Neurologia最新文献

{"title":"Binocular diplopia: a retrospective study of 204 cases.","authors":"M Saint-Gerons, M A Rubio, A Matheu","doi":"10.1016/j.nrleng.2025.03.001","DOIUrl":"10.1016/j.nrleng.2025.03.001","url":null,"abstract":"<p><strong>Objective: </strong>To describe the prevalence and form of onset of different causes of binocular diplopia in our setting.</p><p><strong>Methods: </strong>We conducted a single-centre, cross-sectional, retrospective study reviewing the medical records of all patients visiting a tertiary-level centre between May 2019 and June 2021 with binocular diplopia as the main symptom. All patients underwent a complete neuro-ophthalmological evaluation and complementary tests for the aetiological diagnosis of diplopia. Data were collected on demographic variables, ocular deviation pattern, complementary test results, and diagnosis.</p><p><strong>Results: </strong>A total of 204 patients with binocular diplopia were identified during the study period. The most frequent causes of diplopia overall were fourth nerve palsy (19.12%), sixth nerve palsy (14.71%), decompensated strabismus (14.22%), sagging eye syndrome (12.25%), third nerve palsy (10.78%), myasthenia (7.35%), supranuclear disorders (6.37%), and myopic esotropia (5.88%). Presentation was acute (less than 2 weeks' progression) in 51% of cases. The most frequent causes of acute-onset diplopia were sixth nerve palsy (27.88%), third nerve palsy (21.15%), fourth nerve palsy (19.23%), supranuclear disorders (12.5%), and decompensated strabismus (6.73%). The most frequent causes of subacute/chronic presentation (more than 2 weeks) were decompensated strabismus (22%), sagging eye syndrome (22%), fourth nerve palsy (19%), myopic esotropia (12%), and myasthenia (11%).</p><p><strong>Conclusions: </strong>The most frequent aetiology of diplopia in our environment was fourth nerve palsy, followed by sixth nerve palsy, decompensated strabismus, and sagging eye syndrome. Knowing the frequency of each cause of diplopia can help prioritise neuroimaging studies in each case.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675106","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":"Endovascular treatment of vertebrobasilar ischaemic stroke in Aragon: Clinical and radiological characteristics, management times, and prognosis at 3 months.","authors":"I Saldaña-Inda, H Tejada-Meza, B Domínguez-Lagranja, M R Barrena-Caballo, A Sancho-Saldaña, M Serrano-Ponz, J Marta-Moreno","doi":"10.1016/j.nrleng.2025.03.004","DOIUrl":"10.1016/j.nrleng.2025.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>Posterior circulation stroke accounts for 15% to 20% of ischaemic strokes, but is associated with poor functional and vital prognosis in over 60% of cases. Due to its clinical and radiological peculiarities, diagnosis and management are more complex than in anterior circulation stroke. This study analyses and characterises patients with vertebrobasilar strokes treated with mechanical thrombectomy in our region.</p><p><strong>Methods: </strong>We conducted a descriptive, retrospective analysis of patients with vertebrobasilar stroke and treated with mechanical thrombectomy at our centre, a reference centre for cerebrovascular emergencies for the region of Aragon. We recorded baseline characteristics, risk factors, signs and symptoms at onset, radiological assessment scale scores, procedure-related variables, management times, and functional prognosis at 3 months.</p><p><strong>Results: </strong>We selected 37 patients (39.5% women; mean age [standard deviation], 68.34 [14.1] years). Cardioembolic stroke (42.1%) was the most common aetiology, followed by atherothrombosis (28.9%). The top of the basilar artery was the most common site of obstruction (55.3%). The most frequent clinical features were somnolence (76.3%), motor deficits (71.1%), and nausea (55.3%). Successful reperfusion (mTICI ≥ 2b) was achieved in 81.1% of patients. Functional outcome at 90 days was poor (mRS < 3) in 59% of patients.</p><p><strong>Conclusions: </strong>Posterior circulation stroke is associated with high rates of morbidity and mortality. Its subacute, nonspecific clinical course prolongs management times and hinders early detection. Mechanical thrombectomy is a safe and effective procedure, although further studies are needed to establish the optimal patient profile.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675110","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":"Clinical features of phantom limb pain in patients with lower limb amputation in a Spanish population.","authors":"M Rubiera Valdés, O Gutiérrez Remis, A González Jáimez, C Manzaneque Rodríguez, V Chiminazzo, G Morís","doi":"10.1016/j.nrleng.2025.03.002","DOIUrl":"10.1016/j.nrleng.2025.03.002","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this research is to present the clinical characteristics of Phantom Limb Pain (PLP) in patients with amputation.