Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.07.003
José Fernando Robles Díaz
Wallerian degeneration (WD) refers to the pathological process of secondary degeneration of axons and myelin sheaths that occurs distal to the site of acute injury in the neuronal soma or proximal axon. A rare case is presented of a male patient with an intracerebral tumor who developed WD after receiving external radiotherapy. Clinically, he presented Weber syndrome. Magnetic resonance imaging of the brain in FLAIR and T2 sequences showed hyperintense corticospinal tract. Differential diagnoses and possible treatments are presented.
{"title":"Degeneración walleriana del tracto corticoespinal por radioterapia: a propósito de un caso y revisión de la literatura","authors":"José Fernando Robles Díaz","doi":"10.1016/j.neuarg.2025.07.003","DOIUrl":"10.1016/j.neuarg.2025.07.003","url":null,"abstract":"<div><div>Wallerian degeneration (WD) refers to the pathological process of secondary degeneration of axons and myelin sheaths that occurs distal to the site of acute injury in the neuronal soma or proximal axon. A rare case is presented of a male patient with an intracerebral tumor who developed WD after receiving external radiotherapy. Clinically, he presented Weber syndrome. Magnetic resonance imaging of the brain in FLAIR and T2 sequences showed hyperintense corticospinal tract. Differential diagnoses and possible treatments are presented.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 264-267"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766066","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.05.004
Cintia Pamela Rodriguez, Yobana Delina Lazarte, Cristian David Espona, Maria Laura Menichini, Jorge Pedro Capriotti
Introduction
Syphilis is a disease caused by Treponema Pallidum, usually presenting with nonspecific signs and symptoms. Neurosyphilis occurs in 40% of patients and its diagnosis continues to pose difficulties due to the lack of a sensitive and specific gold standard.
Patients and methods
We present a description of the clinical and analytical
1 ª página characteristics of cerebrospinal fluid in 10 patients with neurosyphilis who were hospitalized in a hospital in the city of Rosario.
Results
Seven patients were men and 3 were women. Mean age was 41.1. Seven of them were HIV carriers. Mean serum VDRL was 256 dils. Reactive VDRL was obtained in CSF in 4 patients, all of them HIV positive. CSF showed a mean of 48.3 elements/mm3 with mononuclear predominance. Proteinorraquia presented a mean of 1.1 g/l. Signs and symptoms were predominantly headache, 6 patients presented meningitis, 2 cerebrovascular events, 1 optic neuropathy and 1 cranial neuropathy. All patients received treatment with EV penicillin.
Conclusions
There is underdiagnosis of neurosyphilis, this may be due to limitations in the diagnostic methodology or to the approximation algorithms that seems to be unspecific. Although we were able to obtain some interesting approximations to the clinical and analytical characteristics of these patients, the small sample size prevents us from drawing conclusions with adequate statistical weight. Therefore, we consider it necessary to carry out new experiments in the future that will allow a better understanding of this type of patients, as well as to develop a sensitive and specific tool for the diagnosis of neurosyphilis.
