Pub Date : 2026-02-28DOI: 10.1016/j.nrleng.2026.501918
M J Gil Moreno, C Terrón Cuadrado, M S Manzano Palomo, A Delgado Alvarez, M Eimil Ortiz, G Garcia Ribas, M Llanero Luque, A Marcos Dolado, J Matias-Guiu Antem, C Ochoa Lopez, N Rodriguez Espinosa, M Salas Carrillo, A Vieira Campos
Recent studies have demonstrated a relationship between the development of cognitive impairment and dementia and lifestyle-related risk factors, many of which are potentially modifiable, making it possible to prevent dementia through a public health approach that includes the implementation of key interventions to delay or slow cognitive decline or dementia. This consensus statement was prepared by a group of experts in cognitive pathology and the Neurogeriatrics Study Group of the Spanish Society of Neurology. This document consists of a review of the existing literature, and its main objective is to serve as a guide for healthcare professionals interested in cognitive impairment and dementia. The different modifiable risk factors related to cognitive decline and dementia are listed and related aspects are analysed; it also presents a series of basic recommendations. This document has been drafted to be a useful tool in the clinical practice of professionals providing care to patients with cognitive impairment and dementia.
{"title":"Consensus document of the Spanish Society of Neurology on the prevention of cognitive decline and dementia.","authors":"M J Gil Moreno, C Terrón Cuadrado, M S Manzano Palomo, A Delgado Alvarez, M Eimil Ortiz, G Garcia Ribas, M Llanero Luque, A Marcos Dolado, J Matias-Guiu Antem, C Ochoa Lopez, N Rodriguez Espinosa, M Salas Carrillo, A Vieira Campos","doi":"10.1016/j.nrleng.2026.501918","DOIUrl":"10.1016/j.nrleng.2026.501918","url":null,"abstract":"<p><p>Recent studies have demonstrated a relationship between the development of cognitive impairment and dementia and lifestyle-related risk factors, many of which are potentially modifiable, making it possible to prevent dementia through a public health approach that includes the implementation of key interventions to delay or slow cognitive decline or dementia. This consensus statement was prepared by a group of experts in cognitive pathology and the Neurogeriatrics Study Group of the Spanish Society of Neurology. This document consists of a review of the existing literature, and its main objective is to serve as a guide for healthcare professionals interested in cognitive impairment and dementia. The different modifiable risk factors related to cognitive decline and dementia are listed and related aspects are analysed; it also presents a series of basic recommendations. This document has been drafted to be a useful tool in the clinical practice of professionals providing care to patients with cognitive impairment and dementia.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"501918"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328863","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 : 2026-02-28DOI: 10.1016/j.nrleng.2026.501917
A Jaimes, A Gómez, O Pajares, J Rodríguez-Vico
{"title":"Beyond indomethacin: A case report of chronic proximal hemicrania with remarkable response to non-invasive vagus nerve stimulation.","authors":"A Jaimes, A Gómez, O Pajares, J Rodríguez-Vico","doi":"10.1016/j.nrleng.2026.501917","DOIUrl":"10.1016/j.nrleng.2026.501917","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"501917"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328861","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 : 2026-02-28DOI: 10.1016/j.nrleng.2026.501915
M Bote Gascón, E Arias Vivas, U A Barrios Machain, A García Ron
Introduction: Peripheral nerve blockade (PNB) is a common treatment in adults with headache. Although there is little evidence in pediatrics, its simplicity, safety and efficacy make it an option that can be extrapolated to our practice. Therefore, we conducted a study in which we evaluated the usefulness of anesthetic blockade of the NOM (greater occipital nerve) as a treatment for migraine in the pediatric population.
Methods: Prospective cohort study in children and adolescents with migraine. We collected demographic and clinical data (pain intensity using the verbal numeric scale) and data related to quality of life (PedMidas and PedsQL questionnaire) at baseline and after performing NOM block with 2.5 ml of 0.5% bupivacaine.
