Neurologia i neurochirurgia polska最新文献

{"title":"Severe hypersensitivity reaction during tofersen therapy in amyotrophic lateral sclerosis associated with the rare SOD1 p.Val120Phe mutation.","authors":"Kamila Żur-Wyrozumska","doi":"10.5603/pjnns.113584","DOIUrl":"10.5603/pjnns.113584","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726905","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":"Endovascular embolization of carotid-cavernous fistulas: a single-center analysis of safety, technical success, and long-term outcomes.","authors":"Maciej Szmygin, Tomasz Roman, Marcin Czeczelewski, Pawel Szmygin, Joanna Bosowska, Radosław Rola","doi":"10.5603/pjnns.111584","DOIUrl":"https://doi.org/10.5603/pjnns.111584","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid-cavernous fistulas (CCFs) are abnormal shunts between the internal carotid artery and the cavernous sinus that may be high-flow direct or low-flow indirect lesions. They present with ocular symptoms and headache and are diagnosed primarily by cerebral angiography. This study evaluated the safety, technical success, and long-term outcomes of endovascular embolization for CCFs.</p><p><strong>Material and methods: </strong>This retrospective single-center study evaluated procedural and clinical outcomes of patients with CCFs treated with endovascular embolization. The evaluated outcomes included immediate procedural success on DSA, symptom resolution, procedure-related complications, and the rate of complete fistula occlusion on follow-up DSA.</p><p><strong>Results: </strong>Twenty-three patients (mean age 57 years; 74% female) underwent endovascular treatment for carotid-cavernous fistulas, including 11 direct and 12 indirect lesions. The most common presenting symptoms were proptosis and orbital pain. Coil embolization was used in all cases, with adjunctive materials in 44% (10/23). Immediate complete occlusion was achieved in 48% (11/23) and complications occurred in 9% (2/23). Final follow-up DSA showed complete fistula closure in 91.3% of patients (21/23). Clinical improvement was achieved in 91.3% (21/23) of the cohort, with complete clinical resolution in 14 patients (61%).</p><p><strong>Conclusions: </strong>The results of our study suggest that long-term radiological and clinical outcomes in patients with CCFs treated with endovascular embolization were very satisfactory across all fistula types. Therefore, modern endovascular methods should be considered during the multidisciplinary evaluation of these patients.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579507","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 the humoral response during ocrelizumab therapy in multiple sclerosis - an observational study.","authors":"Joanna Rychter, Aleksandra Podlecka-Piętowska, Kinga Sujkowska, Janusz Sierdziński, Beata Zakrzewska-Pniewska, Monika Nojszewska","doi":"10.5603/pjnns.108289","DOIUrl":"https://doi.org/10.5603/pjnns.108289","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-CD20 monoclonal antibodies are widely used as high-efficacy treatment agents (HETAs) in multiple sclerosis (MS). In patients treated with ocrelizumab (OCR), reduced serum IgG levels are a common laboratory abnormality. Infections are among the most frequently observed adverse events during OCR therapy.</p><p><strong>Material and methods: </strong>We analyzed the humoral immune response during OCR therapy in 52 people with multiple sclerosis (PwMS) and assessed the safety of this treatment, including treatment-related adverse events and infection rates over a period of up to six years.</p><p><strong>Results: </strong>After three years of treatment, immunoglobulin G (IgG) and IgG1 levels decreased, particularly in the relapsing-remitting MS (RMS) group. Higher body mass index (BMI) was associated with lower Ig levels and greater CD19+ cell depletion. Infections were more frequent in patients with relapses within 3 months prior to OCR initiation. Clinical implications/future directions. Ocrelizumab treatment for up to six years showed a manageable safety profile. Given the higher infection risk in patients with greater disease activity, earlier HETA initiation may be beneficial. The association between higher BMI and CD19+ cell depletion warrants further study to support personalized OCR dosing strategies.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536499","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":"Electrophysiological markers of subclinical central nervous system involvement in patients with non-small-cell lung cancer without brain metastases.","authors":"Karol Marschollek, Monika Kosacka, Maciej Majchrzak, Aneta Kowal, Sławomir Budrewicz, Anna Brzecka-Bonnaud, Anna Pokryszko-Dragan","doi":"10.5603/pjnns.110593","DOIUrl":"https://doi.org/10.5603/pjnns.110593","url":null,"abstract":"<p><strong>Aim of the study: </strong>To evaluate electrophysiological parameters of central nervous system (CNS) function in patients with non-small-cell lung cancer (NSCLC) without detectable CNS metastases.</p><p><strong>Clinical rationale for the study: </strong>Early recognition of nervous system involvement in lung cancer (LC) is important for the management of the disease. Evoked potentials are an objective and noninvasive method for assessing CNS bioelectrical activity, regarded as a useful tool in revealing subclinical CNS dysfunction in systemic diseases, including neoplasms.