Neurologia Argentina最新文献

Introduction

Neurocognitive decline is one of the main negative changes associated with aging. Various factors appear to influence the magnitude of this decline. The objective of the study was to analyze the demographic, medical and lifestyle variables that predict better or worse neurocognitive performance in the older adult population.

Subjects and methods

The sample consisted of 816 Argentine older adults (age M 66.9; 74.3% women) from the general population (non-clinical). It was a non-probabilistic, intentional sampling. Participants were evaluated using two instruments, the Folstein Mini Mental State Examination (MMSE) and a questionnaire for demographic, medical, and other variables related to lifestyle. Data analysis included Student's t-test, Bonferroni-corrected multiple comparison ANOVA, Pearson correlations, and multiple linear regression.

Results

Nine factors explained 23.3% of the variance of the MMSE score (F 9.79 = 28.01, p < 0.00). Frequent mental calculations, smartphone use, computer use, frequent intellectual games, and more formal education predicted better neurocognitive performance. On the contrary, having suffered strokes, suffering from diabetes, taking chronic medication and being older all predicted poorer neurocognitive performance.

Conclusions

Nine factors demonstrate predictive capacity on neurocognitive performance in a large sample of Argentine older adults. Based on the results obtained, recommendations and practical guidelines are offered for the optimization of neurocognitive performance and primary prevention of dementias.

Autoimmune polyglandular syndrome is a rare disease with a low incidence worldwide. We present the case of an adult male with a history of parietal antibody-positive gastritis, central retinal vein obstruction and transverse myelitis. The patient was admitted for exacerbation of myelitis symptoms. The thyroid profile was positive for antibodies, indicating the presence of euthyroid autoimmune thyroid disease. The patient was finally diagnosed with autoimmune polyglandular syndrome type 3B. In the absence of adequate response to methylprednisolone and immunoglobulin, we started treatment with cyclophosphamide and later maintenance therapy with azathioprine. At one year of follow-up, the patient presented paraparesis as sequel, did not present new relapses and control tests were negative for another associated disease.

Introduction

The Wisconsin Card Sorting Test (hereinafter WCST) was created to evaluate the capacity of abstraction, the formation of concepts and the change of cognitive strategies in response to the changes that occur in environmental contingencies. It is a proof of use par excellence in the neuropsychological clinic, however, so far, the version of 64 cards did not have beams for use in Argentina.

Objectives

The objective of this study was to establish the normative values of the WCST, in the version of 64 cards, and to establish correction criteria less complex and consistent with the use given by professionals in the clinical field.

Participants

People between 20 and 60 years of age belonging to a population of people residing in the Province of Córdoba were evaluated.

Methods

An agreement was made between judges to establish the correction variables according to their frequency of use. A multiple regression was carried out in order to analyze differences between age, educational level and gender.

Results

Differences in the variable educational level were observed. The correction variables were established.

Conclusions

Studies previously conducted with WCST show that people with frontal injury complete a smaller number of categories and make more persistent errors, however the test cannot predict the origin of the injury and is not specific to frontal lesions, since people with subsequent injuries also decrease performance in both variables. People with psychiatric disorders may also experience an increased number of persistent errors.

Myxopapillary ependymoma (ME) is a rare tumor of glial lineage that predominantly affects young adults, with an incidence of 0.08 cases per 100,000 people. ME of the conus medullaris, cauda equina, and filum terminale of the spinal cord are generally considered slow-growing, benign tumors. Occasionally, ME can extend to the sacral bones, making it difficult to determine whether the tumor is of intradural or extradural origin. They are generally confined to the spinal canal and the destruction of bony, vertebral or iliac structures adjacent to the tumor are extremely rare events, as are visceral metastatic lesions.

Our case had a voluminous lesion at the level of the sacrum with extensive involvement, with visceral dissemination. A biopsy was performed followed by radiotherapy with a locally stationary result, but continued to progress systemically. We have discussed the clinical presentation, radiological features, and management strategies of this disease.

Introduction

Case reports have documented vestibulocochlear nerve involvement in Guillain-Barré syndrome, but its frequency is still unclear. This study aims to describe possible involvement of the vestibulocochlear nerve in patients with Guillain-Barré syndrome, with hearing loss a potential outcome.

Methods

In this observational, descriptive, prospective study we performed auditory evoked potentials in a sample of consecutive patients with Guillain-Barré syndrome admitted to a university hospital in Bogotá, Colombia, between July 2019 and March 2021.

Results

The study recruited 20 patients, 15 (75%) of them male, ages 19-79 years (mean 52); 8 (40%) had a history of previous infections. In 14 patients (70%), the auditory evoked potentials were abnormal. They had changes in the central conduction interval I-V with wave I to wave III delays, indicative of peripheral involvement of the vestibulocochlear nerve.

Conclusions

Results in this study suggest that vestibulocochlear nerve involvement is frequent in Guillain-Barré syndrome. The sample size is small, however, and larger studies are needed to enable correlation analysis.

The accelerated population aging has increased neurodegenerative diseases such as dementia, which has led to find different contextual factors that promote or prevent their development. In this study, a secondary analysis of the population study of «Health, Well-being and Aging» (SABE) Bogotá, 2012, was made, to know the situation of older adults residing in Bogotá, with the objective of establishing the mediating or moderating role of sociodemographic variables and of well-being in the relationship between depression and dementia.

Data from 2000 adults over 60 years of age were available. PROCESS V4 was used with a P < .05. Educational level, self-perception and comparison of health, social participation and physical activity were found to be mediating factors; age and access to health were moderators of the relationship between depression and dementia. These results indicate guidelines for the care of the elderly, from the model of modifiable factors that allow active aging.

Introduction

Mycobacterium tuberculosis (TB) infection is a public health problem; its pulmonary presentation is the most common, however there is extrapulmonary infection within which the central nervous system represents a high percentage.

Clinical case

Young patient who attends the Emergency Department due to low back pain, paraparesis and urinary retention in which TB myeloradiculitis is diagnosed, becoming a diagnostic challenge.

Conclusions

TB myeloradiculitis is an unusual complication of nervous system involvement. Given our high rate of TB infection, its inclusion in the differential diagnosis of acute spinal cord syndrome should be essential.

Introduction

Epileptic encephalopathies in infants, of genetic origin, manifest in the first two years of life. The peculiarity of this picture is the refractoriness to treatment with usual antiepileptic drugs and the presence of normal neuroimaging, metabolic studies and conventional karyotypes.

Clinical case

Our objective is the description of a 5-year-old patient diagnosed with early childhood epileptic encephalopathy type 42, associated with a de novo mutation of the calcium channel CACNA1A. In the same determination, the patient presented a mutation of the sodium channel SCNSA associated with Brugada syndrome.

Conclusion

In conclusion, the interaction between both genetic syndromes complicated the pharmacological decision.