Results: We included 28 patients (89.3% women) with a mean age of 13.9 years. Mean frequency of 22.8 episodes/month and intensity of 7.7/10 on the verbal-numerical scale (VNS). Post-treatment: significant reduction (P < .01) in frequency to 6.1 episodes/month and intensity: 3.9 points (30 minutes), 4.2 points (1 week), 3.9 points (15 days), 4.4 points (1 month) and 5.4 points (3 months). 100% had an effect on their quality of life, both on the PedMidas and PedsQL scales, the greater the effect, the better the response. Only 2 had adverse effects (syncope and local pain).
Conclusions: NOM blockade is a safe, effective and useful procedure for the acute and preventive treatment of migraine in pediatric age. It relieves the burden associated with headache and is associated with an improvement in the quality of life of patients.
简介：周围神经阻滞（PNB）是成人头痛的常用治疗方法。虽然在儿科学中几乎没有证据，但它的简单性、安全性和有效性使其成为一种可以外推到我们实践中的选择。因此，我们进行了一项研究，评估了麻醉阻断枕大神经（NOM）作为儿科偏头痛治疗的有效性。方法：对儿童和青少年偏头痛患者进行前瞻性队列研究。在基线和用2.5 ml 0.5%布比卡因进行NOM阻断后，我们收集了人口统计学和临床数据（使用口头数字量表的疼痛强度）以及与生活质量相关的数据（PedMidas和PedsQL问卷）。结果：我们纳入28例患者（89.3%为女性），平均年龄13.9岁。言语-数值量表（VNS）平均发作频率为22.8次/月，强度为7.7/10。结论：小儿年龄期偏头痛急性和预防性治疗中，NOM阻断是一种安全、有效和有用的治疗方法。它减轻了与头痛相关的负担，并与患者生活质量的改善有关。
{"title":"Usefulness of anesthetic block of the greater occipital nerve in the treatment of migraine in children and adolescents.","authors":"M Bote Gascón, E Arias Vivas, U A Barrios Machain, A García Ron","doi":"10.1016/j.nrleng.2026.501915","DOIUrl":"10.1016/j.nrleng.2026.501915","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral nerve blockade (PNB) is a common treatment in adults with headache. Although there is little evidence in pediatrics, its simplicity, safety and efficacy make it an option that can be extrapolated to our practice. Therefore, we conducted a study in which we evaluated the usefulness of anesthetic blockade of the NOM (greater occipital nerve) as a treatment for migraine in the pediatric population.</p><p><strong>Methods: </strong>Prospective cohort study in children and adolescents with migraine. We collected demographic and clinical data (pain intensity using the verbal numeric scale) and data related to quality of life (PedMidas and PedsQL questionnaire) at baseline and after performing NOM block with 2.5 ml of 0.5% bupivacaine.</p><p><strong>Results: </strong>We included 28 patients (89.3% women) with a mean age of 13.9 years. Mean frequency of 22.8 episodes/month and intensity of 7.7/10 on the verbal-numerical scale (VNS). Post-treatment: significant reduction (P < .01) in frequency to 6.1 episodes/month and intensity: 3.9 points (30 minutes), 4.2 points (1 week), 3.9 points (15 days), 4.4 points (1 month) and 5.4 points (3 months). 100% had an effect on their quality of life, both on the PedMidas and PedsQL scales, the greater the effect, the better the response. Only 2 had adverse effects (syncope and local pain).</p><p><strong>Conclusions: </strong>NOM blockade is a safe, effective and useful procedure for the acute and preventive treatment of migraine in pediatric age. It relieves the burden associated with headache and is associated with an improvement in the quality of life of patients.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"501915"},"PeriodicalIF":0.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328934","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 : 2026-02-27DOI: 10.1016/j.nrleng.2026.501916
M De la Fuente Gómez-Morán, F Hernández-Fernández, E L Setién, R M Collado Jiménez, C Barrena López, R A Barbella Aponte
{"title":"Iatrogenic cerebral amyloid angiopathy in a young patient: aetiopathogenic hypothesis.","authors":"M De la Fuente Gómez-Morán, F Hernández-Fernández, E L Setién, R M Collado Jiménez, C Barrena López, R A Barbella Aponte","doi":"10.1016/j.nrleng.2026.501916","DOIUrl":"10.1016/j.nrleng.2026.501916","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"501916"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328795","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 : 2026-02-27DOI: 10.1016/j.nrleng.2026.501914
I Comino-Hidalgo, J López Pequeño, A Aguado Del Hoyo, M Vázquez López
{"title":"Use of tocilizumab in acute necrotising encephalitis secondary to influenza A.","authors":"I Comino-Hidalgo, J López Pequeño, A Aguado Del Hoyo, M Vázquez López","doi":"10.1016/j.nrleng.2026.501914","DOIUrl":"10.1016/j.nrleng.2026.501914","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"501914"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328862","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 : 2026-02-27DOI: 10.1016/j.nrleng.2026.501913
L Castilla-Guerra, M C Fernandez-Moreno, M de la Serna Fito, A Palomino-Garcia, G A Escobar Rodriguez, M D Jiménez Hernandez
Introduction: Arterial hypertension is the most prevalent modifiable risk factor for stroke. We aim to establish if there is an association between hypertension and type of stroke, and if this varies with age.
