Safety and effectiveness of surgery for epilepsy in children. Experience of a tertiary hospital in Ecuador.

Introduction: There is sufficient evidence on the usefulness of surgery as a therapeutic alternative for patients with drug-resistant epilepsy; however this treatment is underutilized, especially in developing countries.

Methods: We describe the outcomes of epilepsy surgery in 27 paediatric patients at Hospital Baca Ortiz in Quito, Ecuador. Our analysis considered the following variables: reduction in seizure frequency, surgery outcome according to the Engel classification, improvement in quality of life, and serious complications due to surgery.

Serum neuron specific enolase could predict subclinical brain damage and the subsequent occurrence of brain related vascular events during follow up in essential hypertension.

The object of this work was to explore if blood based biomarkers of brain damage could predict subclinical brain lesions and clinical outcome during follow-up in asymptomatic hypertensive patients. This was a cross-sectional study including 101 patients with essential hypertension and no clinical evidence of neurological disease and 53 healthy controls, followed by a longitudinal study of 62 hypertensive patients for an average of 33 months. Serum concentrations of two brain specific proteins (S100B and neuron specific enolase - NSE) were determined at inclusion.

Stroke incidence and risk factors in Havana and Matanzas, Cuba.

Introduction: Cerebrovascular disease is the third-leading cause of death and the second-leading cause of disability and dementia.

Objective: Determine stroke incidence and risk factors in a population of adults aged 65 and over in Cuba (Havana and Matanzas).

Material And Methods: This prospective longitudinal study, completed between April 2008 and Abril 2011, re-evaluated 2916 elderly adults with an average follow-up time of 4 years.

Reliability and validity of a Spanish version of the Impact of Pediatric Epilepsy Scale in a Cuban population.

The Impact of Pediatric Epilepsy Scale (IPES) is a brief, accurate, and acceptable measurement scale of the impact of pediatric epilepsy on the health-related quality of life (HRQOL) of both the child and the child's family as perceived by the child's parent(s). The aim of this study was to validate a Spanish language version of the IPES in Cuban children with epilepsy. The IPES was translated and adapted to Cuban culture and administered to 76 parents of children with epilepsy.

Serum neuron-specific enolase and S100 calcium binding protein B biomarker levels do not improve diagnosis of acute stroke.

Background: The high sensitivities and specificities reported for blood biomarkers as a supportive test in the diagnosis of acute stroke do not correspond with their performance for decision-making in emergency situations.

Methods: Seventy-two patients with suspected stroke were recruited: 44 with ischaemic stroke, 17 with haemorrhagic stroke and 11 stroke mimics, as well as a high-risk control group of 79 individuals. Serum neuron-specific enolase (NSE) and S100 calcium binding protein B (S100B) biomarker levels were determined on admission, using immunoassay kits.

Short-term prognostic value of serum neuron specific enolase and S100B in acute stroke patients.

Objective: To explore the value of blood markers for brain injury as outcome predictors in acute stroke.

Design And Methods: The study included 61 patients with acute stroke (44 ischemic and 17 hemorrhagic) and a high risk control group (79 individuals with no known history of neurological disease). Serum neuron specific enolase (NSE) and S100B were determined by immunoassay (CanAg Diagnostics, Sweden).

Severity of depressive symptoms as predictor of impairment of quality of life in chronic migraine: comparison with episodic migraine.

To identify predictors of quality of life (QoL) in episodic migraine (EM) and chronic migraine (CM), 116 migraineurs were evaluated using the Headache Needs Assessment (HANA). QoL was significantly more impaired in patients with CM. Disability was a predictor of QoL in both EM and CM.

[Cognitive deterioration following cerebral infarction: frequency and determining factors].

Introduction: Stroke is often associated with cognitive deterioration (CD) in varying degrees, and the risk factors associated to CD after a stroke vary from one study to another.

Aims: To determine the frequency of CD following cerebral infarction and to identify the factors that account for its presence.

Patients And Methods: A descriptive study was performed involving 126 stroke survivors who were hospitalised for rehabilitation.

[Validation of the stroke-specific quality of life scale (ECVI-38)].

Introduction: The stroke-specific quality of life scale (ECVI-38) is the first Spanish-language instrument for evaluating the quality of life in individuals who have survived a stroke.

Aim: To evaluate the psychometric properties of the third version of the ECVI-38.

Patients And Methods: A total of 243 stroke survivors were interviewed 2 months-2 years after the event; 61 of them were surveyed again 7-14 days later and 74 others were interviewed on beginning and ending a two-month period of rehabilitation.

[Stroke-specific quality of life scale (ECVI-38): an evaluation of its acceptance, reliability and validity].

