Pub Date : 2026-03-01Epub Date: 2025-09-26DOI: 10.1016/j.nrl.2025.501931
M. Ruiz-Ortiz , J. Esteban-Pérez , A. Gómez-Grande , E. Martínez-Albero , J. Benito-León
Introduction
Motor neuron diseases (MND) encompass conditions like amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS), marked by progressive degeneration of upper and/or lower motor neurons. The identification of specific biomarkers is crucial to reduce diagnostic delays.
Methods
This study presents three clinical cases evaluated at the Hospital Universitario 12 de Octubre, where the motor band sign on brain 18F-FDG PET/CT aided the diagnosis of MND. The studies were conducted using a SIEMENS Biograph™ TruePoint™ 6, with a review of relevant literature.
Results
In all three patients, PET/CT revealed hypometabolism in the prerolandic region, indicative of the motor band sign, contributing to the diagnosis of PLS or ALS.
Discussion
The motor band sign on 18F-FDG PET/CT emerges as a potential marker of upper motor neuron involvement, though the heterogeneity of MNDs and variability across studies call for further research to establish its specificity and sensitivity.
Conclusion
The motor band sign on 18F-FDG PET/CT is a promising biomarker for MNDs, although further studies are required to confirm its diagnostic validity.
{"title":"Signo de la banda motora en el PET/TC 18F-FDG cerebral: ¿un biomarcador de enfermedad degenerativa de primera motoneurona? A propósito de 3 casos y revisión de la literatura","authors":"M. Ruiz-Ortiz , J. Esteban-Pérez , A. Gómez-Grande , E. Martínez-Albero , J. Benito-León","doi":"10.1016/j.nrl.2025.501931","DOIUrl":"10.1016/j.nrl.2025.501931","url":null,"abstract":"<div><h3>Introduction</h3><div>Motor neuron diseases (MND) encompass conditions like amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS), marked by progressive degeneration of upper and/or lower motor neurons. The identification of specific biomarkers is crucial to reduce diagnostic delays.</div></div><div><h3>Methods</h3><div>This study presents three clinical cases evaluated at the Hospital Universitario 12 de Octubre, where the motor band sign on brain 18F-FDG PET/CT aided the diagnosis of MND. The studies were conducted using a SIEMENS Biograph™ TruePoint™ 6, with a review of relevant literature.</div></div><div><h3>Results</h3><div>In all three patients, PET/CT revealed hypometabolism in the prerolandic region, indicative of the motor band sign, contributing to the diagnosis of PLS or ALS.</div></div><div><h3>Discussion</h3><div>The motor band sign on <sup>18</sup>F-FDG PET/CT emerges as a potential marker of upper motor neuron involvement, though the heterogeneity of MNDs and variability across studies call for further research to establish its specificity and sensitivity.</div></div><div><h3>Conclusion</h3><div>The motor band sign on <sup>18</sup>F-FDG PET/CT is a promising biomarker for MNDs, although further studies are required to confirm its diagnostic validity.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501931"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-24DOI: 10.1016/j.nrl.2025.501940
Z. Shao , Z. Hu , R. Tang , X. Wang , W. Peng
Objective
This study aimed to investigate the interrelationship between sleep disturbances, heart rate variability (HRV), and the risk of sudden unexpected death in epilepsy (SUDEP), with a focus on identifying novel risk factors related to sleep and autonomic function.
Methods
Patients with epilepsy undergoing overnight video-electroencephalographic monitoring were recruited between December 2020 and June 2022. Seizure-related characteristics were collected. Subjective and objective sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), duration of the first and longest cycle of the whole night's sleep (cycle 1 duration), sleep latency, and number of arousals from lights-off to the start of cycle 1 (AR number). Autonomic function was evaluated using HRV parameters, including root mean square of successive differences (RMSSD) and the percentage of NN50 intervals (PNN50), during non-rapid eye movement (NREM) sleep stages 2 and 3. The risk of SUDEP was measured using the 7-item SUDEP inventory (SUDEP-7).
Results
A total of 127 patients with epilepsy were included in the study. Patients with a cycle 1 duration of less than 60 min had significantly higher PSQI scores (t test, P < .05) compared to those with a cycle 1 duration of 60 min or more, consistent with poorer subjective sleep quality. Daytime dysfunction (reflected in the 7th domain of the PSQI) and RMSSD and PNN50 during NREM sleep stage 3 (one of the HRV time domain parameters) were both independent risk factors for SUDEP. Although no positive mediation effect of HRV on daytime dysfunction and SUDEP risk was observed, an inverse relationship between RMSSD during NREM stage 3 and both outcomes was identified.
