Spinal myoclonus: successful treatment with the combination of sodium valproate and L-5-hydroxytryptophan.

We describe a 37-year-old man with spinal segmental myoclonus characterized by symmetric, rhythmic contractions of the abdomen with a frequency ranging between 100 and 150/min. The combination of sodium valproate and L-5-hydroxytryptophan was useful to control the myoclonus. We comment on the possible role of the serotonergic system in this syndrome.

[Etiology of late-onset epilepsy. A prospective study in an area of rural health care]. / Etiología de la epilepsia de comienzo tardío. Estudio prospectivo en un área de salud rural.

A prospective study of 3 years' duration on the etiology of late onset epilepsy was carried out in a rural health area with a population of 135,000. Eighty patients were included. History, neurological physical examination, electroencephalogram, cranial computed tomographic scan (CT) and general laboratory investigations were carried out. The cause of epilepsy was unknown in 51.3% of cases. The most commonly identified causes were cerebrovascular disease (20%), chronic alcohol abuse (10%), tumors of central nervous system (6.3%), neurocysticercosis (6.3%) and post-traumatic epilepsy (2.5%). Our data are compared with those from the previous literature, and the value of cranial CT in the investigation of this clinical condition is discussed.

[Parkinson's disease and epilepsy]. / Maladie de Parkinson et épilepsie.

We report the case of a woman suffering from complex partial seizures who developed Parkinson's disease at the age of 58. Parkinsonian symptoms improved transitorily after complex partial seizures. Although this has been reported after generalized seizures, this case is, to our knowledge, the first description of improvement of parkinsonian symptoms following a complex partial seizure.

[Listeria meningitis and HIV infection]. / Meningitis por Listeria e infeccción por VIH.

Although listeria monocytogenes is an opportunistic pathogen, infection by this bacteria is infrequent in AIDS patients. We were describe a case of L. monocytogenes meningitis in a patient infected by the human immunodeficiency virus (HIV). Literature is reviewed, and the pathogenesis of infection by this bacteria and its relation to AIDS is discussed.

"Premorbid" personality of patients with Parkinson's disease.

To elucidate the possible existence of a so called "premorbid parkinsonian personality" we studied 33 patients with Parkinson's disease (PD) and 66 controls who did not differ in age, sex, geographic origin, and cultural level, with the Spanish version of the Minnesota Multiphasic Personality Inventory (MMPI). Females of the PD group obtained significantly higher scores than females of the control group for the scales of hypochondria (p less than 0.01), depression (p less than 0.01), hysteria (p less than 0.05), and social introversion (p less than 0.01). The scores of the males with PD in all of the clinical scales of MMPI did not differ significantly from those of the male controls. These results, despite the difficulty of interpretation of a test done in a retrospective way, would agree with the hypothesis previously suggested of the possible existence of a "premorbid" parkinsonian personality, at least in females.

Neurobrucellosis mimicking migraine.

Central nervous system involvement in systemic brucellosis is not frequent. Neurobrucellosis may involve several areas of the central nervous system and may be the cause of several clinical pictures. We report a case of brucellar meningitis that was clinically indistinguishable from a migrainous syndrome. The diagnosis of brucellar meningitis was confirmed by the isolation of Brucella sp. in the cerebrospinal fluid.