Neurologia Argentina最新文献

{"title":"Protocolo de valoración neuroconductual estandarizada y de interpretación clínica de pacientes con trastornos crónicos de conciencia","authors":"María Julieta Russo ,&nbsp;Hernán Marcelo Pavón ,&nbsp;Florencia Deschle ,&nbsp;María Verónica Marroquín ,&nbsp;Orlando Aliaga ,&nbsp;María de la Paz Sampayo","doi":"10.1016/j.neuarg.2024.11.004","DOIUrl":"10.1016/j.neuarg.2024.11.004","url":null,"abstract":"<div><div>In this paper we investigate the existing literature on the possibility that some clinical findings may be useful for the diagnosis of the presence of conscious content in patients with chronic alterations of consciousness. From the neurological evaluation of certain characteristics of the patients in a systematized way, we try to detect the presence of content of consciousness in those cases in which the recommended clinical tools, such as the revised coma recovery scale, fail to unmask content of consciousness and we are in the presence of cases of the so-called “covert consciousness”. Although the diagnosis of this type of states is, to date, performed with functional neurological studies, a strategy for detecting phenotypic findings is presented for these patients that may be useful for the correct diagnosis.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 44-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemorragia intracerebral como complicación inusual de la encefalitis herpética tipo 1: reporte de casos","authors":"Gloria Elena Orrego Soto ,&nbsp;Jhoan Emmanuel Orjuela Quiroga ,&nbsp;Juan José Londoño Aranzazu ,&nbsp;José Mauricio Cárdenas Prieto ,&nbsp;Leonardo Favio Montero Riascos","doi":"10.1016/j.neuarg.2024.11.005","DOIUrl":"10.1016/j.neuarg.2024.11.005","url":null,"abstract":"<div><div>Encephalitis caused by herpes virus type 1 (HSV-1) is a serious neurological disease that can cause devastating complications. Among these, intracerebral hemorrhage is described as an unusual complication in the acute phase, which involves complex pathophysiological mechanisms that include transient hypertension and infectious vasculitis, mainly affecting the temporal lobes, generating intracranial hypertension syndrome and ultimately causing death.</div><div>In this report, we describe two clinical cases of immunocompetent patients who presented HSV-1 encephalitis with subsequent development of intracerebral hemorrhage, resulting in fatal outcomes. These cases illustrate the importance of a timely diagnosis and management to avoid serious complications and reduce mortality.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 55-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leucoencefalopatía multifocal progresiva: recursos diagnósticos y evolución en una serie de casos","authors":"Sandra Valeria Mosconi ,&nbsp;Lisi De Rosa ,&nbsp;Maximiliano Talamonti ,&nbsp;María Laura Menichini ,&nbsp;Catalino Reinoso","doi":"10.1016/j.neuarg.2024.11.002","DOIUrl":"10.1016/j.neuarg.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by the reactivation of the John Cunningham virus (JCV) in the central nervous system (CNS) in patients with several degrees of immunocompromised status. Its clinical and imaging manifestations are well described, but a high index of suspicion for the disease is necessary to arrive at a diagnosis.</div></div><div><h3>Objectives</h3><div>To provide a clinical description and complementary studies in patients with confirmed PML.</div></div><div><h3>Patients and methods</h3><div>A retrospective descriptive multicentre study of patients with confirmed PML, obtaining demographic, clinical, imaging, laboratory, and biopsy data from medical records.</div></div><div><h3>Results</h3><div>Twelve patients with a definitive diagnosis of PML: 10 with HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome), 1 with non-Hodgkin lymphoma (NHL) and treatment with rituximab and 1 with HIV/AIDS, NHL and rituximab. In cranial MRI, all lesions appeared hyperintense on FLAIR and T2 and hypointense on T1, with 7 being bilateral, and 4 enhancing with EV contrast. The most affected sites were the frontal lobe, parietal lobe, and brainstem, correlating with the most frequent symptoms (motor disorders and incoordination). CSF showed no significant alterations. The two patients with survival greater than 1<!--> <!-->year were those with negative JC PCR in CSF.</div></div><div><h3>Conclusions</h3><div>PML is a disease that requires high suspicion to be studied and diagnosed. We highlight the considerable involvement of both deep and cortical gray matter evidenced in this study. It is important to note the observation of increased survival in those with negative JC PCR in CSF.