Neurologia Argentina最新文献

{"title":"Dr. Sebastián F. Ameriso (1960-2025)","authors":"Virginia Pujol-Lereis, Matías J. Alet","doi":"10.1016/j.neuarg.2026.100710","DOIUrl":"10.1016/j.neuarg.2026.100710","url":null,"abstract":"","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100710"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429241","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":"Vértigo agudo en la emergencia","authors":"Carlos Martínez ,&nbsp;Diego Kaski ,&nbsp;Sergio Carmona ,&nbsp;Guillermo Zalazar ,&nbsp;Marcela Moro ,&nbsp;Florencia Lerchundi ,&nbsp;Alfredo Laffue ,&nbsp;Myrian Seta ,&nbsp;Francisco Gualtieri ,&nbsp;Guillermo Videla ,&nbsp;Luciana Palmero ,&nbsp;Carolina Piacentini ,&nbsp;Santiago Pagano ,&nbsp;Claudia Adamo ,&nbsp;Emiliano de Schutter ,&nbsp;José Suárez ,&nbsp;María Alejandra Barreiro ,&nbsp;Soledad Etulain ,&nbsp;Lorena Wettstein ,&nbsp;Ana Bisonni ,&nbsp;Susana Ochoa","doi":"10.1016/j.neuarg.2026.100706","DOIUrl":"10.1016/j.neuarg.2026.100706","url":null,"abstract":"<div><div>Acute vertigo is one of the most frequent and complex reasons for consultation in emergency services. Although most cases are due to peripheral etiologies, a significant proportion correspond to serious central causes, such as stroke, which require early and accurate identification. This article presents a review of the recent literature and accumulated clinical experience regarding acute vestibular syndrome, with the aim of updating diagnostic and therapeutic criteria applicable to neurological emergency practice. Validated semiological tools are analyzed —such as the HINTS and STANDING protocols, and the classification of truncal ataxia— and the importance of a detailed physical examination focused on oculomotor assessment (nystagmus, head impulse test, cover test) and the evaluation of ataxia is highlighted. Based on this integration of evidence and clinical practice, a diagnostic-therapeutic algorithm is proposed to facilitate the application of these concepts by emergency physicians without formal training in neuro-otology. The review emphasizes the need for early recognition of central causes, particularly stroke, and the implementation of practical training strategies and audiovisual resources to improve diagnostic accuracy and reduce errors in the initial care of patients with acute vertigo in the emergency setting.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100706"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429249","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":"Tratamiento endovascular en ataque cerebrovascular isquémico agudo. Resultados de un modelo drip and ship en la Ciudad de Buenos Aires","authors":"Manuel Ignacio Chasco ,&nbsp;Matias Alberto Lopez ,&nbsp;Adriana Nora Luraschi ,&nbsp;Juan Jose Cirio ,&nbsp;Mariano Daniel Buezas ,&nbsp;Maria Laura Caballero ,&nbsp;Andrea Luciana Gomez ,&nbsp;Nicolas Perez ,&nbsp;Ivan Lylyk ,&nbsp;Fabio Maximiliano Gonzalez ,&nbsp;Eric Alexis Ludvik ,&nbsp;Santiago Alfredo Cutiller ,&nbsp;Jairo Giovanny Prada Castro ,&nbsp;Esteban Victor Scrivano ,&nbsp;Pedro Lylyk","doi":"10.1016/j.neuarg.2026.100708","DOIUrl":"10.1016/j.neuarg.2026.100708","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute ischaemic stroke (AIS) is a time-dependent emergency, whose medical treatment is intravenous thrombolysis and, in the case of large vessel occlusion (LVO), mechanical thrombectomy. Different working models were developed to respond to the demand for care, such as the ‘Drip and Ship’ system, where the essential centre diagnoses, performs thrombolysis and then refers the patient to the advanced centre if endovascular therapy is indicated.</div></div><div><h3>Objective</h3><div>To analyse the results of a decentralised working model for the treatment of stroke with OGVC.</div></div><div><h3>Material and method</h3><div>Retrospective, descriptive study of patients admitted to the essential stroke unit at Pirovano Hospital between October 2020 and March 2024 with a diagnosis of ACVi secondary to OGVC referred to an advanced private stroke centre in CABA. The primary outcome was functional and safety results (symptomatic intracranial haemorrhage and death) of patients at 90 days.</div></div><div><h3>Results</h3><div>Thirty-six patients were included, with a mean age of 63. Fifty per cent were male. The median NIHSS was 16. Forty-four per cent received intravenous thrombolytics. 