Arquivos de neuro-psiquiatria最新文献

{"title":"Pain on the stage: a historical-neurological analysis of Afife Jale, Türkiye's first Muslim actress.","authors":"Devrimsel Harika Ertem, Yavuz Altunkaynak","doi":"10.1055/s-0046-1829029","DOIUrl":"10.1055/s-0046-1829029","url":null,"abstract":"<p><strong>Abstract: </strong>Afife Jale (1902-1941) was a revolutionary in Turkish history as the first Muslim woman to perform on the professional theater stage. Despite her cultural significance, her life was overshadowed by chronic, debilitating headaches, and a subsequent fatal struggle with substance use disorder. This historical reconstruction explores the intersection of her pioneer identity, the progression of her neurological condition, and the iatrogenic medical practices of the early 20th century. Historical accounts suggest that Jale may have experienced recurrent severe hemicranial pain, exacerbated by the sociopolitical stress of her era. Her exposure to morphine as a primary analgesic, a common practice of the period, may have contributed to a clinical evolution compatible with phenomena currently conceptualized as medication-overuse headache and opioid-induced hyperalgesia. Her decline and eventual death at age 39 illustrate the tragic consequences of failing to distinguish between physical pain and psychological trauma within the therapeutic paradigms of the early Republican era. Her story is a reminder that, despite new treatments for headache, iatrogenic addiction remains a serious risk. Honoring her legacy means committing to ethical, multidisciplinary pain management that protects both the health and the creative soul of every patient.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 12","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuro-ophthalmic sarcoidosis with extraocular-muscle involvement: neuroimaging.","authors":"Lucas Yunes Cominatto Barbosa, Luiza Maretti Scomparin, Rafael Luccas, Fabiano Reis","doi":"10.1055/s-0046-1827163","DOIUrl":"10.1055/s-0046-1827163","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 11","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming the ties of gravity that bind us to Earth: Constantin von Economo, neurologist and pioneering aviator.","authors":"Jéssica Yumi Lago Matsuda, Liria Matsuzawa Figueiredo, Allan Henrique Panisson, Matheus Kahakura Franco Pedro","doi":"10.1055/s-0046-1829049","DOIUrl":"10.1055/s-0046-1829049","url":null,"abstract":"<p><strong>Abstract: </strong>Constantin von Economo was a brilliant neuroscientist whose 33 years of intense productivity are documented in over 4,200 pages of published works. He was best recognized for his notable research on encephalitis lethargica and the detailed cytoarchitectonic mapping of the human cerebral cortex. However, less widely known is that von Economo was also an aviation enthusiast, a skilled balloon and airplane pilot, who held prominent positions in aviation organizations, actively promoted international aeronautical meetings, and gained distinction as a pilot during World War I. Therefore, we aimed to revisit this remarkable but often overlooked aspect of his biography, emphasizing his love of the aeronautical arts and its impact on his medical career.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 11","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downbeat nystagmus: a practical approach based on a clinical case.","authors":"Rebecca Ranzani Martins, Cristiana Borges Pereira","doi":"10.1055/s-0046-1827165","DOIUrl":"10.1055/s-0046-1827165","url":null,"abstract":"<p><strong>Abstract: </strong>Spontaneous downbeat nystagmus (DBN) is the most common form of acquired nystagmus, characterized by a slow upward ocular drift and a corrective downward quick phase. The pathophysiology involves a final common pathway leading to decreased inhibition of the superior vestibular nucleus, often secondary to lesions in the flocculonodular lobes (flocculus/paraflocculus, FL/PFL), the paramedian tract (PMT), or the dorsal vermis. The clinical presentation generally includes chronic dizziness, gait unsteadiness, and oscillopsia. The causes are diverse, encompassing Chiari malformation, vascular and demyelinating lesions, hereditary and acquired cerebellar ataxias, and toxic-metabolic causes. Approximately 40% of DBN cases remain idiopathic. The treatment involves disease-specific management, prism glasses, and vestibular rehabilitation. Pharmacotherapy, such as clonazepam, gabapentin, or baclofen (with 4-aminopyridine being the most beneficial but often unavailable), is considered a second-line intervention.