The case of a 73 years-old woman that, since approximately the age of 30 years started to complain of pain when walking, is presented. The symptom was mainly located in the acchillean regions which, as time advanced, showed gradual volume increase and, finally, forced her to seek medical evaluation. Accompanying relatives reported a several years’ history of gradually increasing cognitive difficulties (i.e., forgetfulness, disorientation, poor attention and concentration), fluctuating mood (from periods of good humor switching to sudden episodes of sadness and crying spells), emotional lability and anxiety crises evolving into brief panic attacks. The Mini-cognitive Fenton Test confirmed severe dementia and the neurological evaluation showed cerebellar ataxia and partial pyramidalism. The ophthalmological examination revealed xanthelasmas, cataracts and dense arcus senilis. Xanthomas we...

The neurological and psychiatric manifestations in two patients who met clinical criteria of Behcet’s disease are observed and described throughout several decades. The presence of recurrent oral and genital canker sores is illustrated with images. One of the patients developed thrombosis of the femoral vein, and erythema nodosus was present in both. The ophthalmological evaluation showed absence of uveitis in both patients, and blindness by adult monocular dystrophic maculopathy without signs of retinal vasculitis in the female. Laboratory tests on blood and cerebrospinal fluid evidenced lymphocytic pleocytosis. The patergia skin test was negative. Likewise, laboratory tests determined an absence of findings compatible with other autoimmune diseases. Throughout the evaluation period, the clinical manifestations were correlated with the findings from tomography and brain magnetic reson...

20 years old farmer, coming from San Miguel of Calleria (Ucayali, Perú: north-eastern jungle 842 km from Lima), bitten by a Bothrops spp snake in his left ankle, who in spite of receiving 18 hours later a unique infusion of 25 mg of antisnake polyvalent serum, develops from the first hours pain, edema and swelling of his left ankle, upward bruising of his left leg, oral bleeding, hematuria, oliguria, headache, altered consciousness, aphasia, dysarthria, meningeal signs, amaurosis, hemiparesis of his right body, ocular muscle paresis to left predominance and bilateral paralytic mydriasis. Bilateral Retinography: pale optic disc and thinned retinal blood vessels. Visual evoked response: absent waves, bilaterally. Brain Tomography (TEM): left parieto-occipital intrabrain hemorrhage. Magnetic resonance imaging (MRI), of optic pathways: inflammation and path’s tortuosity of both optic nerve...

Agricultor de 20 años, procedente de San Miguel de Callería (Ucayali- Perú: selva nor-oriental a 842 km de Lima), mordido por una serpiente Bothrops spp, en el tobillo izquierdo, quien pese a recibir 18 horas después una única infusión de 25 mg de suero antiofídico polivalente desarrolla desde las primeras horas dolor, edema, equimosis de pierna izquierda, gingivorragia, hematuria, oliguria, cefalea, alteraciones de la conciencia, afasia, disartria, signos meníngeos, amaurosis, hemiparesia del hemicuerpo derecho, paresia de músculos oculomotores a predominio izquierdo y midriasis paralítica bilateral. Retinografía bilateral: discos retinales ópticos pálidos y vasos sanguíneos adelgazados. Respuestas visuales evocadas: ausentes, bilateral. Tomografía (TEM), cerebral: hemorragia intracerebral parieto-occipital izquierda. Resonancia magnética (RM) de vías ópticas: inflamac...