Arquivos de neuro-psiquiatria最新文献

{"title":"Clinical outcomes during pregnancy and the postpartum period in women with myasthenia gravis and their newborns.","authors":"Amanda Vitória Freire de Oliveira, Ana Flávia Andrade Lemos, Mariana Ribeiro Pereira, Rodrigo Siqueira Soares Frezatti, André Cleriston José Dos Santos, Claudia Ferreira da Rosa Sobreira, Wilson Marques Junior, Pedro José Tomaselli","doi":"10.1055/s-0046-1829031","DOIUrl":"10.1055/s-0046-1829031","url":null,"abstract":"<p><strong>Background: </strong>Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction associated with increased maternal and fetal risks during pregnancy and the puerperal period.</p><p><strong>Objective: </strong>To describe the longitudinal course of MG, maternal and neonatal outcomes, and the occurrence of transient neonatal myasthenia gravis (TNMG) from the pregestational period until 12 months postpartum in pregnancies complicated by MG.</p><p><strong>Methods: </strong>A retrospective, longitudinal case-series study of pregnancies in women with MG who were followed at a single tertiary center for neuromuscular disorders. Disease severity was assessed using the MG Foundation of America Clinical Classification (MGFA)and MG-Activities of Daily Living (MG-ADL) scale. Treatments, delivery mode, postpartum exacerbations, ventilatory support and TNMG in newborns were collected using a standardized proforma. Longitudinal MG-ADL scores were analyzed using generalized estimating equations.</p><p><strong>Results: </strong>Twenty-four pregnant women with MG were included. Patients had juvenile-onset (<i>n</i> = 12, 50%) or early-onset (<i>n</i> = 12, 50%) MG, which was mostly generalized (<i>n</i> = 20, 83%). Anti-AChR antibodies were positive in 71% (<i>n</i> = 17) and anti-MuSK antibodies in 4% (<i>n</i> = 1). Pyridostigmine was the main therapy; 8% of patients (<i>n</i> = 2) experienced exacerbations during pregnancy. Cesarean delivery occurred in 60% (<i>n</i> = 12), primarily for obstetric indications. The TNMG occurred in 15% of newborns (3 out of 20), and all fully recovered. The MG-ADL scores increased during the first and third trimesters, during the postpartum period, and at 12 months postpartum. Third-trimester MG-ADL scores ≥ 4 were associated with the occurrence of TNMG. No maternal or neonatal deaths occurred.</p><p><strong>Conclusion: </strong>Pregnancy in MG was characterized by variable disease activity, with late gestation and the postpartum period representing clinically relevant periods of vulnerability to maternal exacerbations and neonatal involvement. Increased third-trimester MG-ADL scores, particularly among antibody-positive mothers, were associated with TNMG and postpartum exacerbations, supporting close monitoring during these periods.</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/PMC13652663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147147","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":"Seven hundred years after Mondino de Luzzi (1275-1326): method and observation in medieval neuroanatomy.","authors":"Veaceslav Merlo Solopa, Sara Rota Conti, Michele Augusto Riva","doi":"10.1055/s-0046-1829018","DOIUrl":"https://doi.org/10.1055/s-0046-1829018","url":null,"abstract":"<p><strong>Abstract: </strong>The present paper reexamines the contribution of Mondino de Luzzi (1275-1326) beyond his well-known association with the reintroduction of human dissection in medieval medicine. Focusing on ventricular theory, it explores how Mondino's teaching brought traditional descriptions of the brain into closer contact with the observation of the human body through public dissection. Although his work remained firmly rooted in Galenic and Avicennian traditions, the association of cerebral ventricles with identifiable bodily structures indirectly rendered established doctrines less purely speculative and more susceptible to anatomical scrutiny and criticism. From the Renaissance onward, this contributed to a broader reevaluation of inherited anatomical and physiological theories.</p>","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/PMC13633091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103686","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":"Aneurysmal subarachnoid hemorrhage: predictive score for angiographic vasospasm.","authors":"Mariana Duarte Gomes, Henrique Manuel Campos Cardoso, João Saraiva, Miguel Quintas-Neves","doi":"10.1055/s-0046-1829045","DOIUrl":"https://doi.org/10.1055/s-0046-1829045","url":null,"abstract":"<p><strong>Background: </strong>Aneurysmal subarachnoid hemorrhage is a condition resulting from the rupture of a cerebral aneurysm, sometimes leading to delayed cerebral ischemia, primarily due to angiographic vasospasm; its prediction is crucial to improve patient management and outcomes.</p><p><strong>Objective: </strong>To assess the predictive value of clinical, analytical and imaging parameters for vasospasm in aneurysmal subarachnoid hemorrhage and to develop a clinical practical score.</p><p><strong>Methods: </strong>The current single-center retrospective study included 115 patients with aneurysmal subarachnoid hemorrhage who underwent a computed tomography scan within 24 hours of ictus. Clinical and analytical data were collected, and Hounsfield unit (HU) measurements were independently assessed. Statistical analyses were conducted to identify predictors of vasospasm.