Neurologia最新文献

{"title":"Evaluation of the effect of botulinum toxin A on the physical and mental health of patients with hemifacial spasm","authors":"J.S. Wei ,&nbsp;X. Hu ,&nbsp;L. Xia ,&nbsp;J. Shang ,&nbsp;Q. Han ,&nbsp;D.Y. Zhang","doi":"10.1016/j.nrleng.2024.07.001","DOIUrl":"10.1016/j.nrleng.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Hemifacial spasm (HFS) is a debilitating disease characterized by involuntary tonic and clonic contractions of muscles innervated by the facial nerve. Botulinum toxin A (BTX-A) is the first-line option and the most effective medical treatment for HFS. The objective of this study was to evaluate the effect of BTX-A therapy on the physical and mental health of HFS patients.</p></div><div><h3>Methods</h3><p>Participants included 65 HFS patients and 65 matched healthy controls in the study. Cornell Medical Index (CMI) self-assessment questionnaire was used to detect the psychological health of all participants. Local injection of BTX-A was applied, and the Cohen hierarchical criteria were employed to stratify the degree of spasticity, further evaluating the efficacy of BTX-A before and two months after treatment in HFS patients. The HFS patients at two months post-treatment were re-evaluated by CMI self-assessment questionnaire, and the evaluated factors of these patients were compared with those of patients before treatment.</p></div><div><h3>Results</h3><p>The scores of somatization, depression, anxiety, inadaptation, sensitivity, anger, tension, M-R, and total scores in the HFS group were significantly higher than those in the control group (all <em>P</em> <!-->&lt;<!--> <!-->0.05). Two months post-treatment, among 65 HFS patients who received with BTX-A treatment, 42 (64.6%) were completely relieved, 16 (24.6%) were significantly relieved, 7 (10.8%) were partially relieved, and 0 (0%) cases were invalid, and the total effective rate was 89.2%. Two months after BTX-A treatment, the scores of somatization, tension, anxiety, depression, sensitivity, M-R and total scores of patients with HFS were lower than those before treatment (all <em>P</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>Patients with HFS are often accompanied by somatization, anger, inadaptation, sensitivity, anxiety, depression, and tension. BTX-A can not only alleviate the symptoms of HFS, but also improve the somatization, tension, anxiety, depression, and sensitivity.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 540-548"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000646/pdfft?md5=0d13553a982be0b013d25e78ac129a2a&pid=1-s2.0-S2173580824000646-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122409","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":"Thrombectomy with embed aspiration in acute ischaemic stroke","authors":"","doi":"10.1016/j.nrleng.2021.09.013","DOIUrl":"10.1016/j.nrleng.2021.09.013","url":null,"abstract":"<div><h3>Background</h3><p>In addition to stent retrievers, direct aspiration has become a reasonable thrombectomy strategy.</p></div><div><h3>Objectives</h3><p>We carried out the thrombectomy by guiding the aspiration catheter fully over the clot and performing immediate manual aspiration; we call this procedure “embed aspiration”.</p></div><div><h3>Methods</h3><p>In this prospective, non-randomised, single-centre study, we included all patients treated at a high volume-of-care stroke centre between 2017 and 2018 for the TRIANA (Thrombectomy in Andalusia using Aspiration) registry. Thrombectomy was carried out by embed aspiration. Patients were classified according to the success (eTICI 2b67-2c-3) or failure (eTICI 0-1-2a-2b50) of the procedure. Baseline clinical data and outcomes were compared, and multivariate analysis was performed.</p></div><div><h3>Results</h3><p>The embed aspiration technique was used in 370 patients. Treatment was successful in 90.3% of patients. Mean puncture-to-recanalisation time was 25 minutes. The overall rate of good outcomes (mRS 0–2) at 3 months was 64%.