Neurology International最新文献

{"title":"Successful Long-Term Treatment of Pediatric Relapsing Idiopathic Optic Neuritis with Mycophenolate Mofetil.","authors":"Shuhei Fujino, Keiji Akamine, Eiichiro Noda, Sahoko Miyama","doi":"10.3390/neurolint17030044","DOIUrl":"10.3390/neurolint17030044","url":null,"abstract":"<p><p><b>Background:</b> Pediatric optic neuritis (ON) is a rare but severe condition characterized by acute visual impairment, with 3-5% of relapsing cases lacking identifiable markers for associated conditions, such as neuromyelitis optica spectrum disorder (NMOSD) or multiple sclerosis (MS); these cases are thus classified as relapsing idiopathic optic neuritis (RION). Corticosteroids are typically used for acute management; however, their prolonged use in children poses significant risks, including central obesity, hypertension, and growth impairment, underscoring the need for nonsteroidal, long-term treatment options. Current strategies for preventing recurrence in pediatric RION are limited due to a lack of data on immunosuppressive efficacy and safety. Given its rarity and the challenges of long-term immunosuppression in children, identifying optimal therapeutic approaches remains critical. <b>Case Presentation:</b> We report a case of a six-year-old girl with RION, who was initially treated with intravenous methylprednisolone (IVMP) and prednisolone (PSL) tapering, and who experienced recurrence eight months post-treatment. Additional corticosteroids and intravenous immunoglobulin (IVIg) were administered during relapse, but, due to adverse effects, treatment was transitioned to mycophenolate mofetil (MMF), enabling early PSL tapering. <b>Conclusions:</b> With MMF, the patient maintained stable vision and achieved a five-year recurrence-free period without notable side effects. In conclusion, this case suggests MMF's efficacy as a long-term management option for pediatric RION, potentially reducing corticosteroid-related risks.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730842","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":"Glial Cells in Spinal Muscular Atrophy: Speculations on Non-Cell-Autonomous Mechanisms and Therapeutic Implications.","authors":"Andrej Belančić, Tamara Janković, Elvira Meni Maria Gkrinia, Iva Kristić, Jelena Rajič Bumber, Valentino Rački, Kristina Pilipović, Dinko Vitezić, Jasenka Mršić-Pelčić","doi":"10.3390/neurolint17030041","DOIUrl":"10.3390/neurolint17030041","url":null,"abstract":"<p><p>Spinal muscular atrophy (SMA) is a neuromuscular disorder caused by homozygous deletions or mutations in the <i>SMN1</i> gene, leading to progressive motor neuron degeneration. While SMA has been classically viewed as a motor neuron-autonomous disease, increasing evidence indicates a significant role of glial cells-astrocytes, microglia, oligodendrocytes, and Schwann cells-in the disease pathophysiology. Astrocytic dysfunction contributes to motor neuron vulnerability through impaired calcium homeostasis, disrupted synaptic integrity, and neurotrophic factor deficits. Microglia, through reactive gliosis and complement-mediated synaptic stripping, exacerbate neurodegeneration and neuroinflammation. Oligodendrocytes exhibit impaired differentiation and metabolic support, while Schwann cells display abnormalities in myelination, extracellular matrix composition, and neuromuscular junction maintenance, further compromising motor function. Dysregulation of pathways such as NF-κB, Notch, and JAK/STAT, alongside the upregulation of complement proteins and microRNAs, reinforces the non-cell-autonomous nature of SMA. Despite the advances in SMN-restorative therapies, they do not fully mitigate glial dysfunction. Targeting glial pathology, including modulation of reactive astrogliosis, microglial polarization, and myelination deficits, represents a critical avenue for therapeutic intervention. This review comprehensively examines the multifaceted roles of glial cells in SMA and highlights emerging glia-targeted strategies to enhance treatment efficacy and improve patient outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730829","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 Impact of Age on Outcomes in Seizure Hospitalizations-Analysis of a National Sample.","authors":"Anudeep Surendranath, Saurabh Singhal, Rahul Khanna, Subhendu Rath, Temenuzhka Mihaylova","doi":"10.3390/neurolint17030039","DOIUrl":"10.3390/neurolint17030039","url":null,"abstract":"<p><p><b>Objective:</b> Seizures