Pub Date : 2025-02-17DOI: 10.1016/j.ensci.2025.100561
Lisa Kaindl , Julian Frederic Hotz , Julia Ferrari
Stroke represents a major public health problem, ranking as a leading cause of death and long-term disability worldwide (1–3). The goal of prevention strategies is to avoid the occurrence of stroke by educating both healthcare professionals and patients about the reduction of risk factors. Despite increasing improvements in acute revascularization therapies, preventive measures remain more effective in decreasing the burden of stroke, as evidenced by the fact that over 75 % of strokes are first events (2). This paper attempts to provide a comprehensive approach by outlining risk factors and new therapeutic approaches. Understanding these is essential for healthcare providers and the general public to develop effective prevention strategies and ultimately reduce the overall incidence of stroke.
{"title":"Cutting-edge stroke prevention strategies","authors":"Lisa Kaindl , Julian Frederic Hotz , Julia Ferrari","doi":"10.1016/j.ensci.2025.100561","DOIUrl":"10.1016/j.ensci.2025.100561","url":null,"abstract":"<div><div>Stroke represents a major public health problem, ranking as a leading cause of death and long-term disability worldwide (1–3). The goal of prevention strategies is to avoid the occurrence of stroke by educating both healthcare professionals and patients about the reduction of risk factors. Despite increasing improvements in acute revascularization therapies, preventive measures remain more effective in decreasing the burden of stroke, as evidenced by the fact that over 75 % of strokes are first events (2). This paper attempts to provide a comprehensive approach by outlining risk factors and new therapeutic approaches. Understanding these is essential for healthcare providers and the general public to develop effective prevention strategies and ultimately reduce the overall incidence of stroke.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"39 ","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454656","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}
Pub Date : 2025-02-14DOI: 10.1016/j.ensci.2025.100560
Yacouba Njankouo Mapoure , Elodie Dorothée Ebogo Fouda , Daniel Gams Massi , Caroline Kenmegne , Bertrand Hugo Ngahane Mbatchou
Background
Stroke and anemia are major public health concerns in Sub-Saharan Africa. However, few data are available on anemia and acute ischemic stroke in our setting.
Purpose
To assess the impact of anemia on the outcome of patients with ischemic stroke.
Methods
We collected retrospectively data of patients >15 years hospitalized for ischemic stroke at the Douala General Hospital over a period of 9 years, in whom full blood count was done. Anemia was classified as mild, moderate and severe. Multivariate analysis was used to determine predictive factors of poor outcome at 3 months (mortality and poor functional recovery) in ischemic stroke patients with anemia.
Results
A total of 691 patients (male, 53.3 %) male were included. Anemia was found in 44.4 % of cases (severe anemia, 10.4 %). Severe anemia was significantly associated with poor functional recovery at 3 months (OR:4.43, 95 %CI:1.02–12.24, p = 0.04). We found no difference in mortality at 3 months between patients with (4.6 %, n = 14) and without (3.9 %, n = 15) anemia (OR:1.48, 95 %CI:0.69–3.14, p = 0.330). Age > 60 years, diastolic blood pressure > 90 mmHg, NIHSS score ≥ 15, and INR > 1.2 were predictive factors of mortality at 3 months in ischemic stroke patients with anemia.
Conclusion
Anemia is common in ischemic stroke cases and must be systematically screened.
