MRS of the brain performed on patients with mild cognitive impairment is a valuable tool in predicting conversion to probable Alzheimer's disease. Occipital values were more reliable than hippocampal values in this prediction.

Donepezil and memantine have similar modest clinical and spectroscopic effect on mild to moderate AD. MRS could be useful to monitor progression of the disease.

Spinal epidural abscesses account for 1 or 2 of every 10,000 hospital admissions, Staphylococcus aureus being the bacterium most frequently involved. Brucellosis is a disorder of worldwide distribution, relatively frequent in South America and in Mediterranean countries in Europe and Africa. Whilst in the USA only 200 cases are reported every year, in Spain it is the most frequent zoonosis. This systemic disease seldom produces spondylodiscitis which in a minority of cases may be complicated by spinal epidural abscesses, in general of lumbar location. The purpose of this article is to analyse 4 cases of brucellar spinal epidural abscess of cervical location and diagnosed in the Province of Teruel, Spain, an endemic area for the disease, through 10 consecutive years (1990–1999). We consider noteworthy the following facts: the first case was a technical employee who acquired the infection in our laboratory of microbiology, the second presented with an extensive purulent collection invading prevertebral and retropharyngeal regions, the third case was cured only with antibiotics without residual deficits. In the fourth case we were not able to demonstrate spondylodiscitis accompanying the epidural abscess at the C₂–C₆ levels. We discuss especially the epidemiological aspects of brucellosis, the existence of epidural abscess without spondylodiscitis, the clinical manifestations, the diagnosis by means of magnetic resonance imaging, specific serological tests for Brucella, antibiotic treatment and the prognosis of our cases.

Multiple sclerosis (MS) is one of the most disabling diseases in young people, but the interrelation between disability and quality of life is poorly understood. As individual correlations between disability and the perspective of the patient may be weak in individual subjects, the purpose of our work was to analyze and correlate quality of life with neurologic impairment and disability in all patients with MS from the geographic area of the Bajo Aragón in the northeastern region of Spain. A total of 36 patients with a diagnosis of probable or clinically definite MS had an average age was 38.1 years (range,17-66 years). The majority of them were women (66.6%) and had relapsing-remitting forms (83.3%). The Minimal Record of Disability measured neurologic impairments, functional limitations, and handicaps. Quality of life was measured by the Functional Assessment of Multiple Sclerosis (FAMS) scale. Statistical analysis was performed with the Kruskal-Wallis nonparametric test and Pearson's coefficient of correlation. The mean EDSS of our cohort was 2.76 (range, 0-9). The mean FAMS score was 78.6 (SD, 52.5). We found that patients moderately or severely disabled (EDSS >3) showed a significantly decreased satisfaction in comparison with the nondisabled or mildly disabled ones. Disability and handicaps were significantly related to some items of FAMS: mobility, symptoms, and emotional well-being, but not with the remaining items: general contentment, thinking and fatigue, family and social well-being, and additional concerns. In comparison with patients from other population-based surveys, our patients were less disabled and enjoyed a better quality of life. Although we globally observed poorer quality of life in more disabled patients, the perspectives of the patients did not necessarily agree with disability scales in some domains of health. Quality of life should be included in the approach to MS patients if we want to provide cost-effective health care.

Neurological development over a period of 25 years and MRI findings are reported in two members of the same family affected by mannosidosis type II. Progressive axial and appendicular cerebellar syndrome, moderate hearing loss and deterioration of gait were present in both patients. Neuropsychological deficiency was severe, but progression over the years was not observed except in the woman's speech capacity. Neither of the patients showed clinical improvement. A progressive corticosubcortical atrophy stands out in the brain neuroimaging studies, especially at the vermian cerebellar level. The osseous cranial deformities are very characteristic and include brachycephaly, thickening of the calvaria at the expense of the diploe, and poor pneumatization of the sphenoid. Neither of our cases showed an empty sella turcica.