</p></div><div><h3>Conclusions</h3><p>This study supports real-life evidence that standardised embed aspiration may be an alternative to stent retrievers for thrombectomy.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 530-539"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580823000305/pdfft?md5=ad451f1d606be9bf1e0df6fba02f6e51&pid=1-s2.0-S2173580823000305-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9428822","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":"Assessment of the diagnostic utility of the electroencephalogram in pediatric emergencies.","authors":"M J Abenza Abildúa, T Olmedo Menchen, A Pérez Villena, S Ruhland Paulete, F José Navacerrad, Barrero, J de Ojeda Ruíz de Luna, C Algarra Lucas, G Cordero Martín, S Martínez Ubierna, C Jimeno Montero, I J Navarro López, E Suárez Gisbert, Á Gómez de la Riva, C Pérez López, M L Herreros Fernández","doi":"10.1016/j.nrleng.2024.08.001","DOIUrl":"10.1016/j.nrleng.2024.08.001","url":null,"abstract":"<p><strong>Introduction: </strong>We analyze the diagnostic utility of urgent EEG (electroencephalogram) performed in children under 16 years of age in our center.</p><p><strong>Material and methods: </strong>Descriptive, retrospective, observational study of consecutive patients from 0 to 16 years of age, who underwent an urgent EEG for any reason, from January to December 2022.</p><p><strong>Results: </strong>Of the 388 patients, 70 were children: 37 (52.85%) women, and 33 (47.14%) men. Average age: 6.27 ± 4.809. Of the 70 patients, 6 (8.57%) had previous epilepsy. Reasons for consultation: 17 febrile seizures, 10 first focal seizures, 10 first TCG seizures, 6 paroxysmal episodes, 6 absences, 3 myoclonus of extremities, 3 syncope, 2 SE, 2 visual alterations, 2 low level of consciousness, 2 cyanosis, 2 suspected meningitis or encephalitis, 1 choking, 1 atypical headache, 1 chorea, 1 presyncope, 1 language delay. Of the 70 patients, 47 had a normal EEG (67.14%). Of the 47 patients with a normal EEG, 10 were diagnosed with epilepsy, and 3 of them began receiving antiepileptic treatment upon discharge. None of the patients with suspected syncope or paroxysmal disorder (17 patients, 24.28%) had EEG abnormalities. Of the 17 patients with atypical febrile seizures, 3 had EEG abnormalities.</p><p><strong>Conclusions: </strong>A third of the EEG records performed in the Emergency Department showed alterations, probably due to the time taken. Almost half of the patients with suspected epilepsy or EE showed EEG abnormalities, which confirmed the diagnosis in these cases and encouraged the clinician to start drug treatment. No case with a high suspicion of epilepsy was dismissed due to the normality of the EEG recording in our series. No patient diagnosed with syncope or paroxysmal disorder had EEG abnormalities. Nearly a quarter of patients with atypical febrile seizures showed EEG abnormalities. We barely register cases of status epilepticus, probably due to the degree of complexity of our center.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914888","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":"Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke","authors":"J.A. García-Carmona ,&nbsp;E. Conesa-García ,&nbsp;D. Vidal-Mena ,&nbsp;M. González-Morales ,&nbsp;V. Ramos-Arenas ,&nbsp;C. Sánchez-Vizcaíno-Buendía ,&nbsp;J.J. Soria-Torrecillas ,&nbsp;J.A. Pérez-Vicente ,&nbsp;L. García-de-Guadiana-Romualdo","doi":"10.1016/j.nrleng.2021.09.016","DOIUrl":"https://doi.org/10.1016/j.nrleng.2021.09.016","url":null,"abstract":"<div><h3>Background</h3><p>Despite comprehensive study, the aetiology of stroke is not identified in 35% of cases.</p></div><div><h3>Aims</h3><p>We conducted a study to assess the diagnostic capacity of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the identification of ischaemic stroke of cardioembolic origin. The secondary purpose of the study was to evaluate the prognostic value of NT-proBNP for predicting 90-day all-cause mortality.