{"title":"Anemia and outcome of patients with ischemic stroke in a referral hospital in Cameroon","authors":"Yacouba Njankouo Mapoure , Elodie Dorothée Ebogo Fouda , Daniel Gams Massi , Caroline Kenmegne , Bertrand Hugo Ngahane Mbatchou","doi":"10.1016/j.ensci.2025.100560","DOIUrl":"10.1016/j.ensci.2025.100560","url":null,"abstract":"<div><h3>Background</h3><div>Stroke and anemia are major public health concerns in Sub-Saharan Africa. However, few data are available on anemia and acute ischemic stroke in our setting.</div></div><div><h3>Purpose</h3><div>To assess the impact of anemia on the outcome of patients with ischemic stroke.</div></div><div><h3>Methods</h3><div>We collected retrospectively data of patients >15 years hospitalized for ischemic stroke at the Douala General Hospital over a period of 9 years, in whom full blood count was done. Anemia was classified as mild, moderate and severe. Multivariate analysis was used to determine predictive factors of poor outcome at 3 months (mortality and poor functional recovery) in ischemic stroke patients with anemia.</div></div><div><h3>Results</h3><div>A total of 691 patients (male, 53.3 %) male were included. Anemia was found in 44.4 % of cases (severe anemia, 10.4 %). Severe anemia was significantly associated with poor functional recovery at 3 months (OR:4.43, 95 %CI:1.02–12.24, <em>p</em> = 0.04). We found no difference in mortality at 3 months between patients with (4.6 %, <em>n</em> = 14) and without (3.9 %, <em>n</em> = 15) anemia (OR:1.48, 95 %CI:0.69–3.14, <em>p</em> = 0.330). Age > 60 years, diastolic blood pressure > 90 mmHg, NIHSS score ≥ 15, and INR > 1.2 were predictive factors of mortality at 3 months in ischemic stroke patients with anemia.</div></div><div><h3>Conclusion</h3><div>Anemia is common in ischemic stroke cases and must be systematically screened.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"39 ","pages":"Article 100560"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444320","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}
Pub Date : 2025-02-01DOI: 10.1016/j.ensci.2025.100559
Matthew C. Kiernan
{"title":"Recent developments in consensus diagnostic criteria for amyotrophic lateral sclerosis","authors":"Matthew C. Kiernan","doi":"10.1016/j.ensci.2025.100559","DOIUrl":"10.1016/j.ensci.2025.100559","url":null,"abstract":"","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100559"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146058","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}
Pub Date : 2025-01-26DOI: 10.1016/j.ensci.2025.100558
Jao Jarro B. Garcia , Gilbert J. Cabataña Jr , Iris Ditan , Karl Josef Niño J. Separa , Ida Ingrid Rocha-Tulagan , Han-I Lin , Chin-Hsien Lin , Melanie Leigh D. Supnet-Wells , Alejandro F. Diaz , Arlene R. Ng , Roland Dominic G. Jamora , Gerard Saranza
Huntington's Disease (HD) is an autosomal-dominant, neurodegenerative condition characterized by extrapyramidal, psychiatric, and cognitive disturbances. In the Philippines, only one genetically confirmed sporadic case had been previously reported. This study aims to present ten additional cases of genetically proven familial HD. All cases were of pure Filipino descent, aged 27–65. Six were males, and nine had at least one relative who manifested with the same symptomatology. The youngest age at onset was 21 years old. Nine initially manifested with chorea, whereas one manifested initially with behavioral change. At the time of consult, eight already had cognitive changes exemplified by memory lapses, while six also manifested behavioral or psychiatric disturbances. Workup revealed caudate atrophy in six and cerebral atrophy in five of the cases. All tested positive on genetic testing with the CAG trinucleotide spanning 41 to 53 repeats. The clinical profile of our patients did not differ from the known and published natural course of HD. To date, HD remains underrecognized in the Philippines. Although rare in Asian countries, it should still be a differential for a patient with chorea, cognitive decline, behavioral changes, and a strong family history of the same symptomatology.
