Neurologia最新文献

{"title":"Documento de consenso de la Sociedad Española de Neurología sobre el tratamiento de la esclerosis múltiple y manejo holístico del paciente 2023","authors":"J.E. Meca-Lallana ,&nbsp;S. Martínez Yélamos ,&nbsp;S. Eichau ,&nbsp;M.A. Llaneza ,&nbsp;J. Martín Martínez ,&nbsp;J. Peña Martínez ,&nbsp;V. Meca Lallana ,&nbsp;A.M. Alonso Torres ,&nbsp;E. Moral Torres ,&nbsp;J. Río ,&nbsp;C. Calles ,&nbsp;A. Ares Luque ,&nbsp;L. Ramió-Torrentà ,&nbsp;M.E. Marzo Sola ,&nbsp;J.M. Prieto ,&nbsp;M.L. Martínez Ginés ,&nbsp;R. Arroyo ,&nbsp;M.Á. Otano Martínez ,&nbsp;L. Brieva Ruiz ,&nbsp;M. Gómez Gutiérrez ,&nbsp;C. Oreja-Guevara","doi":"10.1016/j.nrl.2023.06.001","DOIUrl":"10.1016/j.nrl.2023.06.001","url":null,"abstract":"<div><p>The last consensus statement of the Spanish Society of Neurology's Demyelinating Diseases Study Group on the treatment of multiple sclerosis (MS) was issued in 2016. Although many of the positions taken remain valid, there have been significant changes in the management and treatment of MS, both due to the approval of new drugs with different action mechanisms and due to the evolution of previously fixed concepts. This has enabled new approaches to specific situations such as pregnancy and vaccination, and the inclusion of new variables in clinical decision-making, such as the early use of high-efficacy disease-modifying therapies (DMT), consideration of the patient's perspective, and the use of such novel technologies as remote monitoring.</p><p>In the light of these changes, this updated consensus statement, developed according to the Delphi method, seeks to reflect the new paradigm in the management of patients with MS, based on the available scientific evidence and the clinical expertise of the participants.</p><p>The most significant recommendations are that immunomodulatory DMT be started in patients with radiologically isolated syndrome with persistent radiological activity, that patient perspectives be considered, and that the term “lines of therapy” no longer be used in the classification of DMTs (&gt;<!--> <!-->90% consensus). Following diagnosis of MS, the first DMT should be selected according to the presence/absence of factors of poor prognosis (whether epidemiological, clinical, radiological, or biomarkers) for the occurrence of new relapses or progression of disability; high-efficacy DMTs may be considered from disease onset.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 2","pages":"Pages 196-208"},"PeriodicalIF":3.9,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485323000695/pdfft?md5=d3c96ffb5a3fb4583aa1bb4a13fcf481&pid=1-s2.0-S0213485323000695-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome serotoninérgico inducido por amoxicilina-clavulánico","authors":"L. Naya Ríos ,&nbsp;D. Santos García ,&nbsp;C. Cores Bartalomé ,&nbsp;I. Docampo Carro","doi":"10.1016/j.nrl.2023.06.002","DOIUrl":"10.1016/j.nrl.2023.06.002","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 3","pages":"Pages 312-314"},"PeriodicalIF":3.9,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485324000525/pdfft?md5=1365b2b0e53a1befd0b50e97e62836f5&pid=1-s2.0-S0213485324000525-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osmotic demyelination syndrome amidst COVID-19: A case report with literature review","authors":"G. Dimitrov ,&nbsp;D. Naeva ,&nbsp;R. Duparinova ,&nbsp;S. Stratieva ,&nbsp;V. Manev ,&nbsp;K. Prinova","doi":"10.1016/j.nrl.2023.11.001","DOIUrl":"10.1016/j.nrl.2023.11.001","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 2","pages":"Pages 213-217"},"PeriodicalIF":3.9,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S021348532300066X/pdfft?md5=8b08a164a287a84c708a6c670c337a5a&pid=1-s2.0-S021348532300066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asociación entre periodontitis, enfermedad cerebrovascular y demencia. Informe científico del Grupo de Trabajo de la Sociedad Española de Periodoncia y la Sociedad Española de Neurología","authors":"Y. Leira ,&nbsp;J. Vivancos ,&nbsp;P. Diz ,&nbsp;Á. Martín ,&nbsp;M. Carasol ,&nbsp;A. Frank","doi":"10.1016/j.nrl.2023.11.003","DOIUrl":"10.1016/j.nrl.2023.11.003","url":null,"abstract":"<div><h3>Objective</h3><p>This article reviews the scientific evidence on the relationship between periodontitis and neurological disease, and particularly cerebrovascular disease and dementia. We also issue a series of recommendations regarding the prevention and management of periodontitis and these neurological diseases at dental clinics and neurology units.</p></div><div><h3>Development</h3><p>In response to a series of questions proposed by the SEPA-SEN Working Group, a literature search was performed, with no restrictions on study design, to identify the most relevant articles on the association between periodontitis and cerebrovascular disease and dementia from the perspectives of epidemiology, treatment, and the biological mechanisms involved in these associations.</p></div><div><h3>Conclusions</h3><p>Periodontitis increases the risk of ischaemic stroke and Alzheimer dementia. Recurrent bacterial infections and increased low-grade systemic inflammation seem to be possible biological mechanisms underlying this association. Limited evidence suggests that various oral health interventions can reduce the future risk of cerebrovascular disease and dementia.