are a critical public health issue, with incidence rising significantly after age 50. Using this inflection point, we divided patients into two age groups to examine the impact of age on patient characteristics and hospitalization outcomes for seizures. <b>Methods:</b> Using the 2021 National Inpatient Sample (NIS), a nationally representative database, we conducted a retrospective cohort analysis of adult patients aged ≥18 years admitted with a principal diagnosis of seizures. Patients were divided into two age groups: 18-49 and ≥50 years. Outcomes included in-hospital mortality, length of stay, and hospital charges. Multivariate logistic and linear regression models adjusted for confounders were employed to assess the association between age and outcomes. <b>Results:</b> The cohort included 211,055 patients, with 59% aged ≥50 years. Older patients were more likely to have Medicare coverage (66% vs. 16%, <i>p</i> < 0.01), to reside in the south (41% vs. 38%, <i>p</i> < 0.01), and to have a higher proportion of White individuals (62% vs. 54%, <i>p</i> < 0.01). Younger patients were more likely to be Hispanic (15% vs. 9%, <i>p</i> < 0.01), admitted to urban hospitals (96% vs. 94%, <i>p</i> < 0.01), and treated at teaching hospitals (84% vs. 79%, <i>p</i> < 0.01). After adjusting for confounders, older adults had over twice the odds of in-hospital mortality compared with younger patients (adjusted OR 2.17; 95% CI, 1.61-2.92; <i>p</i> < 0.01). They also experienced longer hospital stays (mean difference 0.7 days; 95% CI, 0.54-0.92; <i>p</i> < 0.01) and higher hospital charges (mean increase USD 4322; 95% CI, USD 1914-6731; <i>p</i> < 0.01). <b>Significance:</b> Age is an independent predictor of in-hospital mortality, longer hospitalizations, and higher costs in seizure-related admissions. These findings underscore the need for age-specific management strategies to improve outcomes and optimize healthcare resource utilization for older adults with seizures.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730846","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":"Using Immunoliposomes as Carriers to Enhance the Therapeutic Effectiveness of Macamide N-3-Methoxybenzyl-Linoleamide.","authors":"Karin J Vera-López, María Aranzamendi-Zenteno, Gonzalo Davila-Del-Carpio, Rita Nieto-Montesinos","doi":"10.3390/neurolint17030038","DOIUrl":"10.3390/neurolint17030038","url":null,"abstract":"<p><strong>Background/objectives: </strong>Epilepsy is one of the most common chronic neurological disorders, characterized by alterations in neuronal electrical activity that result in recurrent seizures and involuntary body movements. Anticonvulsants are the primary treatment for this condition, helping patients improve their quality of life. However, the development of new drugs with fewer side effects and greater economic accessibility remains a key focus in nanomedicine. Macamides, secondary metabolites derived from Maca (<i>Lepidium meyenii</i>), represent a promising class of novel drugs with diverse therapeutic applications, particularly in the treatment of neurological disorders.</p><p><strong>Methods: </strong>In this study, we optimized the potential of the macamide N-3-methoxybenzyl-linoleamide (3-MBL) as an anticonvulsant agent through its encapsulation in PEGylated liposomes conjugated with OX26 F(ab')₂ fragments.</p><p><strong>Results: </strong>These immunoliposomes exhibited a size of 120.52 ± 9.46 nm and a zeta potential of -8.57 ± 0.80 mV. Furthermore, in vivo tests using a pilocarpine-induced status epilepticus model revealed that the immunoliposomes provided greater efficacy against epileptic seizures compared to the free form of N-3-methoxybenzyl-linoleamide at the same dose. Notably, the observed anticonvulsant effect was comparable to that of carbamazepine, a traditional FDA-approved antiepileptic drug.</p><p><strong>Conclusions: </strong>This pioneering work employs liposomal nanocarriers to deliver macamides to the brain, aiming to set a new standard for the use of modified liposomes in anticonvulsant epilepsy treatment.