Neurologia最新文献

{"title":"Uso de tocilizumab en encefalitis aguda necrosante secundaria a gripe A","authors":"I. Comino-Hidalgo , J. López Pequeño , A. Aguado del Hoyo , M. Vázquez López","doi":"10.1016/j.nrl.2025.501914","DOIUrl":"10.1016/j.nrl.2025.501914","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501914"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614738","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":"Angiopatía amiloide cerebral iatrógena en paciente joven: hipótesis etiopatogénica","authors":"M. de la Fuente Gómez-Morán , F. Hernández-Fernández , E. Lozano Setién , R.M. Collado Jiménez , C. Barrena López , R.A. Barbella Aponte","doi":"10.1016/j.nrl.2025.501916","DOIUrl":"10.1016/j.nrl.2025.501916","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501916"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614739","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":"Neuroprimaria: evaluación de la teleconsulta como puerta única de entrada a neurología desde atención primaria","authors":"S. Pérez-Sánchez ,&nbsp;M.Á. Quesada García ,&nbsp;F. Sánchez Fernández ,&nbsp;P.L. Guardado Santervás ,&nbsp;J. Dotor ,&nbsp;E. Martínez Fernández ,&nbsp;M. Villagran García ,&nbsp;M. Ben Yelun ,&nbsp;J.D. Guerra Hiraldo ,&nbsp;M.Á. Acevedo ,&nbsp;J.M. Herrerías ,&nbsp;J. Moreno Conde ,&nbsp;Á. Rodríguez ,&nbsp;I. Muñoz Martínez ,&nbsp;J. Montaner","doi":"10.1016/j.nrl.2025.501919","DOIUrl":"10.1016/j.nrl.2025.501919","url":null,"abstract":"<div><h3>Introduction</h3><div>The demand for neurological care from primary care (PC) has grown in recent years. Teleconsultation (TC) is consolidating as another tool in the management of this demand. Therefore, we propose to analyze the TC activity carried out in our health area after its implementation as a single-entry point to neurology.</div></div><div><h3>Method</h3><div>TC from PC was implemented in the 2 health districts of our area in 2020 with a mixed referral system (face-to-face and TC). In March 2023, it was implemented as a single gateway to neurology for one of the health districts (the rural area, Sevilla Norte) and remains mixed for the other. Data were collected on its use during the 6 months after implementation (total number, average delay, resolution capacity –discharge, follow-up, consultation–). A comparison was made with the same semester of the previous year.</div></div><div><h3>Results</h3><div>A total of 7377 TC has been performed since its inception with an annual increase (1247 in 2020, 2370 in 2021, 2542 in 2022, and 3008 until August 2023). This increase is reflected in the access to neurology from PC between both periods. The mean delay for face-to-face referral decreased (41.92<!--> <!-->±<!--> <!-->15.96 days in 2022 vs. 12.66<!--> <!-->±<!--> <!-->11.34 days in 2023, p<!--> <!-->&lt;<!--> <!-->0.001) and the number of patients cited outside the decree (&gt;<!--> <!-->60 days) fell by 96.7% (1936 patients [44.2%] in 2022 and 64 patients [1.2%] in 2023). TC also improved accessibility with a decrease in the mean delay of 68.09% (35<!--> <!-->±<!--> <!-->27.17<!--> <!-->h in 2022 vs. 11.17<!--> <!-->±<!--> <!-->4.12<!--> <!-->h in 2023, p<!--> <!-->=<!--> <!-->0.060). In terms of TC resolution capacity, the number of discharges from TC remained above 50% (59.45<!--> <!-->±<!--> <!-->8.93% in 2022 and 54.07<!--> <!-->±<!--> <!-->6.02% in 2023, p<!--> <!-->=<!--> <!-->0.249).</div></div><div><h3>Conclusions</h3><div>TC as a single gateway is useful and efficient in demand management from PC. It improves accessibility to the population that is attended within hours of the consultation and allows more than half of the consultations to be resolved, avoiding unnecessary visits and trips to the hospital.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501919"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614734","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":"Corrigendum «Tendencia de la mortalidad por Esclerosis Múltiple según sexo: Chile 1997-2019» [Neurologia issue 40, Volume 9 (2025), 840-848/NRL_1872]","authors":"J. Arriagada Opazo ,&nbsp;V. Farah González ,&nbsp;M. González Delgadillo ,&nbsp;L. Núñez-Franz ,&nbsp;C. Morales Garcia ,&nbsp;P. Jiménez Rodríguez","doi":"10.1016/j.nrl.2026.502016","DOIUrl":"10.1016/j.nrl.2026.502016","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 502016"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614735","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":"Documento de consenso de la Sociedad Española de Neurologia sobre prevención del deterioro cognitivo y la demencia","authors":"M.J. Gil Moreno ,&nbsp;C. Terrón Cuadrado ,&nbsp;M.S. Manzano Palomo ,&nbsp;A. Delgado Alvarez ,&nbsp;M. Eimil Ortiz ,&nbsp;G. Garcia Ribas ,&nbsp;M. Llanero Luque ,&nbsp;A. Marcos Dolado ,&nbsp;J. Matias-Guiu Antem ,&nbsp;C. Ochoa Lopez ,&nbsp;N. Rodriguez Espinosa ,&nbsp;M. Salas Carrillo ,&nbsp;A. Vieira Campos","doi":"10.1016/j.nrl.2025.501918","DOIUrl":"10.1016/j.nrl.2025.501918","url":null,"abstract":"<div><div>Recent studies have demonstrated a relationship between the development of cognitive impairment and dementia with lifestyle-related risk factors, many of them potentially modifiable, meaning that dementia prevention is possible through a public health approach that includes the implementation of key interventions that delay or slow cognitive decline or dementia.