Acta Neurologica Scandinavica最新文献

{"title":"Five-Year Risk of Cardiovascular Events after Transient Ischemic Attack: Results from a Prospective Cohort","authors":"Fredrik Ildstad,&nbsp;Torgeir Wethal,&nbsp;Hanne Ellekjær,&nbsp;Stian Lydersen,&nbsp;Tom Eirik Mollnes,&nbsp;Thor Ueland,&nbsp;Pål Aukrust,&nbsp;Bent Indredavik","doi":"10.1155/2024/4982336","DOIUrl":"https://doi.org/10.1155/2024/4982336","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. There are few contemporary, prospective studies reporting on the long-term risk of stroke and other cardiovascular (CV) events after transient ischemic attack (TIA). The primary aim was to examine the risk of new CV events within 5 years after TIA. The secondary aim was to identify baseline predictors of long-term CV events, including inflammatory biomarkers in a subgroup analysis. <i>Materials and Methods</i>. In a prospective, multicenter study, we enrolled 577 TIA patients between 2012 and 2014. The primary outcome was a composite of stroke, acute coronary syndrome, and CV death. We used data from the Norwegian Cardiovascular Disease Registry. In a subgroup of 112 patients, blood samples were analyzed for inflammatory biomarkers. <i>Results</i>. The primary outcome occurred in 108 patients (18.7%), of which 69 patients (12.0%) had a stroke. Sixty-one (56.5%) of the events occurred during year two through five. Increasing age (HR 1.05; 95% CI, 1.03-1.08), male sex (HR 1.82; 95% CI, 1.16-2.85), hypertension (HR 1.67; 95% CI, 1.04-2.67), and acute infarction on brain imaging (HR 1.84; 95% CI, 1.17-2.91) were significant predictors for the primary outcome. In the subgroup analysis, none of the blood inflammatory biomarkers were associated with CV events. <i>Conclusions</i>. The risk of CV events was highest during the first year after TIA, with a lower but sustained risk throughout the follow-up. This emphasizes the importance of both early initiation of and long-term continuation of secondary preventive treatment after TIA. Inflammatory biomarkers are probably not important as prognostic markers of cardiovascular disease in TIA patients.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/4982336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141298429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New-Onset Refractory Status Epilepticus Caused by Autoimmune Encephalitis May Have a Better Prognosis than when due to Other Causes","authors":"Yu Zhang,&nbsp;Xinyue Zhang,&nbsp;Haijiao Wang,&nbsp;Ling Liu","doi":"10.1155/2024/6817696","DOIUrl":"https://doi.org/10.1155/2024/6817696","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To explore whether the new-onset refractory status epilepticus caused by autoimmune encephalitis has a better prognosis. <i>Methods</i>. This retrospective observational study enrolled patients with NORSE who were admitted from January 2015 to February 2024. The clinical data and clinical outcomes of the patients were collected and analyzed, and the primary outcome was seizures still at follow-up. Statistical analyses were performed using SPSS software V.22.0. <i>Results</i>. Among the 42 patients with NORSE, 15 (35.7%) had autoimmune encephalitis (AE), 3 (7.1%) patients had central nervous system infections, 24 (57.1%) patients had an unknown etiology, and 4 (9.5%) patients died in the hospital. Modified Rankin scale (MRS) scores at discharge of NORSE patients in the autoimmune encephalitis group and non-AE group were compared (<i>P</i> = 0.339). After 4 years of follow-up, analysis of patients who still had seizures showed that the only risk factor was etiology and that patients with nonautoimmune encephalitis etiology were more prone to later epilepsy (<i>P</i> = 0.030 (OR = 16.767, 95% CI: 1.454-213.395)). The MRS scores of the AE group and non-AE group were compared (<i>P</i> ≤ 0.001), with the autoimmune group having a better functional outcome. <i>Significance</i>. The overall prognosis of patients with autoimmune encephalitis may be better than that of patients with other etiologies, and later epilepsy is more likely in patients with nonautoimmune encephalitis. However, this result requires further validation in larger studies with more data.