41% had mRs 0-2 points at 90 days and 28% had mRs 6 points. Among the complications, symptomatic intracranial haemorrhage was 25%.</div></div><div><h3>Conclusion</h3><div>The results obtained encourage the establishment of decentralised work systems with the aim of optimising care metrics, expanding access to more patients and improving outcomes.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100708"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429247","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":"Consenso de expertos para el manejo del estado epiléptico convulsivo en los adultos en Argentina","authors":"Cristina Papayannis ,&nbsp;Viviana Ibarra ,&nbsp;Mónica Perassolo ,&nbsp;Vanesa Roig ,&nbsp;Ricardo Bernater ,&nbsp;Lucas Romano ,&nbsp;Analía Calle ,&nbsp;María Belén Viaggio ,&nbsp;Damián Consalvo ,&nbsp;Grupo de Trabajo Epilepsia de la SNA, Buenos Aires, Argentina","doi":"10.1016/j.neuarg.2026.100709","DOIUrl":"10.1016/j.neuarg.2026.100709","url":null,"abstract":"<div><h3>Introduction</h3><div>Convulsive status epilepticus (CSE) represents a neurological emergency with high morbidity and mortality that requires prompt diagnosis and treatment. Given the need to update diagnostic and therapeutic strategies in line with recent evidence and the resources available within the Argentine healthcare system, the Epilepsy Working Group of the Argentine Neurological Society (SNA) conducted a narrative and consensus-based review.</div></div><div><h3>Methods</h3><div>A panel of experts with recognized clinical and academic experience was convened to review literature published over the past ten years, prioritizing clinical trials, international guidelines, and relevant systematic reviews. The topics addressed included the definition, classification, pathophysiology, diagnosis, and treatment of CSE in adults. The main objective was to provide updated recommendations contextualized to the resources of the Argentine healthcare system, aimed at professionals involved in its diagnosis and management.</div></div><div><h3>Development</h3><div>The document presents an operational and structured approach, from the prehospital phase to the management of refractory and super-refractory status epilepticus. Each section highlights key points intended to facilitate understanding and practical application of the recommendations. The importance of early treatment with appropriately dosed benzodiazepines, activation of alert codes, and the selection of second-line drugs —such as levetiracetam, valproic acid, or phenytoin— according to availability and comorbidities, is emphasized. In refractory cases, anesthetic and immunomodulatory alternatives are discussed.</div></div><div><h3>Conclusion</h3><div>These recommendations, adapted to the national healthcare context, aim to optimize therapeutic timing, reduce complications, and improve patient outcomes. This consensus provides a comprehensive update on the management of adult CSE in Argentina and aspires to serve as a practical reference for healthcare professionals as well as a foundation for future local research.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"18 1","pages":"Article 100709"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147429240","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":"Degeneración walleriana del tracto corticoespinal por radioterapia: a propósito de un caso y revisión de la literatura","authors":"José Fernando Robles Díaz","doi":"10.1016/j.neuarg.2025.07.003","DOIUrl":"10.1016/j.neuarg.2025.07.003","url":null,"abstract":"<div><div>Wallerian degeneration (WD) refers to the pathological process of secondary degeneration of axons and myelin sheaths that occurs distal to the site of acute injury in the neuronal soma or proximal axon. A rare case is presented of a male patient with an intracerebral tumor who developed WD after receiving external radiotherapy. Clinically, he presented Weber syndrome. Magnetic resonance imaging of the brain in FLAIR and T2 sequences showed hyperintense corticospinal tract. Differential diagnoses and possible treatments are presented.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 264-267"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766066","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":"Neurosífilis: una enfermedad poco sospechada pero siempre presente","authors":"Cintia Pamela Rodriguez,&nbsp;Yobana Delina Lazarte,&nbsp;Cristian David Espona,&nbsp;Maria Laura Menichini,&nbsp;Jorge Pedro Capriotti","doi":"10.1016/j.neuarg.2025.05.004","DOIUrl":"10.1016/j.neuarg.