Neurologia最新文献

{"title":"Dopa-responsive dystonia and young-onset parkinsonism in a patient with heterozygous mutation in SPR and PRKN treated with pallidal stimulation.","authors":"J García-de Soto, G Fernández Pajarín, D A García Estévez, Á Sesar-Ignacio","doi":"10.1016/j.nrleng.2025.07.005","DOIUrl":"https://doi.org/10.1016/j.nrleng.2025.07.005","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683912","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}

{"title":"Blood-based Biomarkers for Alzheimer's Disease: Positioning Document and Usage Recommendations from the Behavioral Neurology and Dementia Study Group of the Spanish Society of Neurology.","authors":"M Suárez-Calvet, C Abdelnour, D Alcolea, M Mendióroz-Iriarte, M Balasa, E Morenas-Rodríguez, A Puig-Pijoan, P Sánchez-Juan, A Villarejo, R Sánchez-Valle","doi":"10.1016/j.nrleng.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.nrleng.2025.07.004","url":null,"abstract":"<p><strong>Introduction: </strong>The development of blood biomarkers for detecting Alzheimer's disease (AD) represents one of the most significant recent advances, and some are already available for clinical practice. Therefore, the Grupo de Estudio de Conducta y Demencias de la Sociedad Española de Neurología has formed a working group to review the current status and develop consensus recommendations for their clinical implementation.</p><p><strong>Development: </strong>This document was prepared by neurologists from the Grupo de Estudio de Conducta y Demencias de la Sociedad Española de Neurología in two phases. First, a coordinating group defined the basic guidelines of the document, agreed on initial recommendations based on a literature review, and drafted a preliminary version. Subsequently, the proposal was reviewed by the entire working group, all comments were considered, and the coordinating group adjusted the recommendations until consensus was achieved among the participants.</p><p><strong>Conclusions: </strong>The consensus document highlights the importance of early diagnosis of AD. It recommends interpreting blood biomarkers in the patient's clinical context, not in isolation. Specialized units can start using them, but this should be accompanied by ongoing research. More data are needed for their use in general neurology and primary care. Their use is not recommended in asymptomatic individuals, population screenings, or as direct-to-consumer tests. Public health systems should facilitate their implementation through appropriate funding to ensure equitable access. This document should be understood as an initial framework subject to periodic updates as new data emerge.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677074","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}

{"title":"Current management of urgent epileptic seizures in a tertiary referral hospital in the Community of Madrid, a descriptive study.","authors":"Pablo Mayo Rodrígue, María Romeral Jiménez, Beatriz Parejo Carbonell, Clara Lastras Fernández-Escandón, Rafael Sánchez-Del-Hoyo, Irene García Morales","doi":"10.1016/j.nrleng.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.nrleng.2025.07.003","url":null,"abstract":"<p><strong>Objective: </strong>Analyse the current status of the management of urgent epileptic seizures (ES) in a tertiary referral hospital in the Community of Madrid at each stage of the care process and by the different medical teams involved, including out-of-hospital emergency services, hospital emergency departments and neurology teams.</p><p><strong>Method: </strong>Cross-sectional descriptive study with a subsequent 30-day prospective longitudinal follow-up of a consecutive sample of patients with urgent EC, recruited between October 2021 and March 2022.</p><p><strong>Results: </strong>53 patients were included. The mean age was 57.6 (21.2) years. 39.6% were women. 35.8% had a previous diagnosis of epilepsy. The most frequent cause of urgent ES was high-risk seizures (57%), followed by status epilepticus (24%) and cluster seizures (19%). A total of 90.5% of the seizures occurred in the out-of-hospital setting. The median time between ES and emergency services assessment was 40 (27-78) minutes, and between ES and neurology assessment 165 (97.5-290) minutes. 86.8% were treated with benzodiazepines and 81.1% with at least one anti-crisis medication. Urgent video-EEG monitoring was performed in 60.4%. The most frequent destination after emergency management was hospital discharge (47.2%), followed by hospitalisation (39.6%). At 30 days, 20.8% of patients had a new ES and 5.7% had died.</p><p><strong>Conclusions: </strong>Analysis of the current state of emergency EC management shows significant delays at all levels, both in assessment and drug administration.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669208","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}

