Hallazgos electroencefalográficos y polisomnográficos en un paciente con enfermedad de Creutzfeldt-Jakob familiar / Electroencephalographic and polysomnographic findings in a patient with familial Creutzfeldt-Jakob disease

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[Paraneoplastic cerebellar degeneration as initial presentation of a pancreatic small-cell carcinoma]. / Degeneración cerebelosa paraneoplásica como inicio de un carcinoma indiferenciado de células pequeñas de páncreas.

INTRODUCTION: Oat (small) cell carcinoma is the type of tumour most frequently associated to neurologic paraneoplastic syndromes. It is usually located in the lungs although it has been described in some other locations. Cerebellar symptoms may appear alone, associated to anti Yo antibodies ( Breast and gynaecologic carcinomas), or as manifestation of a more generalized paraneoplastic encephalopathy, associated to signs and symptoms of some other neurologic systems affected. CASE REPORT: A 52 year old patient consulted due to a pancerebellar clinical picture, which started about two months before, and later associated to polineuropathy. Abdominal CT showed a 4 cm mass in the head of the pancreas. Pathologic evaluation demonstrated a poorly differentiated small cell pancreatic tumour. Anti Hu antibodies in high titres were found both in serum and cerebrospinal fluid. DISCUSSION: The association of anti Hu immunity and paraneoplastic encephalomyelitis has been observed in patients with neuroblastoma, seminomas, colorectal, breast and prostate carcinomas and some types of sarcoma. Only about 1% of pancreatic malignancies correspond to small cell type. We have not found any previous report about the association between a paraneoplastic syndrome and pancreatic poorly differentiated small cell carcinoma.

Degeneración cerebelosa paraneoplásica como iniciode un carcinoma indiferenciado de células pequeñas de páncreas / Paraneoplastic cerebellar degeneration as initial presentation of a pancreatic small-cell carcinoma

Introducción. El carcinoma de células pequeñas es el tumor que con más frecuencia produce cuadros paraneoplásicos neurológicos. Su localización más frecuente es la pulmonar, aunque se ha descrito en otras localizaciones. La afectación cerebelosa puede aparecer de forma pura, asociada a anticuerpos anti-Yo (carcinoma de mama y ginecológicos), o formando parte de una encefalopatía paraneoplásica , asociada a otros signos y síntomas de afectación del sistema nervioso. Caso clínico. Varón de 52 años, con un cuadro pancerebeloso de dos meses de evolución y posterior asociación de una polineuropatía. En la tomografía computarizada abdominal aparece una masa de 4 cm en la cabeza pancreática. El estudio anatomopatológico determina la presencia de un carcinoma indiferenciado de células pequeñas de origen pancreático. Se identifican anticuerpos anti-Hu en altos títulos en suero y en líquido cefalorraquídeo. Discusión. Se han descrito pacientes con inmunidad anti-Hu y encefalomielitis paraneoplásica asociada a neuroblastoma, seminomas, adenocarcinoma de colon, cáncer de mama, cáncer de próstata y sarcomas. Sólo el 1 por ciento de los tumores malignos de páncreas corresponden al carcinoma indiferenciado de células pequeñas. En la bibliografía revisada no aparecen referencias publicadas que determinen la presencia de un síndrome paraneoplásico y el descubrimiento de un cáncer pancreático indiferenciado de células pequeñas (AU)

[Cerebral venous thrombosis in the region of Murcia]. / Trombosis venosa cerebral en la región de Murcia.

INTRODUCTION AND OBJECTIVE: Massive usage of new neuroimaging techniques has produced an increase in the number of patients with cerebral venous thrombosis. Our aim has been to evaluate this shift in our county through the clinico-radiologic characteristics of the patients admitted to our unit. MATERIAL AND METHODS: Over the last 7 years a total of 12 patients suffering from cerebral venous thrombosis were attended in our department. We have analyzed retrospectively their clinical records. RESULTS: There were 11 women 1 man with a range of ages from 13 to 60 years old. The main associated factor was oral contraceptives intake. Most of them presented with symptoms of benign intracranial hypertension. Magnetic resonance imaging was the most sensitive diagnostic tool. Outcome was good in general. Most of them were treated with intravenous heparin during the acute phase and received oral anticoagulation for 6 months. More than half were diagnosed all over the last three years. CONCLUSIONS: Our data seem to confirm this tendency towards a larger number of cases with the application of new diagnostic tools. In these cases, clinical course is more benign than reported in classical series.