{"title":"Recognizing familial Huntington's disease in an Asian cohort: Insights from the Philippines","authors":"Jao Jarro B. Garcia , Gilbert J. Cabataña Jr , Iris Ditan , Karl Josef Niño J. Separa , Ida Ingrid Rocha-Tulagan , Han-I Lin , Chin-Hsien Lin , Melanie Leigh D. Supnet-Wells , Alejandro F. Diaz , Arlene R. Ng , Roland Dominic G. Jamora , Gerard Saranza","doi":"10.1016/j.ensci.2025.100558","DOIUrl":"10.1016/j.ensci.2025.100558","url":null,"abstract":"<div><div>Huntington's Disease (HD) is an autosomal-dominant, neurodegenerative condition characterized by extrapyramidal, psychiatric, and cognitive disturbances. In the Philippines, only one genetically confirmed sporadic case had been previously reported. This study aims to present ten additional cases of genetically proven familial HD. All cases were of pure Filipino descent, aged 27–65. Six were males, and nine had at least one relative who manifested with the same symptomatology. The youngest age at onset was 21 years old. Nine initially manifested with chorea, whereas one manifested initially with behavioral change. At the time of consult, eight already had cognitive changes exemplified by memory lapses, while six also manifested behavioral or psychiatric disturbances. Workup revealed caudate atrophy in six and cerebral atrophy in five of the cases. All tested positive on genetic testing with the CAG trinucleotide spanning 41 to 53 repeats. The clinical profile of our patients did not differ from the known and published natural course of HD. To date, HD remains underrecognized in the Philippines. Although rare in Asian countries, it should still be a differential for a patient with chorea, cognitive decline, behavioral changes, and a strong family history of the same symptomatology.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143146059","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}
Pub Date : 2025-01-11DOI: 10.1016/j.ensci.2025.100553
Bassem Yamout
Multiple Sclerosis (MS) is a chronic demyelinating disorder of the central nervous system (CNS) that affects predominately patients aged 20–40 years. The epidemiology of MS is changing worldwide, as is the understanding of its immunopathogenesis and natural history, with new evidence pointing towards a multifactorial etiology involving both environmental and genetic factors. The prevalence and incidence rates of MS have been steadily increasing worldwide over the last few decades. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and time. Appropriate selection of MS therapies is critical to maximize patient benefit. The field of MS therapeutics is evolving rapidly as several novel disease modifying therapies (DMTs) have been added to our armamentarium in the last decade. This review will cover the epidemiology of MS, new concepts in immunopathogenesis and etiology, recent diagnostic criteria and red flags for avoiding misdiagnosis, therapeutic advances, disease management during pregnancy, and updated treatment guidelines.
{"title":"Update in multiple sclerosis","authors":"Bassem Yamout","doi":"10.1016/j.ensci.2025.100553","DOIUrl":"10.1016/j.ensci.2025.100553","url":null,"abstract":"<div><div>Multiple Sclerosis (MS) is a chronic demyelinating disorder of the central nervous system (CNS) that affects predominately patients aged 20–40 years. The epidemiology of MS is changing worldwide, as is the understanding of its immunopathogenesis and natural history, with new evidence pointing towards a multifactorial etiology involving both environmental and genetic factors. The prevalence and incidence rates of MS have been steadily increasing worldwide over the last few decades. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and time. Appropriate selection of MS therapies is critical to maximize patient benefit. The field of MS therapeutics is evolving rapidly as several novel disease modifying therapies (DMTs) have been added to our armamentarium in the last decade. This review will cover the epidemiology of MS, new concepts in immunopathogenesis and etiology, recent diagnostic criteria and red flags for avoiding misdiagnosis, therapeutic advances, disease management during pregnancy, and updated treatment guidelines.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100553"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081314","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}
Pub Date : 2025-01-10DOI: 10.1016/j.ensci.2025.100554
Armin Adibi , Iman Adibi , Saeed Bahramian , Saba Naghavi , Fatemeh Gholami
Behcet syndrome is a systemic vasculitis characterized by relapsing uveitis, oral aphthous, and genital ulcers. We present a rare case of a 14-year-old male with juvenile Behcet syndrome (JBS) presenting as bilateral optic neuritis with oral aphthous. Initial treatment with methylprednisolone did not improve the patient's condition. Serum plasmapheresis was performed, resulting in improved visual acuity and papillitis. The patient was discharged with azathioprine, which led to symptom regression. This case highlights the atypical neurologic presentation of JBS and the potential efficacy of plasma exchange in refractory cases.