</p><p><strong>Material and methods: </strong>The study included 11 patients (mean age 67.3 years, 55% females), diagnosed with NSCLC, without CNS metastases, and a group of 24 healthy controls (HC) matched for age. All participants underwent brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP) and electroencephalography (EEG). Parameters of VEP and BAEP were compared between LC patients and HC. In the NSCLC group, they were also referred to the disease outcome evaluation after 12 months of follow-up.</p><p><strong>Results: </strong>In VEPs, patients with NSCLC had significantly longer median P100 and N145 latencies compared to the HC (112 vs. 104 ms, p < 0.001 and 158 vs. 145 ms, p = 0.002, respectively). In BAEPs, longer median latency of wave V and I-V interpeak latency were found in NSCLC patients (5.88 vs. 5.80 ms, p = 0.047 and 4.19 vs. 4.05 ms, p = 0.007, respectively); they also had significantly lower median amplitudes of I and V waves (0.13 vs. 0.25 μV, p < 0.001 and 0.29 vs. 0.39 μV, p = 0.001, respectively). In total, 10 out of 11 patients showed abnormalities in either VEP or BAEP: in 4 patients, delayed latencies or decreased amplitudes were detected for both modalities, in 4, only in BAEP and in 2, only in VEP. EEG abnormalities were detected in two patients in the NSCLC group. After 12 months of follow-up, in none of the patients brain metastases were revealed.</p><p><strong>Conclusions and clinical implications: </strong>This exploratory study demonstrated abnormalities of EP parameters in NSCLC patients, without otherwise detectable CNS involvement. These findings may suggest subclinical brain dysfunction in the course of NSCLC, although the underlying mechanism remains uncertain. The usefulness of electrophysiological methods in monitoring or predicting subtle neurological complications of NSCLC warrants further investigation.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376231","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":"Sacroiliac joint manipulation for low back and radicular pain: outcomes in a 100-patient single-center cohort.","authors":"Patrycja Kowalczyk, Maciej Niewodniczy, Bartosz Szmyd, Karol Wiśniewski, Dariusz J Jaskólski","doi":"10.5603/pjnns.110751","DOIUrl":"https://doi.org/10.5603/pjnns.110751","url":null,"abstract":"<p><strong>Introduction: </strong>Sacroiliac joint (SIJ) dysfunction is an underrecognized source of lumbosacral and leg pain. Manual therapy targeting SIJ hypomobility/blockage may rapidly reduce pain and disability, yet pragmatic outcome data remain limited.</p><p><strong>Material and methods: </strong>We conducted a single-center observational cohort study of 100 consecutive adults (73% women; mean age 49.16 ± 14.28 years; BMI 25.99 ± 4.15 kg/m²) with lumbosacral and/or radicular leg pain attributed to SIJ dysfunction. Eligibility required cross-sectional imaging (CT/MRI) and ≥ 3 positive SIJ provocation tests (e.g., Patrick/FABER, Mennell, thigh thrust, Yeoman's, SIJ compression, hip rotation). All patients received a standardized SIJ manipulation protocol (up to three sessions, 7-day intervals) administered by the same physiotherapist. Pain intensity on the Numerical Rating Scale (NRS) was measured at baseline, after each session, and at 3 months; disability was assessed with the Oswestry Disability Index (ODI). Nonparametric statistics were prespecified (Shapiro-Wilk test for normality; Friedman test with Kendall's W and Holm-adjusted Wilcoxon post hoc test for repeated NRS; Wilcoxon signed-rank test for ODI; α < 0.05).</p><p><strong>Results: </strong>The most frequent abnormal finding was the Mennell sign (clinical finding, 100%); key provocation tests were commonly positive [thigh thrust 89%, Mennell (provocation) test 81%, Yeoman's test 52%]. Median NRS decreased from 8 (IQR: 7-9) at baseline to 1 (IQR: 0-3) after the first manipulation, 0 (IQR: 0-0) after the second and third, and 0 (IQR: 0-2) at 3 months (Friedman p < 0.001). ODI improved from 30 (IQR: 25-35) to 7 (IQR: 6-9; p < 0.001), with significant gains across all domains (all p < 0.001) at 3 months.</p><p><strong>Conclusions: </strong>In carefully triaged patients with suspected SIJ-mediated pain, a short, standardized SIJ manipulation sequence was associated with large, rapid, and sustained improvements in pain and disability through 3 months. These pragmatic data complement prior trials and support considering SIJ manipulation as a low-cost, repeatable option within conservative care pathways. Randomized, assessor-blinded studies with longer follow-up are warranted to confirm causality and identify likely responders.