Methods: Retrospective study of patients with a first stroke discharged from public hospitals in Seville (Spain) between 1999 and 2021. Only patients with hypertension as a risk factor were included. The sample was divided into 3 groups: patients ≤ 50 years, 51 to 79 years and ≥ 80 years.
Results: Of 42 855 strokes, 2141 (4.9%) hypertensive patients with a first stroke, mean age 68 (15) years, and 1010 (47.2%) women, were included. Included were 1274 (59.5%) ischaemic strokes and 867 (40.5%) haemorrhagic strokes, 309 (14.4%) patients ≤ 50 years of age, 1253 (58.3%) patients between 51 and 79 years of age, and 579 (27.3%) patients ≥ 80 years of age. The percentage of patients with a previous diagnosis of hypertension was 24.3% vs 51.3% vs 79.4% (P < .001), with a mean time from diagnosis to stroke of 5.5 (3.7) vs 7.8 (4.9) vs 9.6 (5.1) years (P < .001) respectively. The number of haemorrhagic strokes was: 171 (55.3%), 523 (41.7%), and 172 (29.7%) (P < .001), with mortality at one year being 3.2%, 10%, and 35.6%, respectively (P < .001).
Conclusions: In hypertensive patients with a first stroke, the percentage of haemorrhagic strokes is higher than expected, especially in young patients, where it exceeds half of the cases. It is necessary to optimise prevention in these patients to reduce the enormous social and healthcare burden that stroke represents.
简介：动脉高血压是卒中最普遍的可改变危险因素。我们的目的是确定高血压和中风类型之间是否存在联系，以及这种联系是否随年龄而变化。方法：对1999年至2021年西班牙塞维利亚公立医院首次卒中出院患者进行回顾性研究。仅包括高血压作为危险因素的患者。样本分为≤50岁、51 ~ 79岁和≥80岁3组。结果：在42,855例卒中患者中，2141例（4.9%）高血压患者首次卒中，平均年龄68（±15）岁，1,010例（47.2%）女性。其中缺血性卒中1274例（59.5%），出血性卒中867例（40.5%），年龄≤50岁患者309例（14.4%），51 ~ 79岁患者1253例（58.3%），≥80岁患者579例（27.3%）。既往诊断为高血压的患者比例为24.3% vs. 51.3% vs. 79.4% (p)结论：首次卒中的高血压患者出血性卒中的比例高于预期，尤其是年轻患者，其比例超过一半以上。有必要优化这些患者的预防措施，以减轻卒中所带来的巨大社会卫生负担。
{"title":"Impact of hypertension on stroke. Are there different age profiles?","authors":"L Castilla-Guerra, M C Fernandez-Moreno, M de la Serna Fito, A Palomino-Garcia, G A Escobar Rodriguez, M D Jiménez Hernandez","doi":"10.1016/j.nrleng.2026.501913","DOIUrl":"10.1016/j.nrleng.2026.501913","url":null,"abstract":"<p><strong>Introduction: </strong>Arterial hypertension is the most prevalent modifiable risk factor for stroke. We aim to establish if there is an association between hypertension and type of stroke, and if this varies with age.</p><p><strong>Methods: </strong>Retrospective study of patients with a first stroke discharged from public hospitals in Seville (Spain) between 1999 and 2021. Only patients with hypertension as a risk factor were included. The sample was divided into 3 groups: patients ≤ 50 years, 51 to 79 years and ≥ 80 years.