Revista de neurologia最新文献

[Cost-Effectiveness Analysis of an ICTUS Unit: A Case Study of the University Hospital Complex of Santiago de Compostela]. [ICTUS单位的成本效益分析：以圣地亚哥德孔波斯特拉大学综合医院为例]。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-03-27 DOI: 10.31083/RN39320

Francisco Reyes-Santias, Alicia do Carme Pastoriza Castro, Maria Santamaria-Cadavid, Emilio Castro, Manuel Rodriguez-Yañez, Jose Maria Prieto-Gonzalez, Beatriz Aibar-Guzman

{"title":"[Cost-Effectiveness Analysis of an ICTUS Unit: A Case Study of the University Hospital Complex of Santiago de Compostela].","authors":"Francisco Reyes-Santias, Alicia do Carme Pastoriza Castro, Maria Santamaria-Cadavid, Emilio Castro, Manuel Rodriguez-Yañez, Jose Maria Prieto-Gonzalez, Beatriz Aibar-Guzman","doi":"10.31083/RN39320","DOIUrl":"10.31083/RN39320","url":null,"abstract":"Introduction: Stroke has an enormous impact on society, both socially and economically. It is the most common cause of admission and prolonged stay in the Neurology ward.Methods: We performed a cost-effectiveness analysis of stroke treatment in the Complejo Hospitalario de Santiago de Compostela, where patients are treated in a stroke unit. Firstly, an analysis of the costs of treatment in the stroke unit was carried out, which had not been done before. The costs were compared with those that would be incurred if the disease was treated without the stroke unit, verifying that the existence of such a unit implies an increase in treatment costs. Next, various parameters reflecting the efficacy of the treatment were analyzed to finally perform a cost-effectiveness analysis in order to determine whether the increase in costs is justified by an improvement in outcomes.Results: Stroke treatment in the centralized stroke unit would be cost-effective if we use mortality during hospitalization or 3 months after discharge, the mRS parameter at discharge or 3 months after discharge, and severe disability at discharge as measures of effectiveness.Conclusion: The increased costs of a stroke unit are justified by the improved health of the patients.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"80 2","pages":"39320"},"PeriodicalIF":0.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796244","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}

引用次数: 0

[Spinal Muscular Atrophy: The Reality of the Adult Patient in Spain]. [脊髓性肌萎缩：西班牙成人患者的现实]。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-03-27 DOI: 10.31083/RN33462

Maria Grazia Cattinari, Mencía De Lemus, Maria Dumont, Eduardo Tizzano

{"title":"[Spinal Muscular Atrophy: The Reality of the Adult Patient in Spain].","authors":"Maria Grazia Cattinari, Mencía De Lemus, Maria Dumont, Eduardo Tizzano","doi":"10.31083/RN33462","DOIUrl":"10.31083/RN33462","url":null,"abstract":"Background: Spinal muscular atrophy (SMA) is a neurodegenerative disease in which there has been an increase in survival over the past decade due to proactive, multidisciplinary management and the emergence of disease-modifying therapies. Despite this, there are still several critical challenges that significantly impact the quality of life of individuals with SMA individuals. Given the need to better understand the reality of this disease, Fundación de Atrofia Muscular Espinal (FundAME) created a patient registry (RegistrAME).Methods: RegistrAME is a longitudinal prospective study that collects clinical data and patient-reported outcomes.Results: The registry included 336 individuals, 51.8% of whom were over 16 years old. Most adult subpopulations were classed as type 2 (49.4%) or type 3 (44.8%). Regarding functional status, 19% walked (39.4% used wheelchairs), 46.6% sat without support (84% needed help to sit), and 34.5% were non-sitters. Furthermore, 24.7% reported having no useful function in their hands or not being able to reach their mouths with their hands. Our study indicates that the adult SMA population is progressively accessing disease-modifier treatments. However, 21.8% of the population is still untreated.Conclusions: These results provide evidence of a progressive impairment and increased sensitivity to treatment discontinuations in the SMA adult population, along with delayed or reduced access to commercialised SMA drugs and clinical trials. A more rigorous evaluation of the disease's impact and treatment benefits in the adult SMA population is necessary.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"80 2","pages":"33462"},"PeriodicalIF":0.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796247","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}

