Neurologia最新文献_第2页

Usefulness of anesthetic block of the greater occipital nerve in the treatment of migraine in children and adolescents 麻醉阻断枕大神经治疗儿童和青少年偏头痛的有效性。

Neurologia Pub Date : 2026-04-01 Epub Date: 2026-02-28 DOI: 10.1016/j.nrleng.2026.501915

M. Bote Gascón , E. Arias Vivas , U.A. Barrios Machain , A. García Ron

{"title":"Usefulness of anesthetic block of the greater occipital nerve in the treatment of migraine in children and adolescents","authors":"M. Bote Gascón , E. Arias Vivas , U.A. Barrios Machain , A. García Ron","doi":"10.1016/j.nrleng.2026.501915","DOIUrl":"10.1016/j.nrleng.2026.501915","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral nerve blockade (PNB) is a common treatment in adults with headache. Although there is little evidence in pediatrics, its simplicity, safety and efficacy make it an option that can be extrapolated to our practice. Therefore, we conducted a study in which we evaluated the usefulness of anesthetic blockade of the NOM (greater occipital nerve) as a treatment for migraine in the pediatric population.</div></div><div><h3>Methods</h3><div>Prospective cohort study in children and adolescents with migraine. We collected demographic and clinical data (pain intensity using the verbal numeric scale) and data related to quality of life (PedMidas and PedsQL questionnaire) at baseline and after performing NOM block with 2.5 ml of 0.5% bupivacaine.</div></div><div><h3>Results</h3><div>We included 28 patients (89.3% women) with a mean age of 13.9 years. Mean frequency of 22.8 episodes/month and intensity of 7.7/10 on the verbal-numerical scale (VNS). Post-treatment: significant reduction (<em>P</em> < .01) in frequency to 6.1 episodes/month and intensity: 3.9 points (30 minutes), 4.2 points (1 week), 3.9 points (15 days), 4.4 points (1 month) and 5.4 points (3 months). 100% had an effect on their quality of life, both on the PedMidas and PedsQL scales, the greater the effect, the better the response. Only 2 had adverse effects (syncope and local pain).</div></div><div><h3>Conclusions</h3><div>NOM blockade is a safe, effective and useful procedure for the acute and preventive treatment of migraine in pediatric age. It relieves the burden associated with headache and is associated with an improvement in the quality of life of patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501915"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328934","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

Myasthenia gravis in Spain: A survey of specialized neurologists to uncover unmet needs 西班牙重症肌无力：一项调查的专业神经学家发现未满足的需求

Neurologia Pub Date : 2026-04-01 Epub Date: 2026-04-08 DOI: 10.1016/j.nrleng.2026.501912

E. Cortés-Vicente , C. Casasnovas , R. Juntas , T. Sevilla , J. Pardo , F. Rodríguez de Rivera , A. Guerrero Sola

{"title":"Myasthenia gravis in Spain: A survey of specialized neurologists to uncover unmet needs","authors":"E. Cortés-Vicente , C. Casasnovas , R. Juntas , T. Sevilla , J. Pardo , F. Rodríguez de Rivera , A. Guerrero Sola","doi":"10.1016/j.nrleng.2026.501912","DOIUrl":"10.1016/j.nrleng.2026.501912","url":null,"abstract":"<div><h3>Introduction</h3><div>Myasthenia gravis (MG) is a neuromuscular autoimmune disease that requires prompt diagnosis and management by neurologists. The challenges of MG management are associated with the diagnostic process and the selection of an effective form of therapy enabling long-term remission of the disease. The objective of this study was to assess the state of MG in Spain to identify unaddressed needs in the clinical progression, diagnosis, and treatment approaches.</div></div><div><h3>Methods</h3><div>A survey was distributed via email between 19 July and 25 October 2022 to neurologists belonging to the Spanish Society of Neurology. A comprehensive descriptive analysis was conducted on all collected data.</div></div><div><h3>Results</h3><div>In total, 69 completed surveys, representing 64 Spanish hospitals, were analyzed and included in the results. The study identified that economic difficulties, such as departmental budgets, have led to a lack of access to antibody testing during diagnosis. Furthermore, corticosteroids were found to achieve the best clinical response, despite also being associated with a higher frequency of adverse effects. The results show that 34% of patients with MG present active symptoms. Eighteen percent have symptoms that limit their daily activities. Additionally, 29% of patients have requested an unscheduled follow-up visit within the last year.</div></div><div><h3>Conclusions</h3><div>Several areas present unmet needs in terms of improving access to diagnostic assays, residual disease burden in treated patients, and the management and diagnosis of MG.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501912"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631640","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

