Revue neurologique最新文献

{"title":"Retrospective, descriptive study of acute myelitis in French Guyana.","authors":"P Grimont, A Montcuquet, F Quet, B De Toffol, N Deschamps","doi":"10.1016/j.neurol.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.002","url":null,"abstract":"<p><strong>Background: </strong>Acute myelitis is a neurological entity, often posing the problem of etiology. The two main causes are infectious or autoimmune. French Guyana is a region of the world where infectious etiologies are multiple, in particular human immunodeficiency virus infection, and autoimmune diseases appear to be emerging. The aim of our study was firstly to determine the proportion of each etiology of acute myelitis in French Guyana, and secondly to describe the clinical, paraclinical and epidemiological characteristics of autoimmune myelitis in French Guyana, with particular reference to neuromyelitis optica spectrum disorder (NMOSD).</p><p><strong>Methods: </strong>This retrospective, observational study included all patients who presented with acute myelitis between January 2015 and August 2023 at Cayenne Hospital Center. Each patient's chart was reviewed and patients were classified according to etiology. Demographic and clinical data were collected, as well as blood, lumbar puncture, and cerebral and spinal cord magnetic resonance imaging results.</p><p><strong>Results: </strong>Of the 40 patients included, immune etiology was found in 74%, including 49% with NMOSD (37% with positive anti-aquaporin-4 antibodies) compared with three patients with infectious etiology. There was no statistically significant difference in complementary examinations between immune and infectious etiologies. The prevalence of NMOSD in French Guyana was estimated at 8/100,000 (6/100,000 for patients with positive anti-aquaporin-4 antibodies). No significant difference in the geographic distribution of patients with NMOSD in French Guyana was demonstrated.</p><p><strong>Conclusions: </strong>Our results show a high proportion of autoimmune etiology of acute myelitis in French Guyana, and more particularly of NMOSD. There is a high prevalence of NMOSD, the second highest in the world after the French West Indies. Given this high proportion of autoimmune myelitis, several hypotheses can be put forward, with genetic and environmental factors in the foreground. For patients with acute myelitis in French Guyana, an immune cause is the most likely. It is therefore important to think about this and look for NMOSD in particular, without ignoring an infectious etiology.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075079","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":"Ureaplasma urealyticum septic hip arthritis associated with ocrelizumab therapy in a young patient with multiple sclerosis.","authors":"J Le Bars, L Picard, M Hervouet, E Le Page","doi":"10.1016/j.neurol.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.003","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060474","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":"Stroke Triage Alpha Rescue Score (STARS): Prehospital phone-based tool to identify cerebral large vessel occlusion.","authors":"P Morin, A Boissieux, V Brenckmann, H Merlin, A Baquerre, S Marcel, O Detante, P Usseglio, G Debaty, I Favre-Wiki, J Papassin","doi":"10.1016/j.neurol.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Prehospital identification of stroke patients with large vessel occlusion (LVO) is crucial to optimize transport to an endovascular thrombectomy (EVT)-capable center. Existing scores require medical or paramedical expertise and specific teachings. We aimed to validate a simple prehospital phone-based score for LVO identification.</p><p><strong>Methods: </strong>First, the Stroke Triage Alpha Rescue Score (STARS) was designed among a retrospective cohort of 3452 stroke alerts from the Emergency Medical Dispatch Centers (EMDC) registry. Phone-based neurological assessment, characteristics, final diagnosis, and brain imaging were analyzed. The items weighting was based on odds ratios (ORs) of significant variables after multivariate analysis. Secondly, STARS was assessed by dispatchers for all suspected strokes in a prospective cohort. Receiver operating curve (ROC) and predictive performances were calculated for the external validation.</p><p><strong>Results: </strong>In the retrospective cohort, the best balance between specificity and sensitivity was obtained with a combination of six items (presence or absence of: upper, lower limbs motor deficits, language impairment, facial palsy, consciousness disorder, smoking). Each item value was determined according to their respective OR to obtain a total STARS between 0 and 13, with the most favorable cut-off higher or equal to 7 points. Then, STARS was prospectively assessed in 799 stroke alerts between March 2021 and March 2022. LVO was finally detected in 63 of 653 patients (9.6%). The area under the ROC was 0.83 [95% CI: 0.78; 0.88]. STARS≥7 had 0.83 accuracy, 0.65 sensitivity, and 0.85 specificity for detecting LVO.