Neurology Diagnostics

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Statins (Lipitor, Pravachol, Zocor, Crestor, etc.) Should be initiated early after a first stroke (AC) or transient ischemic attack (TIA).

These drugs not only decrease the risk of a new cerebrovascular event, but also reduce the risk of coronary events, even in patients without history of cardiovascular disease.

This follows from the SPARCL study (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) presented at the 15th European Stroke Conference in mid last year.

Statins have been used traditionally to normalize cholesterol levels in patients with dyslipidemia.

However, the evidence of this scientific work shows that the statin (Lipitor) has benefits beyond just reducing LDL “bad” or LDL, but even in patients with normal total cholesterol, this drug prevents the possibility of a new stroke or coronary event. Read the rest of this entry »

Atrial fibrillation (AF) is an arrhythmia that is associated with stroke (AC) by emboli from the heart.

This arrhythmia causes turbulence in the atrium or left atrium, which helps the formation of thrombi or clots that travel through the aorta to the brain, causing blockage of a cerebral artery and finally AC.

To prevent AC in patients with AF, can handle a blood thinner such as warfarin or acenocoumarol, or simply aspirin.

In under 75 years it is clear that thinner is better than aspirin in preventing AC in patients with AF. But over 75 years, the benefit is lower, increasing the risk of bleeding from anticoagulant, sometimes fatal.

The study BAFTA (Birmingham Atrial Fibrillation Treatment of the Aged) compared Warfarin versus aspirin in patients over 75 years with AF and showed that warfarin is superior to aspirin in the Stroke Prevention in Atrial Fibrillation, as long as they keep a good control of anticoagulation, which should be indicated by blood tests regularly calls the prescribing physician.

The results were published in the journal Lancet on August 11, 2007 and had previously been released in Glasgow, at the 16th European Stroke Conference in Glasgow, Scotland, where I was fortunate to attend.

The PFP is more than two thirds of cases of viral origin, and therefore has been suggested that the early use of prednisone (steroid) and acyclovir (antiviral) would have some utility in the treatment of early-stage, marked by facial nerve inflammation.

On October 18, 2007 was published in the New England Journal of Medicine a double-blind study compared the effects of prednisone and acyclovir in Bell’s palsy or facial nerve palsy (PFP).

The study was conducted in Scotland led by Dr. Frank M. Sullivan, of the Scottish School of Primary Care at the University of Dundee, Scotland.

A 94.4% of patients receiving prednisone within 72 hours of the start of the PFP, had an excellent performance in following up to 9 months. 85.4% of those who received acyclovir had an excellent performance. Read the rest of this entry »

A study by Dr. Martha Clare Morris of Rush University Medical Center, Chicago and published in the journal Neurology, showed that frequent consumption of vegetables reduces the risk of cognitive decline by up to 40%.

The study included 3718 patients over 65 years between 1993 and 2002 and the beneficial effects of vegetables, especially green vegetables, would be given by the high concentration of vitamin E, a potent antioxidant, provided by them.

On the other hand, did not show the same beneficial effect of fruit consumption. It follows that neither vitamin C nor beta-carotene allow a protective effect on cognition.

This study raises again the need for a healthy diet in everybody, not only because it reduces the risk of cardiovascular disease among others, but it reduces the risk of cognitive impairment that usually develops with age.

Intensify fight against diabetes, to reduce risk of dementia

The fight against depression and diabetes may help prevent or delay dementia praecox, according to a study published in the British Medical Journal, which estimates that risk factors such as obesity, hypertension and high cholesterol levels are the dark environment conducive for these patients. Read the rest of this entry »

A major effort has made several research groups to synthesize a vaccine available to prevent Alzheimer’s disease (AD).

In simple terms, the idea is to create in a laboratory, a protein that is very similar to proteins that normally are deposited in the brain of the sick patient and eventually cause the symptoms of dementia.

By exposing a healthy individual and any risk factors, such as a history of having close relatives with the EA, it creates antibodies created in the lab and also with proteins that are characteristic of AD.

This would prevent therefore, protein synthesis and deposition years later that will cause the first symptoms of dementia.

Already there have been many scientific studies and is expected to close in the future hopefully be approved this vaccine, which will undoubtedly be a great addition to the treatment of AD.

Galantamine: Another Alternative for the Treatment of Alzheimer

Soon more will be available in the Chilean market the drug Galantamine (Razadyne ER in the U.S.) and is part of the therapeutic alternatives for Alzheimer’s disease with early or intermediate. Read the rest of this entry »

Arthritis drug yields impressive results in the treatment of Alzheimer’s

Impressive are the findings derived from a study on Alzheimer’s by a team of U.S. scientists from the Universities of California at Los Angeles and Southern California: the application of a drug for arthritis managed to turn “in ten minutes” some signs of disease in a patient of 81 years.

The trade publication Journal of neuroinflammation (Journal of Neuroinflammation) reports that physicians applied to the spine of the patient an injection of Etanercept, a drug used to relieve pain and inflammation associated with rheumatoid arthritis.