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 8-12"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacto del COVID-19 en el desempeño cognitivo de los pacientes recuperados al año de la infección: estudio de cohortes utilizando la herramienta MoCA-T","authors":"Sandra Marcela Cardona Moica ,&nbsp;Loida Camargo ,&nbsp;Enrique Carlos Ramos Clason ,&nbsp;Analida Yovana Martínez Durán ,&nbsp;Jorge Joaquín Urrutia Osorio ,&nbsp;Renata Torres Jaimes ,&nbsp;Brian René Vargas Acosta ,&nbsp;Aury Carrasquilla Romero ,&nbsp;Andrés Enrique Becker Arrieta ,&nbsp;Jorge Armando Daza López ,&nbsp;Juan Felipe Ceballos Moica","doi":"10.1016/j.neuarg.2025.01.003","DOIUrl":"10.1016/j.neuarg.2025.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Secondary cognitive impairment due to SARS-CoV-2 includes neurological and psychiatric manifestations. The impact of acute and subacute infection on cognition is clear, but to date, few studies have been conducted to identify the progression or persistence of these alterations.</div></div><div><h3>Objective</h3><div>To estimate the association between COVID-19 infection and the development of cognitive impairment.</div></div><div><h3>Methodology</h3><div>Observational, analytical, and prospective study of COVID-19 patients in two healthcare institutions in Cartagena. Sociodemographic and clinical characteristics were identified, and one year after discharge, the MoCA-T Test was applied. The comparative cohort included volunteers without neurocognitive comorbidities or history of COVID-19. The association of infection with cognitive impairment was assessed by estimating the relative risk (RR). Frequencies, median, and IQR were calculated. Hypothesis testing included Fisher's test and Mann-Whitney U test. RRs were adjusted using the Poisson regression model.</div></div><div><h3>Results</h3><div>138 patients were evaluated. The COVID-19 cohort included 70, with 45.7% reporting cognitive symptoms. The median MoCA-T score in COVID-19 patients was 18 (IQR: 15-20), compared to 20 (IQR: 19-20) in non-COVID individuals. Executive function, memory and language were the most affected domains. COVID-19 infection was significantly associated with MoCA-T score below 19 (RR: 2.22, 95% CI: 1.09-4.51).</div></div><div><h3>Conclusions</h3><div>COVID-19 infection is associated with an increased risk of cognitive impairment. Patients exhibit mnemonic symptoms and attentional deficits, with lower performance on the MoCA-T test.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 28-34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictores clínicos y neuropsicológicos de progresión a demencia en un estudio de seguimiento de una población de pacientes con deterioro cognitivo leve","authors":"Edith Labos ,&nbsp;Karina Zabala ,&nbsp;Alejandro Renato ,&nbsp;Daniel Seinhart ,&nbsp;Marcelo Schapira ,&nbsp;María Elena Guajardo","doi":"10.1016/j.neuarg.2025.01.002","DOIUrl":"10.1016/j.neuarg.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Several studies relate the progression of mild cognitive impairment (MCI) to dementia with risk factors such as advanced age, vascular disorders, and cognitive and functional deficits, highlighting that the amnesic subtype is more prone to conversion. Annual rates of progression to dementia range from 10% to 25%.</div></div><div><h3>Objective</h3><div>This study examines the clinical and neuropsychological predictors of the progression of MCI to dementia, differentiating between the amnesic and multidomain subtypes.</div></div><div><h3>Subjects and method</h3><div>170 patients over 60 years of age with cognitive complaints were included, evaluated with neuropsychological tests that included memory, attention, executive functions, language, visuospatial skills and functional and cognitive reserve scales. MRI scans were performed on 92 patients to assess vascular damage.</div></div><div><h3>Results</h3><div>The sample had a mean age of 77.94 years and an education of 11.20 years. Of the 170 patients, 140 (82.35%) were diagnosed with MCI. In 24 months, 44.28% of patients with MCI progressed to dementia, with the amnesic subtype being the one with the greatest progression. Significant predictors were performance on memory tests and complex functionality, as well as the presence of vascular risk factors. The main risk factors were hypertension (60.89%), dyslipidemia (51.98%), and smoking (49.29%).</div></div><div><h3>Conclusions</h3><div>Specific cognitive predictors were identified for each subtype of MCI, underlining the relevance of deficit in complex functionality as a possible indicator of progression to dementia. The need for systematized follow-up neuropsychological evaluations and the importance of guiding patients on preventive measures are emphasized.