</p><p><strong>Conclusion: </strong>STARS is a simple and accurate phone-based score, without specific teaching, to detect LVO in prehospital network. STARS correctly classified 83% of stroke alerts and could be useful to identify patients with LVO eligible for EVT.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060419","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":"Diagnosis of subarachnoid haemorrhage: It is time to use spectrophotometry.","authors":"X Moisset, G Demarquay, D Bouvier","doi":"10.1016/j.neurol.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024599","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":"Epidemiology of optic disc edema in 2021/2022: Results from a cohort of 197 patients","authors":"R. Attia ,&nbsp;N. Stolowy ,&nbsp;R. Fitoussi ,&nbsp;K. Mairot ,&nbsp;T. David","doi":"10.1016/j.neurol.2024.09.010","DOIUrl":"10.1016/j.neurol.2024.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of our study was to determine the etiologies of optic disc edema between 2021 and 2022.</div></div><div><h3>Materials and methods</h3><div>This was a multicentric study at the Timone and Nord university hospitals in Marseille. Patients were retrospectively followed in ophthalmology departments, with inclusion between January 2021 and December 2022. All patients presenting with newly diagnosed uni- or bilateral optic disc edema, both adults and children, were included. Their ophthalmological evaluation included a fundus examination and optical coherence tomography if feasible.</div></div><div><h3>Results</h3><div>In total, 197 patients were included. Intracranial hypertension (IH) was the most frequent etiology (37.06%). The primary causes of IH were idiopathic (27/73), intracranial tumors (21/73), and cerebral venous thrombosis (12/73). The second etiology of optic disc edema was retinal vein occlusion in 19.9% of cases (39/197). Edema reactive to uveitis was found in 13.2% of cases (26/197). Finally, inflammatory (17/197) and ischemic (30/197) optic neuropathies were identified.</div></div><div><h3>Conclusion</h3><div>This study updates the most frequent etiologies of optic disc edema in 2021 and 2022 to facilitate diagnostic hypotheses for de novo optic disc edema. It highlights the importance of a comprehensive and personalized evaluation in diagnosing optic disc edema, taking into account recent advances in imaging techniques and biomarkers.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 1","pages":"Pages 93-97"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473656","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":"Adding corticosteroids to galcanezumab in medication overuse headache: A three-arm head-to-head prospective observational cohort study","authors":"S. Braca,&nbsp;R. De Simone,&nbsp;A. Stornaiuolo,&nbsp;G. Cretella,&nbsp;A. Miele,&nbsp;C.V. Russo","doi":"10.1016/j.neurol.2024.10.003","DOIUrl":"10.1016/j.neurol.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Medication overuse headache (MOH) is a condition where pain relief medications cause chronic headaches due to excessive use. Recent advancements highlight the effectiveness of preventive treatments like anti-CGRP monoclonal antibodies. Current strategies combine medication withdrawal and preventive treatments, with corticosteroids traditionally used to ease withdrawal symptoms.</div></div><div><h3>Methods</h3><div>This is a prospective three-arm observational cohort study comparing the effectiveness and safety of galcanezumab alone, galcanezumab plus prednisone and prednisone alone for the treatment of MOH. We enrolled 75 patients. Prednisone was administered at an initial dose of 50<!--> <!-->mg daily, and then tapered off over 28<!--> <!-->days. Duration of follow-up was 3<!--> <!-->months.</div></div><div><h3>Results</h3><div>All treatments proved effective (<em>P</em> <!-->&lt;<!--> <!-->0.001). We found a significant reduction of mean monthly days with headache in the galcanezumab plus prednisone group (baseline: 25, IQR: 20–30; after 3<!--> <!-->months: 7, IQR: 5–10), in the galcanezumab group (baseline: 25, IQR: 20–30; after 3<!--> <!-->months: 10, IQR: 5–14) and in the Prednisone group (baseline: 25, IQR: 20–28; after 3<!--> <!-->months: median: 15 days, IQR: 8–22<!--> <!-->days). Patients treated with prednisone reported a higher incidence of side effects (<em>P</em> <!-->=<!--> <!-->0.002).</div></div><div><h3>Conclusion</h3><div>Our study indicates that both galcanezumab and prednisone decrease the frequency of headaches in patients with MOH. The combined usage of these treatments showed the highest reduction in mean monthly headache days. However, treatment with prednisone determined a significant rate of adverse events, therefore we suggest its use only in unresponsive patients. In all other patients galcanezumab appears to be a safe and effective option.