引用次数: 0

[Successful Management of Wearing-off effect with Eptinezumab: Lessons from a case with Chronic Migraine Refractory to Two Subcutaneous CGRP Antibodies]. [成功管理Eptinezumab的磨损效应：来自两种皮下CGRP抗体难治性慢性偏头痛病例的经验教训]。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-03-12 DOI: 10.31083/RN38974

Marcos Polanco Fernández, Lara Gangas Barranquero, Vicente González-Quintanilla, Jorge Madera Fernández, Julio Pascual

{"title":"[Successful Management of Wearing-off effect with Eptinezumab: Lessons from a case with Chronic Migraine Refractory to Two Subcutaneous CGRP Antibodies].","authors":"Marcos Polanco Fernández, Lara Gangas Barranquero, Vicente González-Quintanilla, Jorge Madera Fernández, Julio Pascual","doi":"10.31083/RN38974","DOIUrl":"10.31083/RN38974","url":null,"abstract":"Introduction Monoclonal antibodies against calcitonin gene-related peptide (CGRP) have revolutionized migraine treatment, though one-third of patients do not respond to these medications. One of the emergent reasons for this apparent lack of response could be a wearing-off effect, as the case of our patient illustrates. Clinical Case A woman aged 36 years with the diagnosis of migraine with aura since childhood, which transforms to chronic migraine and daily headache, with analgesic overuse for the past 5 years. She failed to respond to multiple oral preventatives, botulinum toxin, and two CGRP antibodies (erenumab and galcanezumab). After initiating quarterly eptinezumab, she noticed a relevant improvement in the number of headache days per month for the first 8 weeks but experienced a clear wearing-off effect during the third month of treatment, for two consecutive treatments. We altered administration to every 8 weeks, which better controlled her migraine frequency. Conclusions CGRP antibodies can show a wearing-off effect, which should be identified in order to plan individualized treatment and avoid an incorrect interpretation as therapeutic failure. Our case also shows that patients with chronic migraine refractory to two antibodies can respond to a third CGRP antibody, in this case, intravenous eptinezumab.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"80 2","pages":"38974"},"PeriodicalIF":0.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796248","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}

引用次数: 0

[Key Measures in Epidemiology: Risk Difference, Relative Risk and Odds Ratio]. [流行病学中的关键测量方法：风险差异、相对风险和几率比率]。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-03-07 DOI: 10.31083/RN33481

Carmen Carazo-Díaz, Luis Prieto-Valiente

{"title":"[Key Measures in Epidemiology: Risk Difference, Relative Risk and Odds Ratio].","authors":"Carmen Carazo-Díaz, Luis Prieto-Valiente","doi":"10.31083/RN33481","DOIUrl":"10.31083/RN33481","url":null,"abstract":"In epidemiology, the relative frequency of a disease is expressed as the proportion of individuals affected, typically expressed as a percentage, or per thousand individuals. Another important measure is the odds, which represents the ratio of affected individuals to unaffected individuals, calculated by dividing by the proportion of affected individuals by the proportion of unaffected individuals. To assess whether a specific factor increases or decreases the risk of disease, researchers compare the proportion of affected individuals in an exposed group (where the factor is present) with an unexposed group (where the factor is absent). This comparison can be quantified using three key measures: Risk Difference (RD): The absolute difference in disease risk between the exposed and unexposed groups. Relative Risk (RR): The ratio of disease risk in the exposed group to that in the unexposed group. Odds Ratio (OR): The ratio of the odds of disease in the exposed group to the odds in the unexposed group. While risk reflects the proportion of individuals affected within a population, odds represent the ratio of affected to unaffected individuals. The OR is particularly useful in case-control studies because it can approximate the RR when diseases are rare, providing valuable insights even when direct risk calculations are not feasible.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"80 2","pages":"33481"},"PeriodicalIF":0.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796245","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}

引用次数: 0

[Abusive Head Trauma in Infants: A Case Review (2016-Present) and Prevention Strategies]. [婴儿虐待性头部创伤：病例回顾（2016-至今）及预防策略]。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-03-07 DOI: 10.31083/RN38855

Raquel Pérez Delgado, Jose Luis Peña Segura, María Zenaida Galve Pradel, Elena Javierre Miranda, Paula Almudena Madurga Revilla, Cintia Soro Lorente