</p>\u0000 </div>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2024/6817696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141246102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairment and Fatigue in Intensive Care Patients Three Months after the Acute Phase of COVID-19 Infection: Follow-Up with Focus on Differences between the First and Later Waves of the Pandemic","authors":"M. C. Möller,&nbsp;A. K. Godbolt,&nbsp;Å. Ingvarsson,&nbsp;K. Borg,&nbsp;G. Markovic,&nbsp;E. Melin,&nbsp;M. Löfgren,&nbsp;C. Nygren Deboussard","doi":"10.1155/2024/9469769","DOIUrl":"10.1155/2024/9469769","url":null,"abstract":"<p><i>Background</i>. Cognitive symptoms and fatigue may persist after intensive care unit (ICU) care. It remains unclear whether post-COVID-19 symptoms are related to ICU care itself or the infection. <i>Objective</i>. The primary aim was to investigate the prevalence of residual cognitive impairment and fatigue after ICU care for COVID-19 and to evaluate the importance of demographic factors. A secondary aim was to investigate whether differences in ICU treatment between the first wave (March 2020 to July 2020) and later waves (August 2020 to January 2021) of COVID-19 were associated with differences in cognitive outcomes. <i>Design</i>. Prospective follow-up study. <i>Subjects/Patients</i>. Swedish cohort of COVID-19 patients referred from ICU<i>. Methods</i>. Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory-20 (MFI-20), Hospital Anxiety and Depression Scale, Insomnia Severity Scale, and RAND-36 were administered approximately three months after admission to ICU. Mann–Whitney tests were used to investigate group differences, and multiple linear regression was used to investigate the relationship between fatigue and covarying factors. <i>Results</i>. 71 patients completed follow-up, and 60 patients underwent a cognitive screening of which 30% had MoCA scores indicative of cognitive impairment (&lt;26 points). Higher age was related to poorer cognitive performance. Patients scored above the normal range on all subscales on the MFI-20. There was a significant difference in length of ICU stay between wave one and following waves, but no statistically significant differences emerged on cognitive screening. Intubated patients’ fatigue ratings were lower compared to those not intubated—despite longer ICU stay. No difference in MoCA scores emerged between patients who were, or were not, intubated. <i>Conclusion</i>. Cognitive impairment and fatigue were evident in patients three months after a severe COVID-19 infection, but global cognitive functioning was not related to ICU length of stay. Less fatigue among patients who had been intubated merits further investigation.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140984258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimates and Predictors of Mortality, Stroke Recurrence, and Functional Dependency 1-Year after Ischemic Stroke: A Prospective Multicenter Longitudinal Cohort Study in Central Norway","authors":"Ailan Phan,&nbsp;Bent Indredavik,&nbsp;Stian Lydersen,&nbsp;Åse H. Morsund,&nbsp;Yngve M. Seljeseth,&nbsp;Fredrik Ildstad,&nbsp;Torgeir Wethal","doi":"10.1155/2024/8805152","DOIUrl":"10.1155/2024/8805152","url":null,"abstract":"<p><i>Background</i>. Stroke incidence and mortality have drastically decreased in high-income countries in the past twenty years. In this study, we provide updated estimates on mortality, recurrent stroke, and functional dependency among patients with first-ever ischemic stroke and assess predictors associated with poor outcomes with a focus on age, vascular factors, stroke severity, function, and comorbidity burden. <i>Methods</i>. MIDNOR STROKE is a multicenter prospective longitudinal study including patients with first-ever ischemic stroke admitted to stroke units in Central Norway during 2015-2017. Data on survival, stroke recurrence, and functional dependency were collected during hospital stay and follow-up. Multivariable Cox proportional hazard models and logistic regression models were used to analyze predictors of mortality, stroke recurrence, and functional dependency. <i>Results</i>. A total of 794 participants were included in the study. After a year, 7.6% of the participants had died, 5.8% had a recurrent stroke, and 13.6% experienced functional deterioration to dependency. Multivariable analysis revealed that age (HR: 1.07, 96% CI: 1.03, 1.10), stroke severity (HR: 1.10, 95% CI: 1.07, 1.13), comorbidity burden (low: HR: 4.05, 95% CI: 1.48, 11.10; moderate: HR: 5.44, 95% CI: 2.06, 14.40; and high: 7.72, 95% CI: 2.85, 21.00), and coronary artery disease (HR: 2.40, 95% CI: 1.32, 4.38) predicted all-cause death. Statin therapy predicted improved survival (HR: 0.39, 95% CI: 0.21, 0.75). High age (HR: 1.09, 95% CI: 1.05, 1.14) and increased stroke severity (OR: 1.26, 95% CI: 1.17, 1.38) predicted elevated risk of functional dependency at one year. <i>Conclusions</i>. In this study, we have demonstrated that 1-year survival following first-ever ischemic stroke was high compared to previous reports and that statin therapy predicted improved survival. The risk of recurrent stroke after one year was found to be low compared to previous studies. Approximately 14% of stroke survivors who were initially functionally independent experienced deterioration to functional dependency. In addition to older age and stroke severity, increased comorbidity burden and a history of coronary artery disease predicted poor stroke prognosis. Interventions aimed at reducing stroke severity may improve patient outcomes. Furthermore, prevention efforts targeting conditions such as CAD and reducing overall comorbidity burden in stroke patients may favorably improve survival. This trial is registered with NCT03962127.