{"title":"Four decades of experience with cluster headache: description of a series from a tertiary hospital.","authors":"Jorge Madera, S Pérez Pereda, V González Quintanilla, A González Suárez, E Benito, J Pascual","doi":"10.1016/j.nrleng.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.nrleng.2025.07.001","url":null,"abstract":"<p><strong>Introduction: </strong>There are practically no series of cluster headache (CH) in our country. Our aim was to longitudinally describe the characteristics of patients with CH seen in our Hospital since 1980.</p><p><strong>Methods: </strong>Retrospective analysis of the clinical charts of patients diagnosed as CH.</p><p><strong>Results: </strong>We included 153 patients diagnosed as CH. 137 (89,5%) males, with a mean age (MA) at diagnosis of 39.5 years (mean deviation 11.4) and a MA at the beginning of the symptoms of 32.8 years (mean deviation 11.3). 128 suffered from episodic CH (eCH; 92.2% males) and 25 chronic CH (cCH; 76% males). The MA at the beginning was delayed in cCH as compared with eCH (37.6 versus 31.8; p = 0.023). Four patients (2.6%) had familial antecedents. Only 3 (2%) referred to visual aura. At diagnosis, 66% were smokers and 15% heavy alcohol drinkers. The median duration of cluster period was 60 days, with a median frequency of every 2 years. 16 cases (10.5%) presented a benign course with only one cluster period.</p><p><strong>Conclusions: </strong>The minimal prevalence of CH in our area was 0.05%, with eCH being the most frequent phenotype. Up to one out of 10 patients showed a benign form with just one cluster period. The diagnostic delay close to 7 years indicates an insufficient recognition of this entity. A high proportion of CH patients showed, already at diagnosis, unhealthy life habits. Cluster periods lasted an average of 2 months and occurred approximately every 2 years. A late beginning and being a woman were associated with the variant of cCH.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669210","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}

{"title":"Development and Concurrent Validation of a Retrogenetic Instrument for the Assessment of Activities of Daily Living: The Functional Assessment Scale of the Barcelona Test.","authors":"M Torrente, M Pino, J Peña-Casanova","doi":"10.1016/j.nrleng.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.nrleng.2025.07.002","url":null,"abstract":"<p><strong>Introduction: </strong>The assessment of activities of daily living (ADL) is considered essential in the evaluation of mild cognitive impairment (MCI), dementia and for its correct differential diagnosis. There are many scales for the functional assessment of these entities, although they are not exempt from drawbacks. The Barcelona Test ADL scale was published in 2019 with the aim of having a retrogenetic instrument that could overcome most of the problems encountered by its predecessors.</p><p><strong>Method: </strong>A study was carried out to evaluate the properties of this scale. A total sample of 68 subjects (healthy controls, patients with amnestic-type MCI, and patients with Alzheimer's-type dementia) stratified according to the Global Cognitive Impairment Scale -Global Deterioration Scale- completed with the Functional Assessment Staging- Scale (GDS-FAST). The scores of each group on the scale, as well as on other cognitive tests, were studied to obtain the descriptive and internal consistency, concurrent validity, and discriminative capacity indices.</p><p><strong>Results: </strong>The scale means differed significantly between all stratification groups. A high internal consistency index was obtained (Cronbach's α 0.975), excellent concurrent validity (Spearman's ρ of 0.95) and very good discriminative capacity, especially between the GDS-FAST 3 and 4 groups, and the GDS-FAST 4 and 5 groups.</p><p><strong>Conclusions: </strong>The Barcelona Test ADL scale allows adequately evaluating the retrogenetic functional level of patients and discriminating between the different phases of the GDS-FAST, positioning itself as a very complete and useful scale in our sociocultural environment.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669209","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}