{"title":"Bilateral optic neuritis as an atypical presentation of juvenile Behcet syndrome: A case report","authors":"Armin Adibi , Iman Adibi , Saeed Bahramian , Saba Naghavi , Fatemeh Gholami","doi":"10.1016/j.ensci.2025.100554","DOIUrl":"10.1016/j.ensci.2025.100554","url":null,"abstract":"<div><div>Behcet syndrome is a systemic vasculitis characterized by relapsing uveitis, oral aphthous, and genital ulcers. We present a rare case of a 14-year-old male with juvenile Behcet syndrome (JBS) presenting as bilateral optic neuritis with oral aphthous. Initial treatment with methylprednisolone did not improve the patient's condition. Serum plasmapheresis was performed, resulting in improved visual acuity and papillitis. The patient was discharged with azathioprine, which led to symptom regression. This case highlights the atypical neurologic presentation of JBS and the potential efficacy of plasma exchange in refractory cases.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100554"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081129","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}
Pub Date : 2025-01-09DOI: 10.1016/j.ensci.2025.100549
Abdullah M. Al-Qudah , Pooja S. Tallapaneni , Donald J. Crammond , Jeffrey Balzer , Katherine M. Anetakis , Varun Shandal , Jingyuan Biaesch , Malik Ghannam , Neelesh Nadkarni , Bradley A. Gross , Michael Lang , Kathirvel Subramanium , Senthilkumar Sadhasivam , Parthasarathy D. Thirumala
Objectives
This study aims to evaluate the diagnostic accuracy of significant intraoperative neurophysiological monitoring (IONM) changes as an independent predictor of postoperative delirium (POD) in patients undergoing aneurysm clipping.
Methods
IONM and clinical data from 273 patients who underwent craniotomy for aneurysm clipping from 2019 until 2021 were retrospectively reviewed. Significant IONM changes and POD were respectively evaluated based on visual review of data and clinical documentation. POD was assessed multiple times in the ICU using the Intensive Care Delirium Screening Checklist (ICDSC).
Results
Of the 273 patients undergoing craniotomy with IONM, 83 had POD (30.4 %). Significant IONM changes were noted in 42 patients, of which 19 patients had POD (45.2 %). In contrast, 231 patients had no IONM changes during surgery, of which 64 (27.7 %) patients had POD. Multivariable analysis showed that significant IONM changes were associated with POD, OR: 2.09 (95 % CI 1.01–4.43, p-value: 0.046). Additionally, somatosensory evoked potentials (SSEP) changes were significantly associated with POD (p-value: 0.044).
Conclusion
Significant IONM changes are associated with an increased risk of POD in patients undergoing craniotomy for aneurysm clipping. Our findings offer a strong basis for future research and analysis of EEG and SSEP monitoring to detect and possibly prevent POD.
目的：本研究旨在评估术中显著神经生理监测（IONM）变化作为动脉瘤夹闭患者术后谵妄（POD）的独立预测指标的诊断准确性。方法：回顾性分析2019年至2021年273例开颅动脉瘤夹闭患者的IONM和临床资料。根据视觉资料和临床文献分别评估IONM和POD的显著变化。在ICU使用重症监护谵妄筛查清单（ICDSC）对POD进行多次评估。结果：273例IONM开颅患者中，有83例发生POD（30.4%）。42例患者出现明显的IONM变化，其中19例患者有POD（45.2%）。相比之下，231例患者在手术中没有IONM变化，其中64例（27.7%）患者有POD。多变量分析显示，显著的IONM变化与POD相关，OR: 2.09 （95% CI 1.01-4.43， p值：0.046）。体感诱发电位（SSEP）变化与POD显著相关（p值：0.044）。结论：在接受动脉瘤夹闭开颅手术的患者中，显著的IONM变化与POD风险增加有关。我们的研究结果为未来的研究和分析EEG和SSEP监测提供了强有力的基础，以发现并可能预防POD。