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 20-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenecteplasa: el nuevo estándar en la trombólisis del accidente cerebrovascular isquémico agudo","authors":"Matías J. Alet","doi":"10.1016/j.neuarg.2025.02.001","DOIUrl":"10.1016/j.neuarg.2025.02.001","url":null,"abstract":"","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 62-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diazepam intranasal: una nueva estrategia para el tratamiento inmediato en la emergencia en pacientes con epilepsia","authors":"María del Carmen García ,&nbsp;María Claudia Burbano Donoso ,&nbsp;Yandri Lorena García Fernández ,&nbsp;Enrique Carrazana ,&nbsp;Adrián L. Rabinowicz","doi":"10.1016/j.neuarg.2024.11.003","DOIUrl":"10.1016/j.neuarg.2024.11.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Among the challenges associated with resistant epilepsy is the risk of presenting cluster seizures. Since most of these episodes occur outside the hospital setting, non-intravenous therapies are required that can be easily administered at home, in schools, or by medical or paramedical personnel in emergency services.</div><div>For this reason, it is essential to have alternatives that allow non-invasive, rapid and safe administration, which can be carried out by the patient themselves or their caregiver in any environment, and which facilitate rapid absorption of the drug. Within this alternative, the intranasal route emerges as an ideal option for the rapid administration of medications in medical emergencies, including grouped or prolonged crises.</div></div><div><h3>Objective</h3><div>The objective of this review is to describe the anatomy and physiology of the nose to understand why it is an ideal route for the administration of rescue medications, review the characteristics that a drug must have to be used by this route, and finally analyze data on safety and efficacy of the use of intranasal diazepam.</div></div><div><h3>Conclusion</h3><div>Intranasal diazepam has proven to be effective as an immediate rescue treatment for grouped or prolonged seizures, due to its easy administration, good absorption, low variability between patients and good social acceptance; Therefore, it is an appropriate and effective alternative for out-of-hospital use.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 35-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trombosis venosa cerebral: experiencia en un hospital de referencia nacional del Perú","authors":"Miguel A. Vences ,&nbsp;Liliana Rodriguez-Kadota ,&nbsp;Elder Quispe-Huamaní ,&nbsp;Mary M. Araujo-Chumacero ,&nbsp;Stefany Espinoza-Ramon ,&nbsp;Omar Heredia-Orbegoso ,&nbsp;Christoper A. Alarcon-Ruiz","doi":"10.1016/j.neuarg.2024.11.001","DOIUrl":"10.1016/j.neuarg.2024.11.001","url":null,"abstract":"<div><h3>Aim</h3><div>To describe the incidence, clinical characteristics, evolution, and outcomes of inpatients with the diagnosis of cerebral venous thrombosis (CVT).</div></div><div><h3>Methods</h3><div>Descriptive observational study in a national reference hospital in Peru. The study population included adult patients hospitalized with a diagnosis of CVT, during the period from January 2019 to December 2023. Demographic, clinical, imaging, laboratory, and clinical evolution data were recorded, as well as important clinical outcomes such as admission to the ICU, mortality, functionality at discharge, and recurrence 6<!--> <!-->months after the event. Categorical variables were described, and the annual incidence rate of CVT per 1000 stroke cases was calculated.</div></div><div><h3>Results</h3><div>Twelve patients with a diagnosis of CVT confirmed by an angiographic method were included. The annual incidence rate was between 5.14 cases per 1000 patients with cerebrovascular disease in 2022 and 11.03 cases per 1000 in 2020. The majority were women (58.3%) and the median age was 47.5<!--> <!-->years. The most affected area was the transverse sinus (66.7%). The most frequent initial clinical symptoms were headache, motor deficit and intracranial hypertension. The median time from the onset of the clinical picture to anticoagulant treatment was 6.5<!--> <!-->days and the hospital stay was 33.5<!--> <!-->days. There was a 41.7% admission to the ICU, half were discharged with functional independence, no mortality was reported and a quarter of the cases presented recurrence.</div></div><div><h3>Conclusion</h3><div>A first local study is reported on the incidence, clinical characteristics, and hospital outcome of Peruvian patients with CVT. Certain aspects are highlighted such as timely diagnosis and treatment in this condition that could have been related to the good clinical outcomes.