Neurologia最新文献

{"title":"Euthanasia: neurological diseases predominate in Spain, oncological diseases in the rest of the world","authors":"J.M. Trejo-Gabriel-Galan","doi":"10.1016/j.nrleng.2026.501947","DOIUrl":"10.1016/j.nrleng.2026.501947","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 501947"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019692","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":"Long-lasting autonomic symptoms with hemicranias (LASH) syndrome, an uncommon headache","authors":"J.L. Camacho-Velasquez, B.C. Lobo-Minuve, J.A. Garcia-Alhama","doi":"10.1016/j.nrleng.2026.501949","DOIUrl":"10.1016/j.nrleng.2026.501949","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 501949"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038718","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":"The transition of patients with neuromuscular diseases: recommendations of the Spanish Society of Pediatric Neurology and the Spanish Society of Neurology. Endorsed by SENEP, SEN, and ASEM","authors":"M. Álvarez-Molinero,&nbsp;J. Sotoca,&nbsp;L. Carrera-García,&nbsp;J. Alonso-Pérez,&nbsp;I. Martí-Carrera,&nbsp;I. Pitarch-Castellano,&nbsp;F. Munell,&nbsp;G. Morís,&nbsp;A. Camacho-Salas","doi":"10.1016/j.nrleng.2026.502036","DOIUrl":"10.1016/j.nrleng.2026.502036","url":null,"abstract":"<div><h3>Introduction</h3><div>The increased survival of adolescent patients with neuromuscular disease (NMD) entails the transition of these patients to adult healthcare. The process of care transition seeks to guarantee the continuity of healthcare, although it is not always well planned. This consensus statement aims to provide a conceptual framework for the care transition of young patients with NMD.</div></div><div><h3>Methods</h3><div>A review of the literature on the subject was performed by NMD experts from the Spanish Society of Paediatric Neurology and the Spanish Society of Neurology, and a final consensus statement was drafted.</div></div><div><h3>Results</h3><div>The care transition of patients with NMD requires a multidisciplinary team including paediatric and adult care professionals from the different specialties involved, as well as central services and social workers. Paediatric and adult neurologists are the main physicians responsible for the patients, but a case manager is needed to coordinate the process and liaise with patients. Care transition should begin at the age of 12-14 years and involves 3 stages: preparation of the patient (including psychosocial considerations), transfer (when the patient is medically stable and prepared for the process), and integration (with post-transfer follow-up). The process should be evaluated using specific scales and questionnaires for patients and healthcare professionals.</div></div><div><h3>Conclusions</h3><div>Care transition is a complex process requiring proper planning and coordination between professionals to improve health outcomes and avoid losses to follow-up. Its effective implementation requires institutional backing.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 502036"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059137","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":"Impaired venous drainage and cerebral perfusion abnormalities in Sturge-Weber syndrome type III presenting in late adulthood","authors":"I. García Díaz,&nbsp;E. Ortegón Aguilar,&nbsp;R. Díaz Manga,&nbsp;A. Rodríguez Reguera","doi":"10.1016/j.nrleng.2026.502009","DOIUrl":"10.1016/j.nrleng.2026.502009","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 7","pages":"Article 502009"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059162","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":"Retrospective study with long-term clinical follow-up of a cohort of patients with benign epileptiform variants on EEG.","authors":"R A Saiz-Díaz, S Bellido-Cuéllar, J González de la Aleja-Tejera, D A Pérez-Martínez","doi":"10.1016/j.nrleng.2026.502140","DOIUrl":"10.1016/j.nrleng.2026.502140","url":null,"abstract":"<p><strong>Introduction: </strong>Benign epileptiform variants (BEVs) are uncommon epileptiform-like EEG graphoelements that do not meet diagnostic criteria for epileptiform or pathological discharges. The clinical significance of some subtypes remains uncertain.</p><p><strong>Methods: </strong>We conducted a single-centre, retrospective, observational study of 57 408 EEG recordings from 32 349 patients who were followed up for more than one year. We determined the prevalence of each BEV and compared the presence of epilepsy at baseline and at the end of follow-up.