eNeurologicalSci最新文献

{"title":"Vascular parkinsonism showing dopamine transporter scan findings mimicking those of Parkinson's disease","authors":"Hirotaka Sakuramoto,&nbsp;Hiroaki Fujita,&nbsp;Keitaro Ogaki,&nbsp;Keisuke Suzuki","doi":"10.1016/j.ensci.2024.100528","DOIUrl":"10.1016/j.ensci.2024.100528","url":null,"abstract":"<div><p>Dopamine transporter (DAT) scan is important in the diagnosis of Parkinson's disease (PD). We herein report a patient with vascular parkinsonism (VP) who showed dopamine transporter (DAT) scan findings which mimicked those typically seen in patients with Parkinson's disease (PD). DAT scan findings in patients with VP are characterized by a lower striatal asymmetry index than in patients with PD and decreased uptake in the area consistent with old cerebral infarction or hemorrhage. However, we should be aware that, as in our patient, VP patients with asymmetric basal ganglia lesions, may show increased striatal asymmetry index and asymmetric DAT scan findings.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100528"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000352/pdfft?md5=b1aab43d71f875ab19a490bb60a4b217&pid=1-s2.0-S2405650224000352-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraneoplastic myelitis associated with Waldenström macroglobulinemia responsive to treatment with ibrutinib – venetoclax: A case report","authors":"Sathya Narasimhan ,&nbsp;Kristin M. Galetta ,&nbsp;Jorge J. Castillo ,&nbsp;Shamik Bhattacharyya","doi":"10.1016/j.ensci.2024.100527","DOIUrl":"10.1016/j.ensci.2024.100527","url":null,"abstract":"<div><p>Waldenström macroglobulinemia (WM) is a B-cell lymphoproliferative malignancy characterized by IgM paraproteinemia and presence of lymphoplasmacytic cells in the bone marrow. Isolated longitudinally extensive transverse myelitis (LETM) is a rare manifestation of WM. We report a rare case of paraneoplastic LETM in a 68-year-old male with treatment-naïve WM (MYD88 L265P mutation in bone marrow aspirate), who responded to ibrutinib and venetoclax therapy. Our patient presented with a two-month history of unsteadiness, tingling, and numbness in both hands and feet, that progressed to bilateral leg and arm weakness. Based on radiographic findings, a diagnosis of paraneoplastic LETM was made and he was treated acutely with IV methylprednisolone followed by a quick oral prednisone taper. However, he subsequently relapsed and symptomatically worsened while on rituximab therapy. Accounting for worsening anemia, our patient was enrolled in a Phase II trial evaluating the effects of ibrutinib-venetoclax therapy in treatment naïve WM. After three months of study therapy, he had a complete response of myelopathy symptoms and MRI lesions. Our observation of sustained disease response in this patient may support a role for concurrent BTK and BCL2 inhibition in paraneoplastic myelitis associated with B-cell lymphoproliferative disorders. However, this observation needs to be validated in larger cohort studies and potentially in clinical trials if further data are supportive.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100527"},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000340/pdfft?md5=43afc1ecba5891cbfde9596c785398c2&pid=1-s2.0-S2405650224000340-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142167211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of nerve fiber layer and ganglion cell complex changes in patients with migraine using optical coherence tomography","authors":"Yasmin Walha ,&nbsp;Mona Rekik ,&nbsp;Khadija Sonda Moalla ,&nbsp;Sonda Kammoun ,&nbsp;Omar Ayadi ,&nbsp;Chokri Mhiri ,&nbsp;Mariem Dammak ,&nbsp;Amira Trigui","doi":"10.1016/j.ensci.2024.100525","DOIUrl":"10.1016/j.ensci.2024.100525","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze changes in peripapillary retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness in migraine patients with and without aura compared to healthy controls and to identify factors influencing the occurrence of these anomalies.</p></div><div><h3>Methods</h3><p>This is a cross-sectional case-control study including migraine patients and control subjects. All patients and controls underwent a complete ophthalmological examination, RNFL and GCC thickness measurements using a spectral domain-OCT device.</p><p>The duration of migraine, the frequency and duration of migraine attacks, the migraine disability assessment (MIDAS) and migraine severity scale (MIGSEV) questionnaire scores were recorded.