Neurologia i neurochirurgia polska最新文献

{"title":"Update on diagnosis and treatment of neuromyelitis optica spectrum disorders (NMOSD) - recommendations of Section of Multiple Sclerosis and Neuroimmunology of Polish Neurological Society.","authors":"Beata Zakrzewska-Pniewska, Halina Bartosik-Psujek, Waldemar Brola, Marek Gołębiowski, Alicja Kalinowska, Alina Kułakowska, Dagmara Mirowska-Guzel, Monika Nojszewska, Aleksandra Podlecka-Piętowska, Mariusz Stasiołek, Sławomir Wawrzyniak, Monika Adamczyk-Sowa","doi":"10.5603/pjnns.100945","DOIUrl":"10.5603/pjnns.100945","url":null,"abstract":"<p><strong>Introduction: </strong>An expert panel of the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society has developed principles for the management of neuromyelitis optica spectrum disorders (NMOSD). These principles are based on expert opinion and data from the literature published up to May 2023. Recommendations were developed based on the results of the most recent clinical trials, guidelines of foreign and international scientific societies, and the authors' clinical experience.</p><p><strong>Clinical implications: </strong>The principles for diagnosing NMOSD are discussed, with particular emphasis on serological and neuroimaging diagnosis. Recommendations for the treatment of relapses and chronic immunosuppressive treatment, including the most recent methods of immunotherapy, are also presented. Additionally, the principles of monitoring treatment efficacy and safety are included. Therapy regimens are completed with recommendations for symptomatic treatment. The paper also includes an algorithm for vaccination in patients with NMOSD. Therapeutic management in pregnant women with NMOSD is discussed.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"6-19"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is remission in women with idiopathic generalized epilepsy possible without valproate?","authors":"Kamil Wężyk, Agnieszka Słowik, Magdalena Bosak","doi":"10.5603/pjnns.103380","DOIUrl":"10.5603/pjnns.103380","url":null,"abstract":"<p><strong>Aim of study: </strong>This study aimed to evaluate changes in prescription practices for treating idiopathic generalized epilepsy (IGE) in women of childbearing age, and to assess how switching from valproate (VPA) affects seizure outcomes. IGE accounts for 15-20% of all epilepsy cases. While VPA is the most effective treatment, its teratogenic risk limits its use in women of reproductive age, leading to recommendations for safer alternatives such as lamotrigine (LTG) and levetiracetam (LEV).</p><p><strong>Material and methods: </strong>We retrospectively analysed the data from 130 women aged 18-49 diagnosed with IGE from 2000 to 2022.</p><p><strong>Results: </strong>Of the 107 who used VPA, 44 remained on it until the last follow-up. 74% of participants achieved seizure freedom at some point, and 62% remained seizure-free at the last follow-up. The attempt to switch from VPA to other medications was unsuccessful in 23 (21.5% out of 107) patients due to adverse effects or loss of seizure control. Seizure freedom rates after 12 months were similar between VPA and alternative ASMs like LEV and LTG.</p><p><strong>Conclusions and clinical implications: </strong>Our study indicates that LEV and LTG are effective alternatives to VPA for many women with IGE. However, some patients still require VPA for optimal seizure control. Further large-scale, randomised studies are needed to confirm these findings.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"240-244"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helping the patients find their voice.","authors":"Małgorzata Dec-Ćwiek, Anna Julia Krupa, Marcin Siwek","doi":"10.5603/pjnns.102092","DOIUrl":"10.5603/pjnns.102092","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"79-81"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncommon localised form of axonal injury involving pontes grisei caudatolenticulares.","authors":"Francisca Sena Batista, Filipa Castelão, Carlos Casimiro, Lígia Neves, Denil Champac Tribovane","doi":"10.5603/pjnns.102233","DOIUrl":"10.5603/pjnns.102233","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"82-83"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation analysis of Polish version of Neuropathic Pain Questionnaire - Short Form (NPQ-SF-PL) and assessment of quality of life in patients with chronic neuropathic pain.","authors":"Anna K Szewczyk, Anna Jamroz-Wiśniewska, Konrad Rejdak","doi":"10.5603/pjnns.101185","DOIUrl":"10.5603/pjnns.101185","url":null,"abstract":"<p><strong>Aim of the study: </strong>The aims of this study were to translate and culturally adapt the Polish version (PL) of the Neuropathic Pain Questionnaire-Short Form (NPQ-SF), as well as to compare this questionnaire to other diagnostic tools in terms of reliability and psychometric validity.