Revue neurologique最新文献

{"title":"Lack of efficacy of sofosbuvir in Human Pegivirus associated neurological disorders.","authors":"V Pourcher, M Boudot de La Motte, M Touat, R Deschamps, C Dehais, C Houillier, F Domont, S Bonnin, M-B Le Stang, C Rodriguez, M Eloit, G Peytavin, E Maillart","doi":"10.1016/j.neurol.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.02.002","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531054","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":"Diffuse cerebral vasodilatation at the initial stage of reversible cerebral vasoconstriction syndrome (RCVS).","authors":"M Bertin Terrom, P Constant Dit Beaufils, S de Gaalon, H Desal, R Bourcier, J Aguilar","doi":"10.1016/j.neurol.2025.01.411","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.411","url":null,"abstract":"<p><strong>Background and purpose: </strong>Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headaches and segmental vasoconstriction of cerebral arteries resolutive within three months. However, two case reports in the literature revealed diffuse cerebral vasodilatation rather than vasoconstriction at the early phase of RCVS (Kobayashi, 2016; Oikawa et al., 2017). This study aims at reporting the occurrence of diffuse cerebral vasodilatation at the initial stage of RCVS and at analyzing the clinical and prognostic characteristics of patients with diffuse vasodilatation.</p><p><strong>Materials and methods: </strong>Patients with RCVS were retrospectively gathered from medical files. Initial and follow-up vascular imaging were compared to assess vasodilatation and vasoconstriction for each segment of the circle of Willis on the initial angiogram. Diffuse vasodilatation was defined as dilatation of four or more of the circle of Willis arteries both in the anterior and posterior circulations, without previously described \"string of beads\" appearance of cerebral arteries. Patients were split into two groups based on the presence of diffuse cerebrovascular dilatation for comparison.</p><p><strong>Results: </strong>Among 148 patients with RCVS, 45 patients (30%) had diffuse cerebral vasodilatation. Diffuse vasodilatation was proved to occur at the early phase of RCVS (mean delay between thunderclap headache onset and initial imaging of 2.25days versus 7.63days, P=0.047) and mainly affected the first and second segments of major cerebral arteries. It was significatively associated with distal vasoconstriction (44.44% versus 25.24%, P=0.033). Patients with diffuse cerebral vasodilatation had a greater risk of hemorrhage (15.56% for subarachnoid hemorrhage versus 3.88%, P=0.035; 8.89% for intracranial hemorrhage versus 0.97%, P=0.03). Vasodilatation was more frequent in women (71.11% versus 41.75%, P=0.001). Secondary forms of RCVS were associated with diffuse vasodilatation (51% versus 27%, P=0.008).</p><p><strong>Conclusion: </strong>The early cerebral angiogram may reveal diffuse cerebrovascular dilatation in patients with RCVS. Vasodilatation might have a pathophysiological implication in RCVS with clinical and prognostic consequences for patients.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524170","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":"Ischemic stroke care for patients affiliated to the French agricultural health insurance scheme: A national study.","authors":"O Grimaud, S Kerbrat, L Menant, S Timsit, J-M André, E Nowak, V Olié, C Padilla, N Le Meur","doi":"10.1016/j.neurol.2025.01.410","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.410","url":null,"abstract":"<p><strong>Background: </strong>Health disparities along the rural-urban spectrum are a growing concern. The objective of this study was to determine whether in France, clinical profile, care and outcome after ischemic stroke differed between patients affiliated to the statutory health insurance system dedicated to the agricultural economic sector (i.e., Mutualité Sociale Agricole [MSA]) and all other patients.</p><p><strong>Methods: </strong>Data on all patients aged≥20 years hospitalized for ischemic stroke in mainland France in 2018 were extracted from the French National Health Insurance Data System. Age-standardized percentages were used to compare the care accessed by MSA versus other stroke patients. Associations between health insurance scheme and case fatality were assessed using Poisson regression.</p><p><strong>Results: </strong>Of 87,864 stroke cases 7928 (9%) were MSA patients. MSA patients were more often rural dwellers (75.4 versus 32%) and older (median age: 84 versus 76 years). In the 12 months prior to the stroke, access to general practitioner (GP) was similar, but MSA patients were less likely to have an appointment with a cardiologist. Pre-stroke drug prescriptions suggested a better cardiovascular profile in male MSA patients (e.g., antidiabetics: 18.1 versus 21.5%). A part from a lower access to stroke unit (e.g., women: 55.3 versus 59%) other acute care indicators, including reperfusion therapy, were comparable. The crude 7-day case fatality was higher for MSA patients (Relative Risk [RR]: 1.44, 95% CI [1.32-1.57]), but this disadvantage reduced to non-significant level after adjustment for age, comorbidities and stroke management (adjusted RR: 1.07 95% CI [0.98-1.18]) CONCLUSIONS: For the mostly farming, rural, MSA population, pre-stroke, acute and post-stroke care did not differ markedly from that provided to other patients. The lower density of GP in rural areas and the remoteness from specialized center did not result in less access to preventive and acute stroke care for MSA patients in 2018.