Clinical Neurology最新文献_第8页

Clinical Neurology Pub Date : 2026-04-22 Epub Date: 2026-03-14 DOI: 10.5692/clinicalneurol.cn-002178

Daichi Imamura, Junko Ishii, Satoshi Hosoki, Mayuko Miyata, Shigeo Hara, Michi Kawamoto

引用次数: 0

[Successful early use of mepolizumab in eosinophilic granulomatosis with polyangiitis presenting with peripheral neuropathy and gastrointestinal bleeding]. [早期成功使用mepolizumab治疗伴有周围神经病变和胃肠道出血的多血管炎的嗜酸性肉芽肿病]。

Clinical Neurology Pub Date : 2026-04-22 Epub Date: 2026-03-14 DOI: 10.5692/clinicalneurol.cn-002196

Takumi Sato, Shun Okada, Shinichi Ban, Yasuhisa Akaiwa, Toshiki Nakamura, Tomoyuki Miyamoto

{"title":"[Successful early use of mepolizumab in eosinophilic granulomatosis with polyangiitis presenting with peripheral neuropathy and gastrointestinal bleeding].","authors":"Takumi Sato, Shun Okada, Shinichi Ban, Yasuhisa Akaiwa, Toshiki Nakamura, Tomoyuki Miyamoto","doi":"10.5692/clinicalneurol.cn-002196","DOIUrl":"10.5692/clinicalneurol.cn-002196","url":null,"abstract":"We report a case of a 55-year-old male with eosinophilic granulomatosis with polyangiitis (EGPA) presenting with peripheral neuropathy and gastrointestinal (GI) bleeding. Despite initial treatment with high-dose intravenous methylprednisolone and intravenous immunoglobulin, the patient's symptoms persisted, and GI bleeding worsened. Capsule endoscopy revealed multiple ulcers and erosions throughout the small intestine, and biopsies from the ileum, cecum, and skin showed marked eosinophilic infiltration. Although peripheral blood eosinophil counts were normalized, tissue eosinophilia remained evident. Early administration of mepolizumab, an anti-IL-5 monoclonal antibody, led to rapid improvement in both GI bleeding and neuropathic symptoms. This case highlights the potential role of tissue-infiltrating eosinophils in EGPA pathogenesis and suggests that mepolizumab may be effective even when blood eosinophil levels are not elevated. Early intervention with mepolizumab may be beneficial in severe or refractory EGPA cases with GI involvement, which are associated with poor prognosis and high relapse rates. Careful monitoring and timely therapeutic decisions are essential for improving outcomes in such patients.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"279-282"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463920","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}

引用次数: 0

[A case of refractory meningovascular syphilis followed up by vessel wall imaging]. [难治性脑膜炎血管性梅毒1例血管壁显像]。

Clinical Neurology Pub Date : 2026-04-22 Epub Date: 2026-03-14 DOI: 10.5692/clinicalneurol.cn-002203

Yoji Kasajima, Yasuhisa Akaiwa, Mai Iwahara, Yu Hiromatsu, Toshiki Nakamura, Tomoyuki Miyamoto

