La calidad de vida es un concepto subjetivo y existen cuestionarios destinados a reflejar con la mayor fidelidad posible el punto de vista del enfermo sobre su propia calidad de vida. Para determinar la calidad de vida de los pacientes con epilepsia refractaria, usando la escala Quality of Life in Epilepsy Inventory (QOLIE 31), se realizó un estudio descriptivo y observacional con 35 pacientes de la consulta externa del Servicio de Neurología del Hospital Miguel Grau de EsSalud, en Lima, Perú. Se les administró la escala QOLIE-31 para su auto aplicación y correlación con los datos socio-demográficos y clínicos. Se obtuvo un promedio de mala calidad de vida (≤ 60 puntos) en los dominios: Efectos de los fármacos antiepilépticos, trastornos de las funciones cognitivas y valoración global calidad de vida, siendo el puntaje global: 58,6 puntos. Los resultados del estudio muestran...

Se realizó un estudio de tipo descriptivo y retrospectivo en 462 pacientes con diagnóstico de epilepsia, que asistieron a la consulta externa o fueron hospitalizados en el Hospital III Miguel Grau de EsSalud, durante el año 2006, para evaluar los costos directos de la epilepsia de una población hospitalaria de la Seguridad Social y señalar qué grupo de pacientes epilépticos tienen más costos directos. Se consideraron el Valor de venta = Precio de venta – 19% IGV (impuesto general a la venta), obtenidos del tarifario de EsSalud, y los precios de los fármacos antiepilepticos (FAE) todos genéricos, que son los más bajos del mercado nacional. El análisis estadístico fue de tipo descriptivo y analítico. El estudio concluye que los costos de consulta especializada (37 %) y FAE (34%) representaron los mayores costos anuales; el costo directo promedio fue de 154,61 USD/paciente/a...

There are some variants of Guillain-Barré syndrome (GBS) that are so unusual, such as distal limb weakness (DL-GBS), which features weakness restricted to the distal area of limbs (wrists, hands, ankles, and toes) with preserved muscle strength in the proximal areas during the course of the disease. We report the case of a 26 year-old woman, who at two weeks before admission showed mild distal motor deficit affecting the arms and afterwards her legs, and this was associated to diarrheal disease. Physical examination showed mild distal quadriparesis, with no hyporeflexia/areflexia, and a positive Lasègue sign. Laboratory studies showed ferropenic anemia, immunological tests for commonly associated viruses, tumor markers and vitamin B12 levels were all normal. Also, CSF examination showed no alterations. Cerebral and cervical spine MRI studies were normal. Electromyography and nerve cond...

Objective: To determine the clinical characteristics and EEG-associated features in children with migraine. Patients and methods: This is an observational and analytical study. Fifty-two patients 4-14 years of age were selected, who fulfilled criteria for diagnosing migraine in children (ICHD-II) during 2010. A surface EEG was performed in every child, including photo-stimulation (PS) and hyperventilation (HV), during the interictal period. We used the chi-square method for the statistical analysis. Results: The average age was 10.1 years, 53.8% were male, 32.7% had pulsátiles headache, nausea/vomiting were present in 26.9%, photophobia and sonophobia in 11.5%, and visual aura in 3.8%. The altered EEG patterns were as follows: diffuse slow-down waves in 13.5%, theta-delta wave outbreaks during PS and HV in 34.6%, and interictal epileptiform discharges (IED) were present i...

Introduction: Quality of life is a subjective concept, and there are some questionnaires designed to determine it as accurately as possible, from the patients’ point of view. Objectives: To determine quality of life in patients with refractory epilepsy using the Quality-Of-Life in Epilepsy Inventory (QOLIE 31). Material and method: Thirty-five patients from the outpatient neurology clinic were selected in a descriptive and observational study, the QOLIE-31 was administered to them for self-use, and results were compared with socio-demographic and clinical data. Results: 68.6% were male, the mean age: 45.9 years, the average age of onset was: 16.1 years, the average time of disease was: 29.8 years, representing 60 TCG crisis %. An average low quality of life (= 60 points) in the domains: Effects of antiepileptic drugs (AEDs) 44.7, 56.8 cognitive functions and quality ...

Objectives: To determine direct costs of epilepsy in a population assigned to one hospital in Peruvian Social Security (EsSalud) during year 2006. To point out which group of epileptic patients generate more direct costs. Methodology: A retrospective study including 462 epilepsy patients was performed in order to estimate medical direct costs, considering the Sales Value = Retail price – 19% (Peruvian added value tax), obtained from the EsSalud rate lists; as well as prices for antiepileptic drugs (AED) (generics), which are the lowest within Peru. Descriptive and analytic statistics were used, as well as Chi square and Student’s t tests.   Results: Fifty three per cent patients were male, and their average age was 40.7 years (± 22.03 SD); 95.7% of epileptic episodes were generalized crises, 17.7% were refractory, the average number of hospital visits was 6.26 (±...

There are some variants of Guillain-Barré syndrome (GBS) that are so unusual, such as distal limb weakness (DL-GBS), which features weakness restricted to the distal area of limbs (wrists, hands, ankles, and toes) with preserved muscle strength in the proximal areas during the course of the disease. We report the case of a 26 year-old woman, who at two weeks before admission showed mild distal motor deficit affecting the arms and afterwards her legs, and this was associated to diarrheal disease. Physical examination showed mild distal quadriparesis, with no hyporeflexia/areflexia, and a positive Lasègue sign. Laboratory studies showed ferropenic anemia, immunological tests for commonly associated viruses, tumor markers and vitamin B12 levels were all normal. Also, CSF examination showed no alterations. Cerebral and cervical spine MRI studies were normal. Electromyography and nerve cond...

