Neurologia Argentina最新文献

{"title":"Segmento comprometido en la neuropatía del mediano en el túnel carpiano. Hospital Nacional Hipólito Unanue. 2023","authors":"Carlos Alberto Centeno Marmanillo","doi":"10.1016/j.neuarg.2026.100733","DOIUrl":"10.1016/j.neuarg.2026.100733","url":null,"abstract":"<div><h3>Introduction</h3><div>Improved diagnostic accuracy in median nerve neuropathy in the carpal tunnel could optimize the outcomes of invasive and noninvasive treatments.</div></div><div><h3>Objective</h3><div>To determine the most affected segment in median nerve neuropathy at the carpal tunnel level in patients at a hospital in Lima, Peru.</div></div><div><h3>Subjects</h3><div>161 hands corresponding to 108 patients with an electrophysiological diagnosis of median nerve neuropathy at the carpal tunnel level were included.</div></div><div><h3>Method</h3><div>A quantitative, non-experimental, descriptive, cross-sectional study was conducted. The electrodiagnostic study database was reviewed at the Neurology Department of a hospital in Lima, Peru. The sample was collected from studies that included the inching method in addition to conventional studies. The median nerve segment with nerve conduction slowing was identified.</div></div><div><h3>Results</h3><div>Females predominated (81.5% of patients). Of 161 hands (92 right and 69 left), two segments were most frequently involved: the first located between the distal flexor crease of the wrist and 1<!--> <!-->cm distal to it (50.31%), the second located between 1 and 2<!--> <!-->cm distal to the crease (44.10%). In more than 98% of cases, the involved segment covered an estimated path of less than or equal to 1<!--> <!-->cm from the median nerve.</div></div><div><h3>Conclusions</h3><div>Two segments of the median nerve are most frequently involved in carpal tunnel neuropathy. Most present with median nerve involvement measuring 1<!--> <!-->cm or less.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 2","pages":"Article 100733"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235991","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":"Relación entre el delirium y el pronóstico de la disfagia posextubación en personas con COVID-19: estudio descriptivo","authors":"Rodrigo Rivas ,&nbsp;Verónica Moraga ,&nbsp;Sandra León ,&nbsp;Mayara Daigre ,&nbsp;Nicole Caldichoury ,&nbsp;Breiner Morales-Asencio ,&nbsp;Norman López","doi":"10.1016/j.neuarg.2026.100734","DOIUrl":"10.1016/j.neuarg.2026.100734","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-extubation dysphagia is frequent in critically ill COVID-19 patients and linked to respiratory complications. Delirium, highly prevalent in COVID-19 ICUs, may impact swallowing recovery, but its effect remains unclear.</div></div><div><h3>Objective</h3><div>To determine whether the presence of post-extubation delirium is associated with greater initial severity of dysphagia, differences in the progression of the Functional Oral Intake Scale (FILS) score, and variations in the feeding route at hospital discharge.</div></div><div><h3>Materials and methods</h3><div>Cross-sectional descriptive study of 33 post-extubation COVID-19 patients, divided into a delirium group (n<!--> <!-->=<!--> <!-->17) and a non-delirium group (n<!--> <!-->=<!--> <!-->16). Swallowing was assessed using the FILS at 24<!--> <!-->h post-extubation and at discharge. FILS scores, dysphagia severity, and feeding route were analyzed using Student's t test and χ² (α<!--> <!-->=<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>The initial FILS score was lower in the delirium group (2.9<!--> <!-->±<!--> <!-->1.7) compared with the non-delirium group (3.8<!--> <!-->±<!--> <!-->2.2), with no statistically significant differences between groups (p<!--> <!-->=<!--> <!-->0.38). Both groups showed significant intragroup improvement (delirium: p<!--> <!-->=<!--> <!-->0.01; non-delirium: p &lt;<!--> <!-->0.001), with no statistically significant differences between groups at hospital discharge (8.8<!--> <!-->±<!--> <!-->2.2 vs. 9.3<!--> <!-->±<!--> <!-->0.8; p<!--> <!-->=<!--> <!-->0.38). Severe dysphagia was more frequent initially in the delirium group (76.5% vs. 56.3%), but no patient remained severe at discharge. The zero oral intake route decreased from 59% to 0% (delirium) and from 69% to 0% (non-delirium); at discharge, 82% and 100% of patients were receiving exclusive oral feeding, respectively.</div></div><div><h3>Conclusions</h3><div>Post-extubation delirium was associated with greater initial swallowing impairment but not with poorer functional prognosis, as both groups achieved significant recovery and a safe oral intake at discharge.