Neurology International最新文献

{"title":"Atypical Teratoid/Rhabdoid Tumor of the Lateral Ventricle: A Case Series and Experience with Molecular Subtyping-Guided Immunotherapy.","authors":"Haohan Wang, Zesheng Ying, Zhuo Zhi, Nijia Zhang, Jia Wang, Nan Zhang, Yingjie Cai, Ming Ge","doi":"10.3390/neurolint18040074","DOIUrl":"https://doi.org/10.3390/neurolint18040074","url":null,"abstract":"<p><strong>Background: </strong>Atypical teratoid/rhabdoid tumors (AT/RT) are rare, highly aggressive pediatric central nervous system (CNS) malignancies. AT/RT of the lateral ventricle is an exceptionally rare subgroup, with only 11 reported cases. <i>SMARCB1</i> inactivation is the primary molecular feature of AT/RT. Current consensus is to classify AT/RT based on methylation and molecular profiles into the following subgroups: AT/RT-<i>TYR</i>, AT/RT-<i>SHH</i>, AT/RT-<i>MYC</i>, and a potentially distinct <i>SMARCA4</i>-deficient subtype. AT/RT-<i>MYC</i> exhibits high levels of CD8⁺ tumor-infiltrating lymphocytes, indicating immunogenic potential.</p><p><strong>Case presentation: </strong>We report three pediatric cases presenting with intracranial hypertension and seizures. Diagnosis was confirmed via histopathology and molecular profiling. Interventions included gross total resection, chemotherapy, radiotherapy, and combined immune checkpoint inhibitors (pembrolizumab and ipilimumab). Outcomes varied from rapid progression to 3-year recurrence-free survival. A cohort of 14 pediatric patients with lateral ventricle AT/RT, comprising 3 institutional cases and 11 cases identified from the PubMed database, was evaluated through a narrative synthesis.</p><p><strong>Conclusions: </strong>These advancements highlight the crucial role of molecular subtyping in tailoring personalized treatments, including epigenetic modifiers and immune-based regimens. However, clinical validation is essential to establish standardized protocols. Integrating genomic, epigenetic, and immune microenvironment profiling may enhance risk assessment and treatment precision, ultimately improving survival and quality of life in pediatric patients.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-Induced Coagulopathy in Rat Models: Assessing Hemostatic Changes in Mild and Severe Traumatic Brain Injuries.","authors":"Refat Aboghazleh, Shrouq Al-Sabaileh, Mustafa Nadi, Walid Aburayyan, Mohammad Saadaldin, Ahiam Awadat, Mohammad Badawi, Mimas Al-Helalat, Afnan Atiyat, Manal Udwan, Abdel Latif Al-Houwari, Abdulraheem Alhourani, Abdalraman Al-Eyadah, Radwan Sabayleh, Nesrin Seder","doi":"10.3390/neurolint18040073","DOIUrl":"https://doi.org/10.3390/neurolint18040073","url":null,"abstract":"<p><p><b><i>Background</i></b><i>:</i> Traumatic brain injury (TBI) has been associated with coagulation disorders, and coagulation and fibrinolytic parameters are frequently monitored in the acute stage of TBI. <b><i>Methods</i></b><i>:</i> Using a rat closed head injury model, mild and severe TBIs were induced. Blood samples were obtained at five post-injury time points, including 1 day and 1, 2, 3, and 4 weeks, to assess coagulation and fibrinolytic parameters, specifically prothrombin time (PT), partial thromboplastin time (PTT), D-dimer, and fibrinogen. <b><i>Results</i></b><i>:</i> In mild TBI, all hemostatic parameters remained largely within physiological ranges, despite minor statistical fluctuations in PT and PTT. Conversely, severe TBI resulted in significant elevations of PT (<i>p</i> = 0.00015) and PTT (<i>p</i> = 0.01) during the first week. Additionally, D-dimer levels increased significantly at week 2 (<i>p</i> = 0.024) and week 4 (<i>p</i> = 0.014) post-injury, surpassing the upper limit of normal. Although fibrinogen levels showed a significant increase at week 2 compared to the control group (<i>p</i> = 0.011), they remained within the normal reference range. <b><i>Conclusions</i></b><i>:</i> While mild TBI is characterized by stable hemostatic markers, severe TBI demonstrates a clear and significant progression from acute coagulation activation to secondary fibrinolysis. These findings suggest that severe TBI-induced coagulopathy is a progressive event requiring extended longitudinal monitoring beyond the initial acute phase.