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive Effect of a Cooling Cap on Functional Performance in Thermosensitive People with Multiple Sclerosis: A Randomized Controlled Trial","authors":"K. Novotna,&nbsp;K. Dedinova,&nbsp;I. Menkyova,&nbsp;T. Uher,&nbsp;E. Kubala Havrdova,&nbsp;Y. Angerova","doi":"10.1155/2024/4882755","DOIUrl":"10.1155/2024/4882755","url":null,"abstract":"<p><i>Background</i>. Up to 80% of people with MS experience worsening of their condition upon an increase in body temperature. Therefore, various options of cooling are being evaluated to help improve physical performance in people with MS. Most previous studies used active cooling methods. Our aim was to study the effect of simple device providing passive cooling. <i>Methods</i>. A randomized crossover study was conducted in 21 thermosensitive people with mild to moderate disability. Subjects were tested immediately before and after intervention (experimental or sham cooling). The assessment included timed 25-foot walk test, the 2- and 6-minute walk test, nine-hole peg test, and symbol digit modalities test. <i>Results</i>. A significant improvement was found in the experimental group in timed 25-foot walk test (<i>p</i> = 0.011) and in nine-hole peg test for dominant hand (<i>p</i> = 0.033). No significant improvement was found in the control group (sham cooling). <i>Conclusions</i>. Wearing cooling cap can improve short-term functional performance (walking and fine motor skills) in thermosensitive people with MS. This passive cooling method can be considered as a symptomatic treatment for some people with MS. This trial is registered with ISRCTN56350227.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140675402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectral Domain and Angiography Optical Coherence Tomography in Parkinson’s Disease: Structural And Vascular Changes in the Retina Correlate with Disease Severity and Progression","authors":"Laura Giovanna Di Maio,&nbsp;Gilda Cennamo,&nbsp;Daniela Montorio,&nbsp;Giovanna De Michele,&nbsp;Gianluigi Rosario Palmieri,&nbsp;Luigi Baratto,&nbsp;Sandra Perillo,&nbsp;Augusta Giglio,&nbsp;Alessandro Filla,&nbsp;Vincenzo Brescia Morra,&nbsp;Giuseppe De Michele,&nbsp;Ciro Costagliola,&nbsp;Anna De Rosa","doi":"10.1155/2024/8555083","DOIUrl":"10.1155/2024/8555083","url":null,"abstract":"<p><i>Background</i>. Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by bradykinesia, resting tremor, and muscle rigidity. Visual disturbances have been also described among non-motor features. <i>Objective</i>. We aimed to investigate the structural and vascular changes in the retinal and choroidal vascular networks, and to assess any relationship with motor and non-motor symptoms (NMS) in PD patients. <i>Methods</i>. Ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), and subfoveal choroidal thickness (SFCT) were examined using spectral domain-optical coherence tomography (SD-OCT). The vessel density (VD) of retinal and choriocapillary vascular networks in macular area and the foveal avascular zone (FAZ) area were evaluated by OCT angiography (OCTA). All patients underwent clinical evaluation using motor section of the Unified PD Rating Scale (UPDRS-III) and the Hoehn and Yahr (HY) scale. <i>Results</i>. A total of 48 eyes from 24 PD patients and 50 eyes from 25 controls were assessed. At SD-OCT, GCC and RNFL were more significantly thin in patients compared to controls. At OCTA exam, PD subjects showed lower values in VD of superficial capillary plexus (SCP) and radial peripapillary capillary plexus in comparison to controls, whereas FAZ area resulted in a significant increase in the patient group. We found a negative correlation between the age at onset and VD of SCP, and between HY score and RNFL thickness and FAZ. UPDRS-III score was negatively correlated with VD of deep capillary plexus. <i>Discussion</i>. The impairment of retinal structure and microvasculature seems to correlate with disease severity and progression in PD. Retinal anomalies can be considered as non-motor manifestations that could occur already in the early stage of the disease.