BMC Neurology最新文献

{"title":"The network and care coordination of ambulatory healthcare providers for people with mobility impairments: a cross-sectional network study involving stroke survivors and people with spinal cord injury in Germany.","authors":"T Schmittus, M Wensing, N Weidner, R Rupp, J Koetsenruijter","doi":"10.1186/s12883-026-05208-6","DOIUrl":"10.1186/s12883-026-05208-6","url":null,"abstract":"<p><strong>Background: </strong>People with mobility impairments such as stroke survivors or people with spinal cord injury (SCI) receive ambulatory healthcare from several healthcare providers. The coordination of these providers is challenging because there are usually no team meetings or shared treatment protocols. To gain insights into the coordinative processes of ambulatory care, the information transfer between providers was explored.</p><p><strong>Methods: </strong>A cross-sectional network study was conducted in an urban community in the south-west of Germany. First, an exploratory internet search for local providers was conducted. Then, providers were asked to distribute a survey to their patients (stroke, SCI) to identify the provider network. This was followed by a survey of the providers named by the surveyed patients. Network analysis was applied to explore connections and network characteristics (density, centrality).</p><p><strong>Results: </strong>Based on the patient survey (n = 22), a total of 58 healthcare providers in the community were identified, 20 of whom took part in the provider survey. In the network identified, physiotherapists, general practitioners, occupational therapists, orthopaedic technicians, neurologists, speech therapists and neuropsychologists were connected by 251 ties. The network had a density of 0.152 and a centrality of 0.442. Inter-organizational information sharing was only mentioned for 12 connections between healthcare providers. Care coordination in the community was rated as medium.</p><p><strong>Conclusion: </strong>Network analysis provided insight into a local network of healthcare providers. The network is dominated by a few providers and all providers have a low degree of connectivity. This study found that sharing of patient's information between providers is rarely implemented.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"26 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599330","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":"Patient-reported outcomes in Chinese patients with AQP4-IgG-positive neuromyelitis optica spectrum disorder on inebilizumab therapy: a cross-sectional study.","authors":"Hexiang Yin, Mengdi Hao, Yan Xu","doi":"10.1186/s12883-026-05163-2","DOIUrl":"10.1186/s12883-026-05163-2","url":null,"abstract":"<p><strong>Background: </strong>The treatment of neuromyelitis optica spectrum disorder (NMOSD) has entered the era of targeted biological agents. While relapse control has improved substantially, patient-reported outcomes (PROs) remain understudied. This study aimed to explore real-world patient-reported perceptions of inebilizumab therapy in AQP4-IgG-positive NMOSD.</p><p><strong>Methods: </strong>We conducted a nationwide cross-sectional survey of AQP4-IgG-positive NMOSD patients receiving inebilizumab using an anonymous online questionnaire (April-September 2025). Data collected included demographics, medication history, and multidimensional quality-of-life changes following inebilizumab initiation. Descriptive statistics and correlation analyses were performed. Key outcomes were patient-reported without objective validation.</p><p><strong>Results: </strong>A total of 275 valid questionnaires were analyzed. Respondents were predominantly female (90.5%) with a mean age of 39.7 ± 11.8 years. Mean inebilizumab treatment duration was 14.5 ± 8.4 months. Of all patients, 33.1% received inebilizumab as initial maintenance therapy, 42.9% had previously used conventional immunosuppressants, and 24.0% had switched from other biologics. Among respondents, 92.4% reported meaningful symptom improvement across multiple domains including bodily pain and mental health. Overall, 96.4% expressed willingness to continue therapy, with symptom improvement cited as the predominant reason (91.7%). Correlation analysis revealed weak associations between treatment duration and satisfaction (r = 0.12, p < 0.05) and between medication cost burden and satisfaction (r = - 0.24, p < 0.01).</p><p><strong>Conclusions: </strong>In this cross-sectional survey, Chinese patients with AQP4-IgG-positive NMOSD receiving inebilizumab reported high satisfaction, perceived multidimensional benefit, and strong treatment continuation willingness. These findings provide exploratory patient-reported evidence regarding the acceptability of inebilizumab in routine practice. However, the observed improvements are self-reported and associative rather than causal; interpretation should account for the cross-sectional, non-comparative design, potential selection and recall biases, and lack of objective outcome validation. Prospective controlled studies are required to confirm these preliminary findings.