</p></div><div><h3>Methods</h3><p>We designed a prospective observational study including patients hospitalised due to stroke between March 2019 and March 2020. Blood samples were collected on admission to the emergency department and serum NT-proBNP levels were determined. Statistical analysis was performed using a bivariate logistic regression model and receiver operating characteristic (ROC) and Kaplan–Meier curves. Statistical significance was established at <em>p</em> <!-->&lt;<!--> <!-->.05.</p></div><div><h3>Results</h3><p>The study included 207 patients with first ischaemic stroke. Plasma NT-proBNP levels were significantly higher (<em>p</em> <!-->&lt;<!--> <!-->.001) in the cardioembolic stroke group (2069<!--> <!-->pg/mL<!--> <!-->±<!--> <!-->488.5). ROC curves showed that NT-proBNP<!--> <!-->&gt;<!--> <!-->499<!--> <!-->pg/mL was the optimum value for diagnosing cardioembolic ischaemic stroke (sensitivity, 82%; specificity, 80%). Moreover, plasma NT-proBNP levels<!--> <!-->&gt;<!--> <!-->499<!--> <!-->pg/mL were independently associated with cardioembolic stroke (OR: 9.881; <em>p</em> <!-->=<!--> <!-->.001). Finally, NT-proBNP<!--> <!-->&gt;<!--> <!-->1500<!--> <!-->pg/mL was useful for predicting 90-day mortality (sensitivity, 70%; specificity, 93%).</p></div><div><h3>Conclusions</h3><p>NT-proBNP was independently associated with cardioembolic stroke and should be quantified in blood tests within 24<!--> <!-->h of stroke onset. High plasma levels (&gt;499<!--> <!-->pg/mL) may indicate an underlying cardioembolic cause, which should be further studied, while NT-proBNP &gt;1500<!--> <!-->pg/mL was associated with increased 90-day mortality.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 6","pages":"Pages 496-504"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000555/pdfft?md5=b9e6b899acf116ede9a390a6a10471f0&pid=1-s2.0-S2173580824000555-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424122","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":"Preliminary outcomes of endovascular treatment of moyamoya disease","authors":"Xin-Yu Li ,&nbsp;Yang-Yang Tian ,&nbsp;Cong-Hui Li,&nbsp;Ji-Wei Wang,&nbsp;Hui Li,&nbsp;Jian-Feng Liu,&nbsp;Bu-Lang Gao","doi":"10.1016/j.nrleng.2021.10.011","DOIUrl":"https://doi.org/10.1016/j.nrleng.2021.10.011","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aimed to investigate the effectiveness and safety of endovascular revascularisation of intracranial artery occlusion and stenosis in moyamoya disease using stent angioplasty.</p></div><div><h3>Materials and methods</h3><p>We recruited 12 patients (8 women and 4 men) with occlusion and stenosis of intracranial arteries in the context of moyamoya disease who underwent endovascular stent angioplasty. Clinical data, baseline conditions, lesion location, treatment outcomes, periprocedural complications, and follow-up outcomes were analysed.</p></div><div><h3>Results</h3><p>The occlusion was located at the M1 segment of the middle cerebral artery in 8 patients, at both the M1 and A2 segments in one patient, and at the C7 segment of the internal carotid artery in 3. Thirteen stents were deployed at the occlusion site, including the low-profile visualized intraluminal support (LVIS) device in 8 patients, an LVIS device and a Solitaire AB stent in one, and a Leo stent in 3, with a success rate of 100% and no intraprocedural complications. Plain CT imaging after stenting revealed leakage of contrast agent, which disappeared on the second day, resulting in no clinical symptoms or neurological sequelae. Follow-up angiography studies were performed in all patients for 6–12 months (mean, 8.8). Slight asymptomatic in-stent stenosis was observed in 2 patients (16.7%), and no neurological deficits were observed in the other patients. All preoperative ischaemic symptoms completely disappeared at follow-up.</p></div><div><h3>Conclusion</h3><p>Stent angioplasty is a safe and effective treatment for occlusion and stenosis of intracranial arteries in moyamoya disease.