Neurology Medicine

Archive for the ‘Neurologists’ Category

The human brain has been reduced in the past 30,000 years to the extent that during that time, has lost the size of a tennis ball. This trend baffles scientists. Are we becoming more stupid or, conversely, our brain is transformed to be more agile and efficient? The way in which we live, how we face the world and the demands of everyday life far from those that had, for example, a Neanderthal.

After taking measurements of skulls found in Europe, Middle East and Asia, scientists have concluded that the average size of the brain of modern humans, Homo sapiens has been reduced by 10%, and has grown from 1500-1359 cc. Women, whose brain is smaller than the male, have experienced an evolution equivalent.

Some anthropologists believe that this reduction is not as surprising as the bigger and stronger we are, more gray matter we need to control all that mass. Neanderthal man, a relative of modern man who disappeared about 30,000 years ago for unknown reasons, it was bigger and had larger brains. Cro-Magnon cave paintings left by animals in the monumental Lascaux cave 17,000 years ago, Homo sapiens was the biggest brain. They were also stronger than their modern descendants. Psychology professor David Geary, University of Missouri, believes that these features were necessary to survive in a hostile environment.

Geary complex social environment has studied the evolution of skull sizes from 1.9 million to 10,000 years old, while our ancestors lived in a social environment increasingly complex. Geary and colleagues used population density as a measure of social complexity, with the assumption that the closer humans live, the greater is the exchange between the group, the division of labor and rich and varied interactions between the people.

The scientists found that brain size decreased with increased population density. “As complex societies emerged, the brain became smaller because people do not have to be so smart to stay alive,” says Geary.

But the reduction does not mean that modern humans are dumber than their ancestors. Instead, simply evolved differently, even more sophisticated intelligence, says Brian Hare, an assistant professor of anthropology at Duke University.

The same phenomenon is observed in domestic animals compared to wild specimens. Thus, the Huskies pued
to have smaller brains than wolves, but they are more intelligent and sophisticated as they can understand the human communicative gestures, behaving like a small child. “Despite that a wolf has a much larger brains than dogs Dogs are much more intelligent and flexible, so that intelligence is not directly related to brain size, “Hare explained.

Insomnia is more common in women because of hormonal changes that occur prior to menopause and the responsibility of heads of households, revealed Isabel Tagle, head of the Sleep Laboratory of the National Institute of Neurological Sciences.

He explained that during the hours of sleep, the body not only recovers energy but help the learning process in children, increases the immune system and memory remains active. “A person who does not sleep well, ie if your sleep is interrupted, it is more likely to get the flu, infectious problems, is more irritable, non-profit to develop their daily tasks, even in chronic cases can cause forgetfulness”, said the specialist.

He added that the quality of sleep is related to the quality of life and longevity of people, and recommended to those suffering from sleep disorders, take a nap in the afternoon from 15 to 20 minutes. “The time off is related to age. A newborn should sleep between 14 and 16 hours, a child between 4 and 8 years old, ten hours, one between 8 and 12 years, eight hours for adults, seven hours, and the elderly, between four and five hours, “he said.

INCN The specialist recommended removing the equipment room as the TV, radio or computer, because they can cause insomnia. He also indicated that you should avoid the consumption of chocolates, coffee, tea or drinks that contain caffeine before bedtime. To relax you can drink milk with honey or warm water, and develop habits such as reading in bed.

Iberoamerican Academy of Pediatric Neurology (AINP) legally began in 1992 in Avila (Spain), founded by a group of Latin American pediatric neurologists who had completed three graduate courses in pediatric neurology at Miami, and Cancun Margarita. These courses were successful not only in establishing links of friendship, affection and respect, but in exchange knowledge in order to unify and improve treatment of children with central nervous system diseases. Objectives. It describes the origins and history legalization of the organization in its 10 years of work, highlighting the reason that led to its founding and its subsequent evolution. We must know our history and provenance is vital for developing countries and institutions to which we belong. Conclusions. The AINP has grown rapidly and plays an important role in the development of the Latin American Pediatric Neurology in several respects: first, continuing medical education, our annual conference, and secondly, to implement training of young physicians full graduate courses or partial updates of doctors who are studying in their home country training in pediatric neurology. In all Latin American countries should seek to pediatric neurology is recognized by the governments.