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis is a disease caused by Treponema Pallidum, usually presenting with nonspecific signs and symptoms. Neurosyphilis occurs in 40% of patients and its diagnosis continues to pose difficulties due to the lack of a sensitive and specific gold standard.</div></div><div><h3>Patients and methods</h3><div>We present a description of the clinical and analytical</div><div>1<!--> <!-->ª página characteristics of cerebrospinal fluid in 10 patients with neurosyphilis who were hospitalized in a hospital in the city of Rosario.</div></div><div><h3>Results</h3><div>Seven patients were men and 3 were women. Mean age was 41.1. Seven of them were HIV carriers. Mean serum VDRL was 256 dils. Reactive VDRL was obtained in CSF in 4 patients, all of them HIV positive. CSF showed a mean of 48.3 elements/mm3 with mononuclear predominance. Proteinorraquia presented a mean of 1.1 g/l. Signs and symptoms were predominantly headache, 6 patients presented meningitis, 2 cerebrovascular events, 1 optic neuropathy and 1 cranial neuropathy. All patients received treatment with EV penicillin.</div></div><div><h3>Conclusions</h3><div>There is underdiagnosis of neurosyphilis, this may be due to limitations in the diagnostic methodology or to the approximation algorithms that seems to be unspecific. Although we were able to obtain some interesting approximations to the clinical and analytical characteristics of these patients, the small sample size prevents us from drawing conclusions with adequate statistical weight. Therefore, we consider it necessary to carry out new experiments in the future that will allow a better understanding of this type of patients, as well as to develop a sensitive and specific tool for the diagnosis of neurosyphilis.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 223-226"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766076","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 de senos durales como manifestación inusual de trombofilia hereditaria","authors":"Alejandro Arango ,&nbsp;Julián Mauricio Jiménez Álvarez ,&nbsp;Luisa Fernanda Giraldo Ballesteros ,&nbsp;Juan Carlos Arrieta Bechara ,&nbsp;Rafael Ignacio Herrera Ramos","doi":"10.1016/j.neuarg.2025.08.002","DOIUrl":"10.1016/j.neuarg.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral venous thrombosis (CVT) is an uncommon condition with a multifactorial etiology, including hereditary thrombophilias. Hyperhomocysteinemia, secondary to <em>MTHFR</em> mutations, is a potential risk factor.</div></div><div><h3>Case report</h3><div>A 29-year-old woman with grade III obesity, preeclampsia, and a family history of cerebral thrombosis presented with progressive headache. Neuroimaging revealed extensive dural sinus thrombosis and intracranial hypertension. Hyperhomocysteinemia and an <em>MTHFR</em> (c.677C<!--> <!-->&gt;T) heterozygous mutation were identified, leading to anticoagulation with dabigatran.</div></div><div><h3>Conclusions</h3><div>The association between CVT and <em>MTHFR</em> mutations remains controversial. There is no solid evidence supporting the systematic screening of hyperhomocysteinemia in cerebral thrombosis without a clear triggering factor.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 252-258"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766081","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":"Compromiso bulbar en paciente con mieloma múltiple y neuropatía periférica secundaria","authors":"Martina Scicchitano,&nbsp;Maria Florencia Sica,&nbsp;Ludmila Ortiz,&nbsp;Agustina Babbicola,&nbsp;Daiana Barrio,&nbsp;Emilia Sanchez Toledo,&nbsp;Emilia Clement,&nbsp;Alejandra Heriz,&nbsp;Lucas Romano,&nbsp;Pablo Ioli,&nbsp;Macarena Bermejo","doi":"10.1016/j.neuarg.2025.07.004","DOIUrl":"10.1016/j.neuarg.2025.07.004","url":null,"abstract":"<div><div>Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of abnormal plasma cells and the production of monoclonal proteins, frequently leading to multisystem involvement. Neurological complications, including peripheral neuropathy and cranial nerve involvement, may occur during the course of the disease. We report the case of a patient diagnosed with MM in 2014, who underwent multiple lines of therapy due to successive relapses. Over time, he developed progressive muscle weakness, dysarthria, and bulbar symptoms. Neurological assessment revealed evidence of multifactorial involvement. Despite ongoing treatment, the patient's neurological condition deteriorated, and he ultimately died due to bronchoaspiration. This case underscores the clinical complexity of advanced MM and highlights its potential for atypical neurological manifestations.