</p><p><strong>Clinical rationale for the study: </strong>Neuropathic pain (NP) affects up to 10% of the general population. Despite a large number of studies, almost 50% of patients have a poor therapeutic outcome. Diagnostic tools are intended to distinguish between NP and non-NP (NoP) and to guide the examiner to perform further diagnostics in accordance with the guidelines.</p><p><strong>Material and methods: </strong>A total of 140 patients with chronic pain (ChP), 90 with NP and 50 with NoP, were enrolled into this study. NPQ-SF-PL has been developed following the guidelines for translation and cultural adaptation. Reliability of the translated version was examined using internal consistency, predictive validity, and intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>In the study, women predominated over men, and the average age was 53.22. Cronbach's α value for the entire scale was 0.76 and ICC for test-retest reliability was 0.631. Receiver-operating characteristic curve analysis gave a sensitivity of 90.0% and a specificity of 88.0%. Area under the curve was 0.94. NPQ-SF-PL was moderately associated with self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and weakly associated with the Numerical Rating Scale (NRS). The NP group obtained statistically significantly lower scores than the NoP group in all domains of the 36-Item Short Form Health Survey (SF-36), thus indicating worse health status. Patients aged over 41 years presented a worse quality of life compared to younger ones. Also, more than half of the patients with NP of both genders experienced symptoms of mild or more severe depression.</p><p><strong>Conclusions: </strong>NPQ-SF-PL is a valid screening tool for assessing NP in Polish chronic pain patients. The obtained results showed very good psychometric properties and adequate internal consistency. The repeatability of the questionnaire indicated moderate reliability. Clinical implications/future directions. We believe this study will provide physicians with a new instrument for the evaluation of NP for clinical and research purposes.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"33-40"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of optic nerve with ultrasound elastography in patients with idiopathic intracranial hypertension: a case-control study.","authors":"Mehmet Demir, Dilek Ağırcan","doi":"10.5603/pjnns.102039","DOIUrl":"10.5603/pjnns.102039","url":null,"abstract":"<p><strong>Aim of study: </strong>Idiopathic intracranial hypertension (IIH) is a neurological condition characterised by increased intracranial pressure without a known cause, usually seen in young obese women. Optic nerve ultrasound elastography is a new imaging technique that evaluates the elastic properties of the optic nerve. In this method, deformations caused by mechanical forces applied on the optic nerve are measured using ultrasound waves and the elastic properties of the optic nerve are analysed. This study aimed to evaluate optic nerve (ON) and retrobulbar adipose tissue (RAT) elasticity, optic nerve sheath diameter (ONSD), and optic disc height (ODH) in patients with IIH.</p><p><strong>Clinical rationale for study: </strong>Demonstration of structural changes in the optic nerve in IIH patients.</p><p><strong>Material and methods: </strong>In this prospective study, bilateral ON and optic disc measurements were performed in 30 consecutive patients with IIH and 30 age- and sex-matched healthy volunteers. ONSD, ODH, and SWE (shear wave elastography) of the ON, and SWE of the RAT, were measured.</p><p><strong>Results: </strong>Of 30 patients with IIH, 26 were female and four were male. The mean age of the patients diagnosed with IIH was 37.9 ± 9.9 years and the mean age of the control group was 38.9 ± 10.5 years (p = 0.594). Similarly, no significant difference was found between the two groups in terms of body mass index (BMI): the mean BMI of the patients was 30.8 ± 5.51 and the mean BMI of the control group was 29.6 ± 4.7 (p = 0.214). In the patients, mean ONSD (4.8 ± 1.4 mm), ODH (1.04 ± 1.06 mm), ON SWE [14.7 (4.57-100.7) kPa], and RAT SWE [4.05 (1.6-11. 