Iatrogenic cerebral amyloid angiopathy in a young patient: aetiopathogenic hypothesis 一例年轻患者的医源性脑淀粉样血管病：病原假说。

Neurologia Pub Date : 2026-04-01 Epub Date: 2026-02-27 DOI: 10.1016/j.nrleng.2026.501916

M. De la Fuente Gómez-Morán , F. Hernández-Fernández , E.L. Setién , R.M. Collado Jiménez , C. Barrena López , R.A. Barbella Aponte

引用次数: 0

The Parkinson's Real-World Impact Assessment (PRISM) project in the management and burden of Parkinson's disease in Spain 帕金森氏症现实世界影响评估（PRISM）项目在西班牙的帕金森氏病管理和负担

Neurologia Pub Date : 2026-04-01 Epub Date: 2026-04-08 DOI: 10.1016/j.nrleng.2026.501921

C. Painous Martí , I. Pijuan Jiménez , À. Bayés Rusiñol , J.C. Martínez Castrillo , Á. Sésar Ignacio , E. Tolosa Sarró

{"title":"The Parkinson's Real-World Impact Assessment (PRISM) project in the management and burden of Parkinson's disease in Spain","authors":"C. Painous Martí , I. Pijuan Jiménez , À. Bayés Rusiñol , J.C. Martínez Castrillo , Á. Sésar Ignacio , E. Tolosa Sarró","doi":"10.1016/j.nrleng.2026.501921","DOIUrl":"10.1016/j.nrleng.2026.501921","url":null,"abstract":"<div><h3>Introduction</h3><div>Real-world data studies are a promising option for understanding everyday Parkinson's disease (PD) management and optimizing strategies and therapeutic options. The Parkinson's Real-World Impact Assessment (PRISM) project was conceived as a European survey to evaluate the burden of the disease in people with Parkinson's disease (PwP) and their caregivers. Here, we present the analysis of the Spanish PRISM cohort dataset to describe prescribing patterns, healthcare resource utilization, and the impact of PD on PwP and their caregivers.</div></div><div><h3>Methods</h3><div>Data were collected using an electronic questionnaire distributed through different patient advocacy groups and specialized PD clinics in Spain.</div></div><div><h3>Results</h3><div>A total of 149 PwP (mean age, 62.6 years; mean disease duration, 7.6 years) and 38 caregivers were included. Most PwP (87.1%) received levodopa during the 12 months preceding the survey. A high percentage of patients (62.1%) expressed interest in participating in a clinical trial, but only 20% reported a current or previous enrollment. PwP reported high incidence of non-motor symptoms and poor health-related quality of life. At least one impulse control behavior was reported in 57% of patients. Caregivers reported mild to moderate disease burden.</div></div><div><h3>Conclusions</h3><div>This study identified high rates of motor and non-motor symptoms, impulse control disorders, and considerable disease burden in PwP and their caregivers, even at a relatively young age and a mild/moderate stage of the disease. Also, it highlights the limited use of rehabilitation therapies. These data provide information for PD management and resource utilization in Spain.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501921"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147631639","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

Use of tocilizumab in acute necrotising encephalitis secondary to influenza A 托珠单抗在甲型流感继发急性坏死性脑炎中的应用

Neurologia Pub Date : 2026-04-01 Epub Date: 2026-02-27 DOI: 10.1016/j.nrleng.2026.501914

I. Comino-Hidalgo , J. López Pequeño , A. Aguado del Hoyo , M. Vázquez López

引用次数: 0

Impact of hypertension on stroke. Are there different age profiles? 高血压对中风的影响。有不同的年龄特征吗？

Neurologia Pub Date : 2026-04-01 Epub Date: 2026-02-27 DOI: 10.1016/j.nrleng.2026.501913

L. Castilla-Guerra , M.C. Fernandez-Moreno , M. de la Serna Fito , A. Palomino-Garcia , G.A. Escobar Rodriguez , M.D. Jiménez Hernandez

