Neurologia最新文献

{"title":"Restless legs syndrome in paediatric patients with epilepsy","authors":"A. Pérez-Villena,&nbsp;V. Soto-Insuga,&nbsp;E. Martínez-Cayuelas,&nbsp;M. Furones-García,&nbsp;M.J. Abenza-Abildúa,&nbsp;R. Losada-Del Pozo","doi":"10.1016/j.nrleng.2026.502074","DOIUrl":"10.1016/j.nrleng.2026.502074","url":null,"abstract":"<div><h3>Introduction</h3><div>Restless legs syndrome (RLS) is a neurological condition with defined clinical criteria. The prevalence of RLS in children is around 2%-4%; as patients approach adulthood, prevalence increases. The prevalence of RLS in paediatric patients with epilepsy is unknown.</div></div><div><h3>Material and methods</h3><div>Four Madrid hospitals participated in the study (Fundación Jiménez Díaz, Hospital Universitario Niño Jesús, Hospital Universitario Villalba, and Hospital Universitario Infanta Sofía). The researchers developed a prospective observational study of a cohort of patients with epilepsy under follow-up at paediatric neurology consultations. The data were collected in the department of paediatric neurology. The data collection schedule was established between December 2020 and March 2023.</div></div><div><h3>Results</h3><div>Data were obtained from 117 patients (56% male). The age range was from 4 to 17 years (mean age, 10.3 years). Twenty patients (17.1%) met criteria for RLS, 5 (4.3%) met clinical criteria for possible RLS, and 39 (33.9%) reported insomnia. Sleep onset insomnia was present in 21 patients (18.1%), sleep maintenance insomnia in 8 patients (6.9%), and both types in 6 (5.2%). Insomnia was associated with RLS (<em>P</em> = .041)</div></div><div><h3>Conclusions</h3><div>In our sample, we observed a higher percentage of RLS among paediatric patients with epilepsy than in the general paediatric population. More studies are needed to confirm this finding.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502074"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038728","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":"Rituximab in treatment-resistant anti-HMG-CoA reductase immune-mediated necrotising myopathy","authors":"A. Pato-Pato,&nbsp;L.M. López-Díaz,&nbsp;L. Herrero-Poch,&nbsp;M.S. Fortes-González","doi":"10.1016/j.nrleng.2026.502030","DOIUrl":"10.1016/j.nrleng.2026.502030","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502030"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038830","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":"Prognostic value of personality traits in response to anti-CGRP monoclonal antibodies in patients with refractory migraine","authors":"I. Ros González,&nbsp;M.M. López Navarro,&nbsp;A. Recio García,&nbsp;Y. González Osorio,&nbsp;D. García Azorín,&nbsp;Á.L. Guerrero Peral","doi":"10.1016/j.nrleng.2026.502085","DOIUrl":"10.1016/j.nrleng.2026.502085","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study is to determine whether certain personality traits may predict response to anti–calcitonin gene–related peptide (anti-CGRP) monoclonal antibodies (mAb) in patients with migraine.</div></div><div><h3>Methods</h3><div>We conducted an observational, prospective study of a cohort of patients with chronic migraine (CM) or high-frequency episodic migraine (HFEM) treated with anti-CGRP mAbs according to Spanish national healthcare system reimbursement criteria at the headache unit of a tertiary hospital. We gathered clinical and demographic data. Treatment response was defined as a ≥ 50% decrease in the number of headache days per month at 3 months of treatment. The Salamanca Screening Test was used to evaluate personality traits.</div></div><div><h3>Results</h3><div>We included 104 patients, 88 of whom were women (84.6%), with a mean age (standard deviation) of 46.5 years (10.3) at treatment onset. A total of 88 patients (84.6%) had a diagnosis of CM. Fifty-two patients received galcanezumab and the remaining 52 were treated with fremanezumab. Response was achieved in 75 patients (72.1%). Compared to non-responders, responders presented a younger age at treatment onset (44.1 [10.6] vs 49.7 [9.1]; <em>P</em> =  .006), shorter latency from migraine onset to treatment onset (22.4 [12.2] vs 28.2 [14.4] years; <em>P</em> =  .029), and shorter latency from CM or HFEM diagnosis to treatment onset (90.4 [51.9] vs 118.5 [61.2] months; <em>P</em> = .013). The most prevalent personality traits in our sample were histrionic (64.4%), anankastic (52.9%), and anxious (50%). Borderline personality was found to predict lack of response to treatment (odds ratio [95% confidence interval] = 0.24 [0.09-0.64]).