3) kPa] significantly differed from those in the control group: ONSD (3.1 ± 0.4 mm), ODH (0.4 ± 0.09 mm), ON SWE [10.3 (4.8-42.9) kPa], and RAT SWE [3.58 (1.5-16.7) kPA] (p = 0.001, p = 0.001, p = 0.01, p = 0.033, respectively). The cut-off values for ONSD, ODH, ON SWE and RAT SWE to discriminate IIH patients from controls were 3.5 mm, 0.5 mm and 11.37 kPa and 3.63 kPA, respectively, areas under the curve (AUC) were 0.888, 0.892, 0.67 and 0.613, respectively, and accuracy values were 80%, 81%, 61% and 60%, respectively.</p><p><strong>Conclusions: </strong>ON SWE, RAT SWE, ONSD and ODH measurements may be helpful in the diagnosis of IIH in addition to current imaging methods.</p><p><strong>Clinical implications: </strong>We observed structural changes in the optic nerve and surrounding fatty tissue in IIH, and these factors should be taken into account in future diagnosis and treatment.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"170-176"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole exome sequencing-based testing of adult epilepsy in a Polish population.","authors":"Magdalena Mroczek, Dominika Szczęśniak, Karolina Ziora-Jakutowicz, Magdalena Kacprzak, Paweł Aleksandrowicz, Małgorzata Bednarska-Makaruk, Lidia Kotuła","doi":"10.5603/pjnns.101922","DOIUrl":"10.5603/pjnns.101922","url":null,"abstract":"<p><strong>Aim of the study: </strong>Genetic panel testing in paediatric and mixed adult and children populations has demonstrated clinical utility and provided a diagnostic yield of 18-40%. The data on adult epilepsies is limited. We aimed to investigate the diagnostic yield and analyse genetic diagnoses in whole exome sequenced adult patients with epilepsies in Poland.</p><p><strong>Material and methods: </strong>We recruited 151 patients from 42 clinical centres across Poland. The patients had a diagnosis of epilepsy/ seizures, were 18 or older at the time of the genetic testing, and did not have a genetic diagnosis. All patients were tested with whole exome sequencing after an initial testing with a panel of 47 epilepsy-related genes.</p><p><strong>Results: </strong>We reached a diagnostic yield when considering pathogenic/probably pathogenic variants according to ClinVar of 8.6% (n = 13) and 17% (n = 26) when applying the American College of Medical Genetics (ACMG) criteria. Most patients had a pathogenic/probably pathogenic variant in epilepsy-related genes (54%), followed by potential epilepsy-related genes (19%), and neurodevelopment-associated epilepsy genes (15%).</p><p><strong>Conclusions: </strong>Our study shows that whole exome sequencing-based testing reaches a slightly higher diagnostic yield that the traditional 300 gene panel. Genes related to childhood onset neurodevelopmental disorders and epilepsy should be considered as well. Clinical implications/future directions. Patients may have had a diagnosis related to a childhood syndrome, but due to limited diagnostic possibilities, it was not possible to diagnose them in childhood. We would consider testing adult patients with epilepsy with whole exome or genome sequencing (or if not possible with a panel) in cases of a diagnosis of epilepsy with no hints suggesting secondary epilepsy, and especially with clinical features indicating a genetic epilepsy diagnosis, such as neurodevelopmental delay and early onset of seizures.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"70-74"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury negatively affects short and long-term outcomes of mechanical thrombectomy in acute ischaemic stroke.","authors":"Katarzyna Sawczyńska, Paweł Wrona, Kaja Zdrojewska, Dominik Wróbel, Kamil Wężyk, Paulina Sarba, Tadeusz Popiela, Agnieszka Słowik, Marcin Krzanowski","doi":"10.5603/pjnns.102569","DOIUrl":"10.5603/pjnns.102569","url":null,"abstract":"<p><strong>Aim of study: </strong>We aimed to assess the impact of acute kidney injury (AKI) during hospitalisation on short- and long-term outcomes of mechanical thrombectomy (MT) in patients with acute ischaemic stroke (AIS).</p><p><strong>Clinical rationale for study: </strong>AKI is a common complication in AIS patients treated with MT. Some studies examining its impact on prognosis have shown an association of AKI with worse MT outcomes, but observations exceeding three months are lacking.</p><p><strong>Material and methods: </strong>To this observational cohort study, we included all AIS patients treated with MT in the University Hospital in Krakow from 2019 to 2021. AKI during hospitalisation was diagnosed based on serum creatinine concentration levels according to the KDIGO (Kidney Disease Improving Global Outcomes) guidelines. We compared patients with and without AKI in terms of mortality and functional outcome (assessed with modified Rankin scale, mRS) at discharge, and at 90 and at 365 days from stroke onset. Good functional outcome was defined as mRS 0-2. We identified factors associated with mortality and a good functional outcome using univariate logistic regression analysis, with statistically significant variables subsequently included into multivariate analyses.