The professionals said the patient, who was just beginning to exhibit the symptoms of the disease, could remember the name of your doctor along with the date and place where he was, but ten minutes before had been unable to do so.

However, Dr. Anthony Alvarez, the Biomedical Research Centre in Spain, called for caution with the subject.

“We must be cautious whenever we speak of the experience of a single patient,” he told the BBC the professional currently working on a vaccine against Alzheimer’s disease.

Notes also that it is necessary to show that the drug is safe and runs on a significant number of patients.

Although neurologists for the miokimia or eyelid twitching or MP (episodic involuntary contraction of the lower eyelid) does usually more serious, is a frequent cause of consultation.

Patients usually suffer from panic to see in the mirror and keeps your eyelid contract without being able to control is sometimes close to a patient that you mentioned this annoying condition.

The patient will automatically think the worst diagnosis: brain tumors, epilepsy, the onset of facial paralysis, etc., But fortunately is very wrong.

For peace of patients by far the most common cause of PD is anxiety or stress. Most patients are tired, has not slept well for several days or had problems at work or home.

Then the treatment is first of all try to relax, try to disconnect (it is that you can) the problems, sports, etc. If the MP is very upset or ashamed to have her patient, anxiety may be indicated to lower your anxiety level. Read the rest of this entry »

One of the most frequent causes of consultation is the dizziness. Vertigo is the sensation of things spinning around each other (objective vertigo) or a tour around things (subjective vertigo).

Dizziness is a feeling of instability, as one walks on cotton, in high and low. These can occur separately or together, and the vast majority of cases are of benign origin, ie, not a brain problem, but on one condition at the ear or vestibular nerve, which is carrying the information from ear to the brain.

The most common causes of vertigo or dizziness of non-cerebral origin (peripheral vestibular syndrome or SVP) are of viral origin (vestibular neuronitis, a viral inflammation of the nerve), at the microscopic mechanical disorders of the ear (benign paroxysmal positional vertigo), by increasing pressure of the endolymph which is a liquid in the internal system of the ear (Meniere’s disease), trauma (vertigo post TEC), infectious (syphilis) and others.

The SVP is often accompanied by severe nausea, vomiting, sweating, cold and long malaise. Depending on the cause, can last a couple of days, or chronic. It is with rest, light food and drugs that decrease the dizziness / vertigo (antivertiginosos) and drugs that reduce nausea (antiemetic) and the prognosis is generally good. Read the rest of this entry »

The diagnosis of Parkinson’s disease should not be sure until it is known in detail all drugs that the patient, consciously or inadvertently, come take at the time of the query.

It is well known that neuroleptics (phenothiazines, butyrophenones) may trigger events and parkinsonian tremor by blocking postsynaptic dopamine receptors in the striatum. The same happens with the depleting dopamine (reserpine, tetrabenazine).

Selective blockers of calcium channels (cinnarizine, flunarizine), masked in various commercial preparations of routine administration can produce similar manifestations full or partial recovery in all patients after discontinuation of medication and within a variable.

Some authors argue that drug-induced parkinsonism may be a latent or subclinical parkinsonism revealed by antidopaminergic medication. It is noteworthy that late buccolingual dyskinesia caused by prolonged use of neuroleptics may be associated with parkinsonian manifestations but hardly reason for misdiagnosis is the presence of stereotyped slow and continuous movements that occur in the lower face (lips , jaw and tongue).

The distal parts of the body and trunk tend to show small movements of flexion and extension, while the proximal muscles are not compromised. When the patient is standing may have repetitive movements of the lower extremities (go hard). The patient often develops secondary akathisia. It is assumed that tardive dyskinesia was given to a hypersensitivity of postsynaptic receptors for dopamine and its increased secretion secondary to blockade of these receptors.

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Part of parkinsonian patients develops, over time, subcortical dementia.

Although the diagnosis of Parkinson’s disease is largely clinical, can take account of hyposmia (may precede up to 20 years to your appearance), positron emission tomography showing decrease of dopamine in the striatum, markers recently biological and electromyography to show subclinical tremor.

An important chapter of this issue is that of drug-induced parkinsonism, which generally refers to the interruption but not always. Drugs that can induce are neuroleptics (phenothiazines, butyrophenones), depleting dopamine (reserpine, tetrabenazine) and calcium channel blockers (cinnarizine, flunarizine).

The clinician, before diagnosing Parkinson’s disease, should take into account the possibility cited in the preceding paragraph as well as a number of neurological disorders that are targets of specialized study.

Fustinoni (in Semiology Nervous System [1997]) says the following signs and symptoms exclude the diagnosis of Parkinson’s disease:

Signs and Symptoms that exclude Parkinson

l buccolingual dyskinesia (parkinsonism drug)

l hyperreflexia not justified by previous stroke (Vascular parkinsonism)

l pseudobulbar syndrome (vascular parkinsonism)

l or intentional tremor predominant attitude (Essential tremor)

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