</p></div><div><h3>Results</h3><p>One hundred and twenty eyes from 60 patients (60 eyes in the migraine without aura (MWoA) group and 60 eyes in the migraine with aura (MWA) group) were included. Control group included 30 age and gender matched healthy participants (60 eyes). OCT revealed that RNFL and GCC thickness were significantly reduced in the migraine without aura (MWoA) and in the migraine with aura (MWA) groups compared to the control group and in the migraine with aura (MWA) group compared to the migraine without aura (MWoA) group. Prolonged disease duration was associated to decreased GCC thickness. RNFL and GCC thickness were correlated to disease severity, attack frequency and duration. In the multivariate study, duration of migraine and attack frequency were the main determinant factors of nasal GCC thickness. Disease severity was the main determinant of RNFL and GCC thickness, with the exception of the nasal sector.</p></div><div><h3>Conclusion</h3><p>Our study emphasize the significant impact of both types of migraine on retinal structures. OCT would serve as a valuable biomarker in migraine.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100525"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000327/pdfft?md5=c10cd63368bef8fc8e2711e33ab5ed0b&pid=1-s2.0-S2405650224000327-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic aphasia as an early sign of corticobasal degeneration: Clinico-radio-pathological correlation","authors":"Masanori Kurihara ,&nbsp;Akira Arakawa ,&nbsp;Aya Midori Tokumaru ,&nbsp;Tomoyasu Matsubara ,&nbsp;Hiroto Eguchi ,&nbsp;Yasushi Shimo ,&nbsp;Masato Hasegawa ,&nbsp;Kazutomi Kanemaru ,&nbsp;Katsuhiko Takeda ,&nbsp;Atsushi Iwata ,&nbsp;Shigeo Murayama ,&nbsp;Yuko Saito","doi":"10.1016/j.ensci.2024.100526","DOIUrl":"10.1016/j.ensci.2024.100526","url":null,"abstract":"<div><p>A 72-year-old man presented with a 6-month history of decreased voluntary speech. Sparse speech and decreased word fluency were observed. Articulation, naming, comprehension, and repetition were preserved. Agrammatism and paraphasia were not observed. These characteristics matched those reported as dynamic aphasia. Other findings were mild behavioral symptoms, recent memory impairment, and right hemiparkinsonism. The patient‘s voluntary speech continued to reduce and behavioral symptoms progressed. Brain MRI including voxel-based morphometric analysis showed left-dominant white matter volume reduction in the frontal lobe including those between the left supplementary motor area (SMA)/preSMA and the frontal operculum, likely involving the frontal aslant tract (FAT). The patient became completely mute after two years from disease onset and died of aspiration pneumonia. The neuropathological diagnosis was corticobasal degeneration (CBD). This case suggests that dynamic aphasia may be the initial sign of CBD and that early involvement of left FAT may be responsible for this feature.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100526"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000339/pdfft?md5=470e69884011f9416ef222cc17438085&pid=1-s2.0-S2405650224000339-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142164087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tiny infarction of rostral cerebellum manifested by contralesional body lateropulsion","authors":"Obay Alalousi ,&nbsp;Mickael Bonnan","doi":"10.1016/j.ensci.2024.100523","DOIUrl":"10.1016/j.ensci.2024.100523","url":null,"abstract":"<div><p>Body lateropulsion (BLP) has been reported several times after cerebellar infarction. It is usually ipsilateral to the cerebellar infarction, particularly when limited to the rostral cerebellum. In contrast, contralesional BLP after cerebellar infarction has been reported in more caudal regions of the cerebellum (such as the nodulus or the tonsil).</p><p>We report the case of a small infarction of the left anterior paravermis of the rostral cerebellum which resulted in bilateral symptoms: ipsilesional limb ataxia and, unexpectedly, contralesional BLP.</p><p>Several neurological pathways were potentially involved. Both right and left dorsal spinocerebellar tracts may have been damaged by the infarction of the left anterior paravermis. On the other hand, the proximity of the infarct to the superior cerebellar peduncle may have caused damage to the vestibular pathways (fastigio-vestibular or dentato-vestibular tracts), as they exit the cerebellum by the superior cerebellar peduncle. A lesion of the cerebellum close to the superior cerebellar peduncle could result in a contralesional BLP.