{"title":"[A case of refractory meningovascular syphilis followed up by vessel wall imaging].","authors":"Yoji Kasajima, Yasuhisa Akaiwa, Mai Iwahara, Yu Hiromatsu, Toshiki Nakamura, Tomoyuki Miyamoto","doi":"10.5692/clinicalneurol.cn-002203","DOIUrl":"10.5692/clinicalneurol.cn-002203","url":null,"abstract":"Meningovascular syphilis (MVS) is a rare but important cause of stroke. Vessel wall imaging (VWI) has emerged as a useful tool for evaluating cerebral vasculitis, but its correlation with clinical outcomes remains unclear. A 67-year-old man was admitted to our department with acute onset of left hemiparesis following headache and behavioral abnormalities. Brain MRI revealed subarachnoid hemorrhage in the right frontal lobe and acute infarctions in the right basal ganglia and parietal lobe. MRA demonstrated stenosis of the right middle cerebral artery. Serological and cerebrospinal fluid tests for syphilis were positive, and cerebrospinal fluid analysis showed pleocytosis, leading to a diagnosis of MVS. The patient was treated with intravenous penicillin G for 14 days. Although initial improvement was observed, the patient experienced recurrent subarachnoid hemorrhages and multiple cerebral infarctions, with progressive stenosis in multiple cerebral arteries. VWI revealed concentric wall thickening and homogeneous enhancement of both middle cerebral arteries. Treatment was escalated to include antiplatelet agents and immunosuppressive therapy with corticosteroids. While syphilis markers and VWI enhancement findings improved, clinical symptoms and arterial stenosis showed only limited recovery. This case highlights the utility of VWI in evaluating and monitoring cerebral vasculitis associated with MVS. However, VWI improvement did not correlate with clinical recovery, suggesting the need for further investigation into treatment strategies and prognostic indicators.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"272-278"},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463951","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}

引用次数: 0

[The role of neurointensivists in neuropalliative care]. [神经强化医师在神经姑息治疗中的作用]。

Clinical Neurology Pub Date : 2026-04-22 Epub Date: 2026-03-11 DOI: 10.5692/clinicalneurol.cn-002211

Kotaro Noda, Nobuyuki Nosaka, Nobuhiro Siota, Hiroaki Hara, Shuhei Yasuda, Mahiro Terakita, Toru Hifumi, Yasuhiro Kuroda, Kenji Wakabayashi, Sonoko Misawa

引用次数: 0

A case of myelin oligodendrocyte glycoprotein antibody-associated disease presenting with radiculopathies. 髓鞘少突胶质细胞糖蛋白抗体相关疾病表现为神经根病1例。

Clinical Neurology Pub Date : 2026-03-24 Epub Date: 2026-02-13 DOI: 10.5692/clinicalneurol.cn-002183

Sunao Takahashi, Takashi Irioka, Ryo Iwase, Susumu Igarashi, Toshiyuki Takahashi

{"title":"A case of myelin oligodendrocyte glycoprotein antibody-associated disease presenting with radiculopathies.","authors":"Sunao Takahashi, Takashi Irioka, Ryo Iwase, Susumu Igarashi, Toshiyuki Takahashi","doi":"10.5692/clinicalneurol.cn-002183","DOIUrl":"10.5692/clinicalneurol.cn-002183","url":null,"abstract":"Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a demyelinating disease of the central nervous system (CNS). Recent reports suggest the peripheral nervous system (PNS) could also be involved, although the pathophysiology remains unclear. We report a 50-year-old woman who presented with acute cauda equina syndrome as the initial neurological manifestation of MOGAD. MOG antibodies were detected only in the cerebrospinal fluid (CSF). MRI showed a peripherally located small intramedullary lesion in the ventral spinal cord at the twelfth thoracic level. Leptomeningeal lesions were also present over the epiconus and conus. Despite treatment with corticosteroids and azathioprine, she experienced four relapses over years. During the fourth relapse, she developed left trigeminal neuralgia, and the MRI showed a small lesion at the entry zone of the trigeminal nerve. This case illustrates that leptomeningeal lesions can cause peripheral neuropathies in MOGAD in the absence of overt CNS signs. Testing for MOG antibodies in the CSF should be considered when there is a strong clinical suspicion of MOGAD or combined CNS and PNS involvement, even if serum results are negative.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"167-170"},"PeriodicalIF":0.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203249","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}

引用次数: 0

Before diagnosing immunological cerebellitis in an m.3243A>G carrier, a cerebellar stroke-like lesion should be ruled out. 在诊断m.3243A b> G携带者免疫性小脑炎之前，应排除小脑卒中样病变。

Clinical Neurology Pub Date : 2026-03-24 Epub Date: 2026-02-06 DOI: 10.5692/clinicalneurol.cn-002162