Conclusion
Patients with epilepsy (and especially those with generalised tonic–clonic seizures) exhibiting daytime dysfunction should be prioritised for SUDEP risk screening. Further research should explore additional factors beyond HRV and potential interventions targeting sleep and autonomic function in patients with epilepsy.
{"title":"Daytime dysfunction and SUDEP risk: Exploring the role of sleep and heart rate variability in epilepsy","authors":"Z. Shao , Z. Hu , R. Tang , X. Wang , W. Peng","doi":"10.1016/j.nrl.2025.501940","DOIUrl":"10.1016/j.nrl.2025.501940","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the interrelationship between sleep disturbances, heart rate variability (HRV), and the risk of sudden unexpected death in epilepsy (SUDEP), with a focus on identifying novel risk factors related to sleep and autonomic function.</div></div><div><h3>Methods</h3><div>Patients with epilepsy undergoing overnight video-electroencephalographic monitoring were recruited between December 2020 and June 2022. Seizure-related characteristics were collected. Subjective and objective sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), duration of the first and longest cycle of the whole night's sleep (cycle 1 duration), sleep latency, and number of arousals from lights-off to the start of cycle 1 (AR number). Autonomic function was evaluated using HRV parameters, including root mean square of successive differences (RMSSD) and the percentage of NN50 intervals (PNN50), during non-rapid eye movement (NREM) sleep stages 2 and 3. The risk of SUDEP was measured using the 7-item SUDEP inventory (SUDEP-7).</div></div><div><h3>Results</h3><div>A total of 127 patients with epilepsy were included in the study. Patients with a cycle 1 duration of less than 60<!--> <!-->min had significantly higher PSQI scores (<em>t</em> test, <em>P</em> <!--><<!--> <!-->.05) compared to those with a cycle 1 duration of 60<!--> <!-->min or more, consistent with poorer subjective sleep quality. Daytime dysfunction (reflected in the 7th domain of the PSQI) and RMSSD and PNN50 during NREM sleep stage 3 (one of the HRV time domain parameters) were both independent risk factors for SUDEP. Although no positive mediation effect of HRV on daytime dysfunction and SUDEP risk was observed, an inverse relationship between RMSSD during NREM stage 3 and both outcomes was identified.</div></div><div><h3>Conclusion</h3><div>Patients with epilepsy (and especially those with generalised tonic–clonic seizures) exhibiting daytime dysfunction should be prioritised for SUDEP risk screening. Further research should explore additional factors beyond HRV and potential interventions targeting sleep and autonomic function in patients with epilepsy.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501940"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-01DOI: 10.1016/j.nrl.2025.501929
M. Fernández-Hontoria , R.P. Romero-Galisteo , M. Torres-Lacomba , C. González-Alted , A. Megía-García-Carpintero , C. Lirio-Romero
Introduction
Balance assessment measures are often validated in the general population or older adults, with limited validation in individuals with neurological impairments. The objective of this study is to culturally adapt and validate the Balance Evaluation Systems Test (BESTest) and its shortened versions, the Mini-BESTest and Brief-BESTest, in a Spanish population with acquired brain injury.
Methods
The study was divided into three phases: 1) translation and adaptation of the tests; 2) pilot testing of the adapted version, and 3) assessment of psychometric properties to assess the (reliability and validity). Berg Balance Scale was used as a criterion variable; construct validity was assessed by exploratory factor analysis of all items of each test; and reliability was tested by Cronbach's alpha and intra-class correlation interval.
Results
108 subjects in subacute and chronic phases of brain injury participated. Psychometric analysis of the three tests demonstrated good convergent validity, internal consistency, inter-rater agreement (0.998-0.969), and test-retest reliability (0.985-0.989). Convergent validity was observed with the Berg Balance Scale (r = .901, P < .001; r = .977, P < .001; r = .852, P < .001, respectively), as well as other gait and balance scales. No ceiling or floor effects were found in the adapted versions of the BESTest, Mini-BESTest, and Brief-BESTest for the Spanish population with acquired brain injury.