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100523"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000303/pdfft?md5=457b524f5d4cb98e5d9b00ed240d40b0&pid=1-s2.0-S2405650224000303-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the gold cost criteria as a diagnostic criteria of amyotrophic lateral sclerosis","authors":"Ramez M. Odat ,&nbsp;Omar Alomari ,&nbsp;Anas Elgenidy","doi":"10.1016/j.ensci.2024.100524","DOIUrl":"10.1016/j.ensci.2024.100524","url":null,"abstract":"","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100524"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000315/pdfft?md5=992b5fb83de8f413b3b56767edef22bb&pid=1-s2.0-S2405650224000315-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142150507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the clinical landscape of artery of Percheron infarction: A systematic review","authors":"Oday Atallah ,&nbsp;Yasser F. Almealawy ,&nbsp;Arwa Salam Alabide ,&nbsp;Minaam Farooq ,&nbsp;Vivek Sanker ,&nbsp;Suraa N. Alrubaye ,&nbsp;Rami Darwazeh ,&nbsp;Wireko Andrew Awuah ,&nbsp;Toufik Abdul-Rahman ,&nbsp;Ahmed Muthana ,&nbsp;Aalaa Saleh ,&nbsp;Jack Wellington ,&nbsp;Amr Badary","doi":"10.1016/j.ensci.2024.100521","DOIUrl":"10.1016/j.ensci.2024.100521","url":null,"abstract":"<div><h3>Introduction</h3><p>Infarction of the artery of Percheron (AOP) is a rare vascular condition where a single arterial branch supplies blood to the thalamic and midbrain regions, leading to neurological deficits. The challenge lies in its often-delayed diagnosis due to its rarity and diverse clinical presentations, necessitating heightened awareness among clinicians for expedited diagnosis and appropriate therapeutic interventions.</p></div><div><h3>Materials and methods</h3><p>All relevant studies involving patients diagnosed with infarction of AOP were retrieved from PubMed, Google Scholar, Web of Science, and Scopus. Only human studies that were published in full English-language reports were included. Included in the search were the terms “Artery of Percheron,” “infarction,” “stroke,” and “demarcation”. Age, gender, presenting symptoms, treatment, recovery time, and outcome of patients with AOP infarction were all recorded.</p></div><div><h3>Results</h3><p>A systematic review was conducted on a total of 530 articles, out of which 130 articles met the specified requirements. The average age is 59, with men comprising 57.7% of the population. The symptoms reported were visual disturbance in 43.9% of cases and changed mental state in 77.2% of cases. Treatment options include conservative management (85.4%), thrombolysis (11.3%), and other approaches. The optimal age range for recovery is between 41 and 50 years old.</p></div><div><h3>Conclusion</h3><p>Our study on acute AOP infarction highlights male predominance, common comorbidities like hypertension and diabetes, and prevalent symptoms including visual disturbance and altered mental state. Early recognition is crucial, with thrombolytic therapy within the critical time window showing promising outcomes. These findings offer insights for enhanced clinical management of AOP infarction.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"37 ","pages":"Article 100521"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000285/pdfft?md5=254de266619eecf40f4fc4ea54192342&pid=1-s2.0-S2405650224000285-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sertraline treatment for paroxysmal nonkinesigenic dyskinesia comorbid with anxiety and depression","authors":"Munetsugu Hara ,&nbsp;Toyojiro Matsuishi ,&nbsp;Satoru Takahashi ,&nbsp;Yushiro Yamashita","doi":"10.1016/j.ensci.2024.100520","DOIUrl":"10.1016/j.ensci.2024.100520","url":null,"abstract":"<div><p>Familial paroxysmal non-kinesigenic dyskinesia, which is a major form of paroxysmal dyskinesias, is characterized by intermittent attacks that include one side, subsequently spreading to the other side, involving the limbs and face, and is triggered by caffeine, alcohol, emotional stress, fatigue, and sleep deprivation, but not by sudden movement. A 26-year-old man had experienced dystonic movements and a choreiform right arm spreading to his arms, legs, and face since the age of one year. Oral dyskinesias and, rarely, dysarthria were also observed. Attacks lasting approximately five minutes occurred several times per day. Over three generations, his family members inherited a c.26C &gt; T (p. Ala9Val) missense mutation in exon 1 of <em>PNKD/MR-1</em> in an autosomal dominant manner and reported similar symptoms with clinical manifestations ranging from mild to severe. His scores on the Self-Rating Depression Scale, State–Trait Anxiety Inventory, and Profile of Mood States were high. This suggests that the patient also had comorbidities of anxiety and depression. The patient's attacks decreased from two times per week to once every two months, and his State–Trait Anxiety Inventory score decreased by 5–10 points on treatment with clonazepam and sertraline, allowing his condition to become stable enough that he was able to participate in society. Drug therapy with clonazepam and sertraline is the preferred treatment for reducing attacks in PNKD patients with strong anxiety and depression.