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait Assessment in Chronic Inflammatory Demyelinating Polyradiculoneuropathy","authors":"Arnau Llauradó,&nbsp;Manuel Quintana,&nbsp;Margarita Gratacós-Viñola,&nbsp;Jose Manuel Vidal-Taboada,&nbsp;Juan Luis Restrepo-Vera,&nbsp;José Alemañ,&nbsp;Verónica López-Diego,&nbsp;Maria Salvadó,&nbsp;Daniel Sanchez-Tejerina,&nbsp;Javier Sotoca,&nbsp;Núria Raguer,&nbsp;Raul Juntas-Morales","doi":"10.1155/2024/7037704","DOIUrl":"https://doi.org/10.1155/2024/7037704","url":null,"abstract":"<p><i>Background and Aims</i>. Gait impairment is a common manifestation of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). However, clinicians lack an effective monitoring tool, as no gait test has been validated for CIDP. The aim of this study was to determine the usefulness of three tests in monitoring the clinical course of patients with CIDP: Timed Up and Go (TUG), 10-Meter Walk Test (10MWT), and 30-Second Chair Stand (30SCS). <i>Methods</i>. This is a prospective, single-center observational study. We included newly diagnosed CIDP patients starting treatment or relapsed CIDP patients requiring new treatment. We monitored the clinical course using CIDP-validated clinical scales and correlated changes in clinical status with the results of the gait tests. A ROC curve was developed, and we chose the cut-off point on each scale with the best specificity and sensitivity to detect change in clinical status. <i>Results</i>. A total of 20 patients have been recruited. The 3 tests show a statistical correlation with objective clinical improvement. In patients who have showed clinical improvement during the follow-up examination, a mean reduction of 4.8 seconds in TUG and 2.6 in 10MWT and a gain of 3 repetitions in 30SCS have been observed. The optimal cut-off points for each test were TUG ≤ 1 seconds, 10MWT ≤ 1 seconds, and 30SCS ≥ 1 repetition. The TUG test has the highest sensitivity (82.6%), and the 30SCS test has the highest specificity (100%) for detecting clinical improvement. <i>Conclusions</i>. The study found that the TUG and 30SCS tests could become effective tools for monitoring treatment response in CIDP patients.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141096408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Disturbance and Related Factors in the Patients with Relapsing-Remitting Multiple Sclerosis","authors":"Izabela Sempik,&nbsp;Edyta Dziadkowiak,&nbsp;Małgorzata Wieczorek,&nbsp;Anna Pokryszko–Dragan","doi":"10.1155/2024/6656571","DOIUrl":"10.1155/2024/6656571","url":null,"abstract":"<p><i>Background</i>. Sleep disturbances are commonly reported, although underestimated complaints from people with multiple sclerosis (MS). The aim of the study was to analyze the frequency and type of sleep disturbances in MS patients and to evaluate their relationships with demographics and clinical data. <i>Methods</i>. The study group consisted of 178 patients with relapsing-remitting MS: 130 females and 48 males. Clinical measures (disease duration, disability level in Expanded Disability Status Scale (EDSS), and treatment) were acquired from medical records. The questionnaire was applied, containing questions about sleep disturbances, somatic complaints, perception of fatigue, depression, anxiety, and problems at work and in social/family life. Athens Insomnia Scale (AIS) and Karolinska Sleepiness Scale (KSS) were performed to quantify sleep problems and Hamilton Depression Rating Scale (HDRS) and Addenbrooke’s Cognitive Examination (Mini-ACE) to assess level of depression and cognitive performance. Electroencephalography was recorded to identify electrophysiological indices of sleep. <i>Results</i>. 109 patients (61%) reported sleep disturbances, most frequently insomnia, snoring, and parasomnias. This subgroup had significantly higher scores in AIS (<i>p</i> &lt; 0.0001) and KSS (<i>p</i> = 0.010) and slightly higher EDSS score (<i>p</i> = 0.048) and more often complained of fatigue (71% vs. 53%, <i>p</i> = 0.0148), involuntary limb movement (42% vs. 25, <i>p</i> = 0.0170), and breathing disturbances (10% vs. 0%). There was a significant correlation between the results of AIS and HDRS (Rs = 0.715, <i>p</i> &lt; 0.05). <i>Conclusion</i>. Sleep disturbances, predominantly insomnia, are reported by more than a half of the patients with relapsing-remitting MS. Significant associations were found between sleep problems and MS-related clinical symptoms and psychosocial issues.