Conclusions
All three tests are reliable and valid, with BESTest being the better option for assessing balance in people with acquired brain injury, both in the subacute and chronic phase, as it includes domains that other tools do not assess.
平衡评估措施通常在一般人群或老年人中得到验证，在神经损伤患者中验证有限。本研究的目的是在西班牙获得性脑损伤人群中进行文化适应和验证平衡评估系统测试（BESTest）及其缩短版本，Mini-BESTest和Brief-BESTest。方法研究分为三个阶段：1)测试的翻译和改编；2)改编版本的试点测试，3)心理测量特性评估（信度和效度）。采用Berg平衡量表作为标准变量；构念效度采用探索性因子分析对各测试项进行评估；信度采用Cronbach’s alpha和类内相关区间检验。结果108例脑损伤患者分别处于亚急性期和慢性期。三个测试的心理测量分析结果表明，三个测试具有良好的收敛效度、内部一致性、评估间一致性（0.998 ~ 0.969）和重测信度（0.985 ~ 0.989）。Berg平衡量表（r = .901, P < .001; r = .977, P < .001; r = .852, P < .001）以及其他步态和平衡量表均具有收敛效度。在西班牙获得性脑损伤人群中，BESTest、Mini-BESTest和Brief-BESTest的改编版本没有发现天花板或地板效应。这三个测试都是可靠和有效的，BESTest是评估获得性脑损伤患者平衡性的更好选择，无论是亚急性期还是慢性期，因为它包含了其他工具无法评估的领域。
{"title":"Adaptación transcultural y validación a la población española con daño cerebral adquirido de la Prueba de Sistemas de Evaluación del Equilibrio (BESTest) y sus versiones reducidas (Mini-BESTest y Brief-BESTest)","authors":"M. Fernández-Hontoria , R.P. Romero-Galisteo , M. Torres-Lacomba , C. González-Alted , A. Megía-García-Carpintero , C. Lirio-Romero","doi":"10.1016/j.nrl.2025.501929","DOIUrl":"10.1016/j.nrl.2025.501929","url":null,"abstract":"<div><h3>Introduction</h3><div>Balance assessment measures are often validated in the general population or older adults, with limited validation in individuals with neurological impairments. The objective of this study is to culturally adapt and validate the Balance Evaluation Systems Test (BESTest) and its shortened versions, the Mini-BESTest and Brief-BESTest, in a Spanish population with acquired brain injury.</div></div><div><h3>Methods</h3><div>The study was divided into three phases: 1)<!--> <!-->translation and adaptation of the tests; 2)<!--> <!-->pilot testing of the adapted version, and 3)<!--> <!-->assessment of psychometric properties to assess the (reliability and validity). Berg Balance Scale was used as a criterion variable; construct validity was assessed by exploratory factor analysis of all items of each test; and reliability was tested by Cronbach's alpha and intra-class correlation interval.</div></div><div><h3>Results</h3><div>108 subjects in subacute and chronic phases of brain injury participated. Psychometric analysis of the three tests demonstrated good convergent validity, internal consistency, inter-rater agreement (0.998-0.969), and test-retest reliability (0.985-0.989). Convergent validity was observed with the Berg Balance Scale (r<!--> <!-->=<!--> <!-->.901, <em>P</em> <!--><<!--> <!-->.001; r<!--> <!-->=<!--> <!-->.977, <em>P</em> <!--><<!--> <!-->.001; r<!--> <!-->=<!--> <!-->.852, <em>P</em> <!--><<!--> <!-->.001, respectively), as well as other gait and balance scales. No ceiling or floor effects were found in the adapted versions of the BESTest, Mini-BESTest, and Brief-BESTest for the Spanish population with acquired brain injury.</div></div><div><h3>Conclusions</h3><div>All three tests are reliable and valid, with BESTest being the better option for assessing balance in people with acquired brain injury, both in the subacute and chronic phase, as it includes domains that other tools do not assess.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501929"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-02-17DOI: 10.1016/j.nrl.2024.10.002
J. Benito-León , C.M. Benito-Rodríguez
{"title":"Comentarios sobre el artículo «Las tasas de mortalidad para la Enfermedad de Parkinson están incrementando en España. Un análisis Edad-Periodo-Cohorte y Joinpoints en las tasas de mortalidad desde 1981 a 2020»","authors":"J. Benito-León , C.M. Benito-Rodríguez","doi":"10.1016/j.nrl.2024.10.002","DOIUrl":"10.1016/j.nrl.2024.10.002","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 101893"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-26DOI: 10.1016/j.nrl.2025.501933