{"title":"Neurosífilis: una enfermedad poco sospechada pero siempre presente","authors":"Cintia Pamela Rodriguez, Yobana Delina Lazarte, Cristian David Espona, Maria Laura Menichini, Jorge Pedro Capriotti","doi":"10.1016/j.neuarg.2025.05.004","DOIUrl":"10.1016/j.neuarg.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis is a disease caused by Treponema Pallidum, usually presenting with nonspecific signs and symptoms. Neurosyphilis occurs in 40% of patients and its diagnosis continues to pose difficulties due to the lack of a sensitive and specific gold standard.</div></div><div><h3>Patients and methods</h3><div>We present a description of the clinical and analytical</div><div>1<!--> <!-->ª página characteristics of cerebrospinal fluid in 10 patients with neurosyphilis who were hospitalized in a hospital in the city of Rosario.</div></div><div><h3>Results</h3><div>Seven patients were men and 3 were women. Mean age was 41.1. Seven of them were HIV carriers. Mean serum VDRL was 256 dils. Reactive VDRL was obtained in CSF in 4 patients, all of them HIV positive. CSF showed a mean of 48.3 elements/mm3 with mononuclear predominance. Proteinorraquia presented a mean of 1.1 g/l. Signs and symptoms were predominantly headache, 6 patients presented meningitis, 2 cerebrovascular events, 1 optic neuropathy and 1 cranial neuropathy. All patients received treatment with EV penicillin.</div></div><div><h3>Conclusions</h3><div>There is underdiagnosis of neurosyphilis, this may be due to limitations in the diagnostic methodology or to the approximation algorithms that seems to be unspecific. Although we were able to obtain some interesting approximations to the clinical and analytical characteristics of these patients, the small sample size prevents us from drawing conclusions with adequate statistical weight. Therefore, we consider it necessary to carry out new experiments in the future that will allow a better understanding of this type of patients, as well as to develop a sensitive and specific tool for the diagnosis of neurosyphilis.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 223-226"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766076","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.08.002
Alejandro Arango , Julián Mauricio Jiménez Álvarez , Luisa Fernanda Giraldo Ballesteros , Juan Carlos Arrieta Bechara , Rafael Ignacio Herrera Ramos
Introduction
Cerebral venous thrombosis (CVT) is an uncommon condition with a multifactorial etiology, including hereditary thrombophilias. Hyperhomocysteinemia, secondary to MTHFR mutations, is a potential risk factor.
Case report
A 29-year-old woman with grade III obesity, preeclampsia, and a family history of cerebral thrombosis presented with progressive headache. Neuroimaging revealed extensive dural sinus thrombosis and intracranial hypertension. Hyperhomocysteinemia and an MTHFR (c.677C >T) heterozygous mutation were identified, leading to anticoagulation with dabigatran.
Conclusions
The association between CVT and MTHFR mutations remains controversial. There is no solid evidence supporting the systematic screening of hyperhomocysteinemia in cerebral thrombosis without a clear triggering factor.
{"title":"Trombosis de senos durales como manifestación inusual de trombofilia hereditaria","authors":"Alejandro Arango , Julián Mauricio Jiménez Álvarez , Luisa Fernanda Giraldo Ballesteros , Juan Carlos Arrieta Bechara , Rafael Ignacio Herrera Ramos","doi":"10.1016/j.neuarg.2025.08.002","DOIUrl":"10.1016/j.neuarg.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Cerebral venous thrombosis (CVT) is an uncommon condition with a multifactorial etiology, including hereditary thrombophilias. Hyperhomocysteinemia, secondary to <em>MTHFR</em> mutations, is a potential risk factor.</div></div><div><h3>Case report</h3><div>A 29-year-old woman with grade III obesity, preeclampsia, and a family history of cerebral thrombosis presented with progressive headache. Neuroimaging revealed extensive dural sinus thrombosis and intracranial hypertension. Hyperhomocysteinemia and an <em>MTHFR</em> (c.677C<!--> <!-->>T) heterozygous mutation were identified, leading to anticoagulation with dabigatran.</div></div><div><h3>Conclusions</h3><div>The association between CVT and <em>MTHFR</em> mutations remains controversial. There is no solid evidence supporting the systematic screening of hyperhomocysteinemia in cerebral thrombosis without a clear triggering factor.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 252-258"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766081","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.07.004
Martina Scicchitano, Maria Florencia Sica, Ludmila Ortiz, Agustina Babbicola, Daiana Barrio, Emilia Sanchez Toledo, Emilia Clement, Alejandra Heriz, Lucas Romano, Pablo Ioli, Macarena Bermejo
Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of abnormal plasma cells and the production of monoclonal proteins, frequently leading to multisystem involvement. Neurological complications, including peripheral neuropathy and cranial nerve involvement, may occur during the course of the disease. We report the case of a patient diagnosed with MM in 2014, who underwent multiple lines of therapy due to successive relapses. Over time, he developed progressive muscle weakness, dysarthria, and bulbar symptoms. Neurological assessment revealed evidence of multifactorial involvement. Despite ongoing treatment, the patient's neurological condition deteriorated, and he ultimately died due to bronchoaspiration. This case underscores the clinical complexity of advanced MM and highlights its potential for atypical neurological manifestations.