{"title":"Intraoperative neuromonitoring as an independent predictor for postoperative delirium in ICU following aneurysm clipping","authors":"Abdullah M. Al-Qudah , Pooja S. Tallapaneni , Donald J. Crammond , Jeffrey Balzer , Katherine M. Anetakis , Varun Shandal , Jingyuan Biaesch , Malik Ghannam , Neelesh Nadkarni , Bradley A. Gross , Michael Lang , Kathirvel Subramanium , Senthilkumar Sadhasivam , Parthasarathy D. Thirumala","doi":"10.1016/j.ensci.2025.100549","DOIUrl":"10.1016/j.ensci.2025.100549","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the diagnostic accuracy of significant intraoperative neurophysiological monitoring (IONM) changes as an independent predictor of postoperative delirium (POD) in patients undergoing aneurysm clipping.</div></div><div><h3>Methods</h3><div>IONM and clinical data from 273 patients who underwent craniotomy for aneurysm clipping from 2019 until 2021 were retrospectively reviewed. Significant IONM changes and POD were respectively evaluated based on visual review of data and clinical documentation. POD was assessed multiple times in the ICU using the Intensive Care Delirium Screening Checklist (ICDSC).</div></div><div><h3>Results</h3><div>Of the 273 patients undergoing craniotomy with IONM, 83 had POD (30.4 %). Significant IONM changes were noted in 42 patients, of which 19 patients had POD (45.2 %). In contrast, 231 patients had no IONM changes during surgery, of which 64 (27.7 %) patients had POD. Multivariable analysis showed that significant IONM changes were associated with POD, OR: 2.09 (95 % CI 1.01–4.43, <em>p</em>-value: 0.046). Additionally, somatosensory evoked potentials (SSEP) changes were significantly associated with POD (p-value: 0.044).</div></div><div><h3>Conclusion</h3><div>Significant IONM changes are associated with an increased risk of POD in patients undergoing craniotomy for aneurysm clipping. Our findings offer a strong basis for future research and analysis of EEG and SSEP monitoring to detect and possibly prevent POD.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081208","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}
Cryptococcal meningoencephalitis (CM) in human immunodeficiency virus (HIV)-negative patients are often diagnosed later than in HIV-infected patients, which increases mortality rates concerning the former. Consequently, early diagnosis and treatment are crucial for improving clinical prognosis in HIV-negative patients. This study investigated the utility of magnetic resonance imaging (MRI) in combination with clinical and laboratory findings for early diagnosis of CM in HIV-negative patients.
Methods
This retrospective cohort analysis included consecutive patients diagnosed with central nervous system (CNS) infections. Demographic profiles, laboratory findings, admission symptoms, and MRI findings were assessed. A comparative analysis between CM and other CNS infections was performed.
Results
Twelve HIV-negative patients were diagnosed with CM, while 38 exhibited other CNS infections (two fungal, 23 bacterial, 12 viral, one parasitic). Pseudocysts on MRI (p = 0.002), absence of fever (p = 0.001), headache (p = 0.005), and normal C-reactive protein (CRP) levels (p = 0.020) were specific findings in CM. By applying a cut-off value of one point in combination of pseudocysts, absence of fever, headache, and normal CRP levels in differentiating CM from other CNS infections, the sensitivity and specificity were calculated as 76.3 % and 91.7 %, respectively.
Conclusion
Integrating pseudocysts, absence of fever, headache, and normal CRP levels predicts early CM diagnosis, potentially improving outcomes.