</p><p><strong>Results: </strong>Among 593 MT-treated AIS patients, AKI was found in 12.6%. Patients with AKI had significantly higher mortality and worse functional outcome at discharge, and at 90, and at 365 days from stroke onset. AKI was an independent factor associated with mortality and worse functional outcome at discharge, and at 90, and at 365 days from stroke onset. AKI remained independently associated with a lower chance of a good functional outcome in a 365-day follow-up when the analysis was limited to patients who survived until discharge (OR = 0.244, 95% CI: 0.095-0.624, p = 0.003).</p><p><strong>Conclusions and clinical implications: </strong>AKI during hospitalisation is an independent risk factor of short- and long-term mortality and poor functional outcome in patients with AIS undergoing MT. There is a need to create a protocol to monitor kidney function and ensure prompt AKI treatment in MT-treated AIS patients.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"163-169"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in Parkinson's Disease research.","authors":"Piotr Janik","doi":"10.5603/pjnns.104995","DOIUrl":"https://doi.org/10.5603/pjnns.104995","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":"59 2","pages":"93-96"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of redox balance parameters among patients with acute ischaemic stroke.","authors":"Anna Mirończuk, Katarzyna Kapica Topczewska, Jacek Jamiołkowski, Monika Grabia, Agata Czarnowska, Agnieszka Mitrosz, Dominika Jakubowicz Lachowska, Joanna Tarasiuk, Joanna Kulikowska, Paulina Matys, Cezary Grunwald, Monika Chorąży, Katarzyna Socha, Alina Kułakowska, Jan Kochanowicz","doi":"10.5603/pjnns.104354","DOIUrl":"10.5603/pjnns.104354","url":null,"abstract":"<p><strong>Clinical rationale for study: </strong>Oxidative stress (OS) is believed to play a crucial role in the development of neuronal injury associated with ischaemic stroke (IS). The evaluation of redox homeostasis in patients with acute ischaemic stroke (AIS) and its relation to stroke subtypes and short-term outcomes has scarcely been studied, and the findings are unclear.</p><p><strong>Aim of study: </strong>This study evaluates OS and antioxidant status in patients with AIS in the Podlaskie Voivodeship in Poland within 2-5 days of stroke onset, compared to healthy controls.</p><p><strong>Material and methods: </strong>The study involved 187 patients with AIS, with 85 receiving intravenous thrombolysis and/or mechanical thrombectomy, and included 94 healthy controls as a comparison group. The research measured serum total oxidant status (TOS) and total antioxidant status (TAS) using Erel's method-based kits, and calculated the oxidative stress index (OSI).</p><p><strong>Results: </strong>Significant differences were found in TOS levels between patients with AIS and healthy controls (p = 0.049). Serum TAS concentrations were significantly higher in patients with AIS due to large artery atherosclerosis (LAA) than in those with cardioembolism (CE) or small vessel occlusion (SVO) aetiology, as classified by the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria (p = 0.043). Receiver Operating Characteristic (ROC) curve analysis established cut-off values as potential indicators of OS in patients with AIS: TAS < 1.34 mmol/L, TOS > 5.6 μmol H2O2 equiv./L, and OSI > 3.96.</p><p><strong>Conclusions and clinical implications: </strong>Our findings demonstrate that an imbalance of oxidant and antioxidant status might play a role in the pathogenesis of IS. Patients in the initial phase of IS showed increased TOS, but no change in TAS, compared to healthy controls. This suggests effective initial antioxidant defence. TOS levels exhibited potential utility as clinical diagnostic biomarkers in patients with AIS. Although an imbalance towards oxidants may play a role in the pathogenesis of IS, these markers alone do not adequately predict stroke severity. Therefore, an analysis of the oxidant and antioxidant balance could play a crucial role in clarifying the pathogenic pathways of IS, presenting valuable diagnostic and prognostic tools, and identifying novel targets for antioxidant-focused therapies with neuroprotective agents.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":"272-282"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}