In recent years various studies have shown a progressive increase in the demand for neurological care in the emergency services. To analyze the appropriateness of specific neurology guards or the role it should play a neurologist in the emergency services, it is necessary to answer questions such as: What is the demand for emergency neurological care?, What are the most common neurological emergencies? Who should attend neurological emergencies and why are they needed specific neurology guards? Neurological emergencies are between 2.6% and 14% of medical emergencies. Stroke represents a third of all neurological emergencies, while the diagnoses of acute cerebrovascular disease, epilepsy and headache constitute 50% of all neurological care in the emergency department. Based on criteria of quality of care and professional competence, the best care for patients with a neurological emergency is provided by a specialist in neurology. The implementation of specific physical presence of neurology for 24 hours is associated with a higher quality of care, improved diagnostic and therapeutic guidance when the patient arrives at the emergency room reduces unnecessary admissions, reduces the cost of neurological care and enhances the Neurology service.

Chronic migraine is a difficult to treat primary headache that produces great impact on quality of life of patients. The international classification of headache changed the criteria for chronic migraine recently, so there are few studies that analyze groups with these new criteria. Objective. Analyze a group of patients with chronic migraine referred to a general neurology. Patients and methods. We selected the first 100 patients with migraine. Were established and analyzed subgroups of patients with episodic migraine, probable chronic migraine or chronic drug abuse according to the classification of headaches of the International Headache Society (IHS) and its revision in 2006. Results. Of the total of 738 new patients, 100 (13.5%) had migraine. Of the 100 new patients with migraine, 42 (5.6% of the total series) met the criteria for chronic migraine, and 15 patients with chronic migraine, the criteria for probable medication overuse headache. Before going to the neurology, only 41% had been diagnosed with migraine, 38% had not received information about this institution, only 17% took triptans as symptomatic treatment, and 23% had continued preventive treatment. Conclusions. We emphasize the importance of episodic and chronic migraine in a general neurology, using recent criteria of the IHS. Patients with chronic migraine sent to the neurology follow, a high percentage, without being diagnosed or reported, or treated properly, with a high degree of self-medication and frequent abuse of drugs. Triptan treatment in migraine prevention and heavy are still used little in primary care.

Review recent advances in procedures and techniques that have allowed us to study the anatomy and function of the central nervous system (CNS) in the fetus. Development. The neurological evaluation of the fetus can be done from the standpoint of clinical, anatomical or functional. Clinically, the assessment of fetal body movements, eye and breathing and heartbeat, can define four fetal behavioral states: 1F and 2F correspond to the states of quiet sleep and active. 3F and 4F states exist in a state of wakefulness in the newborn, but there is no scientific evidence that the fetus has the ability to stay awake. The behavioral states probably play an important role in the maturation and development of the CNS. The anatomical evaluation of the CNS to diagnose if it can be malformed ultrasound from week 7-8 of gestation, and magnetic resonance imaging (MRI) from week 18-20. Both techniques are also useful in the diagnosis of fetal neurological diseases acquired. Both methods are consistent in most cases, but in others each provides additional, different. Computed tomography should be used only in very specific cases involving bony structures. Functional evaluation of the fetus can be done with magnetic resonance spectroscopy, which analyzes the brain content of inositol, choline, creatine and N-acetylaspartate. Other techniques for the functional study of fetal brain are functional MRI, spectroscopy, near infrared light beam and magnetoencephalography. Conclusions. The fetal neurology is a discipline that will continue its rapid development in the immediate future. Technological advances will encourage more rapid and accurate diagnosis of anatomical and functional fetal CNS.