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 6","pages":"Pages 449-456"},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000543/pdfft?md5=5c8241e362f291f236369466a71768b7&pid=1-s2.0-S2173580824000543-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424193","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":"Mild sensory symptoms during SARS-CoV-2 infection among healthcare professionals","authors":"D. Gayoso Cantero ,&nbsp;E. Cantador Pavón ,&nbsp;E. Pérez Fernández ,&nbsp;M.E. Novillo López","doi":"10.1016/j.nrleng.2021.06.007","DOIUrl":"10.1016/j.nrleng.2021.06.007","url":null,"abstract":"<div><h3>Introduction</h3><p>It is not yet possible to estimate the proportion of patients with COVID-19 who present distinguishable classical neurological symptoms and syndromes.</p><p>The objective of this study is to estimate the incidence of sensory symptoms (hypoaesthesia, paraesthesia, and hyperalgesia) in physicians who have presented the disease at Hospital Universitario Fundación Alcorcón (HUFA) in Madrid; to establish the relationship between sensory symptoms and the presence of other signs of infection; and to study their association with the severity of COVID-19.</p></div><div><h3>Methods</h3><p>We conducted a descriptive, cross-sectional, retrospective, observational study. HUFA physicians who presented SARS-CoV-2 infection between 1 March and 25 July 2020 were included in the study. A voluntary, anonymous survey was distributed via corporate email. Sociodemographic and clinical characteristics were collected from professionals with PCR- or serology-confirmed COVID-19.</p></div><div><h3>Results</h3><p>The survey was sent to 801 physicians and we received 89 responses. The mean age of respondents was 38.28 years. A total of 17.98% presented sensory symptoms. A significant relationship was found between the presence of paraesthesia and cough, fever, myalgia, asthaenia, and dyspnoea. A significant relationship was also found between paraesthesia and the need for treatment and admission due to COVID-19. Sensory symptoms were present from the fifth day of illness in 87.4% of cases.</p></div><div><h3>Conclusions</h3><p>SARS-CoV-2 infection can be associated with sensory symptoms, mostly in severe cases. Sensory symptoms often appear after a time interval, and may be caused by a parainfectious syndrome with an autoimmunity background.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 392-398"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10133882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9448445","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":"Early beginning of alemtuzumab: Changing the multiple sclerosis treatment paradigm. Interim analysis of the LEMVIDA study","authors":"J.E. Meca-Lallana ,&nbsp;J.C. Álvarez-Cermeño ,&nbsp;B. Casanova Estruch ,&nbsp;G. Izquierdo Ayuso ,&nbsp;R. Ortiz Castillo ,&nbsp;A. Rodríguez-Antigüedad ,&nbsp;C. Calles Hernández ,&nbsp;en nombre del Grupo de Estudio LEMVIDA","doi":"10.1016/j.nrleng.2021.06.006","DOIUrl":"10.1016/j.nrleng.2021.06.006","url":null,"abstract":"<div><h3>Introduction</h3><p>LEMVIDA is a real-world prospective study of 3-year follow-up on quality of life of patients with multiple sclerosis (MS) receiving alemtuzumab in Spain.</p></div><div><h3>Methods</h3><p>This is an interim analysis evaluating the baseline characteristics of patients who started alemtuzumab between October 2016-September 2018. For 3 additional subanalysis patients were categorised by baseline EDSS score; time of alemtuzumab initiation during the recruitment period (cohort 1: October 2016-March 2017, cohort 2: April-September 2017, cohort 3: October 2017-March 2018 and cohort 4: April-September 2018); and the presence of highly active MS criteria.</p></div><div><h3>Results</h3><p>161 patients were analysed: 67.1% female, age 38.7 ± 9.4 years, MS duration 8.5 ± 6.0 years, EDSS 3.3 ± 1.7 and number of relapses in the previous 2 years 1.8 ± 1.3. 