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Follow-Up of a Patient with a Novel Homozygous <i>ASTN1</i> Variant: A Case Report.","authors":"Buşra Kasap, Dilek Uludağ Alkaya, Nilay Güneş, Salih Türk, Barış Korkmaz, Beyhan Tüysüz","doi":"10.3390/neurolint18040072","DOIUrl":"https://doi.org/10.3390/neurolint18040072","url":null,"abstract":"<p><strong>Background/objectives: </strong>Severe neurodevelopmental disorders caused by homozygous <i>ASTN1</i> variants have recently been reported. The aim of this study is to present the expanded phenotype and prognostic findings through a longitudinal follow-up of a patient with a homozygous <i>ASTN1</i> variant.</p><p><strong>Methods: </strong>We conducted a 15-year clinical evaluation of a girl who initially presented at 10 years of age. The genetic etiology was investigated using exome sequencing.</p><p><strong>Results: </strong>The patient had a profound intellectual disability, severe expressive language delay, and infantile-onset epilepsy. She also had microcephaly, achieved independent walking at age 7 and had speech limited to only two words at admission. A novel homozygous frameshift variant, c.2096del (p.Cys699Serfs*22), in <i>ASTN1</i> was identified. Over the follow-up period, her postnatal microcephaly became more pronounced, and she experienced a late relapse into generalized tonic-clonic seizures after a decade-long remission. She remains entirely dependent on caregivers for basic self-care at age 25.</p><p><strong>Conclusions: </strong><i>ASTN1</i>-related phenotype is associated with a severe neurodevelopmental disease, and the late relapse of seizures after prolonged remission highlights the need for lifelong neurological monitoring and multidisciplinary care.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Aquatic Therapy on Balance and Gait in Chronic Stroke: A Systematic Review with Exploratory Meta-Analysis.","authors":"Daniela Ivaldi, Gabriele Triolo, Roberta Lombardo, Carla Susinna, Giovanni Restuccia, Angelo Quartarone, Viviana Lo Buono","doi":"10.3390/neurolint18040071","DOIUrl":"https://doi.org/10.3390/neurolint18040071","url":null,"abstract":"<p><p><b>Background</b>: Aquatic therapy is increasingly used in post-stroke rehabilitation, but its effects on balance and gait in the chronic phase remain variably reported. This systematic review aimed to evaluate the effects of aquatic therapy, alone or combined with land-based rehabilitation, on balance and gait in individuals with chronic stroke. <b>Methods</b>: A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted between February and March 2026. Randomized controlled trials enrolling adults with chronic stroke and evaluating aquatic-containing interventions with quantitative balance and/or gait outcomes were included. Owing to clinical and methodological heterogeneity, the primary synthesis was narrative. An exploratory random-effects meta-analysis was additionally performed for post-intervention Berg Balance Scale (BBS) scores. <b>Results</b>: Thirteen randomized controlled trials involving 468 participants were included. Overall, aquatic therapy was associated with more consistent improvements in balance than in gait, while combined aquatic and land-based programs generally showed broader functional gains than land-based rehabilitation alone. In the exploratory meta-analysis, the primary pooled analysis of four studies favored aquatic-containing interventions for post-intervention BBS scores (MD = 3.69, 95% CI 2.69 to 4.69; <i>p</i> < 0.001), with no observed heterogeneity (I² = 0%). <b>Conclusions</b>: Aquatic therapy may be a useful adjunctive rehabilitation strategy for improving balance in chronic stroke, whereas effects on gait appear more variable. These findings should be interpreted cautiously because the quantitative synthesis was exploratory and the overall evidence base remains heterogeneous and limited by small sample sizes and short follow-up.