Knowledge and skills to analyze neurological medical student should acquire during the undergraduate learning. Development. Was performed by a Medline search, review of neurological knowledge and skills that medical students should acquire during the undergraduate learning. Also carried out the analysis of neurological programs in 28 sites of the Spanish universities with undergraduate medical.
In accordance with the recommendations of major international neurological societies during the undergraduate medical students must learn the skills to conduct a proper clinical examination and neurological impairment and to initiate appropriate investigations and therapy of neurological diseases more frequent, urgent and treatable. Also the student should be aware of situations in which it is appropriate to seek a neurological consultation with a specialist. We discuss the multiple learning strategies to acquire these skills. The information obtained from the web shows several inadequacies with the international recommendations and support the assertions of the White Paper on undergraduate medical education of the need for reform of undergraduate education in Spain. Conclusions. Neurologic education of medical students in Spain must be transformed to adapt to international recommendations.

The woman’s brain, neuro-hormonal interactions

During the life of a woman hormonal changes that influence your mood, empathy, perspective and behavior.

Neuro-hormonal interactions facilitate the adaptation of women to the vital goal in each period of his life.
Hormones that modulate the function of the female brain

The main hormones that influence the behavior of women are:

* DHEA, a prohormone that gives rise to the female sex hormones (estrogen) and male sex hormones (androgens).
* Estrogens main female sex hormones, responsible for the first part of the menstrual cycle. Drive to action.
* Progesterone: main hormone of the second part of the menstrual cycle and pregnancy. Sedative.
* 5-alpha-dihydrotestosterone: male sex hormone. Low concentrations in women. Influences, sex, aggression and welfare.
* Oxytocin: neuro-hormone involved in childbirth, breastfeeding, maternal and paternal power and orgasm.
* Alopregnelonona: neuro-derived hormone progesterone. It produces calm and stress reduction. Its low irritability causes premenstrual syndrome.
* Cortisol hormone involved in stress and physical and emotional adaptation.
* Androstenedione, a precursor of testosterone in the ovaries.
* Vasopressin: related to aggressiveness.

These hormones affect the human brain in general, but this article will focus on the female brain.

The onset of brain differentiation

Until about the eighth week of pregnancy every fetus has a brain, “feminine.” It is only in the second half of pregnancy when men increased testosterone brain defines “masculine.”

According to Dr. Louann Brizendine, a specialist in neuro-hormonal interactions of the female brain, this masculinization means devolution of certain cells of the communication centers and processing of emotions, and increased cellularity in the processing centers aggression .

During the first three months of life, it is usual that girls more easily interpret the faces of their mothers. The language appears in them rather than men and tend to make use only of a word to try to communicate.

In subsequent years, however, there is an inactivation of these circuits.

Hormonal Awakening

Puberty and adolescence marks a major change in life “brain” of the woman in your brain (pituitary gland, hypothalamus) begin to occur large amounts of hormones that reactivate previously inactivated circuits.

High concentrations of estrogen and progesterone influence on the hippocampus (promoting processes of learning, memory and sensitivity to stress), hypothalamus (regulation of body functions) and amygdala (emotion processing).

The female adolescent brain contains new tracks but is still immature, causing a marked impulsivity and low trial.

The onset of menstrual cycles mark a duality of behavior characteristic of women and a high brain stress beyond their control.

As the hippocampus (memory), a structure highly sensitive to estrogen during the first part of the cycle, women reach their peak mental performance while during the second phase (progesterone) the opposite occurs: the need for sleep, poor concentration and less memory.

In the absence of pregnancy, hormone levels decrease dramatically and menstruation are present accompanied by mood changes (irritability, depression), generated by neuronal hyperexcitability and a reduction of the neurotransmitter serotonin.

In the women’s fertile period is common for its evolutionary and genetic memory, associated with hormonal changes, influence their decisions, prioritizing instinctively raising a family with options that would force away from that goal.
Pregnancy and motherhood

The further restructuring of the female brain occurs during pregnancy.

The brain literally decrease in size, but this does not mean a loss of cells but a massive remodeling of the circuits. Two weeks before birth, the brain will regain its normal size and may even “grow” due to new maternal circuits. Postpartum depression is not uncommon.