{"title":"Compromiso bulbar en paciente con mieloma múltiple y neuropatía periférica secundaria","authors":"Martina Scicchitano, Maria Florencia Sica, Ludmila Ortiz, Agustina Babbicola, Daiana Barrio, Emilia Sanchez Toledo, Emilia Clement, Alejandra Heriz, Lucas Romano, Pablo Ioli, Macarena Bermejo","doi":"10.1016/j.neuarg.2025.07.004","DOIUrl":"10.1016/j.neuarg.2025.07.004","url":null,"abstract":"<div><div>Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of abnormal plasma cells and the production of monoclonal proteins, frequently leading to multisystem involvement. Neurological complications, including peripheral neuropathy and cranial nerve involvement, may occur during the course of the disease. We report the case of a patient diagnosed with MM in 2014, who underwent multiple lines of therapy due to successive relapses. Over time, he developed progressive muscle weakness, dysarthria, and bulbar symptoms. Neurological assessment revealed evidence of multifactorial involvement. Despite ongoing treatment, the patient's neurological condition deteriorated, and he ultimately died due to bronchoaspiration. This case underscores the clinical complexity of advanced MM and highlights its potential for atypical neurological manifestations.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 268-271"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766067","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.04.006
Francisco Peñalver , Ana Laura González Bellene , Graciana Galiana , Berenice Silva
Introduction
Multiple sclerosis (MS) is a central nervous system (CNS) disease with various physical, emotional, and cognitive symptoms, including fatigue, which deteriorates health perception. Our study aimed to determine the impact of fatigue on quality of life and its relationship with the Expanded Disability Status Scale (EDSS) in MS patients, as well as to evaluate the impact on work activity since diagnosis.
Materials and methods
We designed a multicenter, observational, descriptive, and cross-sectional study of our MS population. Data were collected using the Modified Fatigue Impact Scale (MFIS) and the International Quality of Life in MS Questionnaire (MusiQol). Parametric and non-parametric data were analyzed using EPI Info 7 and Java 2.5.6 software for binomial linear regression.
Results
We included 101 MS patients over a 4-month period. The median EDSS was 1.5. Fatigue was present in 34.7% of patients, with 45.5% of them showing high impact on the physical subscale. Among patients with fatigue, 62.9% experienced a reduction in their working hours. The global index (GI) of the MusiQol questionnaire revealed moderate quality of life in 62.9% of MS patients. The median EDSS was higher in patients with high fatigue impact in the physical and psychosocial domains compared to those with low impact (p = 0.0003 and p = 0.0001). Patients with moderate GI had a median EDSS of 2, while those with good GI had a median EDSS of 1 (p = 0.003). Non-parametric analysis showed that patients with fatigue had a median EDSS of 2, while those without fatigue had a median of 1 (p = 0.001). Parametric analysis indicated that patients with EDSS < 2 had a moderate GI in 51.7% and a good GI in 44.8%, whereas those with EDSS ≥ 2 had a moderate GI in 72.1% and a good GI in 20.9% (p = 0.004). Fatigue was present in 53.5% of patients with EDSS ≥ 2, compared to only 20.7% of those with EDSS < 2 (p = 0.0003).
Conclusion
Fatigue has a low prevalence but significantly impacts the physical subscale, affecting quality of life and work hours, even in patients with EDSS of 2 or higher.