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive Therapeutic Exercise Integrated with Focal Mechanical Vibrations in a CANVAS Patient: A Case Report.","authors":"Filippo Camerota, Filippo Mario Topa, Giuseppe Di Pietro, Federico Zangrando, Lorenzo Coluccia, Massimiliano Mangone, Marco Paoloni, Andrea Truini, Claudia Celletti","doi":"10.3390/neurolint18040070","DOIUrl":"https://doi.org/10.3390/neurolint18040070","url":null,"abstract":"<p><p>Cerebellar Ataxia, Neuropathy and Bilateral Vestibular Areflexia Syndrome (CANVAS) is a progressive multisystem disorder characterized by cerebellar ataxia, sensory neuropathy and bilateral vestibular failure. Although intensive rehabilitation is commonly recommended, the actual effectiveness and the most appropriate physiotherapeutic strategy for CANVAS have not been clearly established.</p><p><strong>Background/objectives: </strong>To evaluate the effects of an integrated rehabilitation program combining neurocognitive therapeutic exercise and focal muscle vibration (FMV) on clinical and instrumental measures of gait, balance and postural stability in a CANVAS patient.</p><p><strong>Methods: </strong>A structured protocol consisting of neurocognitive therapeutic exercise and FMV was administered. Clinical measures included the Berg Balance Scale, Tinetti, SARA and SF-36. The instrumental evaluations included stabilometry and gait analysis.</p><p><strong>Results: </strong>The intervention produced improvements in balance scores associated with a reduction in fall risk. Stabilometry revealed reduction in oscillation area.</p><p><strong>Conclusions: </strong>FMV combined with neurocognitive therapeutic exercise may promote clinical and biomechanical improvements in CANVAS.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobiology of Anxiety and Depression in CP/CPPS: A Narrative Review of Underlying Mechanisms.","authors":"Neriman Ezgin, Nikola Šutulović, Emilija Djurić, Slaviša Milošević, Milena Vesković, Dušan Mladenović, Aleksandra Rašić-Marković, Olivera Stanojlović, Dragan Hrnčić","doi":"10.3390/neurolint18040069","DOIUrl":"https://doi.org/10.3390/neurolint18040069","url":null,"abstract":"<p><p>Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent urological disorder characterized by persistent pelvic pain, urinary symptoms, and significant impact on quality of life. In addition to its clinical symptoms, CP/CPPS is frequently associated with psychiatric comorbidities, such as anxiety and depression, indicating complex neurobiological mechanisms. This review explores the mechanisms linking CP/CPPS with affective disorders, emphasizing central nervous system alterations, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and neuroimmune interactions. Evidence in-dicates that central sensitization, microglial and astrocytic activation, and elevated proinflammatory cytokines (IL-1β, IL-6, TNF-α) contribute to maladaptive painemotion network interactions. Additionally, dysregulation of hormones and neurotransmitters may exacerbate both pain perception and mood disorders. Psychosocial factors, including stress, coping strategies, and cognitive-emotional processes, further modulate symptom severity and treatment outcomes, highlighting the importance of a biopsychosocial approach. Gaining a deeper understanding of the neurobiological and psychosocial mechanisms behind anxiety and depression in CP/CPPS can lead to more effective, multidimensional management strategies and enhance patient-centered care.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Patterns of Fever Onset as an Indicator of Etiology in Intracerebral Hemorrhage.","authors":"Felix Hess, Enayatullah Baki, Julian McGinnis, Tun Wiltgen, Hannah Scholz, Kathleen Bernkopf, Gerhard Schneider, Jan Kirschke, Dominik Sepp, Bernhard Hemmer, Silke Wunderlich, Mark Mühlau","doi":"10.3390/neurolint18040068","DOIUrl":"https://doi.org/10.3390/neurolint18040068","url":null,"abstract":"<p><strong>Background: </strong>Fever occurs frequently in patients with intracerebral hemorrhage (ICH) and is associated with worse functional outcomes. Rapid identification of the fever's cause is crucial for guiding diagnostics and treatment. Data on the distribution of different fever causes in ICH are limited, and the diagnostic value of the day of fever onset remains uncertain. This study aimed to assess the distribution of fever causes in a large cohort of ICH patients and to evaluate whether temporal patterns of fever onset are associated with its underlying cause in a clinically meaningful manner.