Neurologia最新文献

{"title":"Variables associated with cognitive alterations in a cohort of COVID-19 survivors at a tertiary hospital in Mexico","authors":"M. Rodríguez-Rodríguez ,&nbsp;Y. Rodríguez-Agudelo ,&nbsp;F.J. Soto-Moreno ,&nbsp;A. García-Santos ,&nbsp;D. López-González ,&nbsp;M. González-Navarro ,&nbsp;F. Paz-Rodríguez ,&nbsp;M. Chávez-Oliveros ,&nbsp;S. Lozano-Tovar ,&nbsp;K. González-Alonso ,&nbsp;A. Castorena-Maldonado ,&nbsp;R. Carrillo-Mezo ,&nbsp;O. Marrufo-Meléndez ,&nbsp;A. Gutiérrez-Romero ,&nbsp;M. Del Río Quiñones ,&nbsp;A. Arauz-Góngora ,&nbsp;S. Avila-Rios","doi":"10.1016/j.nrleng.2025.05.002","DOIUrl":"10.1016/j.nrleng.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairments are one of the most common, insidious, and disabling symptoms of post-COVID-19 syndrome (PC-19), which have been correlated with damage to different brain structures.</div></div><div><h3>Objective</h3><div>To describe cognitive impairments in PC-19, identify associated variables, and compare the impact of mechanical ventilation on cognitive and neuroimaging outcomes.</div></div><div><h3>Methods</h3><div>A cohort of COVID-19 survivors was evaluated with neuropsychological tests (NPT) and cranial magnetic resonance imaging (MRI) 12 weeks after hospital discharge. Patients were classified into two groups based on whether they required invasive mechanical ventilation (IMV) or non-invasive mechanical ventilation (nIMV).</div></div><div><h3>Results</h3><div>60 patients completed the study, 41 received IMV and 19 nIMV, with an average age of 57.11 years. 66% scored below 26 points on the MoCA test and 83.3% reported everyday memory failures (EMF). 85% showed impairments in at least one NPT. When comparing results between groups, significant differences were observed in the total MoCA test score (<em>P</em> = .045) and EMF (<em>P</em> = .032). Significant relationships were observed between the Boston Naming Test (−0.287; <em>P</em> = .035), the Rey Figure Recall Test (−0.324; <em>P</em> = .017) with parietal atrophy, as well as phonological verbal fluency with frontal atrophy (−0.276; <em>P</em> = .042). The HVLT (learning trial) test was related to hippocampal hyperintensity (−0.266; <em>P</em> = .050) and cingulate hyperintensity (0.311; <em>P</em> = .021). The TMT-B test was related to white matter hyperintensity (0.345; <em>P</em>= .010). The presence of poor functional prognosis was correlated with anxiety (<em>P</em> &lt; .001), depression (<em>P</em> &lt; .001), elevated D-dimer levels (<em>P</em> = .002) and the increase in days of intubation (<em>P</em> = .005).</div></div><div><h3>Conclusion</h3><div>Our study suggests that COVID-19 survivors who had moderate-to-severe infection experience subjective complaints and cognitive impairments in executive function, attention, and memory, regardless of whether invasive mechanical ventilation was used during treatment. We found white matter lesions and cerebral atrophy in frontal and parietal regions that were associated with cognitive deficits. Our findings highlight the clinical need for longitudinal programmes capable of evaluating the real impact of SARS-CoV-2 infection on the central nervous system, particularly in the cognitive and emotional domains.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 409-421"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129828","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}

{"title":"Prevalence of multiple sclerosis in Spain. Estimates from the Primary Care Clinical Database (BDCAP)","authors":"L. Cayuela ,&nbsp;C. García-Muñoz ,&nbsp;S. Sainz de la Maza ,&nbsp;A. Cayuela","doi":"10.1016/j.nrleng.2025.04.010","DOIUrl":"10.1016/j.nrleng.2025.04.010","url":null,"abstract":"<div><h3>Introduction</h3><div>The global prevalence of multiple sclerosis (MS) has increased in recent decades. However, there is a need for updated prevalence data for Spain.</div></div><div><h3>Objective</h3><div>To analyze the prevalence of MS in Spain using data from the Primary Care Clinical Database (BDCAP, for its Spanish initials) and to compare the prevalence results in different autonomous communities (AC) according to sex in 2021.</div></div><div><h3>Methods</h3><div>This cross-sectional study extracted data from the BDCAP on patients with MS according to sex, age, and place of residence in 2021. Crude prevalence rates were calculated, using the population assigned for each year of the study as the denominator. The geographic pattern of MS prevalence was analyzed using the following risk estimators: standardized prevalence ratio, smoothed relative risk (RR), and posterior probability of RR &gt;1.</div></div><div><h3>Results</h3><div>We estimated 61<!--> <!-->753 cases of MS, with a crude estimated prevalence rate of 132.0 cases per 100<!--> <!-->000 person-years and a female/male ratio of 2.0. The age-standardized prevalence rate was 123.5 cases per 100<!--> <!-->000 person-years. Age-specific prevalence rates were lower in men than in women. All indicators showed a north-south gradient. Seven ACs for women and 5 ACs for men showed a significant excess risk (primarily in the north of Spain), whereas 8 ACs for both women and men presented lower risk (mainly in the south).</div></div><div><h3>Conclusions</h3><div>Our results provide the most recent prevalence data for MS and the geographic patterns at the ACs level in Spain, revealing a north-south gradient. Our results pave the way for future strategies to manage the impact of MS in Spain and to understand causal hypotheses.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 447-455"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281093","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}