</p><p><strong>Results: </strong>BEVs were identified in 192 patients (287 EEG recordings), yielding a prevalence of 0.58% in the total cohort and 1.26% among patients with otherwise normal EEG recordings (n = 15 172). Diagnosis of epilepsy was presentedin 39% of patients with BEVs at baseline and 35% of patients with BEVs after a mean follow-up of 7.4 years. In subtype-based analyses, the 6-Hz spike-and-wave bursts subtype was significantly associated with a higher prevalence of epilepsy at baseline (OR: 12.3; 95% CI, 1.47-103.2; P =  .021), and the small sharp spikes variant was associated with a higher prevalence of focal epilepsy at the end of follow-up (OR: 3.05; 95% CI, 1.43-6.50; P = .004), as compared to other BEVs. In contrast, wicket spikes were associated with a lower presence of epilepsy (OR: 0.31; 95% CI, 0.13-0.72; P =  .007) than other BEVs.</p><p><strong>Conclusions: </strong>BEVs are infrequent, heterogeneous EEG findings. Correct recognition, particularly of wicket spikes, may prevent overdiagnosis and unnecessary treatment. Overall, they lack pathological significance, although 6-Hz spike-and-wave bursts and small sharp spikes showed a stronger association with epilepsy and may be considered variants of uncertain significance warranting clinical follow-up.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"502140"},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726945","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":"Real-life effectiveness, tolerability, and safety of atogepant: a prospective, observational, multicentre study by the Headache Study Group in Castile-La Mancha.","authors":"Marcos Calvo Alzola, José Antonio Garrido Robres, Enrique Francisco Cano Vargas-Machuca, Ana Ávila Fernández, Alberto Andrés López, María Payá Montes, Ramón Ernesto Ibáñez Alonso, José Manuel Flores Barragán, Noelia Sánchez Cano, Alberto José Castellano Vicente, Santiago Navarro Muñoz","doi":"10.1016/j.nrleng.2026.502139","DOIUrl":"10.1016/j.nrleng.2026.502139","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is the most frequent reason for neurology consultation and has a significant impact on patients at the professional, social, and financial level. In the past year, atogepant, an oral drug targeting the calcitonin gene-related peptide (CGRP) receptor, has been approved in Spain, and clinical trials have shown that it is a promising option for the treatment of both episodic and chronic migraine.</p><p><strong>Methods: </strong>We present a prospective, multicentre, observational study of 136 patients with drug-resistant migraine, recruited from seven hospitals in Castile-La Mancha. Our aim was to compare the efficacy of atogepant 60 mg reported in clinical trials with our real-world experience. Data on demographic characteristics, diagnosis, number of monthly migraine days, impact scale scores, adverse reactions, and patient outcomes after 3 months of treatment were gathered and analysed.</p><p><strong>Results: </strong>Forty percent of patients experienced a ≥ 50% reduction in monthly migraine days compared to baseline. An overall net reduction of -5.7 monthly migraine days was observed. Adverse reactions were reported by 41.9% of patients; and treatment was discontinued due to intolerance before the end of the treatment period in 11.7% of patients.</p><p><strong>Conclusion: </strong>Our findings confirm the effectiveness and safety of atogepant reported in clinical trials, although tolerability is poorer, which could compromise treatment adherence in clinical practice.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"502139"},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633274","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":"Response to “Dysautonomia after COVID-19 infection: A case report”: The pathophysiology of COVID-19-related posterior reversible encephalopathy syndrome revisited","authors":"M. León-Ruiz,&nbsp;C. Castañeda-Cabrero,&nbsp;J. Benito-León","doi":"10.1016/j.nrleng.2026.5019440","DOIUrl":"10.1016/j.nrleng.2026.5019440","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 5019440"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427781","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":"Clinical determinants of decision-making for extended-window intravenous thrombolysis","authors":"I. Schonewille,&nbsp;J. Juega,&nbsp;M. Iza,&nbsp;M. Ribo,&nbsp;C. Molina,&nbsp;R. Simonetti,&nbsp;F. Rizzo,&nbsp;M. Olive,&nbsp;N. Rodríguez-Villatoro,&nbsp;D. Rodriguez,&nbsp;M. Rodrigo,&nbsp;A. Nevado,&nbsp;A. Garcia-Tornel,&nbsp;M.A. Muchada,&nbsp;J. Pagola,&nbsp;M. Rubiera","doi":"10.1016/j.nrleng.2026.502013","DOIUrl":"10.1016/j.nrleng.2026.502013","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent trials promote extending intravenous thrombolysis (IVT) window for acute ischemic stroke (AIS) beyond 4.5<!