Journal of the Neurological Sciences最新文献

英文中文

Letter to the Editor: Persistence of pulsatile tinnitus in patients with idiopathic intracranial hypertension following resolution of papilledema. 致编辑的信：特发性颅内高压患者在乳头水肿消退后仍有搏动性耳鸣。

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-30 DOI: 10.1016/j.jns.2026.125774

Felix Tyndel, Anuj Rastogi, Arun N E Sundaram, John A Rutka

A 3D model using computational fluid dynamics may explain the mechanism by which pulsatile tinnitus in idiopathic intracranial hypertension occurs and persists even after successful treatment of the idiopathic intracranial hypertension.

使用计算流体动力学的3D模型可以解释特发性颅内高压患者搏动性耳鸣发生的机制，甚至在特发性颅内高压成功治疗后仍持续存在。

引用次数: 0

Considerations on comorbidity, chronic intravenous immunoglobulins, and methodological clarifications on ZILU25 study. ZILU25研究的合并症、慢性静脉注射免疫球蛋白及方法学澄清。

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-30 DOI: 10.1016/j.jns.2026.125769

Vincenzo Di Stefano, Nicasio Rini, Claudia Vinciguerra, Rita Frangiamore

引用次数: 0

Opisthotonus: Revisiting a classic movement disorder. 斜拉肌：重温经典运动障碍。

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-29 DOI: 10.1016/j.jns.2026.125782

José Fidel Baizabal-Carvallo, Joseph Jankovic

Opisthotonus is characterized by backward arching of the trunk, associated with retrocollis, caused by involuntary contractions of extensor paraspinal muscles. Classical etiologies include tetanus, strychnine intoxication, dystonia (particularly tardive dystonia and neurodegeneration with brain iron accumulation), seizures, and functional movement disorders (MDs). Inborn errors of metabolism, epileptic encephalopathies and other gene mutations should be considered in newborns and infants presenting with opisthotonus. We surveyed 1216 consecutive patients presenting for evaluation in a tertiary care center for MDs and identified 17 (1.4%) with opisthotonus. Functional opisthotonus represented the most common cause, present in 9 (53%) patients. Other etiologies included tardive dystonia (n = 2), dystonia secondary to cavernous hemangioma in the basal ganglia (n = 1), dystonia due to hypoxic encephalopathy (n = 1), and 4 with idiopathic dystonia. Identifying the underlying etiology of opisthotonus is important to guide therapeutic strategies. Benzodiazepines, baclofen, anticholinergics, and botulinum toxin are common pharmacological options, whereas deep brain stimulation and surgical correction of the underlying cause should be considered in selected cases.

斜拉肌的特点是躯干向后拱起，并伴有脊柱后凸，是由脊柱旁伸肌不自觉收缩引起的。经典病因包括破伤风、士的宁中毒、肌张力障碍（特别是迟发性肌张力障碍和脑铁积累的神经变性）、癫痫发作和功能性运动障碍（MDs）。先天性代谢错误，癫痫性脑病和其他基因突变应考虑在新生儿和婴儿呈现斜拉肌。我们调查了1216名在三级医疗中心接受医学博士评估的连续患者，发现17名（1.4%）患有斜拉肌。功能性斜拉肌是最常见的病因，出现在9例（53%）患者中。其他病因包括迟发性肌张力障碍（n = 2）、基底节区海绵状血管瘤继发的肌张力障碍（n = 1）、缺氧脑病引起的肌张力障碍（n = 1）和特发性肌张力障碍4例。确定内窥镜下的病因对指导治疗策略具有重要意义。苯二氮卓类药物、巴氯芬、抗胆碱能药物和肉毒杆菌毒素是常见的药物选择，而在选定的病例中，应考虑深部脑刺激和手术纠正潜在原因。

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引用次数: 0

Pretreatment physical function as a risk factor for movement and neurocognitive treatment-emergent events (MNTs) in multiple myeloma (MM) patients treated with cilta-cel 预处理身体功能是接受cilta- cell治疗的多发性骨髓瘤（MM）患者运动和神经认知治疗突发事件（mnt）的危险因素

