NeurologiaPub Date : 2024-11-01Epub Date: 2024-10-31DOI: 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 cases of venous or arterial thrombosis with thrombocytopenia following administration of adenoviral vector vaccines (AstraZeneca or Janssen) against COVID-19 disease between 1 February and 26 September 2021. We describe the crude rate and the standardised morbidity ratio. We assessed the predictors of mortality.</p><p><strong>Results: </strong>Sixty-one cases were reported and 45 fulfilled eligibility criteria; 82% of patients were women. The crude TTS rate was 4 cases/1 000 000 doses, and 14-15 cases/1 000 000 doses among patients aged 30-49 years. The number of observed cases of cerebral venous thrombosis was 6-18 times higher than that expected in patients younger than 49 years. Symptoms started a median (quartiles 1 and 3 [Q<sub>1</sub>-Q<sub>3</sub>]) of 10 (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% (49%-78%) had D-dimer levels > 2000 ng/mL. Patients had thromboses affecting multiple locations in 36% of cases and fatal outcomea in 24%. Platelet nadir < 50 000/μL (odds ratio [OR]: 7.4; 95% CI: 1.2-47.5) and intracranial hemorrhage (OR: 7.9; 95% CI: 1.3-47.0) were associated with fatal outcomes.</p><p><strong>Conclusion: </strong>TTS must be suspected in patients with symptoms 10 days after vaccination and thrombocytopenia and/or elevated D-dimer levels.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"721-732"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","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}
NeurologiaPub Date : 2024-11-01Epub Date: 2024-02-20DOI: 10.1016/j.nrleng.2024.02.005
J C Romero-Fábrega, R Lorenzo-López, E Rivas-Infante, F Escamilla-Sevilla, M Rashki, A Mínguez-Castellanos, A Carvajal-Hernández
{"title":"Sporadic fatal insomnia: a rapidly progressive phenotype resembling progressive supranuclear palsy.","authors":"J C Romero-Fábrega, R Lorenzo-López, E Rivas-Infante, F Escamilla-Sevilla, M Rashki, A Mínguez-Castellanos, A Carvajal-Hernández","doi":"10.1016/j.nrleng.2024.02.005","DOIUrl":"10.1016/j.nrleng.2024.02.005","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"820-823"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934940","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}
NeurologiaPub Date : 2024-10-01DOI: 10.1016/j.nrleng.2024.09.005
C. González-Mingot , A. Gil-Sánchez , R. Begué-Gómez , R. López-Ortega , B.R. Luis
{"title":"Ischemic encephalopathic debut of CADASIL, a case report: It is better to be safe than sorry","authors":"C. González-Mingot , A. Gil-Sánchez , R. Begué-Gómez , R. López-Ortega , B.R. Luis","doi":"10.1016/j.nrleng.2024.09.005","DOIUrl":"10.1016/j.nrleng.2024.09.005","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 712-715"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416091","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}
NeurologiaPub Date : 2024-10-01DOI: 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}
NeurologiaPub Date : 2024-10-01DOI: 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}
NeurologiaPub Date : 2024-10-01DOI: 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}
NeurologiaPub Date : 2024-10-01DOI: 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}
NeurologiaPub Date : 2024-10-01DOI: 10.1016/j.nrleng.2022.04.007
L. Simón-Vicente , S. Rodríguez-Cano , V. Delgado-Benito , V. Ausín-Villaverde , E. Cubo Delgado
{"title":"Cybersickness. A systematic literature review of adverse effects related to virtual reality","authors":"L. Simón-Vicente , S. Rodríguez-Cano , V. Delgado-Benito , V. Ausín-Villaverde , E. Cubo Delgado","doi":"10.1016/j.nrleng.2022.04.007","DOIUrl":"10.1016/j.nrleng.2022.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Virtual Reality (VR) uses computer technology to create a simulated environment. VR is a growing technology with promising extensive applications in different areas such as Medicine, entertainment, sports, gaming, and simulation. However, information about VR side effects is still limited. We aimed to identify the most frequent physical side effects caused by VR therapeutic applications.</div></div><div><h3>Methodology</h3><div>All available full-text articles evaluating VR as a therapeutic intervention and side effects using the Simulator Sickness Questionnaire (SSQ) between 2016 and 2021 were consulted across 4 electronic (Entrez Pubmed, Scopus, Science Direct, and Wiley databases). The methodological quality was assessed using the PEDro scale.</div></div><div><h3>Results</h3><div>Ten out of 55 reviewed articles (18%) met inclusion/exclusion criteria, including a sample of 416 patients, mean age of 24.54 (15–52.6)<!--> <!-->years old. According to the PEDro scale, two articles (20%) were considered good or excellent. Side effects were reported more frequently with head-mounted displays compared to desktop systems, especially disorientation, followed by nausea and oculomotor disturbances.</div></div><div><h3>Conclusions</h3><div>Although VR might have positive effects as a therapeutic tool, VR can also cause side events. As in any other therapeutic intervention, it is important to understand the effectiveness and safety before planning a VR intervention using a well-designed scientific methodology.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 701-709"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425829","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}