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730776","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":"Confusing Onset of MOGAD in the Form of Focal Seizures.","authors":"Małgorzata Jączak-Goździak, Barbara Steinborn","doi":"10.3390/neurolint17030037","DOIUrl":"10.3390/neurolint17030037","url":null,"abstract":"<p><p>MOGAD is a demyelinating syndrome with the presence of antibodies against myelin oligodendrocyte glycoprotein, which is, next to multiple sclerosis and the neuromyelitis optica spectrum, one of the manifestations of the demyelinating process, more common in the pediatric population. MOGAD can take a variety of clinical forms: acute disseminated encephalomyelitis (ADEM), retrobulbar optic neuritis, often binocular (ON), transverse myelitis (TM), or NMOSD-like course (neuromyelitis optica spectrum disorders), less often encephalopathy. The course may be monophasic (40-50%) or polyphasic (50-60%), especially with persistently positive anti-MOG antibodies. Very rarely, the first manifestation of the disease, preceding the typical symptoms of MOGAD by 8 to 48 months, is focal seizures with secondary generalization, without typical demyelinating changes on MRI of the head. The paper presents a case of a 17-year-old patient whose first symptoms of MOGAD were focal epileptic seizures in the form of turning the head to the right with the elevation of the left upper limb and salivation. Seizures occurred after surgical excision of a tumor of the right adrenal gland (ganglioneuroblastoma). Then, despite a normal MRI of the head and the exclusion of onconeural antibodies in the serum and cerebrospinal fluid after intravenous treatment, a paraneoplastic syndrome was suspected. After intravenous steroid treatment and immunoglobulins, eight plasmapheresis treatments, and the initiation of antiepileptic treatment, the seizures disappeared, and no other neurological symptoms occurred for nine months. Only subsequent relapses of the disease with typical radiological and clinical picture (ADEM, MDEM, recurrent ON) allowed for proper diagnosis and treatment of the patient both during relapses and by initiating supportive treatment. The patient's case allows us to analyze the multi-phase, clinically diverse course of MOGAD and, above all, indicates the need to expand the diagnosis of epilepsy towards demyelinating diseases: determination of anti-MOG and anti-AQP4 antibodies.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730789","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":"Current Management of Aneurysmal Subarachnoid Hemorrhage.","authors":"Jay Max Findlay","doi":"10.3390/neurolint17030036","DOIUrl":"10.3390/neurolint17030036","url":null,"abstract":"<p><p>The diagnosis of aneurysmal subarachnoid hemorrhage (aSAH) is most difficult in patients who are in good clinical condition with a small hemorrhage, especially when a ruptured aneurysm might not be considered, or if a computed tomographic (CT) scan is not obtained, or if when a CT is obtained, the findings are subtle and missed by an inexperienced reviewer. All acute onset (thunderclap) headaches should be considered ruptured aneurysms until proven otherwise. Treatment begins with immediate control of pain and blood pressure, placement of an external ventricular drain (EVD) in poor-grade patients and those with acute hydrocephalus on CT scanning, administration of antifibrinolytic tranexamic acid, and then repair of the aneurysm with either surgical clipping or endovascular techniques as soon as the appropriate treatment team can be assembled. After securing the aneurysm, aSAH patient treatment is focused on maintaining euvolemia and a favorable systemic metabolic state for brain repair. A significant and aneurysm-specific threat after aSAH is delayed arterial vasospasm and resulting cerebral ischemia, which is detected by vigilant bedside examinations for new-onset focal deficits or neurological decline, assisted with daily transcranial Doppler examinations and the judicious use of vascular imaging and cerebral perfusion studies with CT. The management of diagnosed symptomatic vasospasm is the prompt induction of hypertension with vasopressors, but if this fails to reverse deficits quickly after reaching a target systolic blood pressure of 200 mmHg, endovascular angioplasty is indicated, providing CT scanning rules out an established cerebral infarction. Balloon angioplasty should be considered early for all patients found to have severe angiographic vasospasm, with or without detectable signs of ischemic neurological deterioration due to either sedation or a pre-existing deficit.