Josef Finsterer

引用次数: 0

[Percutaneous left atrial appendage closure for atrial fibrillation-related ischemic stroke despite direct oral anticoagulation: a case report]. [经皮左心耳关闭治疗心房纤颤相关性缺血性卒中1例，尽管直接口服抗凝]。

Clinical Neurology Pub Date : 2026-03-24 Epub Date: 2026-02-13 DOI: 10.5692/clinicalneurol.cn-002206

Kenshin Kawabata, Shuhei Egashira, Kyosuke Muramatsu, Fumiaki Henmi, Megumi Ubano, Akinori Konishi, Nami Omori, Tetsuo Yamaguchi, Takahide Kodama, Yoshikazu Uesaka

引用次数: 0

[A case of cryptogenic stroke with platypnea-orthodeoxia syndrome and paroxysmal atrial fibrillation]. 【隐源性脑卒中合并肺动脉-正氧综合征并发阵发性心房颤动1例】。

Clinical Neurology Pub Date : 2026-03-24 Epub Date: 2026-02-05 DOI: 10.5692/clinicalneurol.cn-002165

Tamon Koga, Makoto Eriguchi, Shino Mizoguchi, Kohei Kaneda, Kazuhisa Kodama, Hiroshi Takashima

{"title":"[A case of cryptogenic stroke with platypnea-orthodeoxia syndrome and paroxysmal atrial fibrillation].","authors":"Tamon Koga, Makoto Eriguchi, Shino Mizoguchi, Kohei Kaneda, Kazuhisa Kodama, Hiroshi Takashima","doi":"10.5692/clinicalneurol.cn-002165","DOIUrl":"10.5692/clinicalneurol.cn-002165","url":null,"abstract":"The patient was a 72-year-old man who presented to our hospital with gait disturbance. He had sustained a spinal fracture one year earlier. Neurological examination revealed left-sided hemiparesis, dysarthria, and a National Institutes of Health Stroke Scale (NIHSS) score of 3. Brain MRI demonstrated cortical infarctions in both cerebral hemispheres. Transesophageal echocardiography revealed a grade 3 patent foramen ovale (PFO) accompanied by an atrial septal aneurysm. He exhibited hypoxemia in the upright position, which improved when supine, leading to a diagnosis of platypnea-orthodeoxia syndrome (POS). He underwent percutaneous PFO closure and was subsequently discharged home. Fifteen weeks after surgery, left-sided paralysis was observed, and paroxysmal atrial fibrillation was detected, leading to a diagnosis of cardioembolic stroke. A PFO, which had been asymptomatic, contributed to the development of POS due to its impact on thoracic compression fractures and atherosclerosis. In the care of elderly patients, the coexistence of multiple conditions is not uncommon, necessitating careful interpretation of test results.","PeriodicalId":39292,"journal":{"name":"Clinical Neurology","volume":" ","pages":"182-185"},"PeriodicalIF":0.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120572","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}

引用次数: 0

[A case of proximal cervical spondylotic amyotrophy in which needle electromyography contributed to diagnosis]. [近端颈椎病肌萎缩症1例，针刺肌电图有助于诊断]。

Clinical Neurology Pub Date : 2026-03-24 Epub Date: 2026-02-05 DOI: 10.5692/clinicalneurol.cn-002173

Rina Nakamura, Daisuke Yamamoto, Yuka Kawata, Ikkei Oohashi, Ryou Ishitani

引用次数: 0

[A case of anti-leucine-rich glioma inactivated protein 1 (LGI1) antibody-positive autoimmune encephalitis with electrographic seizures without epileptic seizure symptoms]. [抗富亮氨酸胶质瘤失活蛋白1 （LGI1）抗体阳性的自身免疫性脑炎伴电图发作，无癫痫发作症状]。

Clinical Neurology Pub Date : 2026-03-24 Epub Date: 2026-02-05 DOI: 10.5692/clinicalneurol.cn-002174

Misa Nakano, Fumiya Nakano, Akiko Hosokawa, Hiroshi Sakiyama, Kazuo Kitagawa

引用次数: 0