[Effect of treatment with benzodiazepines on the hospital prognosis of Coronavirus disease 2019]

INTRODUCTION

The consequences of the use of of benzodiazepines in coronavirus disease 2019 have not yet been studied. We compared the hospital prognosis of patients hospitalized for coronavirus disease 2019 in benzodiazepine users and non-users.

PATIENTS AND METHODS

Observational study with a retrospective cohort design. All consecutive patients admitted with a confirmed diagnosis of coronavirus disease 2019 were included. The patients under chronic treatment with benzodiazepines at the time of admission were studied and compared with non-users. The primary objective was to analyze the mortality of patients who used chronic benzodiazepines at the time of admission and compare them with those who did not use them. The secondary objective was to analyze the risk of severe disease due to coronavirus 2019, acute respiratory distress syndrome and admission to the Intensive Care Unit in both groups of patients.

RESULTS

We included 576 patients, 138 (24.0%) used benzodiazepines. After adjusting for sex, age, baseline situation and all the different variables between both groups, benzodiazepine users did not show a higher odds of mortality (OR: 1,1, IC 95%: 0,7-1,9, p = 0,682) or higher risk of severe disease due to coronavirus 2019 (OR: 1.2, 95% CI: 0.7-1.8, p = 0.523). They also did not have a higher risk of acute respiratory distress syndrome (OR: 1.2, IC 95%: 0.8-1.9, p = 0.315) or more admission to the Intensive Care Unit (OR: 0.8, 95% CI: 0.4-1.4, p = 0.433).

CONCLUSION

In our sample, treatment with benzodiazepines at the time of admission was not associated with a worse hospital prognosis in patients with coronavirus disease 2019.

[Temporal pole encephalocele, a surgical treatable cause of drug-resistant epilepsy]

INTRODUCTION

Encephaloceles are herniation of brain parenchyma through a bony skull defect that can cause drug-resistant epilepsy. In these cases, a surgical approach should be considered.

CASE REPORT

38-year-old man with drug-resistant epilepsy and 1.5 T magnetic resonance imaging performed with no relevant findings. After video-electroencephalogram, 3 T magnetic resonance imaging and F-18-fluoro-deoxy-glucose positron emission tomography, a right temporal encephalocele was confirmed. A right temporal polar resection was performed four years ago and the patient remains seizure-free.

DISCUSSION

Anterior temporal encephaloceles are an underdiagnosed cause of epilepsy, and a 3 T magnetic resonance imaging reviewed by an epilepsy expert radiologists is key to diagnosis.

CONCLUSION

In drug-resistant cases with presurgical evaluation compatible with the location, surgical treatment must be considered.

[Chronic migraine with daily headache. Literature review]

INTRODUCTION

Despite representing a significant number of cases, patients with chronic migraine and daily headache are frequently excluded from large therapeutic clinical trials. These individuals have hardly been studied and could have specific properties. Development. A third of patients with chronic migraine may suffer from headaches every day, representing up to 1.7 - 3.3% of patients in a general neurology consultation. These patients are excluded from most studies, so little information is available. They may have a longer lasting migraine and different response to treatment. Patients with chronic migraine and daily headache may have complex pathophysiological mechanisms that favor the daily manifestation of migraine. The management of these patients is a therapeutic challenge, and OnabotulinumtoxinA may be useful.

CONCLUSION

Patients with chronic migraine and daily headache may have specific clinical and therapeutic characteristics. New studies could lead to differentiate it from chronic migraine.