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 11","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated oral methotrexate-induced cerebellar leukoencephalopathy: a rare and underrecognized imaging pattern.","authors":"Aaliyah Shaikh, Abdulrahman Kareem Sidani, Kevin J Abrams, Márcio Luís Duarte, Leonardo Furtado Freitas","doi":"10.1055/s-0046-1827043","DOIUrl":"https://doi.org/10.1055/s-0046-1827043","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it time to consider how to maximize the impact of simple epidemiological studies in the field of movement disorders?","authors":"Vitor Tumas, Bruno Lopes Santos-Lobato","doi":"10.1055/s-0046-1827824","DOIUrl":"10.1055/s-0046-1827824","url":null,"abstract":"","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden and social context of caregivers of children and adolescents with Charcot-Marie-Tooth disease.","authors":"Caroline Soares de Paula, Juliana Cardoso, Wilson Marques Junior, Cyntia Rogean de Jesus Alves de Baptista, Ana Claudia Mattiello-Sverzut","doi":"10.1055/s-0046-1829046","DOIUrl":"https://doi.org/10.1055/s-0046-1829046","url":null,"abstract":"<p><strong>Background: </strong>In pediatric Charcot-Marie-Tooth (CMT) disease, caregivers play an important role in coordinating care and promoting child well-being. Therefore, understanding caregiver burden and social context is key for treatment planning.</p><p><strong>Objective: </strong>To investigate caregiver burden, family income, and level of schooling among caregivers of children and adolescents with CMT disease, and to examine correlations between caregiver burden, patient age, clinical impairment, and caregiver age.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 58 patients (aged 3-18 years) and their primary caregivers. Caregiver profile and burden were obtained through interview. The Caregiver Burden Scale (CBS) assessed burden, and the Brazilian version of the Charcot-Marie-Tooth Pediatric Scale (CMTPedS-Br) assessed patient's clinical impairment.</p><p><strong>Results: </strong>The median age of children and adolescents was of 13.0 (11.0-15.0) years, and that of caregivers was of 41.0 (36.5-46.0) years. Median scores were 22.5 (18.0-27.0) for CMTPedS-Br and 31.5 (25.2-44.8) for CBS. Most caregivers were mothers (85.2%), did not present a CMT diagnosis (59.6%), earned R$ 2,200 to 4,400 per month (42.6%), and completed high school (33.3%). Burden did not differ by income or level of schooling and showed a weak positive correlation (<i>p</i> = 0.17) with caregiver age only.</p><p><strong>Conclusion: </strong>Caregivers of children and adolescents with CMT disease and moderate impairment may experience burden. Although socioeconomic factors were not decisive in explaining differences in caregiver burden, their variability highlights the need to consider them in care planning. Caregiver burden is a complex construct that may involve additional factors not included in the present study. Overall, findings support multidisciplinary, caregiver-centered interventions in pediatric CMT disease care.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma p-tau217 as a biomarker for Alzheimer's disease: diagnostic and prognostic value in clinical and population-based studies.","authors":"Gunter Gerson, Guilherme Nobre Nogueira, Maria Jânia Teixeira","doi":"10.1055/s-0046-1829032","DOIUrl":"10.1055/s-0046-1829032","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is the leading cause of dementia worldwide, and blood-based biomarkers are emerging as accessible diagnostic tools. Plasma phosphorylated tau at position 217 (p-tau217) has shown promise in early detection.</p><p><strong>Objective: </strong>To evaluate the diagnostic accuracy, prognostic value, and applicability of plasma p-tau217 in AD compared with other biomarkers.</p><p><strong>Methods: </strong>We conducted an integrative review on the PubMed, Scopus, Embase, and Cochrane Library databases (2018-2024). Eligible observational and diagnostic studies assessing p-tau217 in plasma were included. Study selection and quality assessment followed the Standards for Reporting of Diagnostic Accuracy (STARD) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.</p><p><strong>Results: </strong>We analized 9 studies involving more than 6 thousand participants analyzed. Plasma p-tau217 demonstrated high accuracy (area under the curve [AUC]: 0.86-0.94) for detecting tau and amyloid pathology, outperforming p-tau181. It was effective in diverse populations, asymptomatic individuals, and primary care settings. Longitudinal data suggest predictive value for cognitive decline.