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 3","pages":"Pages 302-311"},"PeriodicalIF":3.9,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0213485323000683/pdfft?md5=9c580bba8813276d9882ca36bccf5a3f&pid=1-s2.0-S0213485323000683-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alta frecuencia de trombo endoluminal en pacientes con ictus isquémico tras la infección por coronavirus 2019","authors":"P. Gómez-Porro ,&nbsp;B. Cabal-Paz ,&nbsp;S. Valenzuela-Chamorro ,&nbsp;Z. Desanvicente ,&nbsp;J. Sabin-Muñoz ,&nbsp;C. Ochoa-López ,&nbsp;C. Flórez ,&nbsp;S. Enríquez-Calzada ,&nbsp;R. Martín-García ,&nbsp;Í. Esain-González ,&nbsp;B. García-Fleitas ,&nbsp;L. Silva-Hernández ,&nbsp;Á. Ruiz-Molina ,&nbsp;E. Gamo-González ,&nbsp;A. Durán-Lozano ,&nbsp;R. Velasco-Calvo ,&nbsp;L. Alba-Alcántara ,&nbsp;R. González-Santiago ,&nbsp;A. Callejas-Díaz ,&nbsp;B. Brea-Álvarez ,&nbsp;J. Carneado-Ruiz","doi":"10.1016/j.nrl.2021.04.012","DOIUrl":"10.1016/j.nrl.2021.04.012","url":null,"abstract":"<div><h3>Background</h3><p>Ischaemic stroke may be a major complication of SARS-CoV-2 infection. Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment.</p></div><div><h3>Methods</h3><p>Data were collected retrospectively on consecutive patients with SARS-CoV-2 infection who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain).</p></div><div><h3>Results</h3><p>During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack).</p><p>Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%).</p><p>We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients).</p></div><div><h3>Conclusions</h3><p>In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19–associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 1","pages":"Pages 43-54"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.04.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39074534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuronorma Colombia: aportes y características metodológicas","authors":"A. Espitia ,&nbsp;L. Duarte","doi":"10.1016/j.nrl.2021.03.011","DOIUrl":"10.1016/j.nrl.2021.03.011","url":null,"abstract":"<div><h3>Introduction</h3><p>Availability of adequate normative data is essential when performing neuropsychological evaluation; good methodological quality of the studies that propose these data ensures that their conclusions are reliable and valid. We present the methodological characteristics of the Neuronorma Colombia Project in order to analyse its contributions and limitations.</p></div><div><h3>Method</h3><p>We present the characteristics of the normative sample, inclusion and exclusion criteria, statistical analysis, the procedure for obtaining normative data, and the instruments used.</p></div><div><h3>Results</h3><p>We present graphical profiles of patient performance, based on the Neuronorma Work Unit, to illustrate the interpretation of the results obtained when evaluating patients with the Neuronorma Colombia Battery.</p></div><div><h3>Discussion and conclusions</h3><p>Our study presents several methodological advantages, such as its multicentre, co-normalised design and the availability of the Neuronorma Work Unit, which allows the creation of graphical profiles of patient performance, a fundamental tool for diagnosis and research. We present the findings of subsequent research based on the proposed normative data, which demonstrate the value of the battery. The contribution of this study is discussed in the context of its immediate background.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 1","pages":"Pages 10-19"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.03.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39064085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for respiratory failure among hospitalized patients with Guillain–Barré syndrome","authors":"L.P. Maskin ,&nbsp;M. Wilken ,&nbsp;F. Rodriguez Lucci ,&nbsp;J.P. Wisnivesky ,&nbsp;F. Barroso ,&nbsp;N. Wainsztein","doi":"10.1016/j.nrl.2021.04.011","DOIUrl":"10.1016/j.nrl.2021.04.011","url":null,"abstract":"<div><h3>Background</h3><p>Guillain–Barré syndrome (GBS) is an acute inflammatory polyneuropathy that can lead to respiratory failure. In this study, we evaluate early clinical risk factors for respiratory failure at the time of hospital admission.</p></div><div><h3>Methods</h3><p>We studied a retrospective cohort of patients with GBS admitted to a tertiary care center. The potential risk factors studied were sociodemographic characteristics, GBS symptoms, overall and cervical muscle weakness (Medical Research Council [MRC] scores), electromyography findings, and cerebrospinal fluid analysis findings. Unadjusted odds ratios (OR) were calculated and exact logistic regression analysis (adjusted OR) performed to assess the association between baseline risk factors and respiratory failure.</p></div><div><h3>Results</h3><p>Overall, 13 of 113 (12%) patients included in the study developed respiratory failure. Unadjusted analyses showed that involvement of any cranial nerve (OR: 14.7; 95% CI, 1.8–117.1), facial palsy (OR: 17.3; 95% CI, 2.2–138.0), and bulbar weakness (OR: 10.7; 95% CI, 2.3–50.0) were associated with increased risk of respiratory failure. Lower MRC sum scores (for scores &lt;30, OR: 14.0; 95% CI, 1.54–127.2) and neck MRC scores (for scores ≤3, OR: 21.0; 95% CI, 3.5–125.2) were associated with higher likelihood of respiratory failure. Adjusted analyses showed that presence of bulbar weakness (OR: 7.6; 95% CI, 1.3–43.0) and low neck MRC scores (scores ≤3, OR: 9.2; 95% CI, 3.5–125.2, vs scores &gt;3) were independently associated with respiratory failure.