48.3% of patients presented gadolinium-enhanced (Gd+) lesions (mean: 5.2 ± 6.9) and 63.1% had received prior treatment with fingolimod or natalizumab. Baseline EDSS scores and number of Gd+ lesions were higher in cohort 1 than in cohort 4 (4.1 ± 1.8 vs 3.2 ± 1.7; <em>P</em> = .040 and 10.9 ± 11.9 vs 4.5 ± 5.7; <em>P</em> = .020). The frequency of prior treatment with fingolimod and natalizumab was lower in cohort 4 (60.6%) than in cohort 1 (70.6%) (comparison between groups not analysed).</p></div><div><h3>Conclusions</h3><p>Unlike phase 3 studies of alemtuzumab, the patients included in LEMVIDA are older, have a longer duration of MS, higher disability and have received previous immunosuppressants. However, throughout the recruitment period, there is a tendency towards an early beginning of treatment with alemtuzumab, probably due to the evidence of higher effectiveness in the early stages of MS.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 383-391"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580823000159/pdfft?md5=9eb8f8b2e15a6b14c27cd11122c053a6&pid=1-s2.0-S2173580823000159-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827636","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":"Palliative care management in patients with Parkinson’s disease and other movement disorders in Spain. National survey of neurologists","authors":"M. Álvarez Saúco ,&nbsp;R. García- Ramos ,&nbsp;I. Legarda Ramírez ,&nbsp;F. Carrillo García ,&nbsp;J. Fernández Bueno ,&nbsp;S. Martí Martínez ,&nbsp;B. González García ,&nbsp;A. Moya-Martínez ,&nbsp;D. Santos-García","doi":"10.1016/j.nrleng.2021.09.010","DOIUrl":"10.1016/j.nrleng.2021.09.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Palliative care in neurodegenerative diseases is useful but underused. The objective of this study is to know how palliative care (PC) is applied in Spain in order to identify limitations and unmet needs.</p></div><div><h3>Materials and Methods</h3><p>It is a descriptive, observational, cross-sectional study, anonymous survey type of 20 questions, directed and answered by neurologists dedicated to movement disorders (MD) in Spain.</p></div><div><h3>Results</h3><p>58 responses were obtained from neurologists from 15 autonomous communities. 69% answered that they did not have a specialised MD nursing facility but did have a PC team in their centre (81%). No specific protocol for PC in MD was identified. All except one neurologist stated that they lacked sufficient training in PC, the main training need being the “advance directives explanation”. Only 1 in 4 neurologists answered routinely explaining advance healthcare planning to their patients, recognising up to 84.5% of neurologists not knowing how to assess the patient's competence. 60.3% of those surveyed answered that between 10% and 30% of their patients would be candidates for PC, although 1 in 3 said they were not clear when to refer the patient to PC. 100% of neurologists affirmed the priority need to implement PC protocols in MD.</p></div><div><h3>Conclusions</h3><p>Our study shows a formative deficit in PC in this area and in the care of the patient with movement disorders and their environment, and should serve as a starting point to develop consensual care protocols.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 417-425"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580823000196/pdfft?md5=240da4889cf7f6b3d436aa774fdb4e9b&pid=1-s2.0-S2173580823000196-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9423593","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":"3-Acetylpyridine-induced ataxic-like motor impairments are associated with plastic changes in the Purkinje cells of the rat cerebellum","authors":"D. González-Tapia ,&nbsp;N. Vázquez-Hernández ,&nbsp;F. Urmeneta-Ortiz ,&nbsp;N. Navidad-Hernandez ,&nbsp;M. Lazo-Yepez ,&nbsp;A. Tejeda-Martínez ,&nbsp;M. Flores-Soto ,&nbsp;I. González-Burgos","doi":"10.1016/j.nrleng.2021.09.015","DOIUrl":"10.1016/j.nrleng.2021.09.015","url":null,"abstract":"<div><p>Ataxias are characterized by aberrant movement patterns closely related to cerebellar dysfunction. Purkinje cell axons are the sole outputs from the cerebellar cortex, and dysfunctional activity of Purkinje cells has been associated with ataxic movements. However, the synaptic characteristics of Purkinje cells in cases of ataxia are not yet well understood. The nicotinamide antagonist 3-acethylpyridine (3-AP) selectively destroys inferior olivary nucleus neurons so it is widely used to induce cerebellar ataxia. Five days after 3-AP treatment (65<!