Objective: To determine the clinical characteristics and EEG-associated features in children with migraine. Patients and methods: This is an observational and analytical study. Fifty-two patients 4-14 years of age were selected, who fulfilled criteria for diagnosing migraine in children (ICHD-II) during 2010. A surface EEG was performed in every child, including photo-stimulation (PS) and hyperventilation (HV), during the interictal period. We used the chi-square method for the statistical analysis. Results: The average age was 10.1 years, 53.8% were male, 32.7% had pulsátiles headache, nausea/vomiting were present in 26.9%, photophobia and sonophobia in 11.5%, and visual aura in 3.8%. The altered EEG patterns were as follows: diffuse slow-down waves in 13.5%, theta-delta wave outbreaks during PS and HV in 34.6%, and interictal epileptiform discharges (IED) were present i...

Introduction: Quality of life is a subjective concept, and there are some questionnaires designed to determine it as accurately as possible, from the patients’ point of view. Objectives: To determine quality of life in patients with refractory epilepsy using the Quality-Of-Life in Epilepsy Inventory (QOLIE 31). Material and method: Thirty-five patients from the outpatient neurology clinic were selected in a descriptive and observational study, the QOLIE-31 was administered to them for self-use, and results were compared with socio-demographic and clinical data. Results: 68.6% were male, the mean age: 45.9 years, the average age of onset was: 16.1 years, the average time of disease was: 29.8 years, representing 60 TCG crisis %. An average low quality of life (= 60 points) in the domains: Effects of antiepileptic drugs (AEDs) 44.7, 56.8 cognitive functions and quality ...

Objectives: To determine direct costs of epilepsy in a population assigned to one hospital in Peruvian Social Security (EsSalud) during year 2006. To point out which group of epileptic patients generate more direct costs. Methodology: A retrospective study including 462 epilepsy patients was performed in order to estimate medical direct costs, considering the Sales Value = Retail price – 19% (Peruvian added value tax), obtained from the EsSalud rate lists; as well as prices for antiepileptic drugs (AED) (generics), which are the lowest within Peru. Descriptive and analytic statistics were used, as well as Chi square and Student’s t tests.   Results: Fifty three per cent patients were male, and their average age was 40.7 years (± 22.03 SD); 95.7% of epileptic episodes were generalized crises, 17.7% were refractory, the average number of hospital visits was 6.26 (±...

Objective: To investigate the effects of subclinical and clinical primary hypothyroidism on peripheral nerve function. Methods: Prospective study of selected patients diagnosed with subclinical and clinical primary hypothyroidism with sensory or motor symptoms; there were analyzed demographic variables, types of hypothyroidism, treatment with levothyroxine (LT4). The presence of polyneuropathy or focal neuropathy was defined with studies of nerve conduction velocity. Results: We studied 33 patients diagnosed with clinical hypothyroidism (CH) and subclinical (SCH); the average age was 64.76 years; 90.9% of the patients were female. Pain and paresthesia of the extremities were the most frequent symptomatology. In the CH the levels of TSH and free T4 were normal, in the SCH the average levels of TSH and free T4 were in 11.40 mU/L and 0.85 ng/dl respectively. When performing the neurophysiol...

El Síndrome de Guillain-Barré (SGB) es una polirradiculopatía inflamatoria autoinmune aguda. Las manifestaciones clínicas comunes Incluyen debilidad muscular progresiva bilateral, especialmente en la porción distal de las extremidades inferiores, pérdida de la sensibilidad y disminución o pérdida de los reflejos osteotendinosos. Se sabe que los pacientes con hepatitis C son susceptibles de presentar numerosas manifestaciones extrahepáticas, hasta ahora solo se han informado pocos casos de SGB asociados con la infección por el virus de la hepatitis C (VHC). La existencia de una forma puramente sensorial de SGB sigue siendo objeto de controversia, ya que estos casos siempre demuestran un grado de debilidad motora o anomalías en los estudios de conducción nerviosa motora y son difíciles de distinguir de la neuropatía sensorial aguda, en el presente estudio reportamos el caso d...

El presente estudio describe la eficacia del enfoque multidisciplinario e innovador en el manejo de la epilepsia resistente al manejo farmacológico y los resultados obtenidos con el tratamiento quirúrgico de estos casos. Los pacientes con epilepsia refractaria requieren un estudio multidisciplinario para el origen de la epilepsia y realizar la resección quirúrgica. Se hizo la evaluación clínica, neuropsicológica, estudio estructural con resonancia magnética, PET y SPECT y video electroencefalografía de cuero cabelludo e intracraneal en cinco pacientes del Hospital Almenara, con lo que realizamos la cirugía resectiva correspondiente. En 60% de los pacientes se logró la supresión completa de las crisis epilépticas y en el 40 % restante la disminución de la frecuencia en 80%. La morbilidad adicional en los pacientes operados fue leve y manejable.

Se informa que la epilepsia tiene una incidencia de 1% en la población, de los cuales un tercio no responde al tratamiento farmacológico, que conlleva a discapacidad y morbilidad secundaria. Los pacientes con epilepsia refractaria (ER) requieren un estudio multidisciplinario para el origen de la epilepsia y realizar la resección quirúrgica. Se realizó el estudio multidisciplinario y el tratamiento quirúrgico en siete pacientes con criterios de ER, con un promedio de edad al momento de la cirugía de 11,49 años (rango entre 3,4 y 35 años), de los cuales seis fueron mujeres y un paciente varón. La eficacia de la cirugía en el control de la ER fue excelente en 71,4 % (5 de 7 casos) con valores de escala de Engel I (desaparición de las crisis epilépticas) y buena en 28,6 % (2 de 7 pacientes) con valores de escala de Engel II (disminución de crisis entre 75 % y 99 %). La displasi...