</p><p><strong>Methods: </strong>This retrospective single-center study included 547 patients with spontaneous ICH. Fever was defined as a body temperature exceeding 38.3 °C for at least two consecutive days. Fever causes were evaluated by two blinded investigators and categorized as infectious, central, or other causes. Infectious fever causes were further specified.</p><p><strong>Results: </strong>Fever occurred in 213 patients (39%) and was associated with longer hospital and ICU stays (both <i>p</i> < 0.01) and poor functional outcome (odds ratio 2.0, 95% CI 1.1-3.6). The three most frequent fever etiologies (>90% of cases) were pneumonia, central fever, and catheter-associated infections (i.e., urethral tract infections, ventriculitis, and central line-associated bloodstream infections). Median onset day differed across etiologies (overall <i>p</i> < 0.001): central fever developed earliest (2 [IQR 1-3] days), followed by pneumonia (5 [IQR 4-7] days) and catheter-associated infections (8 [IQR 5-12] days).</p><p><strong>Conclusions: </strong>In ICH, the day of fever onset may provide a useful clue to its etiology and could support clinical decision-making, but prospective validation is needed.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Efficacy and Safety of Anti-CGRP Monoclonal Antibodies Versus Topiramate for Migraine Prophylaxis: Six-Month, Real-World, Intention-to-Treat Retrospective Evidence from the GRASP Study Group.","authors":"Michail Vikelis, Dimitrios Rikos, Andreas A Argyriou, Panagiotis Soldatos, Christos Tsironis, Emmanouil Giakoumakis, Georgia Xiromerisiou, Maria Chondrogianni, Aikaterini Foska, Maria Koutsokera, Konstantinos Notas, Eleni Mavraki, Emmanouil V Dermitzakis","doi":"10.3390/neurolint18040067","DOIUrl":"https://doi.org/10.3390/neurolint18040067","url":null,"abstract":"<p><p><b>Objective</b>: This retrospective, intention-to-treat real-world study, designed by the Greek Research Alliance for the Study of headache and Pain (GRASP) sought to compare the effectiveness and safety of anti-CGRP monoclonal antibodies (anti-CGRP Mabs) to topiramate in preventing migraine. <b>Patients and methods</b>: Patients received either fremanezumab, erenumab, galcanezumab, eptinezumab, or topiramate for at least six months. Outcomes included reductions in monthly headache days (MHDs), ≥50% and ≥75% responder rates, monthly acute medication intake (MAI), MHDs with peak headache intensity ≥5 on VAS, migraine-related disability (MIDAS, HIT-6), quality of life (EQ-VAS), discontinuation rates and safety. <b>Results</b>: We included 409 migraine patients (median age 45.2 years), predominantly female (80%) and mostly with long-standing disease and high baseline burden. After six months, all treatments reduced MHDs. Mean MHDs decreased by -7.8 days with anti-CGRP Mabs versus -3.8 days with topiramate (<i>p</i> < 0.001). Higher ≥50% and ≥75% responder rates were observed across all anti-CGRP agents, compared to topiramate. Anti-CGRP Mabs also achieved greater reductions in moderate/severe MHDs, MAI, disability metrics, and superior QOL gains. Among the CGRP-targeted therapies, slight differences in effectiveness outcomes were present, though failing to demonstrate any specific superiority. Safety was favorable for anti-CGRP Mabs, whereas topiramate showed substantially higher adverse events and discontinuations. <b>Conclusions</b>: Anti-CGRP Mabs were more effective, produced greater reductions in disability and higher improvements quality-of-life metrics and were better tolerated than topiramate. Differences among individual anti-CGRP agents were modest and unlikely to represent a clinically meaningful superiority, supporting a class-wide benefit vs. topiramate in migraine prevention both in terms of effectiveness and safety.