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"26 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618145","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":"Hormonal, metabolic, and stress-related clinical differences between episodic and chronic migraine: insights for diagnostic and therapeutic approaches.","authors":"Rabia Gokcen Gozubatik-Celik, Ezgi Uludüz, Sevim Eyüboğlu, Mustafa İskender, Mehmet Ali Sungur, Aynur Özge, Derya Uludüz","doi":"10.1186/s12883-026-05169-w","DOIUrl":"https://doi.org/10.1186/s12883-026-05169-w","url":null,"abstract":"<p><strong>Background: </strong>Migraine, a common neurological disorder, is categorized into episodic (EM) and chronic (CM) forms. Understanding their hormonal and metabolic differences can enhance insights into migraine pathophysiology and guide clinical approaches.</p><p><strong>Objective: </strong>To explore hormonal and metabolic imbalances in EM and CM patients and identify key factors contributing to migraine chronicity.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study included 500 patients with migraine (318 EM and 182 CM). Data were retrospectively extracted from pre-existing clinical records, structured intake forms, physician examination notes, questionnaire-based assessments, and available laboratory results to evaluate demographic, clinical, metabolic, stress-related, mental health-related, and comorbidity variables.</p><p><strong>Results: </strong>CM patients were older (46.28 vs. 43.13 years, p = 0.002) and had more frequent severe attacks (15 vs. 8/month) and mild attacks (12 vs. 6/month) (p < 0.001). CM patients exhibited higher rates of anaemia (34.9% vs. 25.7%, p = 0.035), asthma (12.8% vs. 7.3%, p = 0.046), and sleep apnea (4.7% vs. 1.3%, p = 0.034). Fibromyalgia-related symptoms were common in both groups (82.1% in CM vs. 78.2% in EM), while the number of fibromyalgia tender points was higher in CM than in EM patients (median 8 vs. 6). Ferritin levels were lower in CM but not significantly so (p = 0.139). Suicidal thoughts and feelings of helplessness were more common in CM (p = 0.016, p = 0.002). CM patients used Botox more often but with lower efficacy and engaged in more cognitive behavioural therapy (p = 0.002).</p><p><strong>Conclusion: </strong>CM was associated with more severe symptoms, higher comorbidity burden, more widespread pain features, and distinct metabolic and stress-related profiles compared with EM. These findings support the early recognition of clinical and comorbid factors associated with the chronic migraine phenotype.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547852","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":"Prognostic value of the intracerebral hematoma volume-to-cerebrospinal fluid volume ratio in patients with spontaneous basal ganglia hemorrhage undergoing non-surgical treatment.","authors":"Zhangwei Yan, Xu Xu, Tao Sun, Xingwang Zhou, Han Peng, Xiaoyu Wang, Junshuan Cui, Hua Yang, Xin Xiang","doi":"10.1186/s12883-026-05182-z","DOIUrl":"https://doi.org/10.1186/s12883-026-05182-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the prognostic value of the ratio of intracerebral hematoma volume (IHV) to cerebrospinal fluid volume (CSFV) in patients with basal ganglia hemorrhage undergoing non-surgical treatment. By providing a quantitative reference for clinical decision-making, this research seeks to facilitate the early identification of patients with poor prognoses and to support the selection of optimal treatment strategies tailored to individual needs.</p><p><strong>Methods: </strong>This retrospective study included patients with spontaneous basal ganglia hemorrhage who received non-surgical treatment at our hospital between January 2017 and October 2020. IHV, CSFV, and the maximum transverse diameter of the third ventricle (MTDTV) were measured, and baseline characteristics were collected. Prognosis was assessed at three months using the modified Rankin Scale (mRS), with scores ≤2 indicating good outcomes and scores ≥3 indicating poor outcomes. Correlations between clinical variables and prognosis were analyzed.</p><p><strong>Results: </strong>A total of 125 patients were included in this study, among whom 74 (59.2%) experienced poor outcomes. Univariate analysis revealed significant differences in NIHSS score, GCS score, IHV, systolic blood pressure (SBP) and diastolic blood pressure (DBP) at admission, CSFV, IHV/CSFV, and MTDTV (P<0.05). Logistic regression analysis identified IHV/CSFV (OR=1.074, P=0.041) and SBP at admission (OR=1.052, P=0.005) as independent predictors of patient outcomes.IHV/CSFV demonstrated good discriminatory performance and may reflect the balance between hematoma burden and intracranial CSF reserve, potentially complementing established predictors. The area under the ROC curve for IHV/CSFV was 0.810 (95% CI: 0.733-0.887), with a cutoff value of 18.35% for predicting poor outcomes, yielding a sensitivity of 67.57% and specificity of 92.16%.