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 1","pages":"Pages 106-113"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605926","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":"Iron overload revealing the cytoarchitecture of the red nucleus: A case study","authors":"B. Testud ,&nbsp;M. Guye ,&nbsp;T. Witjas ,&nbsp;S. Grimaldi","doi":"10.1016/j.neurol.2024.11.001","DOIUrl":"10.1016/j.neurol.2024.11.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 1","pages":"Pages 1-2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751388","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 neurologist Henri Hallopeau (1842–1919), a famous dermatologist","authors":"O. Walusinski","doi":"10.1016/j.neurol.2023.10.017","DOIUrl":"10.1016/j.neurol.2023.10.017","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 1","pages":"Pages 124-130"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703257","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":"Disease-modifying treatments for neuromyelitis optica spectrum disorder in the context of a new generation of biotherapies","authors":"S. Demuth ,&nbsp;N. Collongues","doi":"10.1016/j.neurol.2024.01.008","DOIUrl":"10.1016/j.neurol.2024.01.008","url":null,"abstract":"<div><div>Neuromyelitis optica spectrum disorder (NMOSD) is a rare but debilitating autoimmune disease of the central nervous system (CNS) for which several biotherapies have recently been approved on the market. Historically, NMOSD disease-modifying treatments relied on wide-spectrum off-label immunosuppressants, such as azathioprine, mycophenolate mofetil, and cyclophosphamide. Since 2015, evidence has accumulated to support off-label biotherapies (rituximab and tocilizumab) and to approve satralizumab, inebilizumab, eculizumab, and ravulizumab. This next generation of drugs provides several targeted disease-modifying treatment options for NMOSD. Here, we review this modern panel. We first review the mechanistic rationales associated with their specific targets. We then review the pivotal evidence supporting their use in practice and their respective regimens. Lastly, we discuss the positioning of each therapeutic class. The current therapeutic options in NMOSD comprise three targeted mechanisms at different stages of a unique tissue-injury cascade: B-cell depleting, anti-cytokine, and anti-complement therapies. One drug has been approved on the market in each class. The current consensus proposes positioning the approved drugs as first-line treatments for newly-diagnosed patients and as alternative therapies in case of failure of historical treatment. Yet, there has been limited acceptance in practice due to high drug prices.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 1","pages":"Pages 42-51"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327093","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":"Mothership versus Drip-and-Ship for stroke in a rural area: A French prospective observational study","authors":"M. Raquin,&nbsp;C. Lambert,&nbsp;P. Paris,&nbsp;N. Bourgois,&nbsp;P. Clavelou,&nbsp;X. Moisset ,&nbsp;A. Ferrier","doi":"10.1016/j.neurol.2024.06.007","DOIUrl":"10.1016/j.neurol.2024.06.007","url":null,"abstract":"<div><h3>Background</h3><div>The availability of mechanical thrombectomy (MT) is limited. Thus, there are two paradigms for patients living closer to a primary stroke center (PSC) than a comprehensive stroke center (CSC) capable of MT: “Mothership” (direct referral to a CSC) and “Drip-and-Ship” (referral to a PSC for imaging and thrombolysis and transfer to a CSC for thrombectomy or monitoring). We aimed to compare the prognosis of patients at three months between the two paradigms in a rural area.</div></div><div><h3>Materials</h3><div>From September 2019 to March 2021, we prospectively included patients living closer to a PSC than the one CSC, regardless of the type of stroke or reperfusion treatment. The proportion of patients with a good functional outcome (Rankin<!--> <!-->≤<!--> <!-->2) at three months was compared between the two initial orientations for all patients and for subgroups: patients with ischemic stroke and patients treated by MT.</div></div><div><h3>Results</h3><div>Among the 206 patients included, 103 were admitted directly to the CSC (82.5% had an ischemic stroke and 24.3% a MT) and 103 initially admitted to a PSC and then transferred to the CSC (100% had an ischemic stroke and 52.4% a MT). The proportion of patients with a good outcome was comparable between the two groups (54.5% vs. 43.7%, <em>P</em> <!-->=<!--> <!-->0.22). Among the 79 patients who underwent MT, the prognosis at three months was better in the Mothership group (49.3% vs. 15.3%, <em>P</em> <!-->=<!--> <!-->0.01).</div></div><div><h3>Conclusion</h3><div>The functional prognosis is comparable between Mothership and Drip-and-Ship paradigms in our setting, despite a trend towards a better prognosis for the Mothership. As has been shown in urban settings, the mothership paradigm also leads to a better prognosis for patients treated with MT in a rural setting.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 1","pages":"Pages 67-78"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856398","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}