{"title":"Early diagnosis of cryptococcal meningoencephalitis in HIV-negative patients: Integration of brain MRI and clinical findings","authors":"Kosei Nakamura, Masato Kanazawa, Yuka Koike, Takuya Konno, Osamu Onodera","doi":"10.1016/j.ensci.2025.100552","DOIUrl":"10.1016/j.ensci.2025.100552","url":null,"abstract":"<div><h3>Purpose</h3><div>Cryptococcal meningoencephalitis (CM) in human immunodeficiency virus (HIV)-negative patients are often diagnosed later than in HIV-infected patients, which increases mortality rates concerning the former. Consequently, early diagnosis and treatment are crucial for improving clinical prognosis in HIV-negative patients. This study investigated the utility of magnetic resonance imaging (MRI) in combination with clinical and laboratory findings for early diagnosis of CM in HIV-negative patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort analysis included consecutive patients diagnosed with central nervous system (CNS) infections. Demographic profiles, laboratory findings, admission symptoms, and MRI findings were assessed. A comparative analysis between CM and other CNS infections was performed.</div></div><div><h3>Results</h3><div>Twelve HIV-negative patients were diagnosed with CM, while 38 exhibited other CNS infections (two fungal, 23 bacterial, 12 viral, one parasitic). Pseudocysts on MRI (<em>p</em> = 0.002), absence of fever (<em>p</em> = 0.001), headache (<em>p</em> = 0.005), and normal C-reactive protein (CRP) levels (<em>p</em> = 0.020) were specific findings in CM. By applying a cut-off value of one point in combination of pseudocysts, absence of fever, headache, and normal CRP levels in differentiating CM from other CNS infections, the sensitivity and specificity were calculated as 76.3 % and 91.7 %, respectively.</div></div><div><h3>Conclusion</h3><div>Integrating pseudocysts, absence of fever, headache, and normal CRP levels predicts early CM diagnosis, potentially improving outcomes.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100552"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060814","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}
Pub Date : 2025-01-06DOI: 10.1016/j.ensci.2025.100551
Amirhosein Ghasemi , Nima Broomand Lomer , Alia Saberi
Introduction
Guillain-Barré syndrome (GBS) is an inflammatory disorder of the peripheral nervous system, causing acute flaccid paralysis. There have been occasional reports linking Hepatitis A virus (HAV) to GBS. Here we aimed to evaluate the current literature on the association between GBS and HAV, exploring potential mechanisms and clinical implications.
Methods
We conducted a systematic search using PRISMA guidelines in PubMed, Web of Science, Embase, and Scopus. Only published case reports or conference abstracts presenting cases of confirmed HAV infection and GBS were included. Data extraction was performed independently by two reviewers, and quality assessment was conducted using the Joanna Briggs Institute critical appraisal tool.
Results
Out of 581 studies identified, 46 studies encompassing 47 cases met the inclusion criteria. The mean age of patients was 29.47 years, with a male predominance (70.2 %). Geographically, most cases were reported in Asia (74.5 %). Clinical manifestations of HAV included fever, malaise, and jaundice, while GBS presented with muscle weakness and areflexia. Laboratory findings showed albuminocytological dissociation in 76.2 % of cases. Nerve conduction studies predominantly indicated AIDP subtype (32/46, 69.6 %). Treatment involved IVIG, plasmapheresis, and supportive care, with recovery times ranging from one week to 18 months. One fatality was reported.
Conclusions
This review suggests a potential link between HAV infection and GBS, proposing a mechanism: molecular mimicry. It emphasizes the need for increased awareness and preventive measures, especially in areas with lower health standards. However, further research is needed to clarify the possible mechanisms and deepen our understanding.
格林-巴罗综合征（GBS）是一种周围神经系统炎症性疾病，可引起急性弛缓性麻痹。偶尔有报道将甲型肝炎病毒（HAV）与GBS联系起来。在这里，我们旨在评估目前关于GBS和HAV之间关联的文献，探索潜在的机制和临床意义。方法：我们在PubMed、Web of Science、Embase和Scopus中使用PRISMA指南进行了系统检索。仅包括已发表的病例报告或会议摘要，其中包括确诊的甲型肝炎感染和GBS病例。数据提取由两名审稿人独立完成，质量评估使用Joanna Briggs Institute关键评估工具进行。结果：在581项研究中，46项研究包括47例病例符合纳入标准。患者平均年龄29.47岁，男性居多（70.2%）。从地理上看，大多数病例报告在亚洲（74.5%）。HAV临床表现为发热、乏力、黄疸，GBS临床表现为肌肉无力、反射性屈曲。实验室结果显示76.2%的病例有白蛋白细胞分离。神经传导研究主要显示AIDP亚型（32/46,69.6%）。治疗包括IVIG、血浆置换和支持性护理，恢复时间从一周到18个月不等。据报道有一人死亡。结论：本综述提示甲型肝炎感染与GBS之间存在潜在联系，并提出了一种机制：分子模拟。它强调需要加强认识和预防措施，特别是在卫生标准较低的地区。然而，需要进一步的研究来阐明可能的机制并加深我们的理解。