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 268-271"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766067","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 la fatiga sobre la calidad de vida y la funcionalidad en pacientes con esclerosis múltiple","authors":"Francisco Peñalver ,&nbsp;Ana Laura González Bellene ,&nbsp;Graciana Galiana ,&nbsp;Berenice Silva","doi":"10.1016/j.neuarg.2025.04.006","DOIUrl":"10.1016/j.neuarg.2025.04.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Multiple sclerosis (MS) is a central nervous system (CNS) disease with various physical, emotional, and cognitive symptoms, including fatigue, which deteriorates health perception. Our study aimed to determine the impact of fatigue on quality of life and its relationship with the Expanded Disability Status Scale (EDSS) in MS patients, as well as to evaluate the impact on work activity since diagnosis.</div></div><div><h3>Materials and methods</h3><div>We designed a multicenter, observational, descriptive, and cross-sectional study of our MS population. Data were collected using the Modified Fatigue Impact Scale (MFIS) and the International Quality of Life in MS Questionnaire (MusiQol). Parametric and non-parametric data were analyzed using EPI Info 7 and Java 2.5.6 software for binomial linear regression.</div></div><div><h3>Results</h3><div>We included 101 MS patients over a 4-month period. The median EDSS was 1.5. Fatigue was present in 34.7% of patients, with 45.5% of them showing high impact on the physical subscale. Among patients with fatigue, 62.9% experienced a reduction in their working hours. The global index (GI) of the MusiQol questionnaire revealed moderate quality of life in 62.9% of MS patients. The median EDSS was higher in patients with high fatigue impact in the physical and psychosocial domains compared to those with low impact (p<!--> <!-->=<!--> <!-->0.0003 and p<!--> <!-->=<!--> <!-->0.0001). Patients with moderate GI had a median EDSS of 2, while those with good GI had a median EDSS of 1 (p<!--> <!-->=<!--> <!-->0.003). Non-parametric analysis showed that patients with fatigue had a median EDSS of 2, while those without fatigue had a median of 1 (p<!--> <!-->=<!--> <!-->0.001). Parametric analysis indicated that patients with EDSS<!--> <!-->&lt;<!--> <!-->2 had a moderate GI in 51.7% and a good GI in 44.8%, whereas those with EDSS<!--> <!-->≥<!--> <!-->2 had a moderate GI in 72.1% and a good GI in 20.9% (p<!--> <!-->=<!--> <!-->0.004). Fatigue was present in 53.5% of patients with EDSS<!--> <!-->≥<!--> <!-->2, compared to only 20.7% of those with EDSS<!--> <!-->&lt;<!--> <!-->2 (p<!--> <!-->=<!--> <!-->0.0003).</div></div><div><h3>Conclusion</h3><div>Fatigue has a low prevalence but significantly impacts the physical subscale, affecting quality of life and work hours, even in patients with EDSS of 2 or higher.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 213-222"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766075","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 isquémico y síndrome de robo de la subclavia: más que un hallazgo incidental","authors":"Alexandra Ferreirós,&nbsp;Carolina García-Alfonso,&nbsp;Lussiana Folleco Insuasty,&nbsp;Juliana Coral","doi":"10.1016/j.neuarg.2025.07.001","DOIUrl":"10.1016/j.neuarg.2025.07.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Subclavian steal syndrome occurs due to retrograde flow secondary to ipsilateral subclavian stenosis which leads to hemodynamic changes causing cerebrovascular lesions, specifically in the posterior arterial territory.</div></div><div><h3>Case</h3><div>A patient with acute weakness and hypoesthesia. MRI revealed a stroke in the left middle cerebral artery territory. Further studies reported subclavian steal syndrome.</div></div><div><h3>Conclusion</h3><div>Subclavian steal syndrome is associated with cerebrovascular disease, particularly in the posterior territory, hence, neurologists should be aware of the clinical picture, diagnosis approach and treatment options.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 242-246"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766079","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}