</div><div>The current Consensus Document has been prepared by a group of experts in cognitive pathology and by the Neurogeriatrics Study Group of the Spanish Society of Neurology.</div><div>This document has been prepared from a review of the existing literature and its main objective is to serve as a guide for health professionals. with interest in cognitive impairment and dementia. The different modifiable risk factors are listed and aspects related to these risk factors related to cognitive decline and dementia are analyzed, as well as a series of basic recommendations.</div><div>This document aims to be a useful tool in the clinical practice of professionals dedicated to cognitive impairment and dementia.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501918"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614732","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":"Más allá de la indometacina: reporte de un caso de hemicránea paroxística crónica con gran respuesta a la estimulación no invasiva del nervio vago","authors":"A. Jaimes,&nbsp;A. Gómez,&nbsp;O. Pajares,&nbsp;J. Rodríguez-Vico","doi":"10.1016/j.nrl.2025.501917","DOIUrl":"10.1016/j.nrl.2025.501917","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501917"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614740","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":"The Parkinson's Real-World Impact Assessment (PRISM) project in the management and burden of Parkinson's disease in Spain","authors":"C. Painous Martí ,&nbsp;I. Pijuan Jiménez ,&nbsp;À. Bayés Rusiñol ,&nbsp;J.C. Martínez Castrillo ,&nbsp;Á. Sésar Ignacio ,&nbsp;E. Tolosa Sarró","doi":"10.1016/j.nrl.2025.501921","DOIUrl":"10.1016/j.nrl.2025.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-world data studies are a promising option for understanding everyday Parkinson's disease (PD) management and optimizing strategies and therapeutic options. The Parkinson's Real-World Impact Assessment (PRISM) project was conceived as a European survey to evaluate the burden of the disease in people with Parkinson's disease (PwP) and their caregivers. Here, we present the analysis of the Spanish PRISM cohort dataset to describe prescribing patterns, healthcare resource utilization, and the impact of PD on PwP and their caregivers.</div></div><div><h3>Methods</h3><div>Data were collected using an electronic questionnaire distributed through different patient advocacy groups and specialized PD clinics in Spain.</div></div><div><h3>Results</h3><div>A total of 149 PwP (mean age, 62.6 years; mean disease duration, 7.6 years) and 38 caregivers were included. Most PwP (87.1%) received levodopa during the 12 months preceding the survey. A high percentage of patients (62.1%) expressed interest in participating in a clinical trial, but only 20% reported a current or previous enrollment. PwP reported high incidence of non-motor symptoms and poor health-related quality of life. At least one impulse control behavior was reported in 57% of patients. Caregivers reported mild to moderate disease burden.</div></div><div><h3>Conclusions</h3><div>This study identified high rates of motor and non-motor symptoms, impulse control disorders, and considerable disease burden in PwP and their caregivers, even at a relatively young age and a mild/moderate stage of the disease. Also, it highlights the limited use of rehabilitation therapies. These data provide information for PD management and resource utilization in Spain.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501921"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614737","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":"Utilidad del bloqueo anestésico del nervio occipital mayor en el tratamiento de la migraña en niños y adolescentes","authors":"M. Bote Gascón ,&nbsp;E. Arias Vivas ,&nbsp;U.A. Barrios Machain ,&nbsp;A. García Ron","doi":"10.1016/j.nrl.2025.501915","DOIUrl":"10.1016/j.nrl.2025.501915","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral nerve blockade is a common treatment in adults with headache. Although there is little evidence in pediatrics, its simplicity, safety and efficacy make it an option that can be extrapolated to our practice. Therefore, we conducted a study in which we evaluated the usefulness of anesthetic blockade of the greater occipital nerve (NOM) as a treatment for migraine in the pediatric population.</div></div><div><h3>Methods</h3><div>Prospective cohort study in children and adolescents with migraine. We collected demographic and clinical data (pain intensity using the verbal numeric scale) and data related to quality of life (PedMidas and PedsQL questionnaire) at baseline and after performing NOM block with 2.5<!--> <!-->ml of 0.5% bupivacaine.</div></div><div><h3>Results</h3><div>We included 28 patients (89.3% women) with a mean age of 13.9 years. Mean frequency of 22.8 episodes/month and intensity of 7.7/10 on the verbal-numerical scale. Post-treatment: significant reduction (<em>P</em>&lt;<!--> <!-->0.01) in frequency to 6.1 episodes/month and intensity: 3.9 points (30<!