Neurologia Pub Date : 2024-11-09 DOI: 10.1016/j.nrleng.2021.07.008

S Pérez-Pereda, M Toriello, C Bailón, O Umaran Alfageme, F Hoyuela, V González-Quintanilla, A Oterino

{"title":"Frequency and impact of post-traumatic stress disorder and traumatic life events in patients with migraine.","authors":"S Pérez-Pereda, M Toriello, C Bailón, O Umaran Alfageme, F Hoyuela, V González-Quintanilla, A Oterino","doi":"10.1016/j.nrleng.2021.07.008","DOIUrl":"10.1016/j.nrleng.2021.07.008","url":null,"abstract":"<p><strong>Introduction: </strong>Post-traumatic stress disorder (PTSD) has been proposed as a risk factor for chronification of migraine. The aim of this study was to investigate the frequency of PTSD and traumatic life events (TE) in patients with episodic (EM) and chronic migraine (CM) and their impact on clinical parameters, other comorbidities, and migraine biomarkers.</p><p><strong>Material and methods: </strong>Patients with EM and CM according to the International Classification of Headache Disorders (third edition; beta version) were recruited at a headache unit and a primary care centre. We used questionnaires validated for research on PTSD, TEs, cranial autonomic symptoms, comorbidities (depression, anxiety, and fatigue), disability, migraine impact, and quality of life. Baseline serum levels of CGRP, VIP, and PACAP were determined by ELISA.</p><p><strong>Results: </strong>The study included 116 patients: 35 with EM and 81 with CM. Nineteen presented refractory migraine. PTSD was detected in 23 patients (19.8%): 20 with CM and 3 with EM (chi-square: P = .046; Fisher T: P = .073). No significant differences were identified between the EM and CM groups for frequency of any TE nor the number of TEs per patient. A total of 5/19 patients with refractory migraine had experienced sexual violence (vs 2/97 with non-refractory migraine; P = .002). PTSD was associated with more autonomic symptoms; higher scores on anxiety, depression, and fatigue scales; and poorer quality of life; it did not change neuropeptide levels.</p><p><strong>Conclusions: </strong>Our results suggest that PTSD is frequent in patients with migraine, and especially CM, in our setting; history of sexual violence is particularly frequent in patients with refractory migraine. PTSD has a negative impact on migraine, with higher numbers of comorbidities and poorer quality of life; therefore, further research is needed in this patient group.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Headache as main reason for consultation to a hospital Emergency Department in Spain: A prospective study. 头痛是西班牙医院急诊科就诊的主要原因：一项前瞻性研究。

Neurologia Pub Date : 2024-11-09 DOI: 10.1016/j.nrleng.2024.11.001

A Fierro, G Pérez-Rojí, A Blanco, P López, M Andrés, V González-Quintanilla, S Pérez-Pereda, N Fontanillas, J Pascual

{"title":"Headache as main reason for consultation to a hospital Emergency Department in Spain: A prospective study.","authors":"A Fierro, G Pérez-Rojí, A Blanco, P López, M Andrés, V González-Quintanilla, S Pérez-Pereda, N Fontanillas, J Pascual","doi":"10.1016/j.nrleng.2024.11.001","DOIUrl":"10.1016/j.nrleng.2024.11.001","url":null,"abstract":"<p><strong>Introduction: </strong>Headache is common in the general population and a frequent reason for medical consultation.</p><p><strong>Objectives: </strong>To describe the characteristics of patients attending the Emergency Department (ED) for headache.</p><p><strong>Methods: </strong>A descriptive study with prospective collection of 100 consecutive patients over 15 years old who attended our ED due to headache as the main complaint.</p><p><strong>Results: </strong>Headache accounted for 1,4% of ED visits. The most common age range is between 31 and 45 years and the majority of the patients are females (61%). We diagnosed 67 primary and 33 secondary headaches- The most frequent diagnosis was migraine, with 36% of cases one out of 3 patients had a history of headache and 4 out of 5 consulted by their own decision. Only a small percentage of patients were admitted as inpatients (12%), and 3 out of 5 were referred to Primary Care. Complementary tests were performed on 84% of the patients. One CT scan was performed for every 3 patients. A total of 80% patients was correctly diagnosed by the ED physicians.</p><p><strong>Conclusions: </strong>Headache is a frequent complaint in the ED, where primary headaches are the most common with migraine being the most frequent reason for consultation. In our setting, there is a good screening and diagnosis of headaches, as well as an adequate use of the available resources in the ED for their diagnosis and management.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thrombosis with thrombocytopenia syndrome following adenovirus vector-based vaccines to prevent COVID-19: Epidemiology and clinical presentation in Spain. 接种基于腺病毒载体的疫苗以预防 COVID-19 后出现血栓形成伴血小板减少综合征：西班牙的流行病学和临床表现。