C. Domínguez-González , M.Á. Barba Romero , C. Caballero Eraso , J. de las Heras , E. Farrero Muñoz , Ó. García-Campos , M. González , J.M. Grau , A. Hernández-Voth , R. Juntas Morales , J.C. León Hernández , M. Ley Martos , D. López-Padilla , N. Muelas , A. Nascimento , M. Olivé , C. Paradas , J. Pardo Fernández , S.I. Pascual , I. Pitarch , J. Díaz-Manera
Pompe disease or glycogenosis type II is a rare disease caused by mutations in the GAA gene that leads to deficiency of the acid alpha-1,4-glucosidase enzyme. As a result of the enzymatic defect, a progressive accumulation of intralysosomal glycogen occurs in various tissues, causing smooth, cardiac and skeletal muscle involvement. When the age of onset of the disease is after the first year of life, it is called late-onset Pompe disease (LOPD). Weakness of the axial and proximal waist muscles and respiratory dysfunction are common manifestations. Enzyme replacement therapy (ERT) has been available for more than 15 years and is the standard treatment. This therapy changes the course of the disease, although the effectiveness of the treatment reduces over time. New enzyme therapies represent new treatment opportunities for patients with LOPD. Here we present updated recommendations from a group of experts in Pompe disease on the diagnosis, treatment and follow-up of LOPD patients, with the aim of providing a guide for the clinical management of the disease.
{"title":"Recomendaciones para el diagnóstico, tratamiento y seguimiento de la enfermedad de Pompe de inicio tardío","authors":"C. Domínguez-González , M.Á. Barba Romero , C. Caballero Eraso , J. de las Heras , E. Farrero Muñoz , Ó. García-Campos , M. González , J.M. Grau , A. Hernández-Voth , R. Juntas Morales , J.C. León Hernández , M. Ley Martos , D. López-Padilla , N. Muelas , A. Nascimento , M. Olivé , C. Paradas , J. Pardo Fernández , S.I. Pascual , I. Pitarch , J. Díaz-Manera","doi":"10.1016/j.nrl.2025.501933","DOIUrl":"10.1016/j.nrl.2025.501933","url":null,"abstract":"<div><div>Pompe disease or glycogenosis type II is a rare disease caused by mutations in the <em>GAA</em> gene that leads to deficiency of the acid alpha-1,4-glucosidase enzyme. As a result of the enzymatic defect, a progressive accumulation of intralysosomal glycogen occurs in various tissues, causing smooth, cardiac and skeletal muscle involvement. When the age of onset of the disease is after the first year of life, it is called late-onset Pompe disease (LOPD). Weakness of the axial and proximal waist muscles and respiratory dysfunction are common manifestations. Enzyme replacement therapy (ERT) has been available for more than 15 years and is the standard treatment. This therapy changes the course of the disease, although the effectiveness of the treatment reduces over time. New enzyme therapies represent new treatment opportunities for patients with LOPD. Here we present updated recommendations from a group of experts in Pompe disease on the diagnosis, treatment and follow-up of LOPD patients, with the aim of providing a guide for the clinical management of the disease.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501933"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-24DOI: 10.1016/j.nrl.2025.501939
E. Mariscal-Lopez , M. Agredano-Sanchez , R.M. Lopez-Gigosos , A. Mariscal , F. Fariñas-Guerrero , M. Gutierrez-Bedmar , M. Guts-Chornoknyzha
Introduction
Dementias currently impose a significant burden in terms of morbidity, mortality, socio-economic costs, and human suffering. Several studies have indicated that certain infectious diseases may increase the risk of dementia. Additionally, research has suggested that adult vaccines may help to prevent dementia. This systematic review looks into the possible association between adult vaccines and dementia in studies published between 2016 and April 2024.
