We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
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The Neurology Teaching Unit at Vall d’Hebron University Hospital is provided by the Neurology Department with participation from Internal Medicine, Cardiology, Psychiatry, Neurosurgery, Neurophysiology, Neuroradiology, Paediatrics, and A&E.
Neurology training itinerary
Healthcare activity in neurology combines writing medical histories, diagnostic data collection, correct use of complementary exploratory procedures, and accurate clinical and aetiologic diagnosis, as well as choosing appropriate palliative treatments. We also emphasise the role of the relationship between resident doctors and patients in the basic areas of Neurology.
A large number of medical conditions and neurological illnesses can result in critical emergency situations, such as strokes and lupus. With this in mind, from the second year the duty shifts in neurological emergencies become a key aspect of residents’ work, and are always carried out under supervision. Neurologists are also required to carry out a rotation in neurological outpatient care.
Research studies are part of the practical work that neurologists must deepen and develop, with particular emphasis on ethical competence when carrying out research.
Neuroscience research should be done under supervision of a tutor , and requires solid training in scientific methodology as well as in bioethics and scientific communication.
Training itinerary in Psychiatry and Clinical Psychology
It is a chronic brain disorder that can affect people of any age. It is characterised by recurring convulsions caused by excessive electrical impulses in groups of brain cells.
The consequences can be neurological, cognitive, psychological and social.
In 2005, epilepsy was defined as “a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures”. Epilepsy is therefore diagnosed when patients experience two or more seizures, separated by a period of time that can last from 24 hours to 10 years.
Epilepsy causes brief absence seizures, involuntary movements, repetitive reflexes such as sucking movements, loss of consciousness, and so on. It can originate in one area of the brain (focal seizure) or the brain as a whole (generalized seizure). Seizures are sometimes accompanied by loss of consciousness and/or loss of bowel control. Their frequency can vary from only just one over a ten year period to several per day.
Seizures (absence seizures, muscle contractions, etc.) are the main symptom and may vary depending where in the brain the epileptic seizure begins.
For example, in tonic-clonic seizures (GTCS), it is common to observe twitching, muscle contractions, jerking, etc. These movements are called “myoclonus” and may be symmetric or asymmetric and are accompanied by rolling of the eyes. They are followed by a spasm with clenching of the teeth, laboured breathing and an epileptic shout.
Epilepsy affects the entire population, regardless of age, from whilst still in the womb right up to people in their nineties. It is estimated that 8 in 1000 people have the condition.
Related factors:
In some cases the cause of epilepsy may be unknown, as although we can see an epileptic seizure occurring in the brain, current technologies do not reveal what causes them. Epilepsy may also be genetic.
It is the second most common neurological disorder (after stroke) seen in accident and emergency departments. An estimated 3,000 patients are seen in our centre every year. 3% of the population will attend a medical centre at some point during their lifetime to determine whether their symptoms are caused by epilepsy.
Diagnosis requires:
It is advisable to avoid all situations that may create:
When faced with a seizure, a series of recommendations should be followed to avoid injury to the person having the seizure.
Asperger’s syndrome is a neurodevelopmental disorder that falls within the spectrum of autism disorders. It is typified by social awkwardness, limiting interests and ongoing behaviours.
These symptoms make it difficult for patients to have a normal social life and they also affect family life.
Children and teenagers with this disorder show the following symptoms:
People with this disorder may appear normal and have a normal level of intelligence but find it hard to relate to others and communicate.
It is a very common disorder (3-7 of every 1000 births). There are currently more recorded cases in boys than in girls, but this data is likely due to it not being recognised and diagnosed in girls as often.
Structured reliable clinical interviews help to define clinical symptoms at different ages. It is not currently possible to diagnose Asperger’s at birth as the necessary biological markers do not exist yet.
A differential diagnosis is very important to rule out other neurodevelopmental disorders such as foetal alcohol syndrome, and those with a genetic cause such as ADHD.
A mental health professional will prepare treatment, which should focus on teaching the patient social skills and competencies (for example, reading social situations, adjusting the tone of voice according to context, taking turns in conversation, etc.) They can also help patients organise their time and avoid periods of inactivity or excessive time spent on their limiting interests. A stable and planned environment with no abrupt change is essential for the patient's well-being.
It is not currently possible to prevent Asperger’s syndrome as it is probably of genetic origin, which implies multiple genes interacting with the environment.
Psychiatrics, General Hospital
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