</p></div><div><h3>Conclusions</h3><p>Bulbar and neck muscle weakness at admission are clinical predictors of increased risk of respiratory failure in patients with GBS. These findings could guide the adequate management of high-risk patients.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 1","pages":"Pages 36-42"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.04.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38971423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disorders in patients with multiple sclerosis in Spain","authors":"G.X. Zhang ,&nbsp;W.T. Zhang ,&nbsp;S.S. Gao ,&nbsp;R.Z. Zhao ,&nbsp;W.J. Yu ,&nbsp;G. Izquierdo","doi":"10.1016/j.nrl.2021.03.012","DOIUrl":"10.1016/j.nrl.2021.03.012","url":null,"abstract":"<div><h3>Objective</h3><p>This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances.</p></div><div><h3>Methods</h3><p>The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019.</p></div><div><h3>Results</h3><p>The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44–54 years and 55–68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0–3, 3–6, and &gt;6, respectively.</p></div><div><h3>Conclusion</h3><p>Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 1","pages":"Pages 29-35"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.03.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39074532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between psoriasis and dementia: A systematic review","authors":"J. Zhao ,&nbsp;T. Li ,&nbsp;J. Wang","doi":"10.1016/j.nrl.2020.12.007","DOIUrl":"10.1016/j.nrl.2020.12.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic systemic inflammatory phenotype. Psoriasis is also considered to be a chronic systemic inflammatory disease. It has been suggested that psoriasis may also contribute to the risk of dementia. The aim of this study was to systematically review the literature on the association between psoriasis and dementia.</p></div><div><h3>Development</h3><p>Articles were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Web of Science databases to identify articles published in peer-reviewed journals and studying the association between psoriasis and dementia. Studies meeting the inclusion criteria were reviewed. We used the Newcastle–Ottawa Scale to assess the quality of each study. After applying the inclusion and exclusion criteria, we included 8 studies for review, 3 of which were found to present a higher risk of bias. Six of the 8 studies supported the hypothesis that prior diagnosis of psoriasis increases the risk of dementia; one study including only a few cases reported that psoriasis decreased the risk of dementia, and one study including relatively young patients found no significant association between psoriasis and the risk of dementia.</p></div><div><h3>Conclusion</h3><p>Most studies included in this review supported the hypothesis that psoriasis constitutes a risk factor for dementia. However, well-designed stratified cohort studies assessing both psoriasis severity and treatment status are still required to determine the real effect of psoriasis on the risk of dementia and its subtypes.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 1","pages":"Pages 55-62"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2020.12.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25520248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilingüismo y lenguaje en niños con trastorno del espectro autista: una revisión sistemática","authors":"D. Garrido ,&nbsp;B. López ,&nbsp;G. Carballo","doi":"10.1016/j.nrl.2021.04.010","DOIUrl":"10.1016/j.nrl.2021.04.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Communication and language skills are among the most severely affected domains in individuals with autistic spectrum disorder (ASD). When a child diagnosed with ASD lives in a bilingual environment, the parents often express concerns about whether their child should learn both languages simultaneously, turning to specialists for advice. Despite the lack of evidence of any negative effect, some professionals disagree on this subject. In this systematic review we study whether bilingualism affects language development in children with ASD.</p></div><div><h3>Methods</h3><p>We reviewed the literature published in 4 different databases. After applying a series of selection criteria, we selected 12 scientific articles, including a total of 328 children diagnosed with ASD (169 bilingual and 159 monolingual), with ages ranging from 3 to 12 years. These patients were evaluated with different receptive and expressive language assessment instruments covering several areas. The assessments were performed directly on the children, although indirect assessment of parents was also performed in some studies.</p></div><div><h3>Conclusions</h3><p>There seems to be consensus regarding the assertion that bilingualism does not entail any additional difficulty for language development in children with ASD from the age of 3.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"39 1","pages":"Pages 84-96"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.04.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39063523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}