--> <!-->mg/kg) in adult male Sprague-Dawley rats, motor incoordination was revealed through BBB and Rotarod testing. In addition, in Purkinje cells from lobules V–VII of the cerebellar vermis studied by the Golgi method, the density of dendritic spines decreased, especially the thin and mushroom types. Western blot analysis showed a decrease in AMPA and PSD-95 content with an increase of the α-catenin protein, while GAD-67 and synaptophysin were unchanged. Findings suggest a limited capacity of Purkinje cells to acquire and consolidate afferent excitatory inputs and an aberrant, rigid profile in the movement-related output patterns of Purkinje neurons that likely contributes to the motor-related impairments characteristic of cerebellar ataxias.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 408-416"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000518/pdfft?md5=17232e625cc91411acb2acead865a7e9&pid=1-s2.0-S2173580824000518-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237000","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":"Status epilepticus—Therapeutic management at the pediatric emergency department","authors":"I. Pais-Cunha ,&nbsp;D. Valente ,&nbsp;D.B. Abreu ,&nbsp;J. Fonseca ,&nbsp;C. Melo ,&nbsp;M. Sampaio ,&nbsp;L.A. Santos ,&nbsp;R. Sousa","doi":"10.1016/j.nrleng.2021.09.014","DOIUrl":"10.1016/j.nrleng.2021.09.014","url":null,"abstract":"<div><h3>Introduction</h3><p>Status epilepticus is an important cause of pediatric neurological emergency. Immediate treatment is essential to prevent definitive neurological damage. Several antiepileptic drugs are available for the management of status epilepticus.</p></div><div><h3>Methods</h3><p>Retrospective study of patients admitted at the emergency department of a tertiary hospital for 5 years (2014–2019). We analyzed the compliance to the treatment guidelines for pediatric status epilepticus.</p></div><div><h3>Results</h3><p>One hundred and seventeen admissions were identified, 23.9% of these were febrile status epilepticus. Among the other cases, the most frequent cause was genetic (22.2%). The majority were convulsive status epilepticus (93.1%), 58.7% of which were generalized tonic–clonic seizures. Benzodiazepines were the most used first and second line drug (98.2% and 94.8%). The most frequent third drug used was diazepam (56.4%) followed by phenytoin (18.2%). An infra-therapeutic antiepileptic drug dose was given in 48.7% of cases. 49.6% presented with a prolonged status epilepticus and 6.8% needed intensive care. Incorrect sequence of drugs and infra-therapeutic doses were associated with prolonged status (<em>p</em> <!-->&lt;<!--> <!-->0.001 and <em>p</em> <!-->&lt;<!--> <!-->0.05) and an increased number of antiepileptic drugs used (<em>p</em> <!-->&lt;<!--> <!-->0.001 and <em>p</em> <!-->&lt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>Benzodiazepines were the most frequently first and second line drugs used for status epilepticus management. Surprisingly, the most frequently third line drugs used were also benzodiazepines. These findings were partially explained by the misuse of infra-therapeutic doses of these drugs. Noncompliance with the implemented guidelines was associated with unfavorable outcomes.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 5","pages":"Pages 426-431"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000506/pdfft?md5=acdf5e1cad1439da9380b7ce94341855&pid=1-s2.0-S2173580824000506-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237647","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}