</p><p><strong>Conclusion: </strong>For patients with spontaneous basal ganglia hemorrhage undergoing non-surgical treatment, admission SBP and the IHV/CSFV ratio were independently associated with poor prognosis in this cohort. As an exploratory composite imaging marker, IHV/CSFV was associated with outcome in our cohort and may represent a non-invasive, exploratory candidate marker for risk stratification that warrants further validation. Additionally, CSFV was significantly correlated with MTDTV, suggesting that CSFV could be effectively estimated through MTDTV measurements, a finding that could aid clinical decision-making.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535204","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":"Tyrosine kinase inhibitor-associated cerebral vasculopathy with a distinct non-enhancing vessel wall phenotype: a case report.","authors":"Jeong Eun Yang, Jae Ho Jeon, Young Rok Do, Jaeseob Yun","doi":"10.1186/s12883-026-05192-x","DOIUrl":"https://doi.org/10.1186/s12883-026-05192-x","url":null,"abstract":"<p><strong>Background: </strong>Tyrosine kinase inhibitors (TKIs) are associated with adverse vascular events, including cerebrovascular stenosis. However, most reported cases rely on luminal imaging, and the arterial wall characteristics of TKI-associated vasculopathy remain insufficiently characterized.</p><p><strong>Case presentation: </strong>A 47-year-old man with chronic myeloid leukemia developed recurrent transient ischemic attacks during long-term exposure to multiple tyrosine kinase inhibitors, including sequential treatment with nilotinib and ponatinib. Neurovascular imaging revealed extensive multifocal steno-occlusive lesions involving both intracranial and extracranial arteries, accompanied by severe hemodynamic compromise. High-resolution vessel wall MRI demonstrated diffuse circumferential wall thickening with negative remodeling in both distal internal carotid arteries and eccentric thickening along the anterior walls of the bilateral M1 segments of the middle cerebral artery. Notably, no definite mural enhancement was observed. Following discontinuation of ponatinib and transition to alternative therapy, cerebral perfusion improved at two months, and the patient remained clinically stable without recurrent ischemic events.</p><p><strong>Conclusions: </strong>This case illustrates a potentially distinct vessel wall thickening pattern in TKI-associated vasculopathy, providing information beyond luminal stenosis. The absence of definite mural enhancement and clinical and hemodynamic improvement after treatment modification suggest a drug-related vascular component. Vessel wall imaging may aid in the evaluation of this condition and inform management strategies.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535263","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":"Isolated pontomedullary hydatid cyst presenting with progressive bulbar and long-tract dysfunction: a case report and literature review.","authors":"Ahmad Al Malla, Sama Saleh Alagol","doi":"10.1186/s12883-026-05179-8","DOIUrl":"https://doi.org/10.1186/s12883-026-05179-8","url":null,"abstract":"<p><strong>Background: </strong>Intracranial cystic echinococcosis is rare, and primary involvement of the brainstem is exceptional. Because brainstem cystic lesions often share overlapping clinical and radiological features, preoperative diagnosis may be challenging, particularly when the lesion is deep-seated and located near critical bulbar and long-tract pathways.</p><p><strong>Case presentation: </strong>A 47-year-old woman from a rural area presented with a 4-6-week history of progressive dysphagia and worsening weakness of all four limbs. Neurological examination revealed quadriparesis and lower cranial nerve dysfunction, including dysphonia, reduced gag reflex, and mild palatal asymmetry. Brain magnetic resonance imaging revealed a solitary, sharply demarcated intra-axial cystic lesion at the pontomedullary junction, with cerebrospinal fluid-like signal intensity, suppression on fluid-attenuated inversion recovery sequences, a thin regular wall, and no enhancement, mural nodule, calcification, or perilesional edema. Systemic evaluation showed no extracranial hydatid involvement. Given the epidemiological background and imaging pattern, a pontomedullary hydatid cyst was suspected. The narrow brainstem corridor made standard hydrodissection unsuitable, so, the patient underwent left lateral suboccipital craniotomy. Controlled cyst puncture and aspiration were performed to decompress the lesion, followed by meticulous microsurgical removal of the collapsed cyst wall without intradural spillage. Histopathology confirmed hydatid disease. The postoperative course was uncomplicated, with marked improvement of limb strength and marked recovery of swallowing function. Follow-up MRI showed complete excision without residual lesion, hydrocephalus, diffusion restriction, or mass effect.