Development
A search was conducted in accordance with the PRISMA 2020 guidelines to assess the potential association between adult vaccines and dementia in adults aged 50 and above. Quality and potential bias were evaluated using the revised Assessing the Methodological Quality of Systematic Reviews (AMSTAR-2) scale, the Newcastle–Ottawa scale, and the Risk-of-bias in Studies of Temporal Trends (ROBITT) tool. Fifteen out of the 16 selected studies showed a high degree of uniformity in terms of vaccinated adults having lower rates of dementia than unvaccinated adults. The observed risk reduction ranged from 4% to 50% (relative risk measures). The influenza vaccine has been the subject of the most extensive research, with 10 of the 16 studies focusing on it. Five studies demonstrated a dose–response relationship, indicating that a higher number of vaccines per patient is associated with a lower risk of dementia. Only one of the selected studies found an association between vaccination of adults and an increased risk of dementia.
Conclusions
The studies examined provide evidence supporting the hypothesis that adult vaccination may have a protective effect against the development of dementia. However, further molecular biology and pathophysiology studies are required to elucidate the underlying mechanisms and confirm the plausibility of this hypothesis.
{"title":"Protective effect of adult vaccination on the development of dementias: A systematic review","authors":"E. Mariscal-Lopez , M. Agredano-Sanchez , R.M. Lopez-Gigosos , A. Mariscal , F. Fariñas-Guerrero , M. Gutierrez-Bedmar , M. Guts-Chornoknyzha","doi":"10.1016/j.nrl.2025.501939","DOIUrl":"10.1016/j.nrl.2025.501939","url":null,"abstract":"<div><h3>Introduction</h3><div>Dementias currently impose a significant burden in terms of morbidity, mortality, socio-economic costs, and human suffering. Several studies have indicated that certain infectious diseases may increase the risk of dementia. Additionally, research has suggested that adult vaccines may help to prevent dementia. This systematic review looks into the possible association between adult vaccines and dementia in studies published between 2016 and April 2024.</div></div><div><h3>Development</h3><div>A search was conducted in accordance with the PRISMA 2020 guidelines to assess the potential association between adult vaccines and dementia in adults aged 50 and above. Quality and potential bias were evaluated using the revised Assessing the Methodological Quality of Systematic Reviews (AMSTAR-2) scale, the Newcastle–Ottawa scale, and the Risk-of-bias in Studies of Temporal Trends (ROBITT) tool. Fifteen out of the 16 selected studies showed a high degree of uniformity in terms of vaccinated adults having lower rates of dementia than unvaccinated adults. The observed risk reduction ranged from 4% to 50% (relative risk measures). The influenza vaccine has been the subject of the most extensive research, with 10 of the 16 studies focusing on it. Five studies demonstrated a dose–response relationship, indicating that a higher number of vaccines per patient is associated with a lower risk of dementia. Only one of the selected studies found an association between vaccination of adults and an increased risk of dementia.</div></div><div><h3>Conclusions</h3><div>The studies examined provide evidence supporting the hypothesis that adult vaccination may have a protective effect against the development of dementia. However, further molecular biology and pathophysiology studies are required to elucidate the underlying mechanisms and confirm the plausibility of this hypothesis.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501939"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-09-26DOI: 10.1016/j.nrl.2025.501934
J.M. Láinez Andrés , C. Íñiguez Martínez , J. Porta Etessam , D. Ezpeleta Echávarri , M.T. Martínez de Albéniz Zabaleta , M.M. Bilbao , F. Escamilla Sevilla , D.M. Cerdán Santacruz , D. García Azorín , J. Camiña Muñiz , S. Arias Rivas , S. Gil Navarro , I.C. Labordena , M.E. Gil Girbau , C. Santarrosa Mateo
Introduction
With the aim of redesigning the role of promoting and fostering the progress of neurology and anticipating the social, scientific, health, and economic context provided by the development of our specialty, the Spanish Society of Neurology (SEN) has decided to formalize its direction in a Strategic Plan, the elements of which are shared in this article.
Methods
The development of the Plan has been structured in three phases: internal and external analysis, strategic projection, and formalization of the plan. A qualitative and strategic analysis approach has been incorporated, through surveys, interviews, and participatory sessions with the SEN, with the participation of approximately 500 members and other professionals in the field. The current situation of the SEN and its environment has been explicitly stated, the corporate identity has been defined, and strengths, weaknesses, threats, and opportunities have been analyzed using the SWOT/CAME matrix. Finally, an Action Plan has been developed that identifies strategic pillars, objectives, and actions to be implemented.
Results
Five Strategic Pillars have been identified (SEN Image; Service Portfolio; Participation Spaces; Digital Transformation; Results-Oriented Management), comprising a total of 23 strategic objectives. A total of 80 actions are proposed to achieve the Plan's objectives by 2025.