Introduction And Aims: Health-related quality of life (HRQL) is currently essential in the evaluation of stroke-related clinical trials. Existing stroke-specific scales were developed in English-speaking countries and most of them do not satisfy the necessary standards of validity. In consequence, the first Spanish-language scale for evaluating the quality of life (QL) of stroke survivors was developed (ECVI-38).

[Prevalence of neurosonographic disturbances in chronic instability].

Introduction: Dizziness is a common symptom at the outpatient clinic of family doctors. Its origin is usually multifactorial and its outcome is often benign. However, exists a tendency to relate the dizziness with a cerebrovascular disturbance.

[The development of a scale to evaluate the quality of life in stroke survivors].

Introduction: The selection of a measure that can be used to evaluate the outcome of therapeutic interventions in stroke patients has had a conceptual problem in that there is a need to detect a wide range of deficiencies, disabilities and handicaps as part of a patient-based model. It has also suffered from a methodological problem due to the lack of systematic attention given to the development of standard instruments.

Aims: We conducted this study with the aim of getting over these limitations by developing a scale to evaluate the quality of life in stroke survivors.

[Cognitive diagnosis of cerebrovascular disease by event related potentials: anatomical sources that generate P300].

Introduction: Cerebrovascular disease causes different cognitive alterations. There is a need to develop tools that are capable of diagnosing them. One of them could be event related potentials.

[Disability and quality of life in patients with migraine: determining factors].

Aims: The purpose of this paper is to describe the behaviour of disability and quality of life (QOL) in patients suffering from migraine and to identify the factors associated with these variables.

Patients And Methods: A non experimental study based on observation was conducted with 116 patients diagnosed as having migraine, who were consecutively admitted to the Casualty department at the Institute of Neurology and Neurosurgery. The chief variables used in the study were disability, QOL and the overall evaluation of their state of health.

[The role of blood lipids in the different aetiologies of cerebral infarction].

Introduction: In order to determine the role lipids play in cerebral infarction (CI), the different aetiological subgroups of this disease should first be separated.

Aims And Method: We conducted case control studies to identify whether there is a relation between blood lipid levels and the occurrence of cerebral infarction caused by atheromatosis (CIA). Our study involved a total of 98 patients with cerebral infarction of an atherothrombotic or lacunar aetiopathogenesis that were included in the CIA category.

[Characterization of a group of patients with cryptococcosis of the central nervous system].

Introduction: Incidence of cryptococcosis of the central nervous system has risen sharply since AIDS became pandemic; from early 1998, the Instituto de Neurología y Neurocirugía in Havana has beaten its own record in the number of cases attended.

Aim: To describe the clinical epidemiological characteristics of patients with this disease who were hospitalised in this centre between 1991 and 2000.

Patients And Methods: We present a descriptive study of 16 adult individuals who were admitted for this reason.

[Use of event related potentials for the diagnosis and follow up of sub clinical disorders of sustained attention in ischemic cerebrovascular disease].

Introduction: Ischemic cerebrovascular disease causes cognitive disorders among survivors, which may range from vascular dementia to alterations of a sub clinical nature. These are not easily detected using conventional diagnostic tools. Some of the most frequent disorders after a cerebral infarction are those affecting sustained attention or vigilance.

[Usefulness of P300 as a tool for diagnosing alterations in sustained attention in ischemic cerebrovascular disease].

Introduction: Event related potentials, and especially the component P300, can be used to achieve greater precision and sensitivity in the cognitive evaluation of patients. They also enable us to obtain more accurate information about deficiencies in sustained attention, which is a cognitive function associated with the generation of the above mentioned component. Furthermore, the study of disorders triggered off by cerebrovascular disease must be given priority because of the high incidence with which they occur.

[Type A behaviour and life events as risk factors for cerebral infarct].

Introduction: The role of psychosocial factors in cerebral infarct has been little studied and is therefore still undefined. OBJECTIVE and methods. To evaluate the effect of a pattern of behaviour which predisposes to stress, and of life events, on the occurrence of cerebral infarct, we studied a group and control involving 88 patients with cerebral infarcts diagnosed clinically and on imaging studies, and a control group of 99 persons paired for age and sex who lived in our health district.

[Characterization of the patients with cerebral infarcts discharged from a hospital in La Havana in 1998].

Objective: We made a study of the 79 patients who were discharged from the Instituto Nacional de Neurología (La Havana, Cuba) during 1998, with the diagnosis of cerebral infarct, with the objective of analysing their behavior.

Patients And Methods: In this analysis we considered: the previous clinical history of factors and illnesses of risk, the certainty of the diagnosis in the emergency room, presenting symptoms, clinical signs, vascular territory, etiopathogenic category and results of cranial computerized axial tomography (CAT).

Results And Conclusions: Arterial hypertension, smoking, cerebrovascular disease and ischemic cardiopathy were the commonest clinical features seen.