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483894","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 COVID-19 pandemic reduced delays in the care pathway for patients with glioma at a French institute.","authors":"M Brison, W Bouleftour, J-B Pelletier, F Vassal, F Barral-Clavel, E Jadaud, C Boutet, J-P Camdessanche, F Forest, C Ramirez","doi":"10.1016/j.neurol.2025.01.412","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.412","url":null,"abstract":"<p><strong>Context: </strong>Delays in cancer management have been reported during the COVID-19 pandemic. Neuro-oncology patients represent a real challenge as their disease can progress rapidly without appropriate care. However, data available for these patients over this period is scarce.</p><p><strong>Objective: </strong>Therefore, the aim of this study was to examine the impact of the COVID-19 pandemic on therapeutic care within a specific population at a French institute. A retrospective descriptive study was conducted using electronic medical records. All patients who underwent surgery for glioma in a neurosurgery unit between January 1st, 2019 and December 31st, 2020 were included.</p><p><strong>Results: </strong>A total of 114 patients were operated for a glioma; 70 patients in 2019 (before the pandemic) and 44 in 2020 (during the pandemic). Among these patients, 89% were diagnosed with a high-grade glioma, including 81% with glioblastoma. The mean time between first symptoms and imaging process increased from 35days in 2019 to 40days in 2020. However, in the subsequent steps of the care pathway, timelines improved at each stage with a reduction up to four days. The time reduction was statistically significant for two specific stages of care: (i) the interval between the surgery and the histomolecular diagnosis, with a reduction of two days, and (ii) the period between the histomoleculardiagnosis and the consultation for results announcement, with a reduction of three days. In summary, on average, the first treatment was initiated 49 days post-surgery in 2019 and 36days post-surgery in 2020.</p><p><strong>Conclusion: </strong>This study showed that the COVID-19 outbreak positively impacted the therapeutic care pathway of patients with glioma at a French institute. Although the improvement can be measured in days, this acceleration of care was nonetheless crucial for the population studied.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483842","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":"Determinants of the experience of patients living with multiple sclerosis in terms of care pathway quality: An original French study.","authors":"D Veillard, K Baumstarck, A Ousmen, S Hamonic, G Edan, P Auquier","doi":"10.1016/j.neurol.2025.01.375","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.375","url":null,"abstract":"<p><strong>Purpose: </strong>Taking into account the experience of patients living with chronic diseases, like multiple sclerosis (MS), in the assessment of the quality of their care pathway contributes significantly to improve these quality and their own state of health. This challenge requires better identification of the determinants of this experience. The study aimed to explore the determinants of the experience of MS patients in France concerning their care pathway quality.</p><p><strong>Patient and methods: </strong>This study was based on a dedicated cross-sectional national survey that took place in 2021. Teams from regional MS networks and MS unit at the hospital, as well as patients' associations, invited patients to participate throughout France. Patients' experience was assessed using the Musicare questionnaire. The determinants explored concerned their sociodemographic characteristics, quality of life and disease characteristics. To explore association between MusiCare questionnaire dimension scores and these determinants, bivariate and multivariate analysis were performed.</p><p><strong>Results: </strong>Data were exploitable for 1971 patients living throughout France. Multivariate analysis identified significant relationships between all but one of the Musicare dimensions and several of the determinants considered in this study. The presence of a supportive caregiver, better quality of life scores, receiving specialized follow-up for MS, being a male patient and long-term illness significantly improves patient experience on one or more dimensions of the Musicare questionnaire.</p><p><strong>Conclusion: </strong>Some of these results are consistent with those of previous studies on other chronic diseases. They require confirmation, but they pave the way for targeted interventions for these patients in France.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433590","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":"Trigeminal autonomic cephalalgia after common eye surgery: Case series and literature review.","authors":"M Beltramone, S Redon, A Donnet","doi":"10.1016/j.neurol.2025.01.305","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.01.305","url":null,"abstract":"<p><strong>Background: </strong>Secondary cases of trigeminal autonomic cephalalgia have been described, most commonly following tumor, trauma, or vascular causes.</p><p><strong>Cases: </strong>We report a series of 6 patients who experienced ipsilateral headache responding to the International Headache Society criteria for cluster headache, hemicrania continua or probable hemicrania continua. It occurred immediately or in the following days or weeks after cataract or glaucoma surgery. We complete these descriptions with 4 cases from a literature review of trigeminal autonomic cephalalgia attributed to non-destructive eye surgery.</p><p><strong>Conclusion: </strong>We report the largest series of patients who developed TAC after ocular surgery, supplemented by 4 cases from the literature. For many of these patients, TAC treatments can be effective either as a preventive or as an attack.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399897","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":"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}