Conclusions
The deployment of the Strategic Plan involves having a backbone instrument for the strategic lines that are expected to favor the position of the SEN as a key player within the specialty of neurology in the face of current and future challenges.
{"title":"¿Cómo afrontamos los desafíos de la Sociedad Española de Neurología? Plan Estratégico de la Sociedad Española de Neurología","authors":"J.M. Láinez Andrés , C. Íñiguez Martínez , J. Porta Etessam , D. Ezpeleta Echávarri , M.T. Martínez de Albéniz Zabaleta , M.M. Bilbao , F. Escamilla Sevilla , D.M. Cerdán Santacruz , D. García Azorín , J. Camiña Muñiz , S. Arias Rivas , S. Gil Navarro , I.C. Labordena , M.E. Gil Girbau , C. Santarrosa Mateo","doi":"10.1016/j.nrl.2025.501934","DOIUrl":"10.1016/j.nrl.2025.501934","url":null,"abstract":"<div><h3>Introduction</h3><div>With the aim of redesigning the role of promoting and fostering the progress of neurology and anticipating the social, scientific, health, and economic context provided by the development of our specialty, the Spanish Society of Neurology (SEN) has decided to formalize its direction in a Strategic Plan, the elements of which are shared in this article.</div></div><div><h3>Methods</h3><div>The development of the Plan has been structured in three phases: internal and external analysis, strategic projection, and formalization of the plan. A qualitative and strategic analysis approach has been incorporated, through surveys, interviews, and participatory sessions with the SEN, with the participation of approximately 500 members and other professionals in the field. The current situation of the SEN and its environment has been explicitly stated, the corporate identity has been defined, and strengths, weaknesses, threats, and opportunities have been analyzed using the SWOT/CAME matrix. Finally, an Action Plan has been developed that identifies strategic pillars, objectives, and actions to be implemented.</div></div><div><h3>Results</h3><div>Five Strategic Pillars have been identified (SEN Image; Service Portfolio; Participation Spaces; Digital Transformation; Results-Oriented Management), comprising a total of 23 strategic objectives. A total of 80 actions are proposed to achieve the Plan's objectives by 2025.</div></div><div><h3>Conclusions</h3><div>The deployment of the Strategic Plan involves having a backbone instrument for the strategic lines that are expected to favor the position of the SEN as a key player within the specialty of neurology in the face of current and future challenges.</div></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"41 2","pages":"Article 501934"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147412444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-05-28DOI: 10.1016/j.nrl.2024.08.004
C.H. Vera-Cáceres , M. García-Huguet , A. Gil de Genover , S.D. Sagula , L. Martín Muñóz , D. López Domínguez
Introduction
This case report discusses a case of a patient who experienced acute autonomic dysfunction during the parainfectious phase of COVID-19, attributed to Guillain-Barre Syndrome (GBS). This is the first well-documented case of such an association.
Case presentation
A 64-year-old woman, previously infected with COVID-19, was admitted to the emergency department due to altered mental status. Brain computed tomography (CT) revealed bilateral occipital diffuse hypodensity. Throughout her hospitalization, she exhibited elevated blood pressure necessitating intravenous treatment.
The initial brain MRI revealed T2-weighted image hyperintensity at the parietal and occipital levels, indicative of vasogenic edema. These neuroimaging findings were suggestive of posterior reversible encephalopathy syndrome (PRES). Euvolemic hyponatremia with concurrent low serum osmolality and high urine osmolality and sodium was observed, indicating a syndrome of inappropriate antidiuretic hormone (SIADH). Throughout the patient's stay, her level of consciousness exhibited significant improvement. However, she developed ascending symmetrical limb weakness and progressive loss of reflexes, along with a severe motor deficit and gait disturbance, accompanied by arterial blood pressure fluctuations and other signs of autonomic dysfunction.
Clinical manifestations, neurophysiological findings, and laboratory results were indicative of Guillain-Barre Syndrome (GBS), leading to a conclusive diagnosis of GBS with dysautonomia triggered by a COVID-19 infection.
Conclusion
This case reveals the relevance of diagnosing autonomic dysfunction (including PRES) as the initial manifestation of GBS linked to COVID-19 infection and the importance of early diagnosis to prevent potential complications.
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