Papers by Paula Contreras
Revista chilena de neuro-psiquiatría, 2008
Lance-Adams syndrome was described in 1963 is a rare complication due to recovered hypoxic episod... more Lance-Adams syndrome was described in 1963 is a rare complication due to recovered hypoxic episodes or prolonged hypotension events. Is characterized by action myoclonus and cerebellar ataxia. We report two patients studied with this syndrome. A 51 year-old men and a 72 yearsold men fully recovered after a brief cardiorespiratory arrest they developed intention myoclonus, triggered by voluntary movements, posture, also by sounds, touches and emotional stimuli. It also was accompanied by cerebellar syndrome, ataxia and posture control alterations. They had a Magnetic Resonance (MR), EEG and normal metabolic parameters. Myoclonus was treated with sodium valproate and clonazepam. The neurophysiologic interpretation of this motor imbalance is an abnormal functioning of the Central Pattern Generator Netwoks (CPGN) located in the mesencephalic region. Hypoxic lesions in vermian purkinje and paravermal cerebellum neurons have an inhibitory effect in this system, producing motor control attenuation, generating an imbalance in the motoneurons of the spinal cord contraction sequence, which starts shooting in an uncoordinated way. As in almost all cerebellar lesions with time they tend to compensate and to diminish myoclonus.
Revista chilena de neuro-psiquiatría, 2008
MELAS is an acronym for the convergence of mitochondrial myopathy, encephalopathy, lactic acidosi... more MELAS is an acronym for the convergence of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke like episodes. It was described by Pavlakis et al. in 1984.This is a genetic disease caused by mutations in the maternal mitochondrial genome, affecting the adenosine triphosphate (ATP) synthesis. The mutations have heteroplasmic loads on different tissues, which could specially involve those highly energy-dependent such as muscles, brain and CNS tissues. We describe a 33 year old female presenting migraine headaches associated to strokelike episodes, related to an infection. Neurological manifestations include language and visual disturbances. The magnetic resonance imaging (MRI) showed low-intensity areas, predominantly in the temporal, parietal and occipital left lobes. She further presented a status epilepticus. The complementary study shows elevated basal and post exercise lactic acidosis, ragged red fibers in the muscle biopsy, and the mutation of A3243G in the mitochondrial genome. Her asymptomatic mother and sister showed ragged red fibers in muscle biopsy. The patient showed clinical and radiological features improvement, maintaining non epileptic slow focal occipital discharges in the electroencephalogram. The assumption is that this mitochondrial disorder could be more frequent than detected in our medium, given that a significant number of women could be just asymptomatic bearers (like the patient's mother and sister). This pathology should always be assessed in patients less than 40 years of age with strokes, regardless whether they have family history with the disease.
Introducción a encefalopatía hipóxico-isquémica retardada (EIHR) se presenta como una enfermedad ... more Introducción a encefalopatía hipóxico-isquémica retardada (EIHR) se presenta como una enfermedad desmielinizante del sistema nervioso central (SNC). Aparece como consecuencia de la hipoxia,
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Papers by Paula Contreras