</p><p><strong>Results: </strong>Vasospasm occurred in 40% of patients (46/115). The multivariate analysis identified intracerebral hemorrhage (odds ratio [OR] = 2.482; 95%CI = 1.019-6.046; <i>p</i> = 0.045), interpeduncular HU value (per 5 HU increase: OR = 1.253; 95%CI = 1.044-1.504; <i>p</i> = 0.016), and serum chloride ≥ 106 mEq/L (OR = 3.545; 95%CI = 1.457-8.621; <i>p</i> = 0.005) as independent predictors (<i>p</i> < 0.05) of vasospasm. The model, combined as a simplified score including these 3 variables, demonstrated excellent discriminative capacity (area under the curve [AUC] = 0.886; bootstrapped AUC = 0.885).</p><p><strong>Conclusion: </strong>We identified significant predictors of vasospasm in patients with aneurysmal subarachnoid hemorrhage, namely interpeduncular HU value, intracerebral hemorrhage, and serum chloride levels. A practical 5-point score based on these factors offers a potentially-robust, easy-to-use tool for early risk stratification, which may guide personalized follow-up and timely interventions. Further prospective multicenter studies are recommended to validate these findings.</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/PMC13633089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103465","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":"Selective impairment of affective theory of mind in restless legs syndrome: a case-control study.","authors":"Aydan Topal, Suğra Şimşek, Hasan Doğan, Nazlı Durmaz Çelik","doi":"10.1055/s-0046-1827168","DOIUrl":"10.1055/s-0046-1827168","url":null,"abstract":"<p><strong>Background: </strong>Restless legs syndrome (RLS) is traditionally considered a sensorimotor disorder, but increasing evidence suggests that it may also involve brain systems related to emotional and cognitive functions. In this exploratory study, we investigated whether individuals with RLS show differences in social cognition, particularly in the ability to interpret others' emotional expressions and mental states.</p><p><strong>Objective: </strong>To investigate social cognition in individuals with RLS, particularly affective theory of mind.</p><p><strong>Methods: </strong>We compared 22 individuals with RLS and 22 healthy controls matched for age, sex, and education. Participants completed standardized tasks assessing different aspects of social cognition, including affective theory of mind, which refers to the ability to infer others' emotions.</p><p><strong>Results: </strong>We found that individuals with RLS scored lower on the task assessing affective theory of mind. No significant differences were observed in other social-cognitive measures, although the relatively modest sample size may have limited the detection of subtle differences. The group difference in affective theory of mind remained significant after accounting for depressive symptoms.</p><p><strong>Conclusion: </strong>These preliminary findings suggest that RLS may be associated with alterations in affective theory of mind independent of depressive symptoms. This pattern may reflect involvement of limbic-striatal networks. Larger studies incorporating sleep-related measures are needed to better understand social cognition in RLS.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-5"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757850","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":"Erectile dysfunction and lower urinary tract symptoms in men with multiple sclerosis.","authors":"Luciano Gonçalves do Nascimento Júnior, Alex Tiburtino Meira, Felipe Nunes de Araújo, Bianca Etelvina Santos de Oliveira","doi":"10.1055/s-0046-1829050","DOIUrl":"https://doi.org/10.1055/s-0046-1829050","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system commonly associated with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED); however, these conditions remain underinvestigated in Brazilian populations.</p><p><strong>Objective: </strong>To evaluate the prevalence of ED and LUTS, to analyze the correlations involving the 5-item International Index of Erectile Function (IIEF-5), the International Prostate Symptom Score (IPSS), the Expanded Disability Status Scale (EDSS), age, and disease duration, and to identify the subscale items most strongly associated with neurological disability in men with MS.</p><p><strong>Methods: </strong>We conducted a cross-sectional study enrolling 56 men with MS diagnosed through the McDonald criteria at the Reference Center for MS of the state of Paraíba, Brazil. Erectile dysfunction was assessed using the IIEF-5, and LUTS, using the IPSS. Spearman correlations with Bonferroni correction, univariate linear regression, one-way analysis of variance (ANOVA), and Tukey's Honestly-Significant Difference (HSD) post-hoc tests were performed.</p><p><strong>Results: </strong>The mean age of the sample was 39.9 ± 12.3 years, the median EDSS score, 2.75, and the median disease duration, 7 years. The prevalence of ED was of 50%, and that of LUTS, 96.4%. Strong correlations were found between the scores on the EDSS and the IIEF-5, the EDSS and the IPSS, and the IIEF-5 and the IPSS. Through the analysis, we identified erection confidence and urinary intermittency as the subscale items most strongly associated with the EDSS score. One-way ANOVA revealed significant differences across MS phenotypes for the IIEF-5, IPSS, and EDSS, with Tukey HSD confirming relapsing-remitting MS versus secondary progressive MS as the primary source of divergence.