</p><p><strong>Methods: </strong>A retrospective cross-sectional observational study of patients with lower limb amputation is presented. Patients between 18 and 80 years of age with unilateral or bilateral amputation between the years 2015 and 2019 were included. Demographic data, medical history, data related to the amputation, and related abnormal sensations were collected.</p><p><strong>Results: </strong>43 patients (34 men) and 53 amputees were studied, with a mean age of 62 years, with a time elapsed since amputation of 28 months. The most frequent cause of amputation was ischemic (70%). Twenty-three (60%) patients had PLP that began 1 month after amputation with a mean intensity of 3.9 on the VAS scale, in 15 patients the PLP was daily, three patients recognized the disappearance of PLP. 91% of the patients presented non-painful sensations in relation to the phantom limb. No differences were found in the development of the PLP between the 1st and 2nd amputation. A significant association was found between the development of PLP and residual limb pain.</p><p><strong>Conclusions: </strong>PLP is a prevalent pathology among amputee patients, therefore multidisciplinary care with an active neurologic participation is essential. Studies are needed to deepen the knowledge of the factors that favour the development of PLP in order to focus early and targeted therapies to prevent the appearance of PLP.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675109","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":"Knowledge about oral preventive treatments in patients with migraine: A nationwide study.","authors":"A López-Bravo, S Quintas, A Mínguez-Olaondo, A Alpuente, C Nieves-Castellanos, M Pilar Navarro-Pérez, S Pérez-Pereda, A Layos Romero, C Calle de Miguel, D García-Azorín, M Torres-Ferrús, S Santos-Lasaosa","doi":"10.1016/j.nrleng.2025.03.006","DOIUrl":"10.1016/j.nrleng.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Patients' knowledge about their medications is key to guarantee therapeutic compliance in chronic diseases.</p><p><strong>Aims of the study: </strong>To determine patients' knowledge of oral preventive treatment (OPT) in migraine.</p><p><strong>Methods: </strong>This is a cross-sectional study evaluating knowledge of medication with a validated questionnaire that assessed: therapeutic objective, process of use, safety and conservation.</p><p><strong>Results: </strong>198 patients were included. Mean age was 45.4 ± 11.5 years-old and 92.4% were women. A 61.1% of migraine patients did not know the medication they used, 55.1% showed insufficient knowledge and 6.1% had no knowledge. The most known dimension was \"conservation\" (80.3%) and the most unknown dimension of was safety (33.7%). In this regard, 82.3% considered that they should not take precautions when taking the treatment, 80.3% stated that it had no contraindications and 82.8% were unaware of possible interactions with other medications. Worse knowledge about OPT was associated with longer time since migraine onset (p = .049), higher scores on the Hospital Anxiety and Depression Scale (p = .021), less qualified jobs (p = .045), use of monotherapy (p = .001) and longer periods since OPT initiation (p = .013).</p><p><strong>Conclusions: </strong>The majority of migraine patients did not adequately know their preventive treatment, despite identifying some of the items related to their medication. The present study shows that knowledge of patients about their preventive treatment should be evaluated in clinical practice and could help migraine patients in the correct use of OPT.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675112","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":"Quality of life and mental health in young strokes.","authors":"D Alonso Modino, L Perestelo Pérez, F M Rosa González, A Toledo Chavarri, C Valcarcel Nazco, F I Montón Álvarez","doi":"10.1016/j.nrleng.2025.03.003","DOIUrl":"10.1016/j.nrleng.2025.03.003","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke has a significant impact on mental health and health-related quality of life (HRQoL); these aspects have not been sufficiently studied in young stroke.</p><p><strong>Objectives: </strong>To evaluate HRQoL, mental health, and the relationship between these variables and the incorporation of young adults into working life after stroke.</p><p><strong>Material and methods: </strong>We conducted a prospective descriptive study of patients with JS between 2016 and 2017, using such questionnaires and scales as EuroQol-5D, the 36-item Short Form Health Survey, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), 12-item General Health Questionnaire, Hamilton Anxiety and Depression Rating Scales, and BURQOL-meter; tests were administered at 2 interviews, held 6 and 12 months after stroke.