</p><p><strong>Conclusion: </strong>Plasma p-tau217 is a reliable and non-invasive biomarker for AD, with applications in diagnosis, prognosis, and treatment monitoring. Standardization and multicenter validation are necessary before clinical implementation.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological prognostication after cardiac arrest: evidence review and institutional protocol proposal.","authors":"Eduardo Drews Amorim, Rose Plotnik, Raphael Machado Castilhos","doi":"10.1055/s-0046-1829052","DOIUrl":"https://doi.org/10.1055/s-0046-1829052","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrest (CA) is associated with high mortality and neurological morbidity, mainly due to hypoxic-ischemic encephalopathy. Accurate neurological prognostication in CA survivors is essential to guide therapeutic decisions and provide appropriate care.</p><p><strong>Objective: </strong>To review the current evidence on neurological prognostication after CA and to propose an institutional protocol adapted to the resources of Hospital de Clínicas de Porto Alegre (HCPA).</p><p><strong>Methods: </strong>The current narrative review was conducted in two stages: a literature review and the development of an institutional protocol. Articles were selected according to their clinical relevance and their contribution to current evidence on neurological prognostication after CA. The PubMed, Scopus, Web of Science, Embase, and SciELO databases were searched. The protocol was developed considering the clinical tools available at HCPA, including neurological examination, electroencephalography (EEG), and neuroimaging.</p><p><strong>Results: </strong>Brain injury after CA occurs in three stages: intra-arrest ischemia, immediate reperfusion, and delayed postreperfusion injury. Prognostic modalities include neurological examination, EEG, somatosensory-evoked potentials (SSEPs), serum biomarkers, and neuroimaging. Reliable predictors of poor outcome include absent brainstem reflexes at 72 hours, persistent EEG suppression, bilateral absence of cortical N20 potentials, and diffuse abnormalities on magnetic resonance imaging. The proposed protocol organizes assessments from admission to the Intensive Care Unit through day 5 after the return of spontaneous circulation.</p><p><strong>Conclusion: </strong>A standardized post-CA neurological prognostication protocol at HCPA may improve care quality, enhance communication with families, and support ethically-sound decision-making.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fulminant cryptococcal meningoencephalitis with adrenal involvement in an immunocompetent patient: a clinicopathologic correlation.","authors":"Luiza Barbosa de Oliveira, Thrícia Christina Garcia Diniz Rezende, Isadora Lyrio Stábille, Ruben Luis de Avelino Carneiro, Felipe Coelho Batista, João Henrique do Amaral E Silva, Alex Eduardo da Silva","doi":"10.1055/s-0046-1827160","DOIUrl":"10.1055/s-0046-1827160","url":null,"abstract":"<p><strong>Abstract: </strong>Cryptococcus meningoencephalitis (CM) is the most frequently encountered manifestation of cryptococcosis. We report the case of a previously healthy, human immunodeficiency virus (HIV)-negative 65-year-old man who presented with 3 days of severe holocranial headache followed by sudden psychomotor agitation, confusion, and disorganized speech, without improvement after midazolam, requiring endotracheal intubation. Initial neuroimaging suggested inactive neurocysticercosis. Early cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis with negative India ink but positive cryptococcal antigen (latex agglutination), and subsequent testing confirmed <i>Cryptococcus neoformans</i>. The patient received fluconazole and amphotericin B and underwent therapeutic lumbar punctures for intracranial pressure control, with opening pressures decreasing from 25 to 13 cmH₂O and transient clinical improvement. Despite this response, he experienced sudden deterioration and died. Autopsy revealed diffuse cerebral edema and granulomatous adrenal involvement. This case illustrates the potential fulminant course of cryptococcal meningoencephalitis in immunocompetent individuals and reinforces the importance of early recognition and aggressive intracranial pressure management.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}