Revista de neurologia
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The stiff-man syndrome (SPR) is a rare neurological condition characterized by the presence of marked, involuntary rigidity of the axial muscles and limbs, together with intense painful muscle spasms which characteristically occur following external stimuli such as sudden noises, brusque movements or emotional stimuli. Symptoms are markedly improved by sleep and by diazepam. The aetiology is unknown, although it is associated with certain auto-immune disorders, particularly diabetes mellitus (DM) and others such as thyroid disease, vitiligo, pernicious anaemia, adrenal insufficiency, etc. The presence of high titres of glutamate-decarboxylase (GAD) antibodies seems to indicate an auto-immune aetiology. ⋯ A new case of the 'stiff-man' syndrome is presented and aspects of aetiopathology and treatment are reviewed.
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Revista de neurologia · Jun 1997
Case Reports[Myopathy caused by inhibitors of hydroxymethylglutaryl-coenzyme A reductase].
Hydroxymethylglutaryl-Coenzyme A (HMG-CoA) Reductase inhibitors are a group of drugs widely used for hypercholesterolemia. They are known to originate side-effects on muscles but with a very low incidence of myopathy. ⋯ Usage of this group of drugs is wide. Their side effects are rare but it is important to remember their capacity to induce a myopathy, usually reversible upon withdrawal of the drug.
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Coma is differentiated from sleep by the absence of a normal arousal response and from death by the presence of heart beats and the absence of brain death criteria. Most causes of coma are readily diagnosed and treated. Others require a test whose results are not immediately available, transportation or a risky procedure and empirical treatment has to be considered. In addition to treating the cause of coma, treatment of the systemic and neurological causes of secondary brain damage is paramount.
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Revista de neurologia · Feb 1997
Case Reports[Transitory episode of laughter as the initial symptom of an ischemic stroke].
Pathological laughter occurs in pseudobulbar paralysis, in psychiatric disorders and as a sign of convulsions (gelastic crisis). An extremely rare form is the "fou rire prodromique' a pathological episode of laughter preceding a stroke. The pathogenesis is unknown and classically differentiated from gelastic crises. "Fou rire prodromique' has been described in subcortical ischaemic or haemorrhagic strokes, not in cortical strokes. ⋯ We suggest that in the case described it is impossible to differentiate between the "fou rire prodromique' and a gelastic crisis as a first sign of an embolic cerebrovascular accident.