</p><p><strong>Results: </strong>We analysed 41 patients, with a mean age of 41.8 years. At one year, the mean NIHSS score was 0.54 and mRS score was 0-2 in 95.1%. No differences were observed over time in quality of life or mental health scales. Prevalence rates for depression and anxiety at one year were 46.3% and 41.5%, respectively. Male sex and active employment were associated with better HRQoL. A total of 41.5% of patients were in work at one year after the stroke. Statistically significant associations were observed between quality of life, mental health, and incorporation into working life.</p><p><strong>Conclusions: </strong>Young stroke affects HRQoL, and patients are at high risk of anxiety and depression, underdiagnosed and undertreated disorders that affect quality of life and the return to work, which decreases after stroke in young adults.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675044","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":"Lingual dystonia: Response to botulinum toxin treatment.","authors":"A Fernández Revuelta, E López Valdés, R García-Ramos","doi":"10.1016/j.nrleng.2025.03.005","DOIUrl":"10.1016/j.nrleng.2025.03.005","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675041","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":"Focusing on post-COVID syndrome fatigue","authors":"M. Gómez-Eguílaz ,&nbsp;S. López-Alava ,&nbsp;J.L. Ramón-Trapero ,&nbsp;F. Castillo-Álvarez ,&nbsp;N. Gómez Loizaga ,&nbsp;C. García-Penco ,&nbsp;N. Boukichou-Abdelkader ,&nbsp;L. Pérez-Martínez","doi":"10.1016/j.nrleng.2025.02.002","DOIUrl":"10.1016/j.nrleng.2025.02.002","url":null,"abstract":"<div><h3>Introduction</h3><div>More than 100 million people worldwide have been infected by SARS-CoV-2 virus, the virus responsible for the acute disease COVID-19. Multiple studies have shown how various symptoms in these patients can persist for several months after resolution of the acute process, a phenomenon known as post-COVID syndrome. Neurological symptoms are varied, but the great majority of patients present fatigue.</div></div><div><h3>Objective</h3><div>To analyse post-COVID fatigue.</div></div><div><h3>Methods</h3><div>We present a prospective, single-centre, case-control study comparing patients with fatigue in the context of post-COVID syndrome with patients with history of COVID-19 but without post-COVID fatigue. Data were recorded at baseline (April 2021) and at 6 months. Data were recorded on clinical variables, fatigue questionnaires, sleep disorders, depression, anxiety, cognitive impairment, and quality of life. Basic laboratory analysis was performed with blood samples collected at the 2 visits. In addition, a substudy of proinflammatory (IL-6, IL-1β, TNF-α) and anti-inflammatory (IL-10) cytokines was performed.</div></div><div><h3>Results</h3><div>Fatigue as measured by the Chalder Fatigue Scale was mixed (physical and psychological) and of moderate intensity. At 6 months, physical fatigue improved, but psychological fatigue did not. Significant differences were found in sleepiness, cognitive impairment, anxiety, and quality of life. Significant alterations were observed in TNF-α levels, but not in the remaining cytokines.</div></div><div><h3>Conclusions</h3><div>Patients with fatigue presented a poorer quality of life, with an improvement being observed at 6 months, which suggests a course that may be self-limiting; however, this will have to be confirmed with longer studies.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 2","pages":"Pages 204-215"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416649","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}

{"title":"Opsoclonus-myoclonus syndrome and prostate cancer. An entity to be aware of","authors":"C. Guijarro-Castro ,&nbsp;L. Estallo-Guijarro","doi":"10.1016/j.nrleng.2024.02.004","DOIUrl":"10.1016/j.nrleng.2024.02.004","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 2","pages":"Pages 216-217"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934938","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}