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730792","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":"Shifting Outcomes: Superior Functional Recovery in Embolic Stroke of Undetermined Source Compared to Cardioembolic Stroke.","authors":"Jessica Seetge, Balázs Cséke, Zsófia Nozomi Karádi, Edit Bosnyák, László Szapáry","doi":"10.3390/neurolint17030035","DOIUrl":"10.3390/neurolint17030035","url":null,"abstract":"<p><strong>Background/objectives: </strong>An embolic stroke of undetermined source (ESUS) is a subtype of ischemic stroke characterized by a non-lacunar infarct in the absence of a clearly identifiable embolic source, despite comprehensive diagnostic evaluation. While ESUS patients are typically younger, have fewer cardiovascular comorbidities, and experience milder strokes than those with cardioembolic strokes (CEs), their functional recovery remains underexplored.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 374 ischemic stroke patients (<i>n</i> = 94 ESUS, <i>n</i> = 280 CE) admitted to the Department of Neurology, University of Pécs, between February 2023 and September 2024. Functional recovery was assessed using the modified Rankin Scale (mRS). Propensity score matching (PSM) was performed to balance the baseline characteristics, and the mRS-shift was compared between groups. Independent predictors of mRS-shift were identified using Huber regression and extreme gradient boosting (XGBoost).</p><p><strong>Results: </strong>The ESUS patients were significantly younger (60.7 ± 13.8 years vs. 75.1 ± 11.3 years, <i>p</i> < 0.001), had lower pre-morbid modified Rankin Scale (pre-mRS) scores (0.34 ± 0.91 vs. 0.81 ± 1.23, <i>p</i> < 0.001), were less likely to have hypertension (75.5% vs. 86.1%, <i>p</i> = 0.027) and diabetes (23.4% vs. 36.8%, <i>p</i> = 0.024), and presented with milder strokes (National Institutes of Health Stroke Scale [NIHSS] score at admission: 5.4 ± 4.5 vs. 8.1 ± 6.3, <i>p</i> < 0.001, and 72 h post-stroke: 3.0 ± 4.4 vs. 6.5 ± 6.3, <i>p</i> < 0.001) compared to the CE patients. After adjusting for baseline differences, the ESUS patients demonstrated significantly greater functional recovery than the CE patients (adjusted mRS-shift: 1.84 ± 1.14 vs. 2.53 ± 1.69, <i>p</i> = 0.022). Age, pre-mRS score, and NIHSS score at 72 h post-stroke were the strongest predictors of mRS-shift, with an older age, a higher pre-mRS score, and a greater stroke severity significantly decreasing the odds of recovery.</p><p><strong>Conclusions: </strong>The ESUS patients showed superior functional recovery compared to the CE patients, even after accounting for baseline differences. These findings highlight the need for further research into the pathomechanisms underlying ESUSs and the development of optimal treatment strategies to improve patient outcomes.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730838","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":"Evidence-Based Approach to Cerebral Vasospasm and Delayed Cerebral Ischemia: Milrinone as a Therapeutic Option-A Narrative Literature Review and Algorithm Treatment Proposition.","authors":"Pedro Batarda Sena, Marta Gonçalves, Bruno Maia, Margarida Fernandes, Luís Bento","doi":"10.3390/neurolint17030032","DOIUrl":"10.3390/neurolint17030032","url":null,"abstract":"<p><p>Aneurysmal subarachnoid hemorrhage (aSAH) is a severe neurocritical condition often complicated by cerebral vasospasm (CVS), leading to delayed cerebral ischemia (DCI) and significant morbidity and mortality. Despite advancements in management, therapeutic options with robust evidence remain limited. Milrinone, a phosphodiesterase type 3 (PDE3) inhibitor, has emerged as a potential therapeutic option. Intravenous milrinone demonstrated clinical and angiographic improvement in 67% of patients, reducing the need for mechanical angioplasty and the risk of functional disability at 6 months (mRS ≤ 2). Side effects, including hypotension, tachycardia, and electrolyte disturbances, were observed in 33% of patients, occasionally leading to early drug discontinuation. Based on the evidence, we propose a treatment algorithm for using milrinone to optimize outcomes and standardize its application in neurocritical care settings.