--> <!-->h in selected patients. We aimed to evaluate the extended-window (EWIVT) decision-making and outcomes in routine clinical practice.</div></div><div><h3>Methods</h3><div>Retrospective analysis of a prospective uni-center mandatory stroke registry. AIS patients presenting within 4.5–9<!--> <!-->h from symptoms or wake-up strokes with mismatch on computed tomography perfusion (CTP) and/or intracranial occlusion without indication for thrombectomy were selected. We studied factors related to EWIVT treatment decision and compared efficacy (24<!--> <!-->h clinical improvement, 3-months modified Rankin Scale) and safety outcomes (symptomatic intracranial hemorrhage (SICH)).</div></div><div><h3>Results</h3><div>We included 79 patients (51.9% male, mean age 72.2y). Fifty-four (68.4%) had intracranial occlusion and 25(31.6%) CTP-mismatch. Twenty-two patients (27.8%) received EWIVT. EWIVT patients had similar baseline severity [NIHSS 4.5 (2.0–6.0) vs. 4.0 (2.0–6.5); <em>p</em> <!-->=<!--> <!-->0.596], higher ASPECTS [10.0 (10.0–10.0) vs. 10.0 (9.0–10.0); <em>p</em> <!-->=<!--> <!-->0.010] and more often presented with aphasia (63.6% vs. 24.6%; <em>p</em> <!-->=<!--> <!-->0.001). An adjusted logistic regression analysis showed that main predictors of EWIVT were higher ASPECTS and left hemisphere stroke. Clinical improvement at 24<!--> <!-->h was more frequent in the EWIVT group (77.3% vs. 36.8%; aOR 5.02 [95%CI 1.33–18.90]; <em>p</em> <!-->=<!--> <!-->0.017) and no patient experienced SICH, but a non-significant better functional outcome was found in the control group (aOR 0.19 [95% CI 0.03–1.19]; <em>p</em> <!-->=<!--> <!-->0.076).</div></div><div><h3>Conclusions</h3><div>Patients with a left hemisphere stroke and/or higher ASPECTS were more likely to be treated with EWIVT. EWIVT was safe and induced early clinical improvement, but did not lead to better functional outcome at 3 months.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502013"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427731","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":"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,&nbsp;A. Ponz,&nbsp;E. López-Cancio Martinez,&nbsp;M. Rubiera,&nbsp;M. Alonso de Leciñana,&nbsp;O. Ayo,&nbsp;M. Castellanos,&nbsp;J.C. López Fernández,&nbsp;J. Marta-Moreno,&nbsp;A.M. Morales,&nbsp;J.M. Ramirez-Moreno,&nbsp;S. Tur,&nbsp;Á. Ximénez-Carrillo,&nbsp;M. Freijo Guerrero","doi":"10.1016/j.nrleng.2026.502014","DOIUrl":"10.1016/j.nrleng.2026.502014","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Development</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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 &lt; 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.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502014"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world healthcare resource utilisation for migraine: Analysis of an administrative database in Colombia","authors":"F. Sobrino,&nbsp;M. Zorro,&nbsp;M.T. Bedoya,&nbsp;M.L. Ramos","doi":"10.1016/j.nrleng.2026.502008","DOIUrl":"10.1016/j.nrleng.2026.502008","url":null,"abstract":"<div><h3>Introduction</h3><div>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 quality of life highlight the need for research on its epidemiology and management, especially in specific contexts such as Colombia, where information on the subject is scarce.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 the neurology department 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 $110 PPP in 2017 to a minimum of $39 PPP in 2019. The annual pharmacy cost per patient also dropped from $115 PPP in 2017 to $64 PPP in 2019.</div></div><div><h3>Conclusions</h3><div>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 optimised management of migraine.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 6","pages":"Article 502008"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}