</p><p><strong>Conclusion: </strong>Erectile dysfunction and LUTS were highly-prevalent in men with MS in the cohort of the present study. Disability level was the strongest correlate of both dysfunctions, supporting integrated urological-neurological screening in MS care.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 10","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103608","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":"Epidemiology and clinical features of movement disorders in a Mexican Mestizo cohort: a 10-year tertiary-center study.","authors":"Katia Carmina Farias-Moreno, Leonel Villa-Villegas, Biagio David González-Ruffino, Luz Gabriela Lira-Jaime, Karla Berenice Carrazco-Peña, Enrique Gómez-Figueroa, Carlos Zúñiga-Ramírez","doi":"10.1055/s-0046-1829047","DOIUrl":"10.1055/s-0046-1829047","url":null,"abstract":"<p><strong>Background: </strong>Movement disorders comprise a heterogeneous spectrum of neurological conditions characterized by impaired motor control. Limited epidemiological data exist for Latin American populations, particularly for Mexican Mestizos.</p><p><strong>Objective: </strong>To characterize the epidemiological profile and clinical features of movement disorders in a large cohort of Mexican Mestizo patients evaluated at a public tertiary referral center in western Mexico.</p><p><strong>Methods: </strong>We conducted a 10-year retrospective cohort study (2012-2022) analyzing medical records from the Movement Disorders and Neurodegenerative Diseases Unit at the Hospital Civil de Guadalajara, a public tertiary university hospital from the western region of Mexico. Inclusion criteria were confirmed movement disorder diagnosis and a minimum of two clinical evaluations. Binary logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 1,830 records (mean age 58.5 ± 17.0 years, 53.9% female, all self-identified as Mexican Mestizo), hypokinetic disorders comprised 63.9% (n = 1,170) and hyperkinetic disorders 36.1% (n = 660). Parkinsonism (63.6%, n = 1,163) and tremor (11.3%, n = 206) were the most frequent subtypes. Hypokinetic disorders were associated with older age (64.2 ± 12.8 vs. 48.5 ± 18.9 years, <i>p</i> < 0.001), hypertension (OR = 2.29; 1.78-2.95; <i>p</i> = 0.001), and smoking (OR = 1.51; 1.13-2.03; <i>p</i> = 0.005). Hyperkinetic disorders were associated with male sex (OR = 1.47; 1.19-1.82; <i>p</i> < 0.001), family history (OR = 1.92; 1.49-2.47; <i>p</i> < 0.001), and functional presentations (OR = 11.0; 5.53-22.14; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This is the largest reported Mexican Mestizo cohort with movement disorders evaluated in a single public tertiary center. Findings reveal distinct demographic and clinical patterns and may inform integrated cardiovascular-neurological care models, screening protocols, and resource allocation within the Mexican public health system.</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/PMC13652661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147535","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":"Behavior change: from neurobiology to behavioral change theories and back - part 2.","authors":"Fabiano Moulin de Moraes, Conrado Regis Borges, Marcelo Youngblood, Felipe Chaves Duarte Barros, Nancy Huang, Marcos Christiano Lange","doi":"10.1055/s-0046-1827212","DOIUrl":"10.1055/s-0046-1827212","url":null,"abstract":"<p><strong>Background: </strong>Behavior change remains challenging despite a vast body of evidence linking health behaviors with several health outcomes. Over the past few decades, various health behavioral change theories and techniques have emerged, leading to significant advances in the field. However, although some existing theories provide competent models for structuring approaches, they do not provide a unified neurobiological foundation.</p><p><strong>Objective: </strong>To outline the connections between neuroscientific foundations in Part 1 and behavioral change theories in Part 2 and propose an overarching neuroscientific perspective.</p><p><strong>Methods: </strong>A narrative review of the relevant history and background of the most widely adopted behavior change theories and integrates them into the proposed framework of the Behavior Change Resource Model described in Part 1.</p><p><strong>Results: </strong>A structured overview of selected theories was performed. The main theories and techniques described were Social Cognitive Theory, Self-Determination Theory, Motivational Interviewing, Behavioral Activation, Transtheoretical Model, Cognitive Behavioral Therapy, Mindfulness Meditation, Positive Psychology, and Health and Lifestyle Coaching. Finally, their relation to motivation science and the Behavior Change Resource Model was detailed.</p><p><strong>Conclusion: </strong>By bridging the Behavior Change Resource Model (Part 1), and an array of related theories and techniques (Part 2) it was possible to provide a conceptual perspective to further support and propel the scientific understanding of human behavior, especially towards keeping and expanding health through lifespan and across society.