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730821","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":"Novel Metabolites as Potential Indicators of Recovery After Large Vessel Occlusion Stroke: A Pilot Study.","authors":"Evgeny V Sidorov, Kyle Smith, Chao Xu, Dharambir K Sanghera","doi":"10.3390/neurolint17020030","DOIUrl":"10.3390/neurolint17020030","url":null,"abstract":"<p><p><b>Introduction:</b> Serum metabolome changes after acute ischemic stroke (AIS), but the significance of this is poorly understood. We evaluated whether this change is associated with AIS outcomes in patients with large vessel occlusion (LVO). To improve validity, we combined cross-sectional and longitudinal designs and analyzed serum using Nuclear Magnetic Resonance (NMR) and Liquid Chromatography-Mass Spectrometry (LC-MS). <b>Methodology:</b> In the cross-sectional part, we compared serum metabolome from 48 LVO strokes, collected at 48-72 h, and analyzed with NMR, while in the longitudinal part, we compared metabolome from 15 LVO strokes, collected at <24 h, 48-72 h, 5-7 days, and 80-120 days, and analyzed with LC-MS between patients with modified Rankin Scores (mRS) of 0-3 and 4-6 at 90 days. We hypothesized that compounds elevated in patients with mRS 0-3 in the cross-sectional part would also be elevated in the longitudinal part, and vice versa. We used regression for the analysis and TSBH for multiple testing. <b>Results:</b> In the cross-sectional part, cholesterol, choline, phosphoglycerides, sphingomyelins, and phosphatidylethanolamines had lower levels in patients with an mRS of 0-3 compared to an mRS of 4-6. In the longitudinal part, lower levels of sphingomyelin (d18:1/19:0, d19:1/18:0)* significantly correlated with an mRS of 0-3 in patients with small infarction volume, while lower levels of sphingolipid N-palmitoyl-sphingosine (d18:1/16:0), 1-palmitoyl-2-docosahexaenoyl-GPC (16:0/22:6), 1-palmitoyl-2-docosahexaenoyl-GPE, palmitoyl-docosahexaenoyl-glycerol (16:0/22:6), campesterol, and 3beta-hydroxy-5-cholestenoate correlated with an mRS of 0-3 in patients with large infarction volume. <b>Conclusions:</b> This pilot study showed that lower levels of lipidomic components nerve cell membrane correlate with good AIS outcomes. If proven on large-scale studies, these compounds may become important AIS outcome markers.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493033","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":"Etiology and Mortality of Nonconvulsive Status Epilepticus.","authors":"Firdevs Ezgi Uçan Tokuç, Emine Görgülü, Fatma Genç, Meltem Korucuk, Abidin Erdal, Yasemin Biçer Gömceli","doi":"10.3390/neurolint17020029","DOIUrl":"10.3390/neurolint17020029","url":null,"abstract":"<p><strong>Objectives: </strong>Nonconvulsive status epilepticus (NCSE) is a disease with a high mortality rate and a very diverse etiology. The disease prognosis is related to the etiology. We aimed to investigate the etiology, mortality rates, and factors affecting mortality in patients diagnosed with NCSE in a tertiary epilepsy center in Turkey.</p><p><strong>Methods: </strong>All electroencephalograms (EEGs) were taken in the EEG laboratory of the Department of Neurology, Antalya Training and Research Hospital, between June 2021 and February 2024. Patients who met the Salzburg Consensus Criteria (SCC) for NCSE were included. Demographic data, etiologic factors, comorbidities, neuroradiological imaging, laboratory data, treatments administered for NCSE and responses to treatment, short- and long-term outcomes, and EEG findings at follow-up, if any, were noted from the medical records of all patients who met the criteria.</p><p><strong>Results: </strong>A total of 200 patients were included in the study. Mortality was observed in 76 (38.4%) patients with NCSE. There was a statistically significant correlation between NCSE etiology and mortality (<i>p</i> < 0.001). Mortality was most common in patients with cerebral tumors as the etiology, with a rate of 63.6%. The lowest mortality rate was observed in patients with autoimmune encephalitis and epilepsy (14.3% and 17.2%, respectively). After appropriate antiseizure medication (ASM) treatment, 117 (58.5%) patients with NCSE improved. When post-treatment improvement and etiologic factors were analyzed, the highest rate of improvement was observed in the autoimmune encephalitis and CVD groups.</p><p><strong>Conclusions: </strong>Our study showed that advanced age and the presence of stroke are associated with mortality and that patients with NCSE due to autoimmune encephalitis respond well to treatment.</p>","PeriodicalId":19130,"journal":{"name":"Neurology International","volume":"17 2","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493029","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}