{"title":"Impacto de la fatiga sobre la calidad de vida y la funcionalidad en pacientes con esclerosis múltiple","authors":"Francisco Peñalver , Ana Laura González Bellene , Graciana Galiana , Berenice Silva","doi":"10.1016/j.neuarg.2025.04.006","DOIUrl":"10.1016/j.neuarg.2025.04.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Multiple sclerosis (MS) is a central nervous system (CNS) disease with various physical, emotional, and cognitive symptoms, including fatigue, which deteriorates health perception. Our study aimed to determine the impact of fatigue on quality of life and its relationship with the Expanded Disability Status Scale (EDSS) in MS patients, as well as to evaluate the impact on work activity since diagnosis.</div></div><div><h3>Materials and methods</h3><div>We designed a multicenter, observational, descriptive, and cross-sectional study of our MS population. Data were collected using the Modified Fatigue Impact Scale (MFIS) and the International Quality of Life in MS Questionnaire (MusiQol). Parametric and non-parametric data were analyzed using EPI Info 7 and Java 2.5.6 software for binomial linear regression.</div></div><div><h3>Results</h3><div>We included 101 MS patients over a 4-month period. The median EDSS was 1.5. Fatigue was present in 34.7% of patients, with 45.5% of them showing high impact on the physical subscale. Among patients with fatigue, 62.9% experienced a reduction in their working hours. The global index (GI) of the MusiQol questionnaire revealed moderate quality of life in 62.9% of MS patients. The median EDSS was higher in patients with high fatigue impact in the physical and psychosocial domains compared to those with low impact (p<!--> <!-->=<!--> <!-->0.0003 and p<!--> <!-->=<!--> <!-->0.0001). Patients with moderate GI had a median EDSS of 2, while those with good GI had a median EDSS of 1 (p<!--> <!-->=<!--> <!-->0.003). Non-parametric analysis showed that patients with fatigue had a median EDSS of 2, while those without fatigue had a median of 1 (p<!--> <!-->=<!--> <!-->0.001). Parametric analysis indicated that patients with EDSS<!--> <!--><<!--> <!-->2 had a moderate GI in 51.7% and a good GI in 44.8%, whereas those with EDSS<!--> <!-->≥<!--> <!-->2 had a moderate GI in 72.1% and a good GI in 20.9% (p<!--> <!-->=<!--> <!-->0.004). Fatigue was present in 53.5% of patients with EDSS<!--> <!-->≥<!--> <!-->2, compared to only 20.7% of those with EDSS<!--> <!--><<!--> <!-->2 (p<!--> <!-->=<!--> <!-->0.0003).</div></div><div><h3>Conclusion</h3><div>Fatigue has a low prevalence but significantly impacts the physical subscale, affecting quality of life and work hours, even in patients with EDSS of 2 or higher.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 213-222"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766075","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.07.001
Alexandra Ferreirós, Carolina García-Alfonso, Lussiana Folleco Insuasty, Juliana Coral
Introduction
Subclavian steal syndrome occurs due to retrograde flow secondary to ipsilateral subclavian stenosis which leads to hemodynamic changes causing cerebrovascular lesions, specifically in the posterior arterial territory.
Case
A patient with acute weakness and hypoesthesia. MRI revealed a stroke in the left middle cerebral artery territory. Further studies reported subclavian steal syndrome.
Conclusion
Subclavian steal syndrome is associated with cerebrovascular disease, particularly in the posterior territory, hence, neurologists should be aware of the clinical picture, diagnosis approach and treatment options.