{"title":"Impact of hypertension on stroke. Are there different age profiles?","authors":"L. Castilla-Guerra , M.C. Fernandez-Moreno , M. de la Serna Fito , A. Palomino-Garcia , G.A. Escobar Rodriguez , M.D. Jiménez Hernandez","doi":"10.1016/j.nrleng.2026.501913","DOIUrl":"10.1016/j.nrleng.2026.501913","url":null,"abstract":"<div><h3>Introduction</h3><div>Arterial hypertension is the most prevalent modifiable risk factor for stroke. We aim to establish if there is an association between hypertension and type of stroke, and if this varies with age.</div></div><div><h3>Methods</h3><div>Retrospective study of patients with a first stroke discharged from public hospitals in Seville (Spain) between 1999 and 2021. Only patients with hypertension as a risk factor were included. The sample was divided into 3 groups: patients ≤ 50 years, 51 to 79 years and ≥ 80 years.</div></div><div><h3>Results</h3><div>Of 42 855 strokes, 2141 (4.9%) hypertensive patients with a first stroke, mean age 68 (15) years, and 1010 (47.2%) women, were included. Included were 1274 (59.5%) ischaemic strokes and 867 (40.5%) haemorrhagic strokes, 309 (14.4%) patients ≤ 50 years of age, 1253 (58.3%) patients between 51 and 79 years of age, and 579 (27.3%) patients ≥ 80 years of age. The percentage of patients with a previous diagnosis of hypertension was 24.3% vs 51.3% vs 79.4% (<em>P</em> < .001), with a mean time from diagnosis to stroke of 5.5 (3.7) vs 7.8 (4.9) vs 9.6 (5.1) years (<em>P</em> < .001) respectively. The number of haemorrhagic strokes was: 171 (55.3%), 523 (41.7%), and 172 (29.7%) (<em>P</em> < .001), with mortality at one year being 3.2%, 10%, and 35.6%, respectively (<em>P</em> < .001).</div></div><div><h3>Conclusions</h3><div>In hypertensive patients with a first stroke, the percentage of haemorrhagic strokes is higher than expected, especially in young patients, where it exceeds half of the cases. It is necessary to optimise prevention in these patients to reduce the enormous social and healthcare burden that stroke represents.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 3","pages":"Article 501913"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328779","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

Diagnosis and treatment of malignant middle cerebral artery infarction and cerebellar infarction with mass effect. Recommendations of the Spanish Society of Neurology's Stroke Study Group. 恶性脑中动脉梗死及小脑梗死伴肿块效应的诊治。西班牙神经病学学会中风研究小组的建议。

Neurologia Pub Date : 2026-03-30 DOI: 10.1016/j.nrleng.2026.502014

F Moniche, A Ponz, E López-Cancio Martinez, M Rubiera, M A de Leciñana, O Ayo, M Castellanos, J C López Fernández, J Marta-Moreno, A M Morales, J M Ramirez-Moreno, S Tur, Á Ximénez-Carrillo, M Freijo Guerrero

{"title":"Diagnosis and treatment of malignant middle cerebral artery infarction and cerebellar infarction with mass effect. Recommendations of the Spanish Society of Neurology's Stroke Study Group.","authors":"F Moniche, A Ponz, E López-Cancio Martinez, M Rubiera, M A de Leciñana, O Ayo, M Castellanos, J C López Fernández, J Marta-Moreno, A M Morales, J M Ramirez-Moreno, S Tur, Á Ximénez-Carrillo, M Freijo Guerrero","doi":"10.1016/j.nrleng.2026.502014","DOIUrl":"10.1016/j.nrleng.2026.502014","url":null,"abstract":"<p><strong>Aims: </strong>To update the recommendations of the Spanish Society of Neurology's Stroke Study Group on the diagnosis and treatment of malignant middle cerebral artery (MCA) infarction and malignant cerebellar infarction, including the role of decompressive craniectomy.</p><p><strong>Development: </strong>A systematic review of the literature was conducted on PubMed, selecting clinical trials and meta-analyses evaluating malignant infarction as an independent variable. A series of PICO (patient, intervention, comparison, outcome) questions were developed to identify practical aspects of the diagnosis and the medical and surgical treatment of these patients. Based on the results, we developed a series of recommendations in response to each PICO question.</p><p><strong>Conclusions: </strong>We propose evidence-based definitions of malignant MCA infarction and malignant cerebellar infarction. Clinical trials of such anti-oedema therapies as osmotherapy and hypothermia have not been shown to reduce rates of mortality or disability. In patients aged <60 years with malignant MCA infarction, the number needed to treat to avoid a death with decompressive craniectomy is 2, and the number needed to treat to achieve survival with a modified Rankin Scale score ≤ 3 is 4. In patients aged 60-75 years, decompressive craniectomy reduces mortality but is associated with severe sequelae, and therefore is not recommended for routine use. Suboccipital decompressive craniectomy should be considered either as a primary indication or after failure of a ventricular drain, in patients with extensive cerebellar infarction and neurological deterioration due to brainstem compression.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"502014"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597255","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

Spanish consensus statement on the diagnosis and treatment of sialorrhoea in children with cerebral palsy. 西班牙关于脑瘫患儿唾液漏诊断和治疗的共识声明。