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"36 ","pages":"Article 100520"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000273/pdfft?md5=a68d5aa26f3d11f9ed0a4fab36d4ee5b&pid=1-s2.0-S2405650224000273-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Candida dubliniensis meningitis in an immunocompetent patient: A case report and review of the literature","authors":"Denis Babici ,&nbsp;Ali A. Mohamed ,&nbsp;Olivia Mattner ,&nbsp;Jessica Canosa ,&nbsp;Willy Gan ,&nbsp;Pooja Patel","doi":"10.1016/j.ensci.2024.100519","DOIUrl":"10.1016/j.ensci.2024.100519","url":null,"abstract":"<div><h3>Objective</h3><p>We present the fifth case of candida dubliniensis meningitis in a young immunocompetent host and suggest extracorporeal membrane oxygenation (ECMO) as a potential risk factor for colonization.</p></div><div><h3>Methods</h3><p>A 22-year-old immunocompetent female presented with a diagnosis of bacterial meningitis. Two years prior, she received ECMO for Covid-19 pneumonia complicated by viral myocarditis &amp; Takutsobo cardiomyopathy. Following discharge, she reported headaches of increasing intensity, all refractory to treatments. Brain magnetic resonance imaging (MRI) was inconclusive. Two weeks prior to her presentation, she was admitted for worsening headaches with cranial nerve VI palsy. Lumbar puncture (LP) revealed white blood cell count (WBC) of 166 cells/μL with neutrophilic predominance and her symptoms progressed, despite 5 days of treatment with broad spectrum antibiotics. All cultures returned negative.</p></div><div><h3>Results</h3><p>At her current presentation, repeat LP revealed 835 WBC/mm3, 225 mg/dL protein, and 4 mg/100 mL glucose. Brain MRI revealed nodular enhancement in the brainstem and communicating hydrocephalus. MRI of the lumbar spine revealed meningeal enhancement. Cerebrospinal fluid (CSF) cultures came back positive for C.dubliniensis. Treatment began with Amphotericin B and Flucytosine.</p></div><div><h3>Discussion</h3><p>When clinical suspicion for fungal meningitis is high, repeate LP and CSF analysis is indicated to establish a definitive diagnosis and begin treatment. Additional studies are needed to confirm risk factors, like ECMO, for the colonization of C.dubliniensis, which likely predisposes individuals to invasive candidiasis.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"36 ","pages":"Article 100519"},"PeriodicalIF":0.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000261/pdfft?md5=9a8d0f3e4b9a66b314f788e24658e0ae&pid=1-s2.0-S2405650224000261-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epileptic seizures revealing tuberous sclerosis in a tropical environment: A study of 12 case series","authors":"Souleymane M'Bara Diallo ,&nbsp;Mamadou Diallo ,&nbsp;I.S. Barry ,&nbsp;M.L. Touré ,&nbsp;M.C. Barry ,&nbsp;M.T. Diallo ,&nbsp;S.D. Barry ,&nbsp;S.Y. Aminou ,&nbsp;G. Carlos Othon ,&nbsp;B. Diallo ,&nbsp;N. Camara ,&nbsp;M.B. Diallo ,&nbsp;M. Zoumanigui ,&nbsp;E. Lamah ,&nbsp;M. Hinima ,&nbsp;Sindu Mukesh ,&nbsp;A.K.T. Barry ,&nbsp;A. Sacko ,&nbsp;Ramit Singla ,&nbsp;F.A. Cissé ,&nbsp;A. Cissé","doi":"10.1016/j.ensci.2024.100516","DOIUrl":"10.1016/j.ensci.2024.100516","url":null,"abstract":"<div><h3>Background</h3><p>Epilepsy remains a significant public health concern in Sub-Saharan Africa (SSA) where diverse etiological factors contribute to its prevalence. Among these factors are conditions originating from the neuroectoderm, such as tuberous sclerosis. Insufficient medical attention and a lack of comprehensive multidisciplinary care contribute to its under-recognition.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective descriptive study, involving 12 patients admitted to the neurology and pediatric departments of the University Hospital Ignace Deen between 2010 and 2022 due to recurring epileptic seizures. Subsequently, these patients were diagnosed with Tuberous sclerosis using the Schwartz 2007 criteria. The aim of this study is to reassess this condition from a clinical and paraclinical point of view in a tropical environment.</p></div><div><h3>Results</h3><p>Tuberous sclerosis, also known as Bourneville disease, was diagnosed in 12 patients exhibiting focal motor seizures and complex focal seizures likely associated with cortical and subcortical tubers detectable by EEG and neuroimaging, including CT and MRI. Delayed treatment resulted in varying degrees of mental decline. Additionally, some patients displayed cardiac hamartomas and intracranial posterior and anterior aneurysms as minor diagnostic indicators.</p></div><div><h3>Conclusion</h3><p>The study reveals a consistent clinical presentation accompanied by deteriorating neurological and psychological symptoms attributed to delayed multidisciplinary management. These findings are utilized to assess therapeutic strategies and prognostic outcomes.</p></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"36 ","pages":"Article 100516"},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405650224000236/pdfft?md5=229167222f435c158fcd55ae95af9ddc&pid=1-s2.0-S2405650224000236-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}