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 2","pages":"Article 100734"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235993","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 atípicas en enfermedad de Charcot Marie Tooth por variante en el gen GDAP1: reporte de caso","authors":"María Alfaro-Olivera ,&nbsp;Diego Gabriel Flores-Quinteros ,&nbsp;Alessandra Ángeles Salcedo ,&nbsp;Isabel Beatriz Tagle-Lostaunau ,&nbsp;Erasmo Francisco Aquino-Peña ,&nbsp;Juan Manuel Sifuentes Monge ,&nbsp;Víctor Andrés Arias-Hancco ,&nbsp;Jorge Luis Escalante Canorio ,&nbsp;Jordi Diaz-Manera ,&nbsp;Ana Töpf ,&nbsp;Luis Torres Ramirez","doi":"10.1016/j.neuarg.2026.100711","DOIUrl":"10.1016/j.neuarg.2026.100711","url":null,"abstract":"<div><div>Charcot-Marie-Tooth disease (CMT) is the most common hereditary neuropathy, characterized by wide genetic and phenotypic variability. We present the case of a 14-year- old Peruvian female with an autosomal recessive axonal motor neuropathy caused by a homozygous missense mutation in exon 6 of the <em>GDAP1</em> gene (c.928C&gt;T; p.Arg310Trp). The patient showed early-onset progressive distal weakness, quadriparesis, pes valgus, mild scoliosis, and muscle hypotrophy. Atypical clinical findings included upper limb hyperreflexia, finger myokymia, and distal cyanosis in the lower limbs. Electrophysiological studies revealed active denervation and myokymic discharges. The mutation was identified by whole exome sequencing. This case highlights the importance of molecular diagnosis in hereditary neuropathies and expands the phenotypic spectrum associated with <em>GDAP1</em>, emphasizing the relevance of considering CMT in patients with atypical progressive neuropathies.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 2","pages":"Article 100711"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235995","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 de estrategias institucionales en el tiempo puerta-aguja para trombólisis intravenosa en infarto cerebral agudo: estudio comparativo","authors":"Camilo Romero,&nbsp;David Ujueta Jaramillo,&nbsp;María Camila Valencia Mendoza,&nbsp;Natalia Gómez Salazar","doi":"10.1016/j.neuarg.2026.100735","DOIUrl":"10.1016/j.neuarg.2026.100735","url":null,"abstract":"<div><h3>Introduction</h3><div>Intravenous thrombolysis (IVT) improves the prognosis of patients with acute ischemic stroke (AIS). Its benefit is time-dependent, and door-to-needle time can be reduced through the implementation of prehospital and in-hospital strategies.</div></div><div><h3>Objectives</h3><div>To describe and compare door-to-needle times for IVT administration before and after the implementation of institutional strategies.</div></div><div><h3>Methods</h3><div>Retrospective intra- and extra-institutional comparative observational study analyzing door-to-needle times in patients with AIS treated with IVT.</div></div><div><h3>Results</h3><div>In American institutions, the mean door-to-needle time was 77<!--> <!-->minutes before the implementation of strategies and 67<!--> <!-->minutes after. In our institution, the mean door-to-needle time was 97.6<!--> <!-->minutes before implementation and 82.1<!--> <!-->minutes after.</div></div><div><h3>Conclusions</h3><div>In the institutions studied, the mean door-to-needle time remains above that recommended by international guidelines. However, the implementation of prehospital and in-hospital strategies achieved a significant reduction in door-to-needle time.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 2","pages":"Article 100735"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235992","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":"Protocolos de apto neurológico para la conducción vehicular","authors":"Matías J. Alet ,&nbsp;Cristina Papayannis ,&nbsp;Ana Fumagalli ,&nbsp;Norma Deri ,&nbsp;Ricardo Bernater ,&nbsp;Javier Domínguez ,&nbsp;Marina Romano ,&nbsp;Florencia Sica ,&nbsp;Mariana Bendersky ,&nbsp;Alejandro Rodríguez ,&nbsp;Fernando Chloca ,&nbsp;Javier Groppo ,&nbsp;José Santiago Bestoso ,&nbsp;Daniel Raúl Zuin ,&nbsp;Analisa Manin ,&nbsp;Guido Vazquez ,&nbsp;Gabriel Persi","doi":"10.1016/j.neuarg.2026.100732","DOIUrl":"10.1016/j.neuarg.2026.100732","url":null,"abstract":"<div><h3>Introduction</h3><div>Road traffic crashes continue to represent a major public health problem. Driving requires the adequate integration of multiple neurological functions, including motor control, sensation, vision, attention, processing speed, cognition, and coordination. In daily practice, neurologists are frequently consulted to issue certificates or reports on neurological fitness to drive, both in the public and private settings. However, there is substantial heterogeneity in criteria, limited standardization, and a scarcity of guidelines adapted to the Argentine regulatory context.