</p><p><strong>Results: </strong>Of 42 855 strokes, 2141 (4.9%) hypertensive patients with a first stroke, mean age 68 (15) years, and 1010 (47.2%) women, were included. Included were 1274 (59.5%) ischaemic strokes and 867 (40.5%) haemorrhagic strokes, 309 (14.4%) patients ≤ 50 years of age, 1253 (58.3%) patients between 51 and 79 years of age, and 579 (27.3%) patients ≥ 80 years of age. The percentage of patients with a previous diagnosis of hypertension was 24.3% vs 51.3% vs 79.4% (P < .001), with a mean time from diagnosis to stroke of 5.5 (3.7) vs 7.8 (4.9) vs 9.6 (5.1) years (P < .001) respectively. The number of haemorrhagic strokes was: 171 (55.3%), 523 (41.7%), and 172 (29.7%) (P < .001), with mortality at one year being 3.2%, 10%, and 35.6%, respectively (P < .001).</p><p><strong>Conclusions: </strong>In hypertensive patients with a first stroke, the percentage of haemorrhagic strokes is higher than expected, especially in young patients, where it exceeds half of the cases. It is necessary to optimise prevention in these patients to reduce the enormous social and healthcare burden that stroke represents.</p>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":" ","pages":"501913"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328779","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 : 2026-01-01Epub Date: 2025-11-21DOI: 10.1016/j.nrleng.2025.101904
J.M. Ramos-Fernández , A. Extraviz Moreno , N. del Arco Guzmán , R. Calvo Medina , L. Rodríguez Santos , P. Navas Sánchez
Introduction
Absence seizures due to secondary bilateral synchrony may be a manifestation of frontal seizures, indistinguishable from primary absence epilepsy (PAE), with a different prognosis and control. There are few epidemiological studies on frontal absences (FAE) in the group of absence epilepsy (AE) in children.
Objective
To describe the epidemiology of FAE in childhood and compare the characteristics, clinical evolution, and pharmacological response with PAE.
Patients and method
Retrospective study of cases with AE in children under 14 years of age from 2013 to 2022 in a tertiary hospital. Demographic variables, number, duration and type of associated seizures, frontal EEG focality with and without relation to generalized discharge, pharmacological response and neuroimaging were comparatively studied.
Results
94 patients with a median age of 8.6 years (6–10.1 years; 49M/45H) with AE were included. 84% presented exclusively absence seizures. Hyperventilation induced seizures in 94.2%; photoparoxysms present in 5.3%. They showed EEG focus, 63/94 and in 45/94 it was frontal. In 14/94 (14.8%) the frontal focality preceded the critical spike-wave discharge. The bivariate analysis did not show significant differences in age, time until the consultation, psychomotor development/behavior alteration, association of other types of seizures and triggers. The number of absences/days was significantly lower in the EAFs (p = 0.004) and the need for combination therapy was greater in the bivariate (p = 0.005) and multivariate (p = 0.035) analysis.
Conclusions
FAE represents a significant percentage of AE with seizures of identical morphology, age, and duration, although with fewer seizures/day and a worse response to treatment.
