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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un ni&#241;o de 9 a&#241;os con encefa-lopat&#237;a postan&#243;xica diferida &#40;EPD&#41;&#46; El paciente mejor&#243; tras un per&#237;odo de coma y un s&#237;ndrome de distr&#233;s respi-ratorio del adulto secundario a una intoxicaci&#243;n por ben-zodiacepinas&#46; A los 9 d&#237;as del alta de la unidad de cuida-dos intensivos pedi&#225;tricos&#44; con una recuperaci&#243;n inicial aparentemente completa&#44; acudi&#243; de nuevo presentando una rigidez extrapiramidal del brazo izquierdo&#44; que evo-lucion&#243; a un deterioro neurol&#243;gico progresivo&#44; con mo-vimientos involuntarios&#44; no repetitivos y ocasionalmente estereotipados&#44; que afectaban a la musculatura axial&#44; pro-ximal y distal&#46; En la exploraci&#243;n f&#237;sica exist&#237;a una facies bradicin&#233;tica y los movimientos pasivos del brazo iz-quierdo presentaban una rigidez en tubo de plomo&#44; as&#237; como el signo de la &#34;rueda dentada&#34;&#46; La RM craneal reali-zada revelaba signos caracter&#237;sticos de un &#225;rea isqu&#233;mica en los ganglios basales&#44; m&#225;s evidentes en la regi&#243;n dere-cha&#44; compatibles con una encefalopat&#237;a an&#243;xico-isqu&#233;mi-ca&#46; La EPD es una entidad cl&#237;nica poco com&#250;n y a&#250;n no bien explicada&#44; que se manifiesta tras una situaci&#243;n hip&#243;-xico-isqu&#233;mica que causa estupor o coma&#46; La etiopatoge-nia es desconocida&#46; Excepcionalmente&#44; este s&#237;ndrome puede afectar m&#225;s a los ganglios basales que a la corteza cerebral y la sustancia blanca&#46; La mejor&#237;a inicial es segui-da por una reca&#237;da&#44; tras un per&#237;odo de tiempo variable&#44; progresando en semanas o meses hasta dejar al paciente con secuelas permanentes&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We report the case of a 9-year-old boy with delayed postanoxic encephalopathy&#46; The patient improved aftera period of coma and adult respiratory distress syndro-me caused by benzodiazepine intoxication&#46; Initial im-provement appeared to be complete&#44; but 9 days after dis-charge from the pediatric intensive care unit&#44; extrapyra-midal rigidity of the left arm became manifest&#46; This event was followed by progressive neurologic impair-ment with involuntary&#44; non-repetitive&#44; but occasionally stereotyped movements&#44; affecting distal&#44; proximal and axial musculature in various combinations&#46; On physical examination&#44; passive movement of the left arm showed a plastic&#44; lead-pipe rigidity with a ratchet-like cogwheel qualit&#46;Magnetic resonance imaging &#40;MRI&#41; was perfor-med&#46; Axial T2 -weighted images of the brain showed cha-racteristic signs of an ischemic area in the basal ganglia which were more evident in the right region&#44; a finding consistent with anoxic-ischemic encephalopathy&#46; Dela-yed postanoxic encephalopathy is a relatively uncom-mon and unexplained phenomenon which becomes ma-nifest after an initial hypoxic-ischemic event that causes stupor or coma&#46; The pathogenesis is unknown&#46; Excep-tionally&#44; this syndrome can affect the basal ganglia more than the cerebral cortex and white matter&#46; Initial impro-vement is followedafter a variable period of time by re-lapse&#44; progressing for weeks to months until the patient is left with permanent sequelae&#46;</p>"
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Encefalopatía postanóxica diferida
Delayed postanoxic encephalopathy
F.J. Gascón Jiménez*, B. Navarro Gochicoa, M.J. Velasco Jabalquinto, A. Collantes Herrera, M.J. Peña Rosa
Facultad de Medicina. Unidad Docente de Pediatría. Hospital Universitario Reina Sofía. Departamento de Pediatría. Córdoba.
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