</div></div><div><h3>Objective</h3><div>To develop practical, consensus-based protocols for the assessment of neurological fitness to drive in Argentina, to support clinical, medico-legal, and administrative decision-making.</div></div><div><h3>Development</h3><div>Representatives from the working groups of the Argentine Neurological Society developed this document through a review of the literature, current national regulations, and international consensus statements. Operational criteria for fitness to drive, unfitness to drive, and conditional fitness to drive were defined, differentiating license categories and certificate validity periods. Specific recommendations were developed for neurological conditions with potential impact on road safety, including epilepsy, cerebrovascular disease, sleep disorders, psychoactive medication use, movement disorders, demyelinating diseases, cognitive disorders, and peripheral nervous system conditions. Driving-oriented assessment algorithms, referral criteria, and patient counseling guidance are proposed.</div></div><div><h3>Conclusions</h3><div>These protocols aim to standardize clinical practice, improve the quality and traceability of neurological fitness-to-drive reports, and contribute to safer driving by balancing the individual right to mobility with the protection of public road safety.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 2","pages":"Article 100732"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148235994","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":"La fisiopatología como eje del manejo del estatus epiléptico: comprender para tratar","authors":"Carmela Fawcett-Martinez","doi":"10.1016/j.neuarg.2026.100713","DOIUrl":"10.1016/j.neuarg.2026.100713","url":null,"abstract":"","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100713"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429244","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":"Paraparesia espástica tropical subaguda: reporte de caso y revisión de la literatura","authors":"Jose Ricardo Muñoz-Zuñiga ,&nbsp;Julio César Mantilla-Pardo ,&nbsp;Juan David Tascón-Romero ,&nbsp;Juan Camilo Marquez ,&nbsp;Alberto Masaru Shinchi-Tanaka","doi":"10.1016/j.neuarg.2026.100705","DOIUrl":"10.1016/j.neuarg.2026.100705","url":null,"abstract":"<div><h3>Introduction</h3><div>Human T-cell lymphotropic virus type<!--> <!-->1 (HTLV-1) is an oncogenic retrovirus associated with adult T-cell leukemia/lymphoma and tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM), a progressive neurodegenerative disorder primarily affecting the spinal cord.</div></div><div><h3>Case report</h3><div>We present the case of a 36-year-old female nurse from Tumaco, Colombia, with hyperreflexia, urinary dysfunction and sensitive level. A magnetic resonance imaging showed longitudinally extensive transverse myelitis in cervicothoracic spine and serological tests confirmed HTLV-1 infection. Treatment with corticosteroid and posterior plasmapheresis results in neurological improvement in the patient.</div></div><div><h3>Conclusion</h3><div>Early diagnosis through MRI and serology is crucial to preventing disease progression and neurological deterioration in TSP/HAM.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100705"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429243","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":"Ultrasonografía cerebral en cirugía valvular aórtica: una herramienta no invasiva para la vigilancia hemodinámica y neurológica postoperatoria","authors":"Daniel Gaspar Riveros-Nina ,&nbsp;Rodrigo Gopar-Nieto ,&nbsp;Gustavo Rojas-Velasco ,&nbsp;Daniel Manzur-Sandoval","doi":"10.1016/j.neuarg.2026.100707","DOIUrl":"10.1016/j.neuarg.2026.100707","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurological complications continue to be a challenge in aortic valve surgery. Cerebral perfusion pressure (CPP), estimated by transcranial Doppler (TCD), allows for noninvasive assessment of cerebral autoregulation in the immediate postoperative period.</div></div><div><h3>Methods</h3><div>A prospective, descriptive study was conducted in 66 patients undergoing aortic valve replacement at the Ignacio Chávez National Institute of Cardiology. Cardiac output was recorded by echocardiography and CPP by TCD preoperatively, upon admission to intensive care, and at 24 and 48<!--> <!