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Resumen Introduccion El sindrome de piernas inquietas (SPI) es un trastorno caracterizado por la necesidad imperiosa de mover las piernas, estando a menudo acompanado de sensaciones desagradables. Su frecuencia es superior en pacientes con esclerosis multiple (EM) que en la poblacion general. Objetivos Evaluar la prevalencia del SPI, segun el cumplimiento de los 4 requisitos esenciales incluidos en los criterios diagnosticos propuestos por la International Restless leg syndrome study group (IRLSSG, 2003), en una cohorte de pacientes con EM e identificar posibles factores de riesgo y repercusion clinica. Resultados Se incluyeron 120 pacientes con EM, con una edad media de inicio de 40 anos y un tiempo medio de evolucion de 46 meses. La prevalencia de SPI, segun el cumplimiento de criterios diagnosticos de la IRLSSG, fue del 23,3%. El tiempo de evolucion de EM, desde la aparicion de los primeros sintomas, fue significativamente menor en pacientes con SPI (p=0,001). La presencia de un brote reciente, asi como de sintomas de ansiedad, depresion y dolor neuropatico se asociaron de forma significativa con el riesgo de SPI (p=0,001, p Conclusiones El SPI debe ser considerado en la evaluacion neurologica de pacientes con EM, cuyo diagnostico y tratamiento precoz mejoraria la calidad de vida de estos sujetos.

Familial amyloidotic polyneuropathy type I (FAF-I) is caused by a specific genetic mutation that gives rise to a transthyretin anomaly whose presence in serum constitutes the biochemical marker for this disease. We studied the serum of 7 patients and 16 asymptomatic members of their immediate families using ELISA with FD-6 monoclonal antibody to detect the transthyretin anomaly. Positive results were found for the 7 patients, including the 2 patients whose disease was apparently sporadic, and 12 carriers were detected among the family members. This technique makes sural nerve biopsy unnecessary for establishing a diagnosis in patients whose clinical signs are consistent with FAP-I. Asymptomatic carriers are also detected, facilitating appropriate genetic counseling.

A 45-years-old woman developed palilalia without other neurologic symptoms or signs. Cranial MR and CT scan showed only bilateral thalamic infarcts; the SPECT showed bilateral frontoparietal hypoactivity. We conclude that involvement of the supplementary motor area by diaschisis after bilateral thalamic lesions may produce palilalia.

We report a patient that developed a sensorimotor polyneuropathy more than a year before the appearance of the typical clinical signs of progressive systemic sclerosis. A sural nerve biopsy showed epineural vasculitis with involvement of the basal membrane of the endoneural vessels, without proliferation of the connective tissue.

Primary antiphospholipid syndrome (PAS) is characterized by the isolated presence of antiphospholipid antibodies in the absence of other immunological changes. Its association with ischemic cerebrovascular disease is rarely reported. This study analyzes this association in 10 patients (8 women) first presenting with ischemic cerebrovascular accident (ICVA) that met the criteria for PAS. The average age of the patients was 50.4 years. Two patients had Sneddon's syndrome. Prolonged thromboplastin partial activation time was found in only three patients. Eight started aspirin therapy. The average time of follow-up was 17.2 months, during which there was one relapse. PAS should be included as a possible cause when examining individuals with ICVA, particularly when patients are young, when abortion has occurred or when no other cause is evident. Acetylsalicylic acid is effective for preventing relapse when other vascular risk factors are carefully controlled.