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-26 DOI: 10.1016/j.jns.2026.125771

Megan M. Herr , Nisha M. Nair , Theresa Hahn , Chelsea Peterson , Jens Hillengass , Hillary Jacobson , Grant Schofield , Philip L. McCarthy , Ehsan Malek , Renee McKenzie , Hamza Hassan , Joseph D. Tario Jr , Maureen Ross , Marco L. Davila , Brian C. Betts , Shernan Holtan

引用次数: 0

Futile recanalisation in patients with anterior large vessel occlusion stroke randomised to mechanical thrombectomy 前大血管闭塞性卒中患者的无效再通随机选择机械取栓

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-26 DOI: 10.1016/j.jns.2026.125772

Hannah-Lea Handelsmann , Lisa Herzog , Arnolt-Jan Hoving , Charles Majoie , Wim Van Zwam , Aad Van der Lugt , Susanne Wegener , for the MR CLEAN Investigators

Background

Mechanical thrombectomy (MT) is an effective treatment of large vessel occlusion (LVO) stroke. However, about 50% of patients do not achieve a favourable functional outcome after successful recanalisation by MT, considered as futile recanalisation (FR). We aimed at identifying factors associated with treatment response, vessel recanalisation and clinical outcome in LVO stroke patients randomised to MT and to predict FR to evaluate the effect of single predictors on patient outcome.

Methods

We performed a retrospective analysis of the MR CLEAN trial cohort. Ordinal logistic regression with interaction terms between a treatment indicator and patient factors was used to evaluate response to MT in terms of 3-months modified Rankin scale (mRS). In logistic regression, we identified factors associated with vessel recanalisation and FR. We predicted FR in a five-fold cross validation using least absolute shrinkage and selection operator (LASSO) regression.

Results

195 of the 461 included patients were randomised to receive MT. Male sex (OR 0.41, 95% CI 0.21–0.82, p = 0.01) enhanced the treatment effect of MT. Only onset-to-groin time was associated with a technically successful recanalisation (OR 0.99, 95% CI 0.99–1.00, p = 0.01). Higher age (OR 1.05, 95% CI 1.01–1.09, p = 0.02) and worse collateral score (OR 0.05, 95% CI 0.01–0.19, p < 0.01) were associated with FR. Female sex (OR 0.74) and worse collateral status (OR 0.19) showed the best predictive value for FR.

Conclusions

Different patient factors seem to be relevant for technical success and clinical success of MT in LVO stroke patients.

机械取栓术（MT）是治疗大血管闭塞（LVO）卒中的有效方法。然而，大约50%的患者在MT再通成功后没有达到良好的功能结果，被认为是无效的再通（FR）。我们的目的是确定随机分配到MT的LVO卒中患者的治疗反应、血管再通和临床结果的相关因素，并预测FR以评估单一预测因素对患者结果的影响。方法对MR CLEAN试验队列进行回顾性分析。采用具有治疗指标和患者因素之间相互作用项的有序逻辑回归，以3个月修正Rankin量表（mRS）评估MT的疗效。在逻辑回归中，我们确定了与血管再通和FR相关的因素。我们使用最小绝对收缩和选择算子（LASSO）回归进行了五倍交叉验证，预测了FR。结果461例纳入的患者中有195例被随机分配接受MT治疗。男性（OR 0.41, 95% CI 0.21-0.82, p = 0.01）增强了MT的治疗效果。只有从发作到腹股沟的时间与技术上成功的再通相关（OR 0.99, 95% CI 0.99 - 1.00, p = 0.01）。较高的年龄（OR 1.05, 95% CI 1.01-1.09, p = 0.02）和较差的侧支评分（OR 0.05, 95% CI 0.01 - 0.19, p < 0.01）与FR相关。女性（OR 0.74）和较差的侧支状态（OR 0.19）是FR的最佳预测价值。结论不同的患者因素似乎与左脑卒中患者MT的技术成功和临床成功相关。