</div></div><div><h3>Conclusions</h3><div>Personality traits, along with other clinical and demographic variables, may predict response to treatment with anti-CGRP mAbs in patients with migraine.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502085"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848274","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":"Is headache training improving during neurology residency in Spain? A ten-year comparative study from the dual perspective of residents and tutors","authors":"A.B. Gago-Veiga,&nbsp;V. González-Quintanilla,&nbsp;J. Camiña,&nbsp;J. Díaz-de-Terán,&nbsp;N. González-García,&nbsp;M. Torres-Ferrus,&nbsp;A. López-Bravo,&nbsp;Á.L. Guerrero-Peral,&nbsp;R. Belvís,&nbsp;P. Pozo-Rosich","doi":"10.1016/j.nrleng.2026.502043","DOIUrl":"10.1016/j.nrleng.2026.502043","url":null,"abstract":"<div><h3>Introduction</h3><div>Residency is a key stage for acquiring the clinical and research competencies required in neurology. Although headache disorders are highly prevalent and disabling, they do not always receive adequate attention during training. In 2015, a national survey revealed major gaps in headache training among neurology residents in Spain. This study aims to assess the current situation (2025) and compare it with previous data, while incorporating the perspective of residency tutors.</div></div><div><h3>Material and methods</h3><div>We conducted a cross-sectional, observational study based on an anonymous online survey distributed to neurology residents and tutors across Spain. The survey collected data on rotations, technical procedures, perceived quality of training, and research involvement. Current results were compared with those from 2015, as well as between residents and tutors.</div></div><div><h3>Results</h3><div>A total of 109 residents and 54 tutors participated. Eighty-eight percent of residents had rotated through a headache unit vs 48% in 2015. Forty-four percent reported being proficient in techniques such as botulinum toxin injections or nerve blocks vs 36%. Only 47% of residents considered their headache training adequate, compared to 83% of tutors. While 21% of residents had participated in headache-related research, tutors estimated this at 62%. Eighty-nine percent of tutors supported making headache rotations mandatory.</div></div><div><h3>Conclusions</h3><div>Although progress has been made over the past decade, headache training is still perceived as insufficient by many residents. We recommend implementing a mandatory rotation in headache, reinforcing hands-on training in technical procedures, and promoting structured research mentorship.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502043"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059134","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":"Spontaneous intracerebral hemorrhage as initial manifestation of CADASIL with a p.Arg578Cys variant in the exon 11 of NOTCH3","authors":"I. Rosa-Batlle,&nbsp;S. Rudilosso","doi":"10.1016/j.nrleng.2026.502028","DOIUrl":"10.1016/j.nrleng.2026.502028","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502028"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009661","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":"Descriptive analysis of mortality due to Parkinson’s disease and Alzheimer disease in Argentina","authors":"F. Molinatti,&nbsp;L. de Gracia,&nbsp;A. Oliva","doi":"10.1016/j.nrleng.2026.502084","DOIUrl":"10.1016/j.nrleng.2026.502084","url":null,"abstract":"<div><h3>Introduction</h3><div>Parkinson’s disease (PD) and Alzheimer disease (AD), along with other nervous system disorders, are the leading causes of global disease burden. Although global trends have remained stable in recent decades, an increase in years of life lost due to these diseases has been recorded. In Argentina, though no prevalence records are available for PD and AD, reliable mortality data do exist. Similarities and differences in mortality caused by PD and AD are analysed in the present study.