--> <!-->minutes), 4.2 points (one week), 3.9 points (15 days), 4.4 points (one month) and 5.4 points (3 months). A 100% had an effect on their quality of life, both on the PedMidas and PedsQL scales, the greater the effect, the better the response. Only 2 had adverse effects (syncope and local pain).</div></div><div><h3>Conclusions</h3><div>NOM blockade is a safe, effective and useful procedure for the acute and preventive treatment of migraine in pediatric age. It relieves the burden associated with headache and is associated with an improvement in the quality of life of patients.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501915"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147614668","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":"Signo de la banda motora en el PET/TC 18F-FDG cerebral: ¿un biomarcador de enfermedad degenerativa de primera motoneurona? A propósito de 3 casos y revisión de la literatura","authors":"M. Ruiz-Ortiz ,&nbsp;J. Esteban-Pérez ,&nbsp;A. Gómez-Grande ,&nbsp;E. Martínez-Albero ,&nbsp;J. Benito-León","doi":"10.1016/j.nrl.2025.501931","DOIUrl":"10.1016/j.nrl.2025.501931","url":null,"abstract":"<div><h3>Introduction</h3><div>Motor neuron diseases (MND) encompass conditions like amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS), marked by progressive degeneration of upper and/or lower motor neurons. The identification of specific biomarkers is crucial to reduce diagnostic delays.</div></div><div><h3>Methods</h3><div>This study presents three clinical cases evaluated at the Hospital Universitario 12 de Octubre, where the motor band sign on brain 18F-FDG PET/CT aided the diagnosis of MND. The studies were conducted using a SIEMENS Biograph™ TruePoint™ 6, with a review of relevant literature.</div></div><div><h3>Results</h3><div>In all three patients, PET/CT revealed hypometabolism in the prerolandic region, indicative of the motor band sign, contributing to the diagnosis of PLS or ALS.</div></div><div><h3>Discussion</h3><div>The motor band sign on ¹⁸F-FDG PET/CT emerges as a potential marker of upper motor neuron involvement, though the heterogeneity of MNDs and variability across studies call for further research to establish its specificity and sensitivity.</div></div><div><h3>Conclusion</h3><div>The motor band sign on ¹⁸F-FDG PET/CT is a promising biomarker for MNDs, although further studies are required to confirm its diagnostic validity.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501931"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412482","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":"Daytime dysfunction and SUDEP risk: Exploring the role of sleep and heart rate variability in epilepsy","authors":"Z. Shao ,&nbsp;Z. Hu ,&nbsp;R. Tang ,&nbsp;X. Wang ,&nbsp;W. Peng","doi":"10.1016/j.nrl.2025.501940","DOIUrl":"10.1016/j.nrl.2025.501940","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the interrelationship between sleep disturbances, heart rate variability (HRV), and the risk of sudden unexpected death in epilepsy (SUDEP), with a focus on identifying novel risk factors related to sleep and autonomic function.</div></div><div><h3>Methods</h3><div>Patients with epilepsy undergoing overnight video-electroencephalographic monitoring were recruited between December 2020 and June 2022. Seizure-related characteristics were collected. Subjective and objective sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), duration of the first and longest cycle of the whole night's sleep (cycle 1 duration), sleep latency, and number of arousals from lights-off to the start of cycle 1 (AR number). Autonomic function was evaluated using HRV parameters, including root mean square of successive differences (RMSSD) and the percentage of NN50 intervals (PNN50), during non-rapid eye movement (NREM) sleep stages 2 and 3. The risk of SUDEP was measured using the 7-item SUDEP inventory (SUDEP-7).</div></div><div><h3>Results</h3><div>A total of 127 patients with epilepsy were included in the study. Patients with a cycle 1 duration of less than 60<!--> <!-->min had significantly higher PSQI scores (<em>t</em> test, <em>P</em> <!-->&lt;<!--> <!-->.05) compared to those with a cycle 1 duration of 60<!--> <!-->min or more, consistent with poorer subjective sleep quality. Daytime dysfunction (reflected in the 7th domain of the PSQI) and RMSSD and PNN50 during NREM sleep stage 3 (one of the HRV time domain parameters) were both independent risk factors for SUDEP. Although no positive mediation effect of HRV on daytime dysfunction and SUDEP risk was observed, an inverse relationship between RMSSD during NREM stage 3 and both outcomes was identified.</div></div><div><h3>Conclusion</h3><div>Patients with epilepsy (and especially those with generalised tonic–clonic seizures) exhibiting daytime dysfunction should be prioritised for SUDEP risk screening. Further research should explore additional factors beyond HRV and potential interventions targeting sleep and autonomic function in patients with epilepsy.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501940"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412024","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}