</p><p><strong>Conclusion: </strong>Hydatid disease should be considered in the differential diagnosis of well-circumscribed, non-enhancing cystic brainstem lesions, particularly in patients from endemic settings. This case highlights the value of combining neuroimaging findings with epidemiological context to raise preoperative suspicion, and illustrates the need for individualized microsurgical planning in eloquent pontomedullary locations where standard hydrodissection may be unsafe or impractical.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535116","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":"Guillain-Barré syndrome and its variants during COVID-19 pandemic: a retrospective study in Iran.","authors":"Maryam Abedini Parizi, Somaye Ebrahimi Nejhad, Hossein Ali Ebrahimi Meimand, Mahdiyeh Khazaneha","doi":"10.1186/s12883-026-04716-9","DOIUrl":"10.1186/s12883-026-04716-9","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barre syndrome (GBS) is a rare neurologic disorder with potential associations with viral triggers. This study aimed to investigate the incidence of GBS and its variants during COVID-19 pandemic in patients admitted to Kerman Shafa Hospital within 2020-2023.</p><p><strong>Methods: </strong>This was retrospective cross-sectional analysis of GBS cases reported during the COVID-19 pandemic in Shafa Hospital -Kerman during 2020-2023. to explore the incidence rate of GBS and, the association between demographic variables, the history of COVID-19 infection and vaccination within one month of GBS diagnosis, and the clinical outcomes. Data were analyzed using the SPSS 26 software.</p><p><strong>Results: </strong>A total of 87 patients with GBS were reported between 2020 and 2023, of whom 75.9% were men and the average age of the patients was 43.62 ± 20.85 years. The most common variants included AIDP (56.3%) and AMAN (24.1%). Overall, 21.8% of patients had a history of COVID-19 infection in the past month and 19.5% had positive COVID-19 PCR test. There was no significant association between the distributions of disease variants with other variables except year. The incidence rate of GBS in the population covered by Kerman University of Medical Sciences was estimated to be 1.33 cases per 100,000 person-year.</p><p><strong>Conclusion: </strong>Our study suggests that the overall incidence rate and clinical outcomes of GBS remained relatively consistent with pre-pandemic levels. Further research is needed to elucidate the complex relationship between GBS, COVID-19, and vaccination and to explore potential risk factors for severe outcomes in GBS patients.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535191","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":"Contralateral middle cerebral artery embolization following transradial vertebral artery stenting: a case report.","authors":"Jiashan Tu, Wei Qiu, Weisheng Deng, Hua Peng, Qinghua Liu, Xiaoya Gao","doi":"10.1186/s12883-026-05098-8","DOIUrl":"https://doi.org/10.1186/s12883-026-05098-8","url":null,"abstract":"<p><strong>Background: </strong>Transradial vertebral artery (VA) stenting is an effective, and relatively safe treatment for symptomatic extracranial VA stenosis-the main cause of posterior circulation ischemia. Still, rare non-target anterior circulation cerebral embolisms can occur intraoperatively.</p><p><strong>Case presentation: </strong>A 63-year-old male with prior cerebral infarction (NIHSS score 0, mRS score 1) presented with recurrent dizziness. Pre-admission CTA imaging confirmed severe (> 70%) bilateral VA ostial stenosis. The patient underwent right transradial VA stenting. Ten minutes post-procedure, he developed altered consciousness, mixed aphasia, and right hemiplegia (NIHSS score 16). Angiography confirmed acute occlusion in the M2 segment of the left middle cerebral artery (MCA). Mechanical thrombectomy was attempted but terminated due to severe vascular tortuosity, with no recanalization achieved. Immediate postoperative CT revealed contrast extravasation (CE) in the left frontoparietal sulci, rather than intracranial hemorrhage. The patient received tirofiban, dual antiplatelet therapy, and early rehabilitation. By discharge on day 7, he had achieved partial recovery (NIHSS score 9, mRS score 4).</p><p><strong>Conclusion: </strong>Despite its extremely low incidence, the risk of anterior circulation cerebral embolism persists during transradial posterior circulation interventions. Gentle manipulation and emboli monitoring may mitigate this risk. Intraoperative neuromonitoring and rapid imaging are critical, and precise diagnosis and treatment can facilitate functional recovery.