</div></div><div><h3>Methods</h3><div>The study was performed in the total population between 2000 and 2019. Age-standardised mortality rates (ASMR) were calculated. At the national level, annual trends were analysed and comparisons between provinces were made. Subsequently, spatial autocorrelation in the Centre Region (CR) was examined.</div></div><div><h3>Results</h3><div>Between 2000 and 2019, there were no statistically significant changes in ASMR for PD or AD, in either sex. In most cases, ASMR in the CR and its provinces were higher than the national average. At the department level, a trend towards the concentration of similar values was observed, with the exception of mortality due to PD among women.</div></div><div><h3>Conclusions</h3><div>The CR exhibits a higher ASMR than the national average, with rates of mortality due to AD in men in Santa Fe province being particularly noteworthy. It also shows a distinct spatial concentration pattern, with 2 distinct clusters. Further research is required to investigate the underlying sociodemographic and environmental factors contributing to this pattern.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502084"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825189","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":"Age, sex, and gender distribution of neurology faculty in Spain: Results of a national survey by the Spanish Society of Neurology","authors":"Á. Lambea-Gil,&nbsp;A. Frank-García,&nbsp;E. Díez-Tejedor,&nbsp;P. Martínez-Sánchez,&nbsp;Consejo “Neurología y Universidad” de la Sociedad Española de Neurología","doi":"10.1016/j.nrleng.2026.502077","DOIUrl":"10.1016/j.nrleng.2026.502077","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 8","pages":"Article 502077"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059091","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":"Cross-cultural adaptation and clinical validation of the Spanish version of the Simplified Evaluation of Consciousness Disorder (SECONDs)","authors":"E. Noé,&nbsp;R. Llorens,&nbsp;C. Colomer,&nbsp;M.D. Navarro,&nbsp;M. O’Valle,&nbsp;A. Barra,&nbsp;A. Galvao-Carmona,&nbsp;B. Moliner,&nbsp;J. Ferri","doi":"10.1016/j.nrleng.2026.502042","DOIUrl":"10.1016/j.nrleng.2026.502042","url":null,"abstract":"<div><h3>Introduction</h3><div>The Simplified Evaluation of Disorders of Consciousness scale (SECONDs) has been proposed as a brief and efficient tool for the accurate diagnosis of patients with prolonged disorders of consciousness (DoC). Previous validation studies have only compared its total score with that of the Coma Recovery Scale-Revised (CRS-R). Our objective was to validate the Spanish-language version of the SECONDs, including its additional index, and to compare it with other scales such as the Disability Rating Scale (DRS).</div></div><div><h3>Materials and methods</h3><div>Thirty-two patients with prolonged DoC were included. Each patient was assessed using the CRS-R, DRS, and SECONDs on 2 consecutive days. The SECONDs was translated into Spanish following the methodology proposed by Beaton et al. (2000). Diagnostic agreement (weighted kappa coefficient) and inter-scale correlations (Spearman coefficient) were analysed.</div></div><div><h3>Results</h3><div>The SECONDs showed excellent agreement with the CRS-R (κ = 0.81-0.83) and high intra- and inter-rater reliability (κ = 0.70-0.77). Administration time was significantly shorter than that of the CRS-R (7.2 [1.4] vs 16.6 [2.4] minutes; <em>P</em> &lt; .001). Correlation with the DRS was moderate (r = –0.5 to –0.64).</div></div><div><h3>Conclusions</h3><div>The SECONDs is a valid, reliable, and rapid tool for assessing patients with DoC in Spanish-speaking populations. Although it is not a replacement for the CRS-R, its brevity makes it ideal for use in critical care settings or as an initial screening instrument, optimising resources and clinical time.