{"title":"Multiple sclerosis mortality trends in Spain from 1981 to 2020.","authors":"L Cayuela, A de Albóniga-Chindurza, S Gómez Enjuto, J Lapeña-Motilva, S Sainz de la Maza, A González García, A Cayuela","doi":"10.1016/j.nrleng.2025.06.006","DOIUrl":"10.1016/j.nrleng.2025.06.006","url":null,"abstract":"<p><strong>Objective: </strong>Assess time trends in mortality from multiple sclerosis (MS) in the Spanish population (1981-2020), considering the influence of independent effects of gender, age, period, and birth cohort.</p><p><strong>Methods: </strong>MS deaths and populations needed for calculations were obtained from the National Institute of Statistics. Age-standardised mortality rates (ASMR) and trend analysis were performed using joinpoint regression software. Age-period-cohort (APC) analysis was performed using the web-based statistical tool of the US National Cancer Institute to explore the underlying reason for the MS mortality.</p><p><strong>Results: </strong>ASMR increased significantly in both women and men (1.7% and 1.2% respectively). The joinpoint analysis detected no trend change for women, but for men it detects a first period where rates remain stable (1981-2000; annual percentage change: -0.7%, not significant) followed by a period of significant increase (2000-2020; 2.6%, p < 0.05). For period effects, a steady increase was observed among women since the early 1990s and among men since the late 1990s. A birth cohort-related increase in mortality was detected: women born from 1916 onwards see their risk of MS mortality increase until it peaks in 1956, after which it decreases. A similar pattern is observed in men, albeit with a decade delay (from 1926 to 1966).</p><p><strong>Conclusion: </strong>ASMR shows a steady increase in both sexes over the last decades, although it has been more intense in men. The decreasing birth cohort pattern for MS mortality in men born since the mid-1960s and women born since the mid-1950s is similar to APC analyses in other countries.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499931","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}

{"title":"Status of neurosonology in Spain. A study from the Spanish Society of Neurosonology (SONES).","authors":"J Rodríguez-Pardo, J Carneado-Ruiz, M Martínez-Martínez, J M Moltó-Jordá, P Irimia, J Serena-Leal, Ó Ayo-Martín, P Martínez-Sánchez, J Pagola, J Fernández-Domínguez","doi":"10.1016/j.nrleng.2025.06.003","DOIUrl":"10.1016/j.nrleng.2025.06.003","url":null,"abstract":"<p><strong>Introduction: </strong>Neurosonology is the field of study of the ultrasound techniques applied to neurological diseases. The Spanish Society of Neurosonology (SONES) was funded in 1997 to promote training and education in these techniques, especially focused on the study of cerebrovascular diseases. After 25 years, the increased use of other advanced neurovascular imaging techniques and the emergence of novel applications of ultrasound in other fields of neurology, have modified the classic role of neurosonology. From the SONES we aimed to evaluate the current status of neurosonology in Spain.</p><p><strong>Methods: </strong>Cross-sectional survey of neurologists and neurology residents working in Spain regarding training, education, and local daily practice, including a strengths, weaknesses, opportunities and threats (SWOT) analysis.</p><p><strong>Results: </strong>One-hundred seventy-eight neurologists and thirty-four neurology residents participated in the survey. A wide experience in vascular neurosonology (90% of respondents' Neurology departments) and limited experience in brain parenchyma sonography (34%), cardiac echoscopy (25%), ultrasound-guided techniques (24%), and nerve ultrasound (14%) was reported. Fifty-three percent of the participants reported to have a full-time neurosonology lab in their department and only 14% reported to have neurologists dedicated exclusively to neurosonology. Most participants (54%) reported to lack continuous learning opportunities, and 97% to need training in one or more neurosonology techniques. Main SWOT were respectively requiring expertise, shortage of time, versatility and comprehensive management of the neurological patient.</p><p><strong>Conclusion: </strong>Vascular neurosonology is widely instituted in Spain, but the implementation of full-time neurosonology labs and training in non-vascular neurosonology techniques is yet scarce.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478376","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}