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引用次数: 0

Letter to the editor: Early real-life experience on Zilucoplan for generalized myasthenia gravis: ZILU25 multicenter observational study 致编辑的信：Zilucoplan治疗广泛性重症肌无力的早期实际经验：ZILU25多中心观察研究

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-23 DOI: 10.1016/j.jns.2026.125768

Yao Yang , Ye Hu

引用次数: 0

Letter to editor: Early real-life experience on zilucoplan for generalized myasthenia gravis: ZILU25 multicenter observational study. 致编辑：zilucoplan治疗广泛性重症肌无力的早期实际经验：ZILU25多中心观察研究。

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-22 DOI: 10.1016/j.jns.2026.125759

Muhammad Uzair, Ali Momin

引用次数: 0

Authors' reply to comment letter on ZILU25 study 作者对ZILU25研究评论函的回复

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-20 DOI: 10.1016/j.jns.2026.125758

Vincenzo Di Stefano , Claudia Vinciguerra , Michelangelo Maestri Tassoni , Rita Frangiamore

引用次数: 0

Upper limb plexopathy secondary to herpes zoster: A PRISMA-guided systematic case review 继发带状疱疹的上肢神经丛病：一个prisma引导的系统病例回顾

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-20 DOI: 10.1016/j.jns.2026.125767

Francisco Jover-Diaz , Lucia Parra-Muñoz , Mar Trigueros-Rocamora , Elisabet Delgado-Sánchez , Pedro Esteve-Atiénzar , Jorge Peris-García

Objective

To systematically analyze published clinical cases of upper limb plexopathy secondary to herpes zoster (HZ) to clarify epidemiology, clinical features, diagnostic methods, treatments, and outcomes.

Background

Plexopathy caused by HZ is a rare neurological complication predominantly affecting older adults. Despite scattered case reports, knowledge gaps remain regarding its incidence, pathophysiology, management, and prognosis. This review addresses these gaps by synthesizing individual patient data with a rigorous methodology.

Methods

A systematic review adhering to PRISMA-IPD guidelines was conducted by searching PubMed, Scopus, and EMBASE from 2000 to 2025 for case reports and series of HZ-associated upper limb plexopathy published in English, Spanish, or French. Data extracted included demographics, clinical manifestations, electrophysiological and imaging findings, treatments, and outcomes.

Results

Sixty articles describing 123 patients (mean age 69.5 years, balanced sex distribution) met inclusion criteria. Most patients presented with mixed motor and sensory nerve involvement, primarily involving C5-C6 dermatomes. Common comorbidities included diabetes mellitus and immunosuppression. Treatment typically combined antivirals, neuropathic pain management, and rehabilitation. Complete recovery occurred in 47% of cases, partial improvement in most others, while 27% experienced persistent sequelae. Delayed diagnosis, immunosuppression, pure axonal EMG patterns, and age over 70 years were associated with worse outcomes.

Conclusions

This PRISMA-IPD systematic review provides the most comprehensive synthesis to date on HZ-associated brachial plexopathy, emphasizing the importance of early clinical and electrophysiological diagnosis and multimodal treatment. Findings underscore the need for standardized diagnostic protocols and prospective studies to improve patient management and prognosis in this rare but disabling condition.

目的对已发表的带状疱疹（HZ）继发上肢神经丛病的临床病例进行系统分析，以阐明其流行病学、临床特征、诊断方法、治疗方法及预后。背景：HZ引起的神经丛病是一种罕见的神经系统并发症，主要影响老年人。尽管有零星的病例报告，但关于其发病率、病理生理学、管理和预后的知识差距仍然存在。本综述通过严谨的方法综合个体患者数据来解决这些差距。方法根据PRISMA-IPD指南，通过检索PubMed、Scopus和EMBASE，检索2000年至2025年期间以英语、西班牙语或法语发表的与hz相关的上肢神经丛病的病例报告和系列文献，进行系统评价。提取的数据包括人口统计学、临床表现、电生理和影像学发现、治疗和结果。结果60篇文章123例患者符合纳入标准，平均年龄69.5岁，性别分布均衡。大多数患者表现为混合运动和感觉神经受累，主要累及C5-C6皮节。常见的合并症包括糖尿病和免疫抑制。治疗通常结合抗病毒药物，神经性疼痛管理和康复。47%的病例完全恢复，大多数病例部分改善，而27%的患者有持续的后遗症。延迟诊断、免疫抑制、纯轴突肌电图模式和年龄超过70岁与较差的结果相关。结论本PRISMA-IPD系统综述提供了迄今为止最全面的关于hz相关臂丛病的综合研究，强调了早期临床和电生理诊断以及多模式治疗的重要性。研究结果强调了标准化诊断方案和前瞻性研究的必要性，以改善这种罕见但致残的疾病的患者管理和预后。