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestaciones neuropsiquiátricas en el lupus eritematoso sistémico juvenil: estudio observacional","authors":"Presley Gruezo-Realpe ,&nbsp;Carlos Rodríguez-Alarcón ,&nbsp;Danny Japón-Cueva ,&nbsp;Linker Viñan-Paucar ,&nbsp;Wilton Cueva-Espinoza ,&nbsp;Josué Layedra-Luna ,&nbsp;Javier Tomalá Haz","doi":"10.1016/j.neuarg.2025.01.001","DOIUrl":"10.1016/j.neuarg.2025.01.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Juvenile-onset systemic lupus erythematosus (SJLE) is a multisystem inflammatory disease, with involvement of neuropsychiatric manifestations (NPSLE) ranging from 37 to 95%.</div></div><div><h3>Objective</h3><div>To describe the neuropsychiatric manifestations of JLE and the factors associated with its presentation.</div></div><div><h3>Methods</h3><div>Observational, cross-sectional, retrospective, case-control, retrospective study of patients with a diagnosis of SJSLE by SLICC 2012 and American Collegue of Rheumatology (ACR) criteria seen between 2018 to 2023 in a pediatric referral hospital.</div></div><div><h3>Results</h3><div>Forty-eight patients with JESL were included, of which 28 (58.3%) presented with NPSLE and 20 (41.7%) were controls. Mean age was similar in both groups (10.8<!--> <!-->±<!--> <!-->2.96 years) and female sex predominated (78.6%). Skin symptoms were common in the NPSLE group (75%). Fever was more frequent in controls (<em>P</em>=.03), while serositis affected 75% of patients with NPSLE (<em>P</em>=.006). Leukopenia was observed in 32.1% of patients with NPSLE (<em>P</em>=.02), and anti-P ribosomal antibodies were present in 71.4% of this group, showing a significant association (<em>P</em>&lt;.001). The most common neuropsychiatric manifestations were headache (46.4%) and seizures (17.9%). Most patients in both groups had positive ANA (92.9% in NPSLE and 95% in controls). Treatment focused on hydroxychloroquine (96.4%) and other immunosuppressants such as cyclophosphamide (50%).</div></div><div><h3>Conclusions</h3><div>Neuropsychiatric manifestations in JSLE pose challenges due to their diversity and lack of consensus on their causal association. Female predominance is notable, with headache as the main symptom, but more specific classifications are needed to better understand their relationship with the disease.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 1","pages":"Pages 13-19"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encefalitis de Rasmussen de inicio tardío: presentación de un caso y revisión de la literatura","authors":"Diana Soledad Barrio ,&nbsp;Agustina Belén Babbicola ,&nbsp;María Florencia Sica ,&nbsp;Alejandra Nerea Heriz ,&nbsp;María Emilia Clément ,&nbsp;Lucas Martín Romano","doi":"10.1016/j.neuarg.2024.09.001","DOIUrl":"10.1016/j.neuarg.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Rasmussen's encephalitis (RE) is a rare neurological disorder that causes continuous partial epilepsy, cognitive decline, and hemiparesis in children, with no sex preference. It is characterized by affecting a single cerebral hemisphere, with possible aphasia if it affects the dominant side. Histologically, it shows perivascular inflammation and hemispheric atrophy in frontotemporal and insular areas. Radiologically, cortical atrophy is observed on MRI. Although it typically begins in childhood, it can appear in adolescence or adulthood as adult-onset RE.</div></div><div><h3>Clinical case</h3><div>The case of a 46-year-old female patient is presented, with the onset of the disease at 18 years of age.</div></div><div><h3>Discussion</h3><div>This is an uncommon disease that classically presents in childhood. However, approximately 10% of cases develop in adults. The disease progresses through three phases: prodromal with focal seizures, acute with increased seizures and brain volume loss, and residual with hemispheric atrophy and neurological deficits. Diagnosis is supported by clinical criteria and studies such as MRI and EEG. In the presented case, the disease presentation was atypical, constituting a diagnostic challenge. Treatment includes immunotherapy and, in severe cases, hemispherectomy.</div></div><div><h3>Conclusion</h3><div>RE in adults presents clinical challenges due to its rarity and distinctive manifestations compared to pediatric cases, including a better prognosis and slower progression with fewer cognitive deficits and continuous epilepsy.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"16 4","pages":"Pages 210-217"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}