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 502042"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038759","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":"Optimising the management of spontaneous intracerebral haemorrhage: the ActúA project. Expert recommendations on the management of spontaneous intracerebral haemorrhage","authors":"M.M. Freijo,&nbsp;D. Rodríguez-Luna,&nbsp;M. Castellanos,&nbsp;X. Jiménez,&nbsp;A. Martin,&nbsp;J. Masjuan,&nbsp;F. Moniche,&nbsp;M. Quintana-Diaz,&nbsp;C. Molina","doi":"10.1016/j.nrleng.2026.502041","DOIUrl":"10.1016/j.nrleng.2026.502041","url":null,"abstract":"<div><h3>Introduction</h3><div>Spontaneous intracerebral haemorrhage (ICH) is a neurological emergency. While code stroke has improved the management of ischaemic stroke in Spain, ICH lacks a specific protocol, leading to significant variability in its treatment. The ActúA project aims to standardise ICH care through recommendations tailored to the Spanish healthcare system.</div></div><div><h3>Material and methods</h3><div>The project was conducted in four phases: <em>1)</em> initial recommendation proposal by a multidisciplinary scientific committee (MSC); <em>2)</em> 7 regional workshops to review and assess applicability; <em>3)</em> final version prepared by the MSC; and <em>4)</em> final validation using the Delphi methodology. Indicators were defined to evaluate the implementation and impact of the recommendations.</div></div><div><h3>Results</h3><div>The MSC identified key areas and proposed a total of 42 recommendations (17 pre-hospital, 12 in-hospital, and 13 post-discharge). These address, among other aspects, code stroke activation, the use of validated neurological scales, the implementation of essential care bundles, and early rehabilitation. Simultaneously, 27 clinical performance indicators were established. Subsequently, 217 healthcare professionals participated in the regional workshops. Finally, 43 experts took part in the validation phase, achieving consensus on all recommendations in a single round.</div></div><div><h3>Conclusions</h3><div>The ActúA project provides a comprehensive framework for standardising ICH management in Spain, based on the available evidence and the consensus of a multidisciplinary panel. The coordinated implementation of these recommendations has the potential to contribute to more consistent and structured care, laying the groundwork for the development of a future national “code ICH.”</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 502041"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038688","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":"Spanish expert consensus statement on the use of inhaled levodopa for the treatment of fluctuations in Parkinson’s disease","authors":"J. Pagonabarraga,&nbsp;M. Blázquez-Estrada,&nbsp;E. Freire-Álvarez,&nbsp;L. López-Manzanares,&nbsp;N. López-Ariztegui,&nbsp;Á. Sánchez-Ferro,&nbsp;D. Santos-García","doi":"10.1016/j.nrleng.2026.502040","DOIUrl":"10.1016/j.nrleng.2026.502040","url":null,"abstract":"<div><h3>Introduction</h3><div>The majority of Parkinson’s disease (PD) patients undergoing treatment with levodopa (LD) —the first-line therapy for motor manifestations in PD— experience OFF episodes, characterized by symptom exacerbation. Inhaled LD is an on-demand therapy aimed at managing OFF episodes.</div></div><div><h3>Methods</h3><div>A scientific committee comprising six PD experts developed statements regarding inhaled LD based on evidence and their clinical practice experience. Using a two-round Delphi study, these statements were evaluated on a Likert scale ranging from 1 (completely disagree) to 9 (completely agree) by a panel of Spanish neurologists specialising in the management of PD patients. Consensus was considered achieved if ≥ 66.67% of responses fell within the same tertile as the median response for each statement ([1–3] disagreement, [4–6] neutral, [7–9] agreement).</div></div><div><h3>Results</h3><div>Forty-four statements across six thematic areas were developed. A total of 48 experts were invited to participate in the Delphi study, with participation rates of 91.7% in the first round and 83.3% in the second. After two rounds, consensus was reached in agreement on 40 out of 44 statements (91%). There was a high degree of expert consensus on the utility of inhaled LD for the rapid and reliable on-demand treatment of both motor and non-motor fluctuations in PD patients.</div></div><div><h3>Conclusions</h3><div>Inhaled LD was deemed a useful, effective, and safe on-demand treatment for OFF episodes in PD.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 502040"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458213","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}