-->hours. Neurological (delirium, stroke, seizures) and systemic complications were evaluated.</div></div><div><h3>Results</h3><div>CPP decreased significantly upon admission (55-56<!--> <!-->mmHg) and normalized at 48<!--> <!-->hours (≈<!--> <!-->59<!--> <!-->mmHg; <em>P</em> <!-->&lt;<!--> <!-->.005). Delirium was the most frequent neurological complication (13.6%), followed by CVA (3%) and seizures (1.5%). A right CPP<!--> <!-->&lt;<!--> <!-->55<!--> <!-->mmHg was associated with increased delirium (23.3% vs. 5.6%), pneumonia, vasoplegic syndrome, and prolonged hospital stay (<em>P</em> <!-->≤<!--> <!-->.03).</div></div><div><h3>Conclusions</h3><div>CPP estimated by TCD is a feasible and useful tool for neurological monitoring after valve surgery. Values &lt;<!--> <!-->55<!--> <!-->mmHg are associated with a higher risk of complications, underscoring its prognostic value and potential to guide individualized interventions.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100707"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429245","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":"Accidente cerebrovascular del joven en Uruguay: análisis de 355 pacientes de la Unidad Cerebrovascular del Hospital de Clínicas","authors":"Gonzalo Pérez-Hornos ,&nbsp;María Paz Rodríguez ,&nbsp;Ramiro Rodríguez ,&nbsp;Andrés Gaye ,&nbsp;Matías Alet","doi":"10.1016/j.neuarg.2026.100712","DOIUrl":"10.1016/j.neuarg.2026.100712","url":null,"abstract":"<div><h3>Introduction</h3><div>Stroke is the second leading cause of death and a major cause of disability worldwide and in Uruguay. Between 10-15% of cases occur in young adults, although there is no consensus on the age limit (45, 50, or 55 years). Defining this population is essential due to its etiological and therapeutic differences.</div></div><div><h3>Objective</h3><div>To describe demographic variables associated with stroke in young adults and to estimate the optimal age cut-off in our population.</div></div><div><h3>Materials and methods</h3><div>Descriptive, retrospective study of 355 patients ≤55 years with ischemic or hemorrhagic stroke admitted to the Stroke Unit of Hospital de Clínicas (July 2007-July 2024). Patients were divided into 4<!--> <!-->groups: 16-39, 40-45, 46-50, and 51-55 years.</div></div><div><h3>Results</h3><div>83.7% had ischemic stroke and 16.3% hemorrhagic stroke.</div><div>Age distribution: 21.1% (16-39), 16.9% (40-45), 24% (46-50), and 38% (51-55). Classical risk factors predominated in 51-55 years, significantly hypertension (47.3%), diabetes (58.1%), and dyslipidemia (52.5%). In &lt;40 years, the main etiology according to TOAST was «other causes» (49.2%), mainly arterial dissection (41.4%). Among hemorrhagic strokes, 98.3% were intraparenchymal hematomas; 59.6% were associated with hypertension and 29.3% with vascular malformations. Overall in-hospital mortality was 8.7%, with no age differences.</div></div><div><h3>Conclusions</h3><div>We propose 45 years as the cut-off point for young stroke in Uruguay, both ischemic and hemorrhagic. This is the largest national study with the longest follow-up on this topic.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100712"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429248","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":"Phenocopy of frontotemporal dementia: An unusual case with 20 years onset and preserving cognitive skills","authors":"María Manuela Maldonado-Hoyos ,&nbsp;Juan Felipe Quintero-Moreno ,&nbsp;Carolina Zapata-Ramírez ,&nbsp;Julián Carvajal-Castrillón ,&nbsp;Sergio Andrés Taborda-Holguín","doi":"10.1016/j.neuarg.2026.100704","DOIUrl":"10.1016/j.neuarg.2026.100704","url":null,"abstract":"<div><div>Phenocopy frontotemporal dementia (phFTD) manifests with behavioral symptoms resembling behavioral variant FTD (bvFTD) but without cognitive decline or neuroimaging progression. Differentiating phFTD from bvFTD remains clinically challenging. We reported a 71-year-old man with a 20-year history of behavioral changes, characterized by apathy and reduced spontaneity, with a dysexecutive profile, and frontal atrophy. Despite multiple psychiatric treatments and stable structural imaging findings, the patient has remained functioning independently, with preserved memory, language, and visuospatial skills. PhFTD is a FTD spectrum of symptoms without progressive cognitive or functional decline. This case demonstrates the importance of distinguishing phFTD from bvFTD, late-onset psychiatric disorders.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100704"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429242","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}