{"title":"Effect of the combination pallidotomy-subthalamotomy performed in opposite cerebral hemispheres for the treatment of motor signs in Parkinson's disease.","authors":"R C Braña Miranda, N E Quintanal Cordero, N Pavón Fuentes, I Pedroso Ibáñez, R Macías González, J Teijeiro Amador, A Abreu Duque, R Garbey Fernández","doi":"10.1016/j.nrleng.2025.06.001","DOIUrl":"10.1016/j.nrleng.2025.06.001","url":null,"abstract":"<p><strong>Introduction: </strong>Functional Neurosurgery constitutes a therapeutic alternative for patients with Parkinson's Disease (PD). It is known that both bilateral subthalamotomy and bilateral pallidotomy cause neurological complications, so in ablative techniques a bilateral approach to the GPi is not recommended in PD and caution is suggested with the indication of bilateral subthalamotomy. Our group has refined the surgical technique for the ablation of the subthalamic nucleus seeking to reduce the appearance of dyskinesias induced by surgery and obtain a better therapeutic effect, so the approach to the NST in a second surgical procedure in the opposite hemisphere to the one performed previously pallidotomy, would avoid the complications derived from bilateral pallidotomy and can be a safe alternative for patients even when they present symptoms of dyskinesias. We set out to evaluate the effect and safety of the combination of GPi and NST lesion in opposite cerebral hemispheres in PD patients.</p><p><strong>Method: </strong>A retrospective study was carried out that included all patients operated on at the CIREN in a period of 22 years, who underwent a pallidotomy contralateral to the most affected hemibody; followed by a subthalamotomy of the opposite hemisphere in a second surgical procedure. The effect on the neurological condition was evaluated using section III of the MDS-UPDRS scale. Safety was evaluated according to the adverse effects scale and the Clavien and Dindo scale.</p><p><strong>Results: </strong>Both surgical interventions had a positive impact on the patients' pharmacological treatment, significantly reducing the doses of L-dopa. A significant improvement was observed in the motor condition of the patients in relation to dyskinesias, as well as rigidity, bradykinesia and tremor.</p><p><strong>Conclusions: </strong>The pallidotomy/subthalamotomy combination showed to be an effective alternative for the treatment of complicated PD, capable of allowing better motor control and a reduction in the dose of L-Dopa with a low rate of complications; it also allows to avoid complications derived from bilateral pallidotomy and subthalamotomy, proving to be a safe alternative for patients even when they present symptoms of dyskinesias.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478375","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}

{"title":"Complex regional pain syndrome and palmar fibromatosis secondary to treatment with primidone.","authors":"C Utrilla-Pérez, M C Mateos-De Pablo, C Guijarro-Castro","doi":"10.1016/j.nrleng.2025.06.004","DOIUrl":"10.1016/j.nrleng.2025.06.004","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478352","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}

{"title":"The economic burden of migraine: a nationwide cost-of-illness approach from the year 2020 European Health Survey in Spain.","authors":"J Fernández-Ferro, C Ordás-Bandera, J Rejas-Gutiérrez, B Ferro-Rey, S Gómez-Lus, J M Láinez Andrés","doi":"10.1016/j.nrleng.2025.06.002","DOIUrl":"10.1016/j.nrleng.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a chronic highly disabling disease that manifests itself with recurrent episodes of headache. The objective of the study was to ascertain the cost-of-illness (COI) of migraine from the perspective of Society in Spain and to characterize its excess cost.</p><p><strong>Methods: </strong>The nationwide year-2020 European-Health-Survey-in-Spain was used; 1442 persons with migraine (77.3% women, 52.5 years) and 4288 without migraine (76.7% women, 52.8 years) were abstracted by propensity score optimal matching. COI accounted healthcare resources utilization (HRU) and non-HRU (productivity loss). Costs were expressed as Per-Patient-Per-Year (PPPY) in Euros year 2020, and the excess cost was computed as the difference between persons with and without migraine.</p><p><strong>Results: </strong>The PPPY cost was more than double in persons with migraine; €5862 vs €2981; excess cost of €2881€ (95% CI: 2410-3353, P < 0.001), mainly attributable to labour productivity loss; €1928 (1532-2325, P < 0.001) annually (66.9% of total excess cost). This excess labour cost is explained by the greater number of additional days of absenteeism, 22.35 (16.12; 28.57), and presenteeism, 31.39 (27.36; 35.41) in persons with migraine, P < 0.001 in both cases. National Health System (NHS)-funded healthcare PPPY cost represented the 29.0% of total excess cost; €836 (618-1055), this because higher utilization of all-type medical visits.</p><p><strong>Conclusion: </strong>In Spain, persons with migraine showed a meaningful excess cost compared with persons without migraine, particularly due to labour cost component, although the economic cost to the NHS was also considerable. Given the high prevalence of migraine, its overall attributable economic impact for Spain might range between 10 394 and 14 cost 230 million Euros in year 2020.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478377","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}