{"title":"Is there a link between Hepatitis A virus and Guillain-Barré syndrome? A systematic review of case reports","authors":"Amirhosein Ghasemi , Nima Broomand Lomer , Alia Saberi","doi":"10.1016/j.ensci.2025.100551","DOIUrl":"10.1016/j.ensci.2025.100551","url":null,"abstract":"<div><h3>Introduction</h3><div>Guillain-Barré syndrome (GBS) is an inflammatory disorder of the peripheral nervous system, causing acute flaccid paralysis. There have been occasional reports linking Hepatitis A virus (HAV) to GBS. Here we aimed to evaluate the current literature on the association between GBS and HAV, exploring potential mechanisms and clinical implications.</div></div><div><h3>Methods</h3><div>We conducted a systematic search using PRISMA guidelines in PubMed, Web of Science, Embase, and Scopus. Only published case reports or conference abstracts presenting cases of confirmed HAV infection and GBS were included. Data extraction was performed independently by two reviewers, and quality assessment was conducted using the Joanna Briggs Institute critical appraisal tool.</div></div><div><h3>Results</h3><div>Out of 581 studies identified, 46 studies encompassing 47 cases met the inclusion criteria. The mean age of patients was 29.47 years, with a male predominance (70.2 %). Geographically, most cases were reported in Asia (74.5 %). Clinical manifestations of HAV included fever, malaise, and jaundice, while GBS presented with muscle weakness and areflexia. Laboratory findings showed albuminocytological dissociation in 76.2 % of cases. Nerve conduction studies predominantly indicated AIDP subtype (32/46, 69.6 %). Treatment involved IVIG, plasmapheresis, and supportive care, with recovery times ranging from one week to 18 months. One fatality was reported.</div></div><div><h3>Conclusions</h3><div>This review suggests a potential link between HAV infection and GBS, proposing a mechanism: molecular mimicry. It emphasizes the need for increased awareness and preventive measures, especially in areas with lower health standards. However, further research is needed to clarify the possible mechanisms and deepen our understanding.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100551"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047858","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}
Pub Date : 2025-01-06DOI: 10.1016/j.ensci.2025.100550
Sara Samadzadeh , Roy D. Sleator
Fluid biomarkers such as Glial Fibrillary Acidic Protein (GFAP) and Neurofilament Light (NfL) play important roles in the diagnosis, monitoring, and evaluation of therapeutic responses in conditions such as Multiple Sclerosis (MS) and Aquaporin-4 Neuromyelitis Optica Spectrum Disorder (AQP4-NMOSD). These biomarkers offer key insights into the underlying pathophysiological mechanisms of these diseases, enabling effective follow-up and personalized treatment approaches, which are essential for improving patient outcomes. Herein, we synthesize the structural attributes, functional roles, and clinical significance of GFAP and NfL in the context of MS and AQP4-NMOSD. We explore the critical implications of these biomarkers in disease manifestation and progression, emphasizing the necessity to develop standardized methodologies and multicentric studies to confirm their clinical applicability.
{"title":"The role of Neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in MS and AQP4-NMOSD: Advancing clinical applications.","authors":"Sara Samadzadeh , Roy D. Sleator","doi":"10.1016/j.ensci.2025.100550","DOIUrl":"10.1016/j.ensci.2025.100550","url":null,"abstract":"<div><div>Fluid biomarkers such as Glial Fibrillary Acidic Protein (GFAP) and Neurofilament Light (NfL) play important roles in the diagnosis, monitoring, and evaluation of therapeutic responses in conditions such as Multiple Sclerosis (MS) and Aquaporin-4 Neuromyelitis Optica Spectrum Disorder (AQP4-NMOSD). These biomarkers offer key insights into the underlying pathophysiological mechanisms of these diseases, enabling effective follow-up and personalized treatment approaches, which are essential for improving patient outcomes. Herein, we synthesize the structural attributes, functional roles, and clinical significance of GFAP and NfL in the context of MS and AQP4-NMOSD. We explore the critical implications of these biomarkers in disease manifestation and progression, emphasizing the necessity to develop standardized methodologies and multicentric studies to confirm their clinical applicability.</div></div>","PeriodicalId":37974,"journal":{"name":"eNeurologicalSci","volume":"38 ","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048120","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}
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