{"title":"Accidente cerebrovascular isquémico y síndrome de robo de la subclavia: más que un hallazgo incidental","authors":"Alexandra Ferreirós, Carolina García-Alfonso, Lussiana Folleco Insuasty, Juliana Coral","doi":"10.1016/j.neuarg.2025.07.001","DOIUrl":"10.1016/j.neuarg.2025.07.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Subclavian steal syndrome occurs due to retrograde flow secondary to ipsilateral subclavian stenosis which leads to hemodynamic changes causing cerebrovascular lesions, specifically in the posterior arterial territory.</div></div><div><h3>Case</h3><div>A patient with acute weakness and hypoesthesia. MRI revealed a stroke in the left middle cerebral artery territory. Further studies reported subclavian steal syndrome.</div></div><div><h3>Conclusion</h3><div>Subclavian steal syndrome is associated with cerebrovascular disease, particularly in the posterior territory, hence, neurologists should be aware of the clinical picture, diagnosis approach and treatment options.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 242-246"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766079","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.09.001
Antonio Cristóbal Luque-Ambrosiani , Francisco Javier Gómez-Fernández
{"title":"Lipomatosis múltiple simétrica y neuropatía axonal en paciente con enfermedad de Charcot-Marie-Tooth debida a mutación homocigota en MFN2","authors":"Antonio Cristóbal Luque-Ambrosiani , Francisco Javier Gómez-Fernández","doi":"10.1016/j.neuarg.2025.09.001","DOIUrl":"10.1016/j.neuarg.2025.09.001","url":null,"abstract":"","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 276-278"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766069","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.07.002
Alejandra Heriz , Andrea Horsch , Jorge Norscini
Introduction
Abducens (sixth cranial nerve) pseudoparalysis is a rare condition, with few reported cases in the literature. There's no clear consensus on the precise anatomical mechanisms that cause it, though damage to structures like the mesencephalon, thalamus, or pons is suggested as a potential origin. It's hypothesized that an impairment of the descending pathways controlling convergence inhibition, specifically those descending through the paramedian thalamic area and decussating in the subthalamic region, could lead to hyperfunction of the contralateral medial rectus, mimicking a sixth nerve deficit.
Case report
This article presents a case of abducens pseudoparalysis in a patient with exquisite and isolated thalamic involvement. Magnetic resonance imaging (MRI) scans in coronal and sagittal views showed a lesion almost exclusively in the dorsomedial thalamic nucleus, with no involvement of other regions.
Discussion
This finding is crucial as it suggests that an isolated lesion in the dorsomedial thalamic nucleus is sufficient to cause this clinical presentation. Most previously reported cases involve multiple structures, making this report extremely rare and the first with such a circumscribed lesion.
Conclusion
Abducens pseudoparalysis results from the alteration of suprananclear pathways as they pass through the thalamus and mesencephalon. Our case highlights that a focal lesion in the dorsomedial thalamic nucleus can be the sole cause, representing an infrequent and unique presentation in medical literature.
{"title":"Seudoparálisis del abducens","authors":"Alejandra Heriz , Andrea Horsch , Jorge Norscini","doi":"10.1016/j.neuarg.2025.07.002","DOIUrl":"10.1016/j.neuarg.2025.07.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Abducens (sixth cranial nerve) pseudoparalysis is a rare condition, with few reported cases in the literature. There's no clear consensus on the precise anatomical mechanisms that cause it, though damage to structures like the mesencephalon, thalamus, or pons is suggested as a potential origin. It's hypothesized that an impairment of the descending pathways controlling convergence inhibition, specifically those descending through the paramedian thalamic area and decussating in the subthalamic region, could lead to hyperfunction of the contralateral medial rectus, mimicking a sixth nerve deficit.</div></div><div><h3>Case report</h3><div>This article presents a case of abducens pseudoparalysis in a patient with exquisite and isolated thalamic involvement. Magnetic resonance imaging (MRI) scans in coronal and sagittal views showed a lesion almost exclusively in the dorsomedial thalamic nucleus, with no involvement of other regions.</div></div><div><h3>Discussion</h3><div>This finding is crucial as it suggests that an isolated lesion in the dorsomedial thalamic nucleus is sufficient to cause this clinical presentation. Most previously reported cases involve multiple structures, making this report extremely rare and the first with such a circumscribed lesion.</div></div><div><h3>Conclusion</h3><div>Abducens pseudoparalysis results from the alteration of suprananclear pathways as they pass through the thalamus and mesencephalon. Our case highlights that a focal lesion in the dorsomedial thalamic nucleus can be the sole cause, representing an infrequent and unique presentation in medical literature.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 247-251"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766080","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.08.004
Guillermo Bizantino , Ana Arduz , Alejandro Ceciliano , Santiago Farfán , Cristian Noriega , Agustina Palmero , Bruno Petrini , Sol Pratesi , Josefina Seguí , Francisco Villasante , Carolina Zúñiga
We present the case of a 76-year-old male diagnosed with capsular alarm syndrome, defined by at least three stereotyped, self-limiting neurological episodes within 72 hours, affecting the face, arm, or leg, without cortical signs and with full symptom resolution. This syndrome often precedes a symptomatic infarction in 40–60% of cases. The exact pathophysiological mechanism remains unclear. High-resolution MRI and MRA are the most precise diagnostic tools. Therapeutic management includes combined antiplatelet therapy, strict control of blood pressure, and intravenous thrombolysis in selected cases. Early recognition and intervention are essential to reduce the risk of progression to a disabling ischemic event.