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140746304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint Association of Low Nadir Serum Sodium and Potassium with Worse Outcomes after Ischemic Stroke","authors":"Zijuan Feng,&nbsp;Ting Chen,&nbsp;Peng Liu,&nbsp;Ziyi Zhang,&nbsp;Zhetao Wang,&nbsp;Yanan Wang,&nbsp;Quhong Song,&nbsp;Chen Ye,&nbsp;Ming Liu,&nbsp;Shuting Zhang","doi":"10.1155/2024/5541608","DOIUrl":"10.1155/2024/5541608","url":null,"abstract":"<p><i>Background</i>. Potassium and sodium are inextricably linked to the maintenance of cell potential and electrolyte homeostasis. Few studies have examined their joint relationship with outcomes after stroke. The objective of this study is to ascertain whether combined low nadir serum sodium and potassium levels are correlated with an unfavorable outcome in ischemic stroke. <i>Methods</i>. Retrospective cohort study of 2,920 consecutive patients with first-ever ischemic stroke. Serum sodium and potassium levels were measured at 10 consecutive time points over 10 days poststroke. The Youden Index was performed to identify patients with low nadir sodium (&lt;140 mmol/L) and potassium (&lt;3.65 mmol/L) levels, defined as a NaK score of 2. Multivariable logistic regression and Cox proportional hazard analysis were used to evaluate the independent relationship of sodium and potassium levels with clinical outcomes at three months. <i>Results</i>. A total of 2,920 patients with ischemic stroke were analyzed (mean age 62.14 ± 14.13 years; 60.19% male), of whom 740 (25.3%) with both low nadir sodium and potassium levels had a quintuple 3-month case fatality compared to other patients (10.6% vs. 2.1%). Multivariable analyses identified NaK = 2 as an independent predictor of 3-month death (adjusted odds ratio (OR) 2.23; 95% confidence interval (CI) 1.17-4.53; <i>p</i> = 0.019) and an unfavorable shift in the distribution of scores on the modified Rankin scale (adjusted OR 1.51, 95% CI 1.12-2.04; <i>p</i> = 0.007). <i>Conclusions</i>. Low sodium and potassium levels are common after ischemic stroke and are independent predictors of subsequent death.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140364533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizures as Initial Presentation and Enduring Predisposition to Seizures in Autoimmune Encephalitis","authors":"Yingying Zhou,&nbsp;Chunmei Wu,&nbsp;Huiting Wu,&nbsp;Kai Zheng,&nbsp;Shanshan Huang,&nbsp;Suiqiang Zhu","doi":"10.1155/2024/6183939","DOIUrl":"10.1155/2024/6183939","url":null,"abstract":"<p><i>Purpose</i>. This retrospective study is aimed at investigating the clinical characteristics of autoimmune encephalitis (AE) and long-term prognosis of patients who initially present with seizures as well as risk factors for enduring predisposition to seizures in AE. <i>Methods</i>. From January 1, 2013, to October 31, 2021, a total of 343 AE patients from a single center diagnosed with autoimmune encephalitis (AE) were enrolled in this study, including 198 antibody-positive AE and 145 antibody-negative but probable AE. According to initial symptoms, AE patients were divided into two groups: onset with seizure group and onset with nonseizure group. The clinical characteristics were retrospectively reviewed. Patients were clinically evaluated at onset and at 6, 12, and 24 months of follow-up. Modified Rankin Scale (MRS) score, Clinical Assessment Scale in Autoimmune Encephalitis (CASE) score, and seizure-related information were assessed. <i>Results</i>. In AE, patients with seizures as the first presentation were younger, with a median-onset age of 28 years old. Compared with other types of antibody-positive AE, anti-GABABR AE more frequently began with seizures, while anti-CASPR2, anti-AMPAR, and anti-DPPX encephalitis usually began with symptoms other than seizures. The most common type of initial seizures in AE was focal to bilateral seizure (67.6%), with a significant prevalence in antibody-positive AE (<i>P</i> = 0.001). In addition, compared with nonseizure group, patients with seizures as an initial presentation had higher MRS and CASE scores at 24 months of follow-up. Older age at onset and focal nonmotor seizure type were independent risk factors for an enduring predisposition to seizures in AE patients. <i>Conclusion</i>. The younger and anti-GABABR-positive AE patients are more prone to onset with seizures. AE patients who initially presented with seizures had worse long-term neurological recovery. Onset age and seizure type should be highly appreciated when formulating the strategy for therapy at post-AE status.</p>","PeriodicalId":6939,"journal":{"name":"Acta Neurologica Scandinavica","volume":"2024 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}