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535167","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":"Low uric acid predicts severe outcomes in neuronal surface antibody-mediated autoimmune encephalitis.","authors":"Ying-Zhe Shao, Ning Zhao, Qiu-Xia Zhang, Lin-Jie Zhang, Li Yang","doi":"10.1186/s12883-026-05099-7","DOIUrl":"10.1186/s12883-026-05099-7","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune encephalitis (AE) mediated by neuronal surface antibodies is a severe neuroinflammatory disorder with heterogeneous clinical manifestations. Early identification of patients at risk for severe outcomes, such as intensive care unit (ICU) admission, remains a challenge. Uric acid (UA), known for its dual role in inflammation as both a danger-associated molecular pattern (DAMP) and an antioxidant, has been implicated in various autoimmune diseases, but its prognostic significance in AE has not been systematically explored.</p><p><strong>Methods: </strong>This retrospective study enrolled 90 patients with neuronal surface antibody-positive AE. Serum UA levels were measured at admission, and clinical outcomes, including Clinical Assessment Scale for Autoimmune Encephalitis (CASE), discharge modified Rankin Scale (mRS) and ICU admission were analyzed. Statistical methods included Spearman correlation, logistic regression, and receiver operating characteristic (ROC) curve analysis to evaluate predictive value of UA.</p><p><strong>Results: </strong>Patients requiring ICU admission had significantly lower UA levels (median 193.0 vs. 250.0 µmol/L, p = 0.008). UA negatively correlated with CASE scores (r = -0.237, p = 0.024) and discharge mRS (r = -0.267, p = 0.011). Logistic analysis identified UA as a potential adjunct biomarker of ICU admission (yes/no) (OR = 0.985, 95%CI:0.971-1.000, p = 0.044), with an optimal cutoff of 213.5 µmol/L (AUC = 0.703, sensitivity 63.9%, specificity 77.8%). Patients with UA < 213.5 µmol/L were older and had higher CASE scores and worse functional outcomes (p < 0.05).</p><p><strong>Conclusion: </strong>Decreased serum UA at admission is associated with increased risk of ICU admission in neuronal surface antibody-mediated AE, and correlate with a more severe disease severity and poorer functional outcomes, suggesting its potential as a prognostic biomarker, possibly reflecting its neuroprotective role.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497005","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":"Facial diplegia as the first manifestation of Burkitt lymphoma with a Guillain-Barré syndrome-like presentation: a case report.","authors":"Irem Yagmur Demir, Ahmet Kasim Kilic, Banu Ozen Barut","doi":"10.1186/s12883-026-05153-4","DOIUrl":"https://doi.org/10.1186/s12883-026-05153-4","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barré syndrome (GBS) is among the most common causes of acute inflammatory polyneuropathy and may present with cranial nerve involvement, including facial diplegia. Rarely, hematologic malignancies can produce a GBS-compatible or GBS-like neurological phenotype, creating a diagnostic challenge in the acute setting.</p><p><strong>Case presentation: </strong>A 50-year-old immunocompetent woman presented with bilateral facial paralysis, dysarthria, dysphagia, areflexia, and mild left upper-limb weakness. Cerebrospinal fluid (CSF) analysis showed albuminocytologic dissociation. Baseline electromyography and nerve conduction studies (EMG/NCS), performed early in the course, showed non-specific sensorimotor polyneuropathy without definitive demyelinating features. Because the clinical syndrome and CSF findings were compatible with a time-sensitive working diagnosis of GBS, intravenous immunoglobulin was initiated. Follow-up EMG/NCS in the second week evolved to show demyelinating features with secondary axonal involvement, compatible with GBS. However, rapidly progressive leukocytosis, markedly elevated lactate dehydrogenase and ferritin levels, profound weight loss, splenomegaly, para-aortic lymphadenopathy, and blast-like cells on peripheral smear prompted parallel hematologic reassessment. Peripheral blood flow cytometry was consistent with Burkitt lymphoma, and repeat CSF flow cytometry demonstrated a CD10 + germinal center-derived B-cell neoplastic population, indicating central nervous system involvement. The patient subsequently deteriorated with aspiration pneumonia, sepsis/shock, and a fatal course before lymphoma-directed chemotherapy could be initiated.</p><p><strong>Conclusions: </strong>Burkitt lymphoma with central nervous system involvement can present with a GBS-compatible acute neuropathic phenotype, including facial diplegia. The initial diagnosis of GBS may be clinically reasonable in a time-sensitive setting; however, major systemic and hematologic red flags should prompt early parallel evaluation for malignancy. Peripheral blood and CSF flow cytometry may provide decisive diagnostic evidence when biopsy or further work-up is not feasible.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497040","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}