Motherhood modifies the structure and function of the brain irreversibly. The intimate mother-child relationship creates and reinforces those brain circuits that are related to the maternal role. The new alert level enables it to react to the slightest movement or sound of your baby. The smell of the baby, your skin and the perception of her crying stimulate the secretion of several maternal hormones, including oxytocin and milk secretion.

Feeling and being a mother means to communicate to the other, feet to the brain.

Perimenopause, menopause and postmenopause

Perimenopause begins about age 43. The brain begins to be less sensitive to estrogen and testosterone energy may begin to decrease their levels and cause decreased sexual desire. Insomnia may be installed.

The brain may experience drastic changes caused by the decline in hormone levels normal. The humor becomes unbalanced and the woman goes into a stage of “do not know what’s wrong but I feel like forever.” It is a very particular and neuro-psychological aspects differ greatly for each woman.

After 8 to 10 years of perimenopause, menopause is present, and the brain goes into a kind of shock by hormonal withdrawal. All hormone levels change and with them the neurotransmitters that control mood, memory, desire, etc.. However, it is expected a positive refocusing of the woman herself, in their projects and pleasures behind by the needs of others.

In menopause, when the brain is retrofitted to the lack of sex hormones, if they have not been supplemented pharmacologically, estrogen-dependent circuits gradually be reduced and memory may decrease significantly over time.
Conclusion

To paraphrase the neuropsychiatrist Louann Brizendine, “hormones can determine the focus of the brain at any given time and influence the desires, beliefs, expectations and perception of reality by the women in each of the periods of his life “.

Key Points

• Treaty on sleep disorders, which contains some basic science knowledge, a technical and a clinical part.
• Under the authority of Dr Chokroverty are grouped contributions from 50 renowned disferentes professional disciplines such as neurology, neurophysiology, respiratory, ENT and psychiatry.
• A multidisciplinary approach that includes Expert Consult online resource in English.

Index

Contents

The work is presented in its 3 rd ed as a treatise on the diseases of sleep (or sleep medicine) that contains a part of science knowledge basically very important to Conod the basics of discipline, a technical part, which covers technical aspects of sleep tests and a clinical part, extensively describing all the different sleep disorders. It is considered as the reference work in the discipline, as it has responsibility for the Dr Chokroverty, with proven international reputation. Presents the latest developments and advances in this field as new and emerging in our country as sleep medicine, the organization of the book and its multidisciplinary approach makes it the reference work for anyone connected to professional discipline. It includes chapters such as deprivation and lack of sleep, Sleep and memory consolidation, the importance of d eneuroimagen techniques in the study of sleep and disruption of this, the relationship between nutrition and sleep, sleep evolution from birth through adolescence and sleep in women. Reflecting this multidisciplinary approach and under the authority of Dr Chokroverty are grouped contributions from 50 renowned disferentes professional disciplines such as neurology, neurophysiology, respiratory, ENT and psychiatry. This edition incorporates ExpertConsult to access the entire content of the livery, all images, allowing for quick searches, and view PubMed abstracts ed to increase the number of references.

What is it?

These techniques study the peripheral nerves and muscle, and therefore useful in the diagnosis of diseases that occur with loss of strength, weakness or loss of muscle mass or in a particular area or upper and lower limbs. The diseases which are necessary to confirm the diagnosis are common, such as carpal tunnel syndrome, diabetic polyneuropathy, radiculopathy, or diseases such as neuropathies, other polyneuropathies, myasthenia gravis, amyotrophic lateral sclerosis or myopathies.

Techniques are very useful in various fields, especially neurology, traumatology, rehabilitation, internal medicine or endocrinology. Will serve to locate the injured area, and establish whether it is a problem of a hand, arm or leg, or is something more diffuse, and defining whether the injury is a muscle, nerve, nerve trunk or root, or more than one. Help localize the lesion find a cause. Read the rest of this entry »