Neurologia Pub Date : 2026-03-28 DOI: 10.1016/j.nrleng.2026.502032

A Garcia Ron, E Arias Vivas, G Arriola Pereda, L Cuesta, A Garcia Ribes

{"title":"Spanish consensus statement on the diagnosis and treatment of sialorrhoea in children with cerebral palsy.","authors":"A Garcia Ron, E Arias Vivas, G Arriola Pereda, L Cuesta, A Garcia Ribes","doi":"10.1016/j.nrleng.2026.502032","DOIUrl":"10.1016/j.nrleng.2026.502032","url":null,"abstract":"<p><strong>Introduction: </strong>Anterior sialorrhoea, or \"drooling,\" is the involuntary loss of saliva due to an inability to manage oral secretions. In cerebral palsy (CP), drooling results from oral motor dysfunction, significantly impacting the quality of life of both patients and their caregivers. Despite its physical and psychological repercussions, the clinical approach to sialorrhoea remains poorly defined.</p><p><strong>Objectives: </strong>This document aims to provide a guideline for the evaluation and management of sialorrhoea in children with CP, based on the best available evidence and expert consensus. Additionally, it seeks to identify gaps in the literature and propose future research directions.</p><p><strong>Methodology: </strong>A working group was formed, composed of paediatric neurologists from the Spanish Society of Paediatric Neurology (SENEP). A systematic review of the literature was conducted in databases such as MEDLINE, PubMed, and Cochrane, prioritising randomised clinical trials and systematic reviews. Clinical evidence was included when higher-level evidence was unavailable, and recommendations were formulated based on expert consensus.</p><p><strong>Consensus and discussion: </strong>The management of sialorrhoea should be multidisciplinary, including thorough clinical evaluations and assessment scales for severity and impact. Treatment should follow a stepwise approach, starting with non-pharmacological strategies (oromotor therapy, postural correction) and, if necessary, pharmacological interventions with anticholinergics (glycopyrrolate, trihexyphenidyl) or botulinum toxin injection. Surgical options and radiotherapy are reserved for refractory cases.</p><p><strong>Conclusion: </strong>Sialorrhoea is a clinically relevant issue in children with CP, requiring an individualised approach based on the best available evidence. This consensus provides a useful guideline for clinical practice and highlights the need for further studies to optimise treatment.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"502032"},"PeriodicalIF":0.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583324","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

Real-world healthcare resource utilisation for migraine: Analysis of an administrative database in Colombia. 现实世界中偏头痛的医疗资源利用：哥伦比亚行政数据库分析。

Neurologia Pub Date : 2026-03-28 DOI: 10.1016/j.nrleng.2026.502008

F Sobrino, M Zorro, M T Bedoya, M L Ramos

{"title":"Real-world healthcare resource utilisation for migraine: Analysis of an administrative database in Colombia.","authors":"F Sobrino, M Zorro, M T Bedoya, M L Ramos","doi":"10.1016/j.nrleng.2026.502008","DOIUrl":"10.1016/j.nrleng.2026.502008","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is a chronic condition characterised by recurrent episodes of severe headache, significantly affecting the functionality of the individuals. The global prevalence and the impact on the quality of life highlight the need for research on its epidemiology and management, especially in specific context such as Colombia, where information on the subject is scarce.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted with data from the Information System for Social Protection in Colombia (SISPRO) between 2027 and 2021, evaluating the incidence, prevalence, treatment pattern and cost associated with migraine management.</p><p><strong>Results: </strong>293 028 incident cases and 1 711 794 prevalent cases of migraine were identified with a higher incidence and prevalence in women. The use of prophylactic treatments and visits to neurology showed an increasing trend. Although pharmaceutical costs represented the greatest economic burden, they decreased over the course of the study. The annual healthcare cost per patient, expressed in Purchasing Power Parity (PPP) decreased from PPP$110 in 2017 to a minimum of PPP$39 in 2019. The annual pharmacy cost per patient also dropped from PPP$115 in 2017 to PPP$64 in 2019.</p><p><strong>Conclusions: </strong>This study highlights migraine as a common condition in Colombia, with a prevalence and management that reflect a need for improved educational and treatment strategies. The research also highlights the importance of national data in understanding and addressing this condition, suggesting the need for public health policies focused on the prevention and optimized management of migraine.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"502008"},"PeriodicalIF":0.0,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583343","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

Adult-onset arginase-1 deficiency mimicking hereditary spastic paraplegia. 成人发病精氨酸酶-1缺乏症模拟遗传性痉挛性截瘫。

Neurologia Pub Date : 2026-03-28 DOI: 10.1016/j.nrleng.2026.501943

F Castellanos-Pinedo, J M Morán-López, S Moreno-Pulido, B Rodríguez-Fúnez, I Royo Boronat

引用次数: 0