Neurologia Pub Date : 2024-10-31 DOI: 10.1016/j.nrleng.2024.10.001

D García-Azorín, E Lázaro, D Ezpeleta, R Lecumberri, R de la Cámara, M Castellanos, C Iñiguez Martínez, L Quiroga-González, G Elizondo Rivas, A Sancho-López, P Rayón Iglesias, E Segovia, C Mejías, D Montero Corominas

{"title":"Thrombosis with thrombocytopenia syndrome following adenovirus vector-based vaccines to prevent COVID-19: Epidemiology and clinical presentation in Spain.","authors":"D García-Azorín, E Lázaro, D Ezpeleta, R Lecumberri, R de la Cámara, M Castellanos, C Iñiguez Martínez, L Quiroga-González, G Elizondo Rivas, A Sancho-López, P Rayón Iglesias, E Segovia, C Mejías, D Montero Corominas","doi":"10.1016/j.nrleng.2024.10.001","DOIUrl":"10.1016/j.nrleng.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>We describe the epidemiological and clinical characteristics of thrombosis with thrombocytopenia syndrome (TTS) cases reported in Spain.</p><p><strong>Methods: </strong>We included all venous or arterial thrombosis with thrombocytopenia following adenovirus vector-based vaccines (AstraZeneca or Janssen) to prevent COVID-19 disease between February 1st and September 26th, 2021. We describe the crude rate and the standardized morbidity ratio. We assessed the predictors of mortality.</p><p><strong>Results: </strong>Sixty-one cases were reported and 45 fulfilled eligibility criteria, 82% women. The crude TTS rate was 4/1 000 000 doses and 14-15/1 000 000 doses between 30-49 years. The number of observed cases of cerebral venous thrombosis was 6-18 higher than the expected in patients younger than 49 years. Symptoms started 10 (interquartile range (IQR): 7-14) days after vaccination. Eighty percent (95% confidence interval (CI): 65%-90%) had thrombocytopenia at the time of the emergency department visit, and 65% (95% CI: 49%-78%) had D-dimer >2000 ng/mL. Patients had multiple location thrombosis in 36% and fatal outcome in 24% cases. A platelet nadir < 50 000/μL (odds ratio (OR): 7.4; CI 95%: 1.2-47.5) and intracranial hemorrhage (OR: 7.9; IC95%: 1.3-47.0) were associated with fatal outcome.</p><p><strong>Conclusion: </strong>TTS must be suspected in patients with symptoms 10 days after vaccination and thrombocytopenia and/or D-dimer increase.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Encephalitis after COVID-19 vaccination 接种 COVID-19 疫苗后出现脑炎。

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2024.02.002

引用次数: 0

Unilateral MRIgFUS thalamotomy: Long-term follow-up in fragile X-associated tremor/ataxia syndrome 单侧 MRIgFUS 丘脑切开术：脆性X相关震颤/共济失调综合征的长期随访

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2024.09.004

M. Campins-Romeu , R. Conde-Sardón , J.L. León-Guijarro , I. Sastre-Bataller

引用次数: 0

Ischemic encephalopathic debut of CADASIL, a case report: It is better to be safe than sorry CADASIL缺血性脑病首发病例报告：安全胜于遗憾

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2024.09.005

C. González-Mingot , A. Gil-Sánchez , R. Begué-Gómez , R. López-Ortega , B.R. Luis

引用次数: 0

Cerebral venous thrombosis in children an 18-year review of a Portuguese hospital 葡萄牙一家医院 18 年来的儿童脑静脉血栓病回顾