{"title":"Síndrome de alarma capsular: reporte de un caso y revisión bibliográfica","authors":"Guillermo Bizantino , Ana Arduz , Alejandro Ceciliano , Santiago Farfán , Cristian Noriega , Agustina Palmero , Bruno Petrini , Sol Pratesi , Josefina Seguí , Francisco Villasante , Carolina Zúñiga","doi":"10.1016/j.neuarg.2025.08.004","DOIUrl":"10.1016/j.neuarg.2025.08.004","url":null,"abstract":"<div><div>We present the case of a 76-year-old male diagnosed with capsular alarm syndrome, defined by at least three stereotyped, self-limiting neurological episodes within 72<!--> <!-->hours, affecting the face, arm, or leg, without cortical signs and with full symptom resolution. This syndrome often precedes a symptomatic infarction in 40–60% of cases. The exact pathophysiological mechanism remains unclear. High-resolution MRI and MRA are the most precise diagnostic tools. Therapeutic management includes combined antiplatelet therapy, strict control of blood pressure, and intravenous thrombolysis in selected cases. Early recognition and intervention are essential to reduce the risk of progression to a disabling ischemic event.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 272-275"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766068","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}
Pub Date : 2025-10-01DOI: 10.1016/j.neuarg.2025.08.003
Alfredo Puy Núñez , Nuria Redondo Rafales , Francisco Javier Cores González , Julia Barreiro Honrado , Luis Anibarro García , Ana Rodríguez Regal
Introduction
Uveitis is one of the major causes of visual impairment and remains a challenge.
Clinical case
We present a case of a rapid bilateral visual acuity deficit in a patient with fundus compatible with Birdshot's chorioretinopathy (BCR) and human leukocyte antigen A29 (HLA-A29) positivity. We discuss the differential diagnosis and the tests performed that, together with the follow-up time with the established treatment, allow the diagnosis of neurosarcoidosis.
Conclusions
Screening for systemic clinical manifestations should be consubstantial with the findings of a fundus compatible with BCR. HLA-A29 positivity does not allow a diagnosis to be confirmed by itself.
{"title":"No es un Birdshot: un debut atípico de sarcoidosis","authors":"Alfredo Puy Núñez , Nuria Redondo Rafales , Francisco Javier Cores González , Julia Barreiro Honrado , Luis Anibarro García , Ana Rodríguez Regal","doi":"10.1016/j.neuarg.2025.08.003","DOIUrl":"10.1016/j.neuarg.2025.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Uveitis is one of the major causes of visual impairment and remains a challenge.</div></div><div><h3>Clinical case</h3><div>We present a case of a rapid bilateral visual acuity deficit in a patient with fundus compatible with Birdshot's chorioretinopathy (BCR) and human leukocyte antigen A29 (HLA-A29) positivity. We discuss the differential diagnosis and the tests performed that, together with the follow-up time with the established treatment, allow the diagnosis of neurosarcoidosis.</div></div><div><h3>Conclusions</h3><div>Screening for systemic clinical manifestations should be consubstantial with the findings of a fundus compatible with BCR. HLA-A29 positivity does not allow a diagnosis to be confirmed by itself.</div></div>","PeriodicalId":39051,"journal":{"name":"Neurologia Argentina","volume":"17 4","pages":"Pages 259-263"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766082","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}
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