{"title":"Dopamine agonist therapy in Parkinson’s disease: Spanish expert consensus on its use in different clinical situations","authors":"D. Santos García ,&nbsp;J. Pagonabarraga Mora ,&nbsp;F. Escamilla Sevilla ,&nbsp;P.J. García Ruiz ,&nbsp;J. Infante Ceberio ,&nbsp;J. Kulisevsky Bojarski ,&nbsp;G. Linazasoro Cristóbal ,&nbsp;M.R. Luquín Piudo ,&nbsp;J.C. Martínez Castrillo ,&nbsp;S. Jesús Maestre ,&nbsp;L. Vela Desojo ,&nbsp;F.J. Campos Lucas ,&nbsp;F. Caballero Martínez ,&nbsp;P. Mir ,&nbsp;Panel of Experts Phase 1","doi":"10.1016/j.nrleng.2023.04.008","DOIUrl":"10.1016/j.nrleng.2023.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Different types of therapies were proven effective for the medical management of motor and non-motor symptoms in Parkinson’s disease (PD). We aimed to gain consensus on the dopamine agonist (DA) therapy use in different clinical scenarios of Parkinson’s disease (PD) patients.</div></div><div><h3>Methods</h3><div>This consensus study was based on the nominal group technique. Initially, a consensus group comprising 12 expert neurologists in the PD field identified the topics to be addressed and elaborated different evidence-based preliminary statements. Next, a panel of 48 Spanish neurologists expressed their opinion on an internet-based systematic voting program. Finally, initial ideas were reviewed and rewritten according to panel contribution and were ranked by the consensus group using a Likert-type scale. The analysis of data was carried out by using a combination of both qualitative and quantitative methods. The consensus was achieved if the statement reached ≥ 3.5 points in the voting process.</div></div><div><h3>Results</h3><div>The consensus group produced 76 real-world recommendations. The topics addressed included 12 statements related to DA therapy in early PD, 20 statements concerning DA treatment strategy in patients with motor complications, 11 statements associated with DA drugs and their side effects, and 33 statements regarding DA therapy in specific clinical scenarios. The consensus group did not reach a consensus on 15 statements.</div></div><div><h3>Conclusion</h3><div>The findings from this consensus method represent an exploratory step to help clinicians and patients in the appropriate use of DA in different stages and clinical situations of PD.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 2","pages":"Pages 171-181"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9779042","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}

{"title":"Selection of patients for percutaneous closure in nonlacunar cryptogenic stroke associated with patent foramen ovale. Data from the NORDICTUS cooperative registry","authors":"J. Tejada García ,&nbsp;L.B. Lara Lezama ,&nbsp;R. de la Fuente Blanco ,&nbsp;A. Pérez de Prado ,&nbsp;L. Benavente Fernández ,&nbsp;M. Rico Santos ,&nbsp;M.D. Fernández Couto ,&nbsp;L. Naya Ríos ,&nbsp;I. Couso Pazó ,&nbsp;P.V. Alba ,&nbsp;L. Redondo-Robles ,&nbsp;L. López Mesonero ,&nbsp;S. Arias-Rivas ,&nbsp;M. Santamaría Cadavid ,&nbsp;H. Tejada Meza ,&nbsp;L. Horna Cañete ,&nbsp;I. Azkune Calle ,&nbsp;A. Pinedo Brochado ,&nbsp;J.M. García Sánchez ,&nbsp;I. Caballero Romero ,&nbsp;M. Martínez Zabaleta","doi":"10.1016/j.nrleng.2022.09.008","DOIUrl":"10.1016/j.nrleng.2022.09.008","url":null,"abstract":"<div><h3>Introduction</h3><div>There is an extending use of percutaneous closure of patent foramen ovale (PFO) as therapy for PFO-associated cryptogenic strokes. The aim of our study was to investigate the clinical practice of percutaneous closure of PFO and to analyse the variables for decision-making on the selection of patients for this procedure.</div></div><div><h3>Method</h3><div>A prospective observational multicentric survey was conducted using all the cases of cryptogenic stroke/transient ischaemic attack associated with PFO recorded in the NORDICTUS hospital registry during the period 2018-2021. Clinical data, radiological patterns, echocardiogram data and factors related to PFO-associated stroke (thromboembolic disease and paradoxical embolism criteria) were recorded. The indication for closure was analysed according to age (≤/&gt; 60 years) and the characteristics of the PFO.</div></div><div><h3>Results</h3><div>In the group ≤ 60 years (n = 488), 143 patients (29.3%) underwent PFO closure. The most influential variables for this therapy were detection of a high-risk PFO (OR 4.11; IC 2.6-6.5, <em>P</em> &lt; .001), criteria for paradoxical embolism (OR 2.61; IC 1.28−5.28; <em>P</em> = .008) and previous use of antithrombotics (OR 2.67; IC 1.38−5.18; <em>P</em> = .009). In the &gt; 60 years group (n = 124), 24 patients had PFO closure (19%). The variables related to this option were history of pulmonary thromboembolism, predisposition to thromboembolic disease, paradoxical embolism criteria, and high-risk PFO.</div></div><div><h3>Conclusions</h3><div>The detection of a high-risk PFO (large shunt, shunt with associated aneurysm) is the main criterion for a percutaneous closure-based therapy. Other conditions to consider in the eligibility of patients are the history of thromboembolic disease, paradoxical embolism criteria or the previous use of antithrombotics.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 2","pages":"Pages 139-149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474072","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}