{"title":"Epidemiology and clinical characteristics of frontal absence seizures compared with primary absence seizures","authors":"J.M. Ramos-Fernández , A. Extraviz Moreno , N. del Arco Guzmán , R. Calvo Medina , L. Rodríguez Santos , P. Navas Sánchez","doi":"10.1016/j.nrleng.2025.101904","DOIUrl":"10.1016/j.nrleng.2025.101904","url":null,"abstract":"<div><h3>Introduction</h3><div>Absence seizures due to secondary bilateral synchrony may be a manifestation of frontal seizures, indistinguishable from primary absence epilepsy (PAE), with a different prognosis and control. There are few epidemiological studies on frontal absences (FAE) in the group of absence epilepsy (AE) in children.</div></div><div><h3>Objective</h3><div>To describe the epidemiology of FAE in childhood and compare the characteristics, clinical evolution, and pharmacological response with PAE.</div></div><div><h3>Patients and method</h3><div>Retrospective study of cases with AE in children under 14 years of age from 2013 to 2022 in a tertiary hospital. Demographic variables, number, duration and type of associated seizures, frontal EEG focality with and without relation to generalized discharge, pharmacological response and neuroimaging were comparatively studied.</div></div><div><h3>Results</h3><div>94 patients with a median age of 8.6 years (6–10.1 years; 49M/45H) with AE were included. 84% presented exclusively absence seizures. Hyperventilation induced seizures in 94.2%; photoparoxysms present in 5.3%. They showed EEG focus, 63/94 and in 45/94 it was frontal. In 14/94 (14.8%) the frontal focality preceded the critical spike-wave discharge. The bivariate analysis did not show significant differences in age, time until the consultation, psychomotor development/behavior alteration, association of other types of seizures and triggers. The number of absences/days was significantly lower in the EAFs (p = 0.004) and the need for combination therapy was greater in the bivariate (p = 0.005) and multivariate (p = 0.035) analysis.</div></div><div><h3>Conclusions</h3><div>FAE represents a significant percentage of AE with seizures of identical morphology, age, and duration, although with fewer seizures/day and a worse response to treatment.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101904"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590522","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 : 2026-01-01Epub Date: 2025-11-21DOI: 10.1016/j.nrleng.2025.101887
Vidal Fernández-Rodríguez, José María Losada Domingo, Ana Moreno-Estébanez, Alba Rebollo Pérez
{"title":"Fourth cranial nerve neuropathy due to Ecchordosis physaliphora: literature review and case report","authors":"Vidal Fernández-Rodríguez, José María Losada Domingo, Ana Moreno-Estébanez, Alba Rebollo Pérez","doi":"10.1016/j.nrleng.2025.101887","DOIUrl":"10.1016/j.nrleng.2025.101887","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101887"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590549","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 : 2026-01-01Epub Date: 2026-01-22DOI: 10.1016/j.nrleng.2025.101897
P. Salgado-Cámara , B. De la Casa-Fages , A. Sánchez-Soblechero , O. Mateo Sierra , M.L. Martín-Barbero , F. Grandas
Introduction
During surgical admissions, the use of antidopaminergic drugs is associated with increased morbimortality and hospital stay in patients with Parkinson's disease (PD) and other parkinsonisms. We implemented a protocol to ensure adequate perioperative pharmacological management in our center, including educational sessions and complementary tools, such as an electronic Pharmacological Alert and a Patient Information Sheet.
Objective
The objective of this study was to analyze the changes in the prescription of contraindicated medications to PD or parkinsonism patients admitted for surgery, in the three years following implementation of the protocol, and to establish the compliance with the protocol among the medical staff involved in their hospital care over the same period.
Methods
This is an observational, analytical, prospective study with a before–after design.
Results
Prescription of contraindicated drugs decreased significantly over the study period (from 57.8% to 20.6%; p < 0.001). Patients without an activated Pharmacological Alert had a 13.31 times higher risk of being prescribed contraindicated drugs than patients with such an alert (p < 0.001). Neurologists and neurosurgeons used the protocol tools more than Emergency Department surgeons. There was very high compliance with the protocol in admissions for deep brain stimulation and related surgeries.
Conclusions
The protocol reduced the prescription of contraindicated drugs to PD and parkinsonism patients during their surgical admissions in our center. The Pharmacological Alert and Neurology clinics played a crucial role.