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2024.09.002

J. Tenente , S. Lopes , P. Bem , M. Vila-Real , D. Ferreira , A.F. Geraldo , F. Santos

{"title":"Cerebral venous thrombosis in children an 18-year review of a Portuguese hospital","authors":"J. Tenente , S. Lopes , P. Bem , M. Vila-Real , D. Ferreira , A.F. Geraldo , F. Santos","doi":"10.1016/j.nrleng.2024.09.002","DOIUrl":"10.1016/j.nrleng.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral venous thrombosis (CVT) is an uncommon and clinically heterogeneous cerebrovascular particularly in children, only a few published case series focused in the pediatric population.</div></div><div><h3>Patients and methods</h3><div>Retrospective single-center observational and analytical study of consecutive pediatric patients admitted in a level II Portuguese hospital with a confirmed diagnosis of CVT, from 2003 to 2021. Clinical presentation, neuroimaging findings, prothrombotic factors, treatment strategies, outcome and recanalization were documented.</div></div><div><h3>Results</h3><div>Twelve children were included (58% female). Mean age was 7.3 years. The most frequent symptoms were vomiting, headache and behavioral alterations. Infection was the triggering factor in 50% of the cases. The diagnosis of CVT was made based on imaging evidence of thrombosis through magnetic imaging resonance (MRI) with venography and/or computed tomography (CT) with venography. In 67% of cases there were multiples sinuses involved; the transverse sinus was the most affected, followed by the sigmoid sinus. In 83% of cases anticoagulant therapy was initiated with low molecular weight heparin (LMWH) and associated prothrombotic factors were investigated, with no major prothrombotic factors identified. No deaths occurred, but 30% had long-term neurological sequelae. One patient recurred 18 years later.</div></div><div><h3>Conclusion</h3><div>The results of this study are consistent with data from other published studies. MRI is the preferred imaging method for diagnosis in children by avoiding ionizing radiation and allowing identification of subjacent causes. Anticoagulation with LMWH is recommended and important to reduce mortality and sequelae. Infectious diseases are the most common trigger for CVT and can also be the cause for high morbidity and poor outcomes.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 658-665"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychometric properties of the Spanish version of the Frontal Assessment Battery (FAB-E) and normative values in a representative adult population sample 西班牙文版前额叶评估测验（FAB-E）的心理测量特性和具有代表性的成人样本的标准值。

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2022.09.004

{"title":"Psychometric properties of the Spanish version of the Frontal Assessment Battery (FAB-E) and normative values in a representative adult population sample","authors":"","doi":"10.1016/j.nrleng.2022.09.004","DOIUrl":"10.1016/j.nrleng.2022.09.004","url":null,"abstract":"<div><h3>Background</h3><div>The Frontal Assessment Battery is a short bedside test used to assess executive functions (EF). The aims of the present study were, first, to evaluate the psychometric proprieties of the Spanish version of the FAB (FAB-E) in a representative sample, and second, to establish cut-off points for impairment in executive function according to age and education level.</div></div><div><h3>Methods</h3><div>A sample of 798 healthy Spanish adult subjects aged 19 to 91 participated in this study. Neuropsychological assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). We examined internal consistency, intraclass correlation, test-retest reliability, and concurrent and divergent validity. In addition, we established a cut-off point for detecting executive function impairment based on the 5th percentile by age group and education level.</div></div><div><h3>Results</h3><div>The analysis of the psychometric properties of the FAB-E showed good internal consistency (Cronbach’s α = 0.60), intraclass correlation (0.72), test-retest reliability (0.70) and concurrent and divergent validity between the TMT (<em>r</em> = −0.523), MMSE (<em>r</em> = 0.426) and the FAB-E. The cut-off points for each age group were 16 points for the ≤ 29 group, 15 points for the 30-39 group, 14 points for the 40-49 and 50-59 groups, 12 points for the 60-69 group, and 10 points for the ≥ 70 age group.</div></div><div><h3>Conclusions</h3><div>The psychometric analysis showed that the FAB-E has good validity and reliability. Thus, FAB-E may be a helpful tool to evaluate EF in a healthy Spanish population. In addition, this study provides information on reference data that will be very valuable for clinicians and researchers.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 694-700"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33497663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kernohan-Woltman notch phenomenon: an exceptional neurological picture? 克诺汉-沃尔特曼缺口现象：一种特殊的神经症状？