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 9","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862861","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":"Willis and Sydenham: intersections and contrasts in early modern England.","authors":"João Pedro Sá Lins, Rodrigo da Silva Sousa, Lucca Passow Carpinelli, Gustavo Leite Franklin, Hélio Afonso Ghizoni Teive, Alex Tiburtino Meira","doi":"10.1055/s-0046-1827164","DOIUrl":"10.1055/s-0046-1827164","url":null,"abstract":"<p><strong>Abstract: </strong>Thomas Willis and Thomas Sydenham exemplify contrasting modes of medical validation in Early Modern England shaped by political and institutional realignments after the English Civil War and the Stuart Restoration. Benefiting from his ties to the Crown and the Church of England, Willis combined anatomical investigation of the nervous system with iatrochemical and theological frameworks. In contrast, Sydenham, aligned with the Parliamentary cause and operating outside academic institutions, developed a clinical method grounded in systematic bedside observation and nosological description during London epidemics. Their trajectories reveal divergent medical epistemology that coalesced to influence the foundations of neurological reasoning and the modern clinical method.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 9","pages":"1-4"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757380","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":"Clinical and epidemiological comparison between perimesencephalic and non-perimesencephalic, non-aneurysmal subarachnoid hemorrhage: a single-center cohort study from a referral center in a developing country.","authors":"João Pedro Einsfeld Britz, Rafael Harter Tomaszeski, Carla Bittencourt Rynkowski, Diego Zambonin, Ericson Sfreddo, Paulo Valdeci Worm","doi":"10.1055/s-0046-1827159","DOIUrl":"10.1055/s-0046-1827159","url":null,"abstract":"<p><strong>Background: </strong>Non-aneurysmal subarachnoid hemorrhage (SAH) represents a heterogeneous entity with implications for management and prognosis. Perimesencephalic SAH (PSAH) is associated with a more benign clinical course, lower rates of complications, and favorable outcomes, whereas non-perimesencephalic SAH (NPSAH) tends to present with higher rates of vasospasm, hydrocephalus, and worse neurological outcomes. Recognizing these distinct bleeding patterns is, therefore, essential for clinical management.</p><p><strong>Objective: </strong>The present study aims to analyze a series of patients with nonaneurysmal SAH, since it remains a poorly understood and requires further investigation.</p><p><strong>Methods: </strong>A single-center cohort study was carried out with all hospitalizations for spontaneous SAH. Patients were classified according to the pattern of bleeding at cranial computed tomography (CT), as those with a PSAH pattern and those with an aneurysmal pattern of bleeding (NPSAH). A DSA was performed in all patients, and only those who showed no vascular abnormalities were included for data collection. Clinical, epidemiological and functional data were collected and analyzed, comparing the results between both groups.</p><p><strong>Results: </strong>A total of 550 patients with spontaneous SAH were treated at our center, and 74 were classified as nonaneurysmal and included in the final analysis. The bleeding pattern was classified as PSAH in 20 patients and as NPSAH in 54. The NPSAH was more prevalent in women, and PSAH in men. Rates of hydrocephalus and vasospasm were higher in patients with the NPSAH pattern, and clinical outcomes were worse.</p><p><strong>Conclusion: </strong>The NPSAH pattern had an intermediate clinical behavior between perimesencephalic and aneurysmal bleeding. On the other hand, PSAH had a benign course and excellent prognosis.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 9","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759611","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":"IgG4-related inflammatory pseudotumor presenting with refractory seizures: a diagnostic pitfall.","authors":"Polyana Favero Ferreira Caetano, Vitor Ribeiro Paes, Carlos Eduardo Roelke, Lívia Almeida Dutra","doi":"10.1055/s-0046-1822633","DOIUrl":"10.1055/s-0046-1822633","url":null,"abstract":"<p><strong>Abstract: </strong>Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory condition that can mimic malignancy, infection, or other autoimmune disorders, causing significant diagnostic challenges. Neurological involvement is uncommon, most frequently presenting as hypertrophic pachymeningitis or hypophysitis, but it may also manifest as inflammatory ophthalmic or cerebral pseudotumors. We herein describe a complex case of neurological IgG4-RD with a 10-year disease course, initially presenting with focal epilepsy and later evolving into a tumefactive brain lesion. This case highlights key clinical lessons: neurological IgG4-RD may remain subclinical, with only functional symptoms preceding structural abnormalities; the histopathological demonstration of storiform fibrosis and IgG4-positive plasma cell infiltration remain the diagnostic cornerstone; and systemic assessment is essential due to frequent multiorgan involvement. Finally, we discuss strategies to interpret brain-biopsy findings in inflammatory brain disorders and emphasize the importance of maintaining a high index of suspicion for IgG4-RD in atypical presentations.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"84 9","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13301291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326082","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}