引用次数: 0

[Clinical Features and Functional Prognosis in Patients with Possible Autoimmune Encephalitis in a Neurological Emergency Department]. [神经急诊科自身免疫性脑炎患者的临床特征和功能预后]。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-03-05 DOI: 10.31083/RN36202

Paula Catalina Robles-Monroy, Victoria Martínez-Angeles, Jesús Ramírez-Bermúdez, Arturo Violante-Villanueva, Lilia Salas-Alvarado, Xiomara García, Juan Carlos López-Hernández

{"title":"[Clinical Features and Functional Prognosis in Patients with Possible Autoimmune Encephalitis in a Neurological Emergency Department].","authors":"Paula Catalina Robles-Monroy, Victoria Martínez-Angeles, Jesús Ramírez-Bermúdez, Arturo Violante-Villanueva, Lilia Salas-Alvarado, Xiomara García, Juan Carlos López-Hernández","doi":"10.31083/RN36202","DOIUrl":"10.31083/RN36202","url":null,"abstract":"Introduction: Autoimmune encephalitis (AE) represents a severe neuropsychiatric disorder that requires early diagnosis. This study describes the frequency, clinical characteristics, and paraclinical findings in patients with possible autoimmune encephalitis treated in a neurological emergency department, as well as factors associated with poor functional prognosis at discharge.Material and methods: This was an observational ambispective cohort study including patients diagnosed with AE who were treated in a neurological emergency department in 2022. Demographic, clinical, and paraclinical characteristics were evaluated, along with functional outcomes using the modified Rankin scale (mRS); ≤2 points, was considered as good prognosis. In the statistical analysis we used the chi-squared test, Fisher's exact test, Student's T-test, and Mann-Whitney U test.Results: Out of 9046 patients, 31 (0.3%) met the criteria for probable autoimmune encephalitis (PAE). The average age was 28.4 ± 12.1 years and 51.6% were female. Cognitive alterations (90.3%), psychosis (74.2%), abnormal movements (71%), catatonia (67.7%), seizures/status epilepticus (64.5%, 19.4%), and dysautonomia (58.1%) were observed; 58.1% had a good functional prognosis. Factors associated with poor prognosis included older age (24.8 ± 5.0 vs. 33.4 ± 16.8, p = 0.049), status epilepticus (0% vs. 46.2%, p = 0.002), and lower frequency of headache (61.1% vs. 15.4%, p = 0.025).Conclusions: AE represents a rare diagnosis even in a neurological emergency center; older age, status epilepticus and absence of headache were associated with poor functional prognosis at discharge.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"80 1","pages":"36202"},"PeriodicalIF":0.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625772","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}

引用次数: 0

Unforeseen Sequelae: Myxomatous Aneurysm and Cerebral Metastasis in a Case of Atrial Myxoma-A Clinical Image. 不可预见的后遗症：1例心房黏液瘤的黏液瘤性动脉瘤及脑转移——临床影像。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-02-12 DOI: 10.31083/RN37950

Sukalyan Purkayastha, Rajinder Kumar, Dinesh Verma, Deepak Dhurvey, Nitin Kumar, Surajit Jana

引用次数: 0

A Rare Guillain-Barré Syndrome Variant with Multi-Ganglioside Reactivity: A Case of Severe Cranial Nerve Involvement. 伴有多神经节苷类反应的罕见格林-巴勒综合征变型：1例严重脑神经受累。

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-02-12 DOI: 10.31083/RN37744

Laura Gómez-Dabó, Arnau Llaurado, Daniel Sánchez-Tejerina, Victoria González, Carmen Montalvo-Olmedo, Carlos Lázaro-Hernández, Marc Rodrigo-Gisbert, Samuel López-Maza, Maider Iza-Achutegui, Lídia Giramé-Rizzo, Nuria Raguer, Raúl Juntas