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2022.09.010

{"title":"Kernohan-Woltman notch phenomenon: an exceptional neurological picture?","authors":"","doi":"10.1016/j.nrleng.2022.09.010","DOIUrl":"10.1016/j.nrleng.2022.09.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Ipsilateral hemiparesis (IH) can be defined as a paradoxical dysfunction of the first motor neuron involving the extremities on the opposite side to that expected, given the location of the triggering intracranial pathology. Compression of the corticospinal tract (CSt) along its course through the contralateral cerebral peduncle against the free edge of the tentorium, known as the Kernohan-Woltman notch phenomenon (KWNP), represents the main cause of IH.</div></div><div><h3>Methods</h3><div>This retrospective study analyses a series of 12 patients diagnosed with IH secondary to KWNP treated at our institution, including a descriptive study of epidemiological, clinical, radiological, neurophysiological, and prognostic variables.</div></div><div><h3>Results</h3><div>In 75% of the cases, symptoms had an acute or subacute onset. Initial imaging studies showed signs of significant mass effect in half of the patients, whereas magnetic resonance imaging (MRI) identified a structural lesion in the contralateral cerebral peduncle in two thirds of them. Impairment of the motor evoked potentials (MEP) was verified in 4 patients. During follow-up 7 patients experienced improvement in motor activity, and near half of the cases were classified in the first three categories of the modified Rankin scale.</div></div><div><h3>Conclusions</h3><div>In contrast to prior historical series, most of our patients developed a KWNP secondary to a traumatic mechanism. MRI represents the optimal method to identify both the classic cerebral peduncle notch and the underlying structural lesion of the CSt. The use of MEP can help to establish the diagnosis, especially in those cases lacking definite radiological findings.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 683-693"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40711319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Design and validation of a questionnaire for monitoring neurological dysphagia and respiratory deterioration in patients with amyotrophic lateral sclerosis (DEREDELA) 设计并验证用于监测肌萎缩性脊髓侧索硬化症患者神经性吞咽困难和呼吸恶化的调查问卷（DEREDELA）

Neurologia Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2024.09.003

S. Bermudo Fuenmayor , P.J. Serrano Castro , P. Quiroga Subirana , S. López Palmero , M.M. Requena Mullor , T. Parrón Carreño

{"title":"Design and validation of a questionnaire for monitoring neurological dysphagia and respiratory deterioration in patients with amyotrophic lateral sclerosis (DEREDELA)","authors":"S. Bermudo Fuenmayor , P.J. Serrano Castro , P. Quiroga Subirana , S. López Palmero , M.M. Requena Mullor , T. Parrón Carreño","doi":"10.1016/j.nrleng.2024.09.003","DOIUrl":"10.1016/j.nrleng.2024.09.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Amyotrophic lateral sclerosis (ALS) is a degenerative disease of unknown origin that affects the motor neurons. It has a rapid, fatal course.</div></div><div><h3>Method</h3><div>For this study, an initial questionnaire of eleven items was developed by experts in the field, who evaluated the suitability and relevance of the items.</div></div><div><h3>Results</h3><div>The questionnaire was then applied to a pilot group of 22 patients diagnosed with ALS. Confirmatory factor analysis, based on estimating maximum likelihood, confirmed the three domains detected in the exploratory factor analysis. The reliability of the scale was tested using Cronbach's <em>α</em> (0.801) and the Kaiser–Meyer–Olkin test (0.770) confirmed the construct validity.</div></div><div><h3>Conclusions</h3><div>The DEREDELA questionnaire is valid, in terms of its content, for monitoring the neurological dysphagia and respiratory deterioration suffered by patients diagnosed with ALS.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 666-674"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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