{"title":"Impact of a perioperative protocol for Parkinson's disease patients on use of contraindicated drugs","authors":"P. Salgado-Cámara , B. De la Casa-Fages , A. Sánchez-Soblechero , O. Mateo Sierra , M.L. Martín-Barbero , F. Grandas","doi":"10.1016/j.nrleng.2025.101897","DOIUrl":"10.1016/j.nrleng.2025.101897","url":null,"abstract":"<div><h3>Introduction</h3><div>During surgical admissions, the use of antidopaminergic drugs is associated with increased morbimortality and hospital stay in patients with Parkinson's disease (PD) and other parkinsonisms. We implemented a protocol to ensure adequate perioperative pharmacological management in our center, including educational sessions and complementary tools, such as an electronic Pharmacological Alert and a Patient Information Sheet.</div></div><div><h3>Objective</h3><div>The objective of this study was to analyze the changes in the prescription of contraindicated medications to PD or parkinsonism patients admitted for surgery, in the three years following implementation of the protocol, and to establish the compliance with the protocol among the medical staff involved in their hospital care over the same period.</div></div><div><h3>Methods</h3><div>This is an observational, analytical, prospective study with a before–after design.</div></div><div><h3>Results</h3><div>Prescription of contraindicated drugs decreased significantly over the study period (from 57.8% to 20.6%; <em>p</em> <!--><<!--> <!-->0.001). Patients without an activated Pharmacological Alert had a 13.31 times higher risk of being prescribed contraindicated drugs than patients with such an alert (<em>p</em> <!--><<!--> <!-->0.001). Neurologists and neurosurgeons used the protocol tools more than Emergency Department surgeons. There was very high compliance with the protocol in admissions for deep brain stimulation and related surgeries.</div></div><div><h3>Conclusions</h3><div>The protocol reduced the prescription of contraindicated drugs to PD and parkinsonism patients during their surgical admissions in our center. The Pharmacological Alert and Neurology clinics played a crucial role.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 101897"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015553","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 : 2026-01-01Epub Date: 2026-01-22DOI: 10.1016/j.nrleng.2025.501911
L. Cayuela , E. Zapata-Arriaza , A. de Albóniga-Chindurza , A. González García , A. Cayuela
Objective
This observational retrospective study aimed to analyse the mortality trends of Parkinson's disease (PD) in Spain from 1999 to 2021, by autonomous community and sex.
Methods
The study collected PD mortality data from 1999 to 2021 from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by sex and age group, using joinpoint analysis to identify significant trends.
Results
Over the study period, 72 907 deaths due to PD were recorded in Spain, with 51% occurring in men and 49% in women. Both men and women showed a consistent upward trend in PD mortality rates at the national level, with annual increases of 2.1% for men and 2.0% for women. Joinpoint analysis revealed significant changes in trends within specific regions. Among men, rates in Catalonia stabilised after an initial increase, whereas Madrid showed a significant increase after a period of stability. Conversely, La Rioja exhibited a notable decrease after a period of increase. Similar patterns were observed for women, with certain regions showing stable rates while others displayed an upward trend. Cantabria, Galicia, and Valencia stabilised after an initial significant increase, Madrid showed a significant increase after a period of stability, and Andalusia demonstrated an acceleration after an initial increase.
Conclusions
Our findings underscore the significance of monitoring PD mortality trends and their varying impact across different regions and sexes. This valuable information can play a crucial role in shaping future healthcare policies and designing effective prevention strategies.
{"title":"Unravelling the temporal evolution of Parkinson's disease mortality in Spanish autonomous communities (1999–2021)","authors":"L. Cayuela , E. Zapata-Arriaza , A. de Albóniga-Chindurza , A. González García , A. Cayuela","doi":"10.1016/j.nrleng.2025.501911","DOIUrl":"10.1016/j.nrleng.2025.501911","url":null,"abstract":"<div><h3>Objective</h3><div>This observational retrospective study aimed to analyse the mortality trends of Parkinson's disease (PD) in Spain from 1999 to 2021, by autonomous community and sex.</div></div><div><h3>Methods</h3><div>The study collected PD mortality data from 1999 to 2021 from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by sex and age group, using joinpoint analysis to identify significant trends.</div></div><div><h3>Results</h3><div>Over the study period, 72<!--> <!-->907 deaths due to PD were recorded in Spain, with 51% occurring in men and 49% in women. Both men and women showed a consistent upward trend in PD mortality rates at the national level, with annual increases of 2.1% for men and 2.0% for women. Joinpoint analysis revealed significant changes in trends within specific regions. Among men, rates in Catalonia stabilised after an initial increase, whereas Madrid showed a significant increase after a period of stability. Conversely, La Rioja exhibited a notable decrease after a period of increase. Similar patterns were observed for women, with certain regions showing stable rates while others displayed an upward trend. Cantabria, Galicia, and Valencia stabilised after an initial significant increase, Madrid showed a significant increase after a period of stability, and Andalusia demonstrated an acceleration after an initial increase.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the significance of monitoring PD mortality trends and their varying impact across different regions and sexes. This valuable information can play a crucial role in shaping future healthcare policies and designing effective prevention strategies.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"41 1","pages":"Article 501911"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015556","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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