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1.
Neurologia (Engl Ed) ; 36(9): 666-672, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34752344

RESUMO

Safinamide is a new add-on drug to levodopa for the treatment of Parkinson's disease (PD) with motor fluctuations. Due to the recent incorporation of safinamide into routine clinical practice, no post-authorisation phase IV studies on the safety of safinamide have been conducted to date. This study provides clinical management guidelines for safinamide based on the opinion of a group of experts in movement disorders. This project was developed in 2 phases: 16 local meetings in phase 1 and a national meeting in phase 2. The meetings followed a pre-established agenda. The present clinical practice guidelines are based on the main conclusions reached during the national meeting. The group concluded that safinamide is effective in reducing motor and non-motor fluctuations. PD patients with mild-to-moderate fluctuations benefit most from treatment, although the drug may also improve the clinical status of patients with advanced PD. The dose of other dopaminergic drugs may be reduced after introducing safinamide, which would contribute to reducing such adverse reactions as impulse control disorder. At doses higher than those usually prescribed, safinamide may also improve dyskinesia. The experts agreed that safinamide is well tolerated and causes few adverse reactions when compared with placebo.


Assuntos
Antiparkinsonianos/uso terapêutico , Benzilaminas/uso terapêutico , Doença de Parkinson , Alanina/análogos & derivados , Antiparkinsonianos/efeitos adversos , Benzilaminas/efeitos adversos , Consenso , Humanos , Doença de Parkinson/tratamento farmacológico , Espanha
2.
Neurologia (Engl Ed) ; 2018 Jul 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30072274

RESUMO

Safinamide is a new add-on drug to levodopa for the treatment of Parkinson's disease (PD) with motor fluctuations. Due to the recent incorporation of safinamide into routine clinical practice, no post-authorisation phase IV studies on the safety of safinamide have been conducted to date. This study provides clinical management guidelines for safinamide based on the opinion of a group of experts in movement disorders. This project was developed in 2 phases: 16 local meetings in phase 1 and a national meeting in phase 2. The meetings followed a pre-established agenda. The present clinical practice guidelines are based on the main conclusions reached during the national meeting. The group concluded that safinamide is effective in reducing motor and non-motor fluctuations. PD patients with mild-to-moderate fluctuations benefit most from treatment, although the drug may also improve the clinical status of patients with advanced PD. The dose of other dopaminergic drugs may be reduced after introducing safinamide, which would contribute to reducing such adverse reactions as impulse control disorder. At doses higher than those usually prescribed, safinamide may also improve dyskinesia. The experts agreed that safinamide is well tolerated and causes few adverse reactions when compared with placebo.

3.
Rev Neurol ; 41(5): 273-6, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-16138283

RESUMO

INTRODUCTION: The uveo-meningitic syndrome, or the combination of chronic or recurrent meningitis and acute uveitis, has a specific differential diagnosis. This syndrome can be the clinical debut of systemic disorders, vasculophathies, connective tissue disorders and inmuno-mediated diseases. In patients with AIDS, the syndrome often appears in relation with an opportunist concomitant infection of the central nervous system (CNS). CASE REPORT: We present one case of subacute uveo-meningitic syndrome as symptomatic presentation of a early infection of HIV. The patient was a man, 37 years-old. He was inmunocompetent and did not know his seropositivity for HIV type 1. We relate the results of the neurologic examination and complementary tests. Only serologic test for HIV type 1 and detection of IgG anti-HIV in cerebrospinal fluid were positives. CONCLUSIONS: In patients HIV-positive the ocular infection, usually a posterior uveitis, appears together with systemic disorders or central nervous infections. In other hand, the cause of meningitic infection depends on grade of immunocompromise. Aseptic meningitis, for early stages of the disease, is usually no symptomatic. After, opportunist infections or neoplasic infiltration of CNS can be cause of meningoencephalitis. In this patient, the early infection of HIV causes an subacute uveomeningoencephalitis. Early infection of HIV increases the possibilities of aetiological diagnosis of uveomeningitic syndrome.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções por HIV/complicações , HIV-1 , Síndrome Uveomeningoencefálica/etiologia , Adulto , Anticorpos Anti-HIV/líquido cefalorraquidiano , Infecções por HIV/diagnóstico , Soropositividade para HIV , Humanos , Masculino , Síndrome , Síndrome Uveomeningoencefálica/diagnóstico
8.
Neurologia ; 21(8): 439-43, 2006 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-17013790

RESUMO

INTRODUCTION: Creutzfeldt-Jakob disease (CJD) is the most frequent of the human transmissible spongiform encephalopathies. Pathogenic mechanisms of CJD are still unknown. Sporadic CJD, the most habitual, is clinically characterized by rapidly progressive dementia, myoclonia and ataxia. Panencephalic variant CJD, typically from Japan, is characterized by extensive involvement of the cerebral white and gray matter. International interest has grown from more than one decade ago in relation to the diagnosis of new variant (vCJD). New protocols of MR imaging have contributed to the early diagnosis of CJD with specific signs. CASE REPORT: We report a case of panencephalic CJD, with atypical clinical presentation and unusual MR imaging findings. DISCUSSION: Our patient developed visual and psychiatric symptoms. Brain MR imaging showed extensive white matter lesions in posterior parietal lobe and occipital regions, which disappeared after steroid treatment. The most characteristic radiological sign for sporadic CJD is the high signal intensity of the basal ganglia, for vCJD the pulvinar sign and, for panencephalic CJD the presence of periventricular white matter lesions, with tendency to the spread when the disease progress. In serial MR imaging studies of our patient, we could see how typical signs were appearing. However, the complete and unusual resolution of the original white matter lesions makes us to think about a possible inflammatory component, in some time in the evolution of white matter damage.


Assuntos
Síndrome de Creutzfeldt-Jakob , Adulto , Síndrome de Creutzfeldt-Jakob/diagnóstico , Síndrome de Creutzfeldt-Jakob/patologia , Síndrome de Creutzfeldt-Jakob/fisiopatologia , Evolução Fatal , Feminino , Humanos , Imageamento por Ressonância Magnética
9.
Neurologia ; 20(3): 133-42, 2005 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-15815948

RESUMO

Posttraumatic headache (PTHA) is, usually, one of several symptoms of the posttraumatic syndrome and therefore may be accompanied by somatic, psychological or cognitive disturbances. The aetiology of these symptoms in individuals with mild traumatic brain injury or whiplash injury has been a subject of some controversy with explanations ranging from neural damage to malingering. PTHA can resemble a tension-type headache, migrainous or cervicogenic headaches. Post-whiplash headache habitually is a pain radiating from the neck to the forehead, with moderate intensity and benign, but prolonged course. The pathogenesis of PTHA is still not well-known but might share some common headache pathways with primary headaches. In this chapter, we review recent investigations in the pathophysiology of PTHA, review recognised risk factors for a poor outcome and give some recommendations of management. We also discuss the new diagnostic criteria of IHS Classification, 2004, for PTHA and Headache attributed to whiplash.


Assuntos
Lesões Encefálicas/complicações , Cefaleia/etiologia , Traumatismos em Chicotada/complicações , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Cefaleia/terapia , Humanos
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