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Added Value of Endoscopic Micro-Inspection in Microvascular Decompression for Trigeminal Neuralgia and Hemifacial Spasm: Literature Review and Single-Center Experience.","authors":"Alexandra Mihaela Pătrășcan, Felix Mircea Brehar, Radu Mircea Gorgan, Viorel Mihai Prună","doi":"10.3390/neurolint18040066","DOIUrl":"https://doi.org/10.3390/neurolint18040066","url":null,"abstract":"<p><p><b>Background:</b> In the last few decades, microvascular decompression has been proven to be one of the best therapeutic options in the management of neurovascular compression syndromes, especially trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia. However, higher rates of recurrences and morbidities have been recorded postoperatively. In the thorough search for better solutions, the option of adjuvant QEVO^® endoscopy has arisen as a very promising alternative. <b>Methods:</b> In this study, a retrospective single-center observational analysis was conducted, comprising patients who underwent microvascular decompression for trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia at our institution, between January 2020 and November 2025. Demographical data and outcomes of therapeutic management were statistically analyzed and presented accordingly. <b>Results:</b> A total of 40 patients diagnosed with neurovascular compression syndromes were neurosurgically treated in our center, and the most common diagnosis was represented by trigeminal neuralgia, identified in 32 patients (80%). Another five (12.5%) patients underwent microvascular decompression for hemifacial spasm, two (5%) patients were treated for combined trigeminal neuralgia and hemifacial spasm, and one patient (2.5%) for glossopharyngeal neuralgia. Arterial conflict was the triggering factor in the majority of cases, and no postoperative mortality was recorded. In patients treated using adjuvant QEVO endoscopy, the identification of hidden conflicts may be facilitated. Furthermore, the use of the QEVO endoscope allowed the identification of additional neurovascular conflicts and influenced intraoperative management in a subset of patients. <b>Conclusions:</b> Notwithstanding the medical literature suggesting that the main influential factor for therapeutic success is the vessel type and the pattern of compression, many authors identified the cornerstone of favorable outcomes as being endoscopic assistance. Nevertheless, this adjuvant factor has had a positive impact on the majority of patients.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13119251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure and Status Epilepticus in Human Organophosphate Poisoning: A Narrative Review.","authors":"Giuseppe Magro, Oreste Marsico, Federico Tosto, Concetta Lobianco, Laura Rapisarda, Giovanni Mastroianni, Angelo Pascarella","doi":"10.3390/neurolint18040065","DOIUrl":"https://doi.org/10.3390/neurolint18040065","url":null,"abstract":"<p><p>Organophosphate (OP) exposure can trigger seizures within minutes and can rapidly evolve into status epilepticus (SE). Early seizure generation is plausibly driven by acetylcholinesterase inhibition, leading to central cholinergic overstimulation. With increasing seizure duration, experimental data are consistent with a time-dependent shift toward glutamatergic maintenance (NMDA/AMPA), oxidative stress, neuroinflammation, and progressive failure of GABAergic inhibition. This framework predicts a narrow window in which benzodiazepine (BDZ) monotherapy is most effective and a rising probability of BDZ non-response when seizures are prolonged, while anti-glutamatergic strategies may retain relative efficacy later in the course. This narrative review integrates clinical phenomenology, diagnostic limitations, and mechanistic evidence to propose an operational approach for OP-related seizures and SE in emergency settings. We discuss a pragmatic \"Stage 1 Plus\" framing for patients presenting after prolonged seizures or in non-convulsive SE with coma. Human evidence remains limited and heterogeneous, and inference is constrained by confounding due to delayed recognition, variable decontamination/resuscitation pathways, sparse EEG confirmation, and selection bias in mass-casualty reporting.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"18 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13118794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}