, adverse drug reactions and three dimensions of the SF-36 questionnaire (vitality, mental health and self-perceived health status). RESULTS: 21 % of women and 8% of men were treated with new AEDs. Women were more likely to be treated with new generation AEDs. Moreover, age of epilepsy onset was also positively related to new AEDs and a gradient was found. Whereas no differences in effectiveness, adverse drug reactions or quality of life were observed among men, among women, those treated with new generation AEDs had less adverse drug reactions but, on the other hand, effectiveness for controlling seizures was lower. CONCLUSIONS: Women are more likely to be treated with new AEDs. Although these new treatments seem to have less adverse drug reactions among females, their effectiveness in controlling seizures are lower than that of classic AEDs.

[Practical exercises on diagnostic test interpretation]. / Ejemplos prácticos de interpretación de pruebas diagnósticas.

Although medical literature places great emphasis on therapy, diagnosis remains an essential part of medical practice. We present four clinical cases that show the interaction between pre-test probabilities and the accuracy of investigations (sensitivity, specificity, predictive values and likelihood ratios) The first example studies the influence of meningeal signs in the diagnosis of meningitis. The second one analyzes the diagnostic utility of investigations in patients suspected of dementia. The third example examines the change in the probability of carpal tunnel syndrome depending on the physical examination and the electrodiagnostic studies. The last example explains the use of ROC curves in the diagnosis of demyelinating disease with CSF-IgG index.

[Febrile seizures: is EEG useful?]. / Tiene sentido realizar un EEG en las crisis febriles?

OBJECTIVE: The purpose of this study was to determine the clinical relevance of electroencephalograms (EEG) with generalized spike-wave (S-W) in pediatric patients, especially in children with febrile seizures. PATIENTS AND METHODS: One hundred and seventy pediatric patients with S-W were found from a register of 39,322 consecutive EEGs performed in an EEG laboratory dedicated to general clinical practice. Patients that only suffered febrile seizures were not considered epileptic. RESULTS: Of the 170 patients, 154 (90.6%) were epileptic and 16 (9.4%) were not. Mean follow-up was 4.5 years. Twelve of the 16 non-epileptic children with S-W suffered febrile seizures. CONCLUSIONS: The presence of S-W in EEGs is uncommon. Almost 10% of the children with S-W were not epileptic patients and none of them suffered from epilepsy during the follow-up period. Performance of an EEG on a child without epilepsy, especially those with febrile seizures, can be a factor of confusion.

[Perinatal antecedents, psychomotor retardation, learning difficulties and family history. Are they a risk factor for epilepsy?]. / Antecedentes perinatales, retraso psicomotor, dificultades del aprendizaje e historia familiar. Son un factor de riesgo para la epilepsia?

OBJECTIVE: Epilepsy has been associated with certain circumstances such as perinatal pathology, learning difficulties, head trauma, infections of the central nervous system, febrile seizures and family history of epilepsy. The objective of our study was to analyze the association of the mentioned circumstances with epilepsy in a group of children with generalized spike-wave (S-W) in the electroencephalogram (EEG). PATIENTS AND METHODS: One hundred seventy pediatric patients with, S-W were found from a register of 39,322 consecutive EEGs. The patients were classified into 2 groups: epileptic and non-epileptic. Both groups were compared for the presence of known risk factors of epilepsy. RESULTS: Of the 170 patients, 154 (90.6%) were epileptic and 16 (9.4%) were not. Mean follow-up was 4.5 years. Neither past medical antecedents nor family history was found to be associated with epilepsy. CONCLUSIONS: The risk of epilepsy in children with S-W in the EEG is not associated with problems in pregnancy, the birth or neonatal period, learning difficulties or family history of epilepsy.