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252562","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":"Expanding the phenotypic spectrum of RYBP-related neurodevelopmental disorder: report of the ninth patient worldwide.","authors":"Agata Cieślikowska, Marzena Gawlik, Maria Franaszczyk, Elżbieta Ciara, Rafał Płoski, Piotr Iwanowski, Elżbieta Jurkiewicz, Agnieszka Madej-Pilarczyk","doi":"10.5603/pjnns.111527","DOIUrl":"https://doi.org/10.5603/pjnns.111527","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199297","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":"A correlation between cognitive dysfunction and employment status in multiple sclerosis - a systematic literature review.","authors":"Justyna Wołos, Olga Grodzka, Jan Kochanowski, Izabela Domitrz","doi":"10.5603/pjnns.111207","DOIUrl":"https://doi.org/10.5603/pjnns.111207","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a disease of the central nervous system (CNS) with a complex pathogenesis characterized by inflammation, demyelination, and progressive neurodegeneration. Cognitive impairment (CI) is a common manifestation of MS, with a prevalence ranging from 40% to 70% of patients. It also appears to be one of the factors involved in deterioration of work ability, which negatively affects patients' independence and carries a substantial socioeconomic burden.</p><p><strong>Material and methods: </strong>We aimed to summarize the most recent findings regarding the relationship between CI and employment status in MS. PubMed and Embase were searched in accordance with PRISMA guidelines, which resulted in the inclusion of the 37 most appropriate studies.</p><p><strong>Results: </strong>Patients with MS scored significantly worse on cognitive assessment tests than healthy controls. Significant correlations were found between worse performance in different cognitive domains and unemployment. Moreover, some studies reported that CI may also predict future vocational deterioration in patients with MS.</p><p><strong>Conclusions: </strong>Cognitive dysfunction may play an important role in the deterioration of employment status among patients with MS. Of the analyzed neuropsychological tests, the Symbol Digit Modalities Test (SDMT) appears to be the most suitable tool for cognitive evaluation in this patient group.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148033502","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":"Myotonic dystrophy type 2 is frequently diagnosed in Poland.","authors":"Anna Łusakowska, Ewelina Elert-Dobkowska, Anna Sulek","doi":"10.5603/pjnns.112080","DOIUrl":"https://doi.org/10.5603/pjnns.112080","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148033541","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":"Subclinical brainstem encephalitis in Ramsay Hunt syndrome: a case of radiological-clinical dissociation.","authors":"Anna E Żurawska, Małgorzata J Czarniawska, Marcin P Mycko","doi":"10.5603/pjnns.112324","DOIUrl":"https://doi.org/10.5603/pjnns.112324","url":null,"abstract":"","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988493","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":"Diagnostic accuracy of the Warsaw Cognitive Assessment Scale for detecting mild cognitive impairment and dementia: a comparison with the Addenbrooke's Cognitive Examination III and the Mini-Mental State Examination.","authors":"Anna Barczak","doi":"10.5603/pjnns.111892","DOIUrl":"https://doi.org/10.5603/pjnns.111892","url":null,"abstract":"<p><strong>Aim of the study: </strong>To evaluate the diagnostic accuracy of the Warsaw Cognitive Assessment Scale (Warszawska Skala Oceny Poznawczej, WSOP) for detecting mild cognitive impairment (MCI) and dementia, and to compare its performance with the Addenbrooke's Cognitive Examination III (ACE-III) and the Mini-Mental State Examination (MMSE).</p><p><strong>Clinical rationale for the study: </strong>Early detection of cognitive impairment remains challenging in clinical practice. Existing screening tools are limited by administration time, sensitivity to early deficits, and reliance on auditory input. The WSOP was developed as a brief, multidomain screening instrument tailored to the Polish population, aiming to balance diagnostic accuracy with clinical efficiency.</p><p><strong>Material and methods: </strong>A total of 370 participants (111 Controls, 138 with MCI, 121 with mild dementia) were assessed using WSOP, ACE-III, and MMSE. Group differences were analyzed using non-parametric tests, and convergent validity was evaluated with Spearman's correlations. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis, including area under the curve (AUC), sensitivity, specificity, and optimal cut-off values. Additional analyses controlled for age, education, and sex.</p><p><strong>Results: </strong>WSOP demonstrated high diagnostic accuracy comparable to ACE-III. For distinguishing Controls from MCI, AUC values were 0.945 (WSOP) and 0.951 (ACE-III), both exceeding MMSE (0.80). For MCI versus dementia, AUC values were 0.943 and 0.964, respectively. The optimal WSOP cut-offs were 67.5 for MCI and 53.5 for dementia. Diagnostic performance remained stable after adjusting for demographic variables. WSOP scores showed moderate to strong correlations with ACE-III, providing initial evidence of convergent validity.</p><p><strong>Conclusions and clinical implications: </strong>WSOP is a brief, reliable multidomain cognitive screening tool with diagnostic accuracy comparable to ACE-III. Its balance of comprehensiveness and efficiency supports its potential use in clinical screening settings, pending further validation in broader populations.</p>","PeriodicalId":19132,"journal":{"name":"Neurologia i neurochirurgia polska","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982583","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}