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引用次数: 0

Analysis of prognostic factors in acute encephalopathy with biphasic seizures and late reduced diffusion: a retrospective study on MRI findings and the treatments 急性脑病伴双相发作和晚期弥散减弱的预后因素分析：MRI表现和治疗的回顾性研究

IF 3.2 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Neurological Sciences

Pub Date : 2026-01-20 DOI: 10.1016/j.jns.2026.125760

Masataka Fukuoka , Ichiro Kuki , Megumi Nukui , Takeshi Inoue , Hideo Okuno , Junichi Ishikawa , Yasunori Otsuka , Kiyoko Amo , Masao Togawa , Hiroshi Rinka , Masashi Shiomi , Shin Okazaki

Background

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a subtype of acute encephalopathy diagnosed based on its characteristic clinical course and imaging findings. However, AESD presents with various symptoms and diverse neurological outcomes. We aimed to identify prognostic factors for AESD by analyzing clinical data.

Methods

This retrospective study included patients diagnosed with AESD at our institution between 1997 and 2015. 57 patients (29 male and 28 female) were included for analysis, with a median age at onset of 13 months (interquartile range: 11–22 months). Short-term outcome was defined as neurological status at 6 months post-onset, and long-term outcome as status at more than 2 years post-onset. Patients were categorized into favorable (Pediatric Cerebral Performance Category [PCPC] 1–2) and unfavorable (PCPC 3–6) outcome groups. We reviewed the clinical course, laboratory data (blood and cerebrospinal fluid during the early and late seizure phases), magnetic resonance imaging (MRI) findings, and treatment interventions. Univariate and multivariate logistic regression analyses were conducted to identify prognostic factors (p < 0.05 was considered statistically significant).

Results

In the multivariate analysis, extensive MRI lesions were significantly associated with poor short-term outcomes (p = 0.009, odds ratio [OR] 8.333), while edaravone use was significantly associated with favorable long-term outcomes (p = 0.007, OR 0.105).

Conclusions

The extent of MRI lesions predicted short-term outcomes, while edaravone administration was associated with improved long-term outcomes in patients with AESD.

急性脑病伴双相发作和晚期弥散减少（AESD）是急性脑病的一种亚型，诊断基于其特征性的临床病程和影像学表现。然而，AESD表现出不同的症状和不同的神经预后。我们的目的是通过分析临床数据来确定AESD的预后因素。方法回顾性研究纳入我院1997 - 2015年间诊断为AESD的患者。57例患者（男性29例，女性28例）纳入分析，发病年龄中位数为13个月（四分位数范围：11-22个月）。短期结果定义为发病后6个月的神经状态，长期结果定义为发病后2年以上的状态。将患者分为良好（小儿脑功能分类[PCPC] 1-2）和不良（PCPC 3-6）两组。我们回顾了临床过程、实验室数据（癫痫发作早期和晚期的血液和脑脊液）、磁共振成像（MRI）结果和治疗干预措施。进行单因素和多因素logistic回归分析以确定预后因素（p <； 0.05认为有统计学意义）。结果在多因素分析中，广泛的MRI病变与不良的短期预后显著相关（p = 0.009，比值比[OR] 8.333），而依达拉奉与良好的长期预后显著相关（p = 0.007, OR 0.105）。结论MRI病变程度预测了AESD患者的短期预后，而依达拉奉给药与AESD患者的长期预后改善相关。

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