{"title":"A Rare Guillain-Barré Syndrome Variant with Multi-Ganglioside Reactivity: A Case of Severe Cranial Nerve Involvement.","authors":"Laura Gómez-Dabó, Arnau Llaurado, Daniel Sánchez-Tejerina, Victoria González, Carmen Montalvo-Olmedo, Carlos Lázaro-Hernández, Marc Rodrigo-Gisbert, Samuel López-Maza, Maider Iza-Achutegui, Lídia Giramé-Rizzo, Nuria Raguer, Raúl Juntas","doi":"10.31083/RN37744","DOIUrl":"10.31083/RN37744","url":null,"abstract":"Introduction: We present a rare case of acute immune-mediated polyradiculoneuritis, a Guillain-Barré Syndrome (GBS) variant, manifesting as ophthalmoparesis-ataxia, facial diplegia, and acute bulbar palsy, accompanied by a unique autoimmune profile.Clinical case: A 75-year-old female developed rapidly progressive symptoms, including bilateral non-reactive mydriasis, ptosis, complete ophthalmoplegia, bilateral facial weakness, tongue immobility, palatal paralysis, limb dysmetria, ataxia, and brisk generalized tendon reflexes, all while maintaining a preserved mental state. Symptoms emerged 10 days after a probable gastrointestinal infection. Severe bulbar dysfunction necessitated orotracheal intubation and a tracheotomy. Extensive cranial nerve involvement initially suggested a brainstem lesion, with oculomotor and acute bulbar palsy as prominent signs. However, brainstem and spinal magnetic resonance imaging along with cerebrospinal fluid analysis yielded negative results. Electromyography reveled a sensorimotor demyelinating polyradiculoneuropathy, and serum testing identified IgG antibodies targeting multiple gangliosides, including the disialosyl group and terminal NeuNAc(α2-3)Gal. Treatment with intravenous immunoglobulin (IVIG) led to gradual clinical improvement.Conclusions: This case highlights a rare and severe GBS phenotype characterized by reactivity to multiple gangliosides. It highlights the role of shared ganglioside epitopes in antibody-mediated neurological damage and expands the clinical spectrum of GBS variants.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"80 1","pages":"37744"},"PeriodicalIF":0.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625773","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}

引用次数: 0

[Cognition and Long COVID: A PRISMA Systematic Review of Longitudinal Studies].

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-01-24 DOI: 10.31083/RN37385

María Alejandra Tudorache Pantazi, Marien Gadea-Doménech, Raúl Espert Tortajada

{"title":"[Cognition and Long COVID: A PRISMA Systematic Review of Longitudinal Studies].","authors":"María Alejandra Tudorache Pantazi, Marien Gadea-Doménech, Raúl Espert Tortajada","doi":"10.31083/RN37385","DOIUrl":"10.31083/RN37385","url":null,"abstract":"Introduction: Long COVID is defined by National Institute for Health and Care Excellence (NICE) as the set of signs and symptoms that develop during or after a SARS-CoV-2 infection and continue for more than twelve weeks without any alternative diagnosis. One of the most frequent persistent symptoms reported by patients and verified in neuroimaging studies is cognitive dysfunction, due to a generalized hypoconnectivity and a diffuse axonal lesion in white matter. Therefore, the objectives of the present review are to determine how long cognitive functions remain affected during Long COVID and to explore which cognitive functions are most affected beyond three months of follow-up in patients up to 65 years of age without previous neuropsychological or psychiatric complications.Methods: A systematic review was performed using PRISMA criteria and 11 articles were included through a comprehensive search of five different databases: PubMed, Medline, Scopus, WOS and ProQuest. The risk of bias of the articles was assessed using the Newcastle-Ottawa scale.Results: Cognitive problems in Long COVID persist over time and improve slowly, although studies seem to agree that most areas improved significantly after one year. The cognitive functions that remained impaired the longest were processing speed and attention.Conclusions: These cognitive alterations cause a reduction in the quality of life of the patients and a reduction in work capacity and manifest the need for a cognitive intervention.","PeriodicalId":21281,"journal":{"name":"Revista de neurologia","volume":"79 12","pages":"37385"},"PeriodicalIF":0.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256144","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}

引用次数: 0

[Neurology in Bohemian Lights].

IF 0.8 4区医学

Revista de neurologia Pub Date : 2025-01-20 DOI: 10.31083/RN37281

Alfredo Puy-Núñez, Ana Guitián-Pena, Irene Expósito-Ruiz, Mercedes Macías-Arribí, Jose Manuel Aldrey-Vázquez, Juan Manuel Pías-Peleteiro

引用次数: 0