{"title":"Cockayne syndrome B with axonal sensorimotor polyneuropathy caused by a de novo mutation of the gene ERCC6: A novel phenotypic and genotypic variant","authors":"R. Ghosh ,&nbsp;M. León-Ruiz ,&nbsp;A.S. Mondal ,&nbsp;S. Dubey ,&nbsp;J. Benito-León","doi":"10.1016/j.nrleng.2025.04.012","DOIUrl":"10.1016/j.nrleng.2025.04.012","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Pages 484-487"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281096","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}

{"title":"Dystonic head tremor and neurocysticercosis","authors":"A. Kleebayoon ,&nbsp;V. Wiwanitkit","doi":"10.1016/j.nrleng.2025.04.011","DOIUrl":"10.1016/j.nrleng.2025.04.011","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 5","pages":"Page 483"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281095","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}

{"title":"The association between lifestyle factors and mortality in Huntington's disease","authors":"E. Cubo ,&nbsp;J. Rivadeneyra ,&nbsp;L. Simón-Vicente ,&nbsp;L. Aguado ,&nbsp;S. Calvo ,&nbsp;M. Saiz-Rodríguez ,&nbsp;N. Mariscal ,&nbsp;I. Muñoz-Siscart ,&nbsp;D. Diaz-Piñeiro ,&nbsp;I. Miguel-Pérez ,&nbsp;G. Gámez-Leyva ,&nbsp;Á. García-Bustillo ,&nbsp;A. Martinez-Descalls ,&nbsp;Spanish Enroll Mortality Study","doi":"10.1016/j.nrleng.2025.04.001","DOIUrl":"10.1016/j.nrleng.2025.04.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the wealth of evidence suggesting a protective role of lifestyle factors on Huntington's disease (HD) onset and progression, their association with mortality has not been extensively studied. The aim of this study was to examine whether lifestyle factors such as caffeine and alcohol consumption, smoking, physical activity level, and Mediterranean diet (MeDi) adherence are associated with mortality among a Spanish cohort of patients with HD with a 9-year surveillance period.</div></div><div><h3>Methods</h3><div>This national study was performed using a nested, observational, longitudinal design. We included subjects diagnosed with HD who participated in the European Huntington's disease network and Enrol-HD studies. Date of death and baseline lifestyle factor information, demographics, disease severity assessed by the Unified Huntington's Disease Rating Scale (UHDRS), Problem Behaviours Assessment, total functional capacity (TFC) scores, and comorbidities were collected. Adjusted Cox proportional hazards models were conducted to determine the association of lifestyle factors with mortality.</div></div><div><h3>Results</h3><div>We included 87 patients (52 females) with a mean age of 48.62<!--> <!-->±<!--> <!-->14.43 years and CAG repeats of 43.76<!--> <!-->±<!--> <!-->5.92. Sixteen deaths were recorded. After correcting for multiple comparisons, deceased patients had higher UHDRS scores at baseline and lower caffeine consumption than live patients. In multivariate Cox regression models, after adjusting for age, CAG repeats, and TFC, mortality risk was associated with lower caffeine consumption (HR 0.13, 95% CI 0.04, 0.45).</div></div><div><h3>Conclusions</h3><div>This national-based study suggests that increased caffeine consumption is associated with decreased HD mortality. Our results may help guide clinicians in counselling lifestyle practices for decreasing mortality in HD.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 361-371"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090363","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}

{"title":"Mortality and long-term recurrence of ischaemic stroke in young adults of a northern Spanish region (Aragón)","authors":"H. Tejada-Meza ,&nbsp;Á. Lambea-Gil ,&nbsp;B. Pardiñas-Barón ,&nbsp;D. Sagarra-Mur ,&nbsp;M. Viscasillas-Sancho ,&nbsp;C. Moreno-Loscertales ,&nbsp;C. Tejero-Juste ,&nbsp;C. Pérez-Lázaro ,&nbsp;J. Artal-Roy ,&nbsp;O. Alberti-González ,&nbsp;P. Ruiz-Palomino ,&nbsp;N. Hernando-Quintana ,&nbsp;I. Campello-Morer ,&nbsp;Á. Giménez-Muñoz ,&nbsp;M. Palacín-Larroy ,&nbsp;C. García-Arguedas ,&nbsp;L. Ballester-Marco ,&nbsp;J. Marta-Moreno ,&nbsp;on behalf of the Neurovascular Diseases Study Group of Aragon (GEENV-Aragón)","doi":"10.1016/j.nrleng.2025.04.002","DOIUrl":"10.1016/j.nrleng.2025.04.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of ischemic stroke in young adults is increasing worldwide, and it is not uncommon in our region. It is associated with the presence of traditional vascular risk factors. However, there is little information about its prognosis, unlike other age groups. The objective of this study is to determine mortality, both in the short and long term follow-up, and the long-term follow-up recurrence of ischemic stroke in young adult patients in Aragon, making up the first study of this kind in Spain, and one of the few that addresses this issue in Europe.</div></div><div><h3>Methods</h3><div>Multicenter, observational, retrospective study of all patients between 18 and 50 years old who were admitted for an ischemic stroke in any hospital in Aragon between 2005−2015. The follow-up was carried out until March 31, 2021. Mortality, causes of death and recurrence of cerebrovascular events were collected, stratifying the sample based on the sex and age group of the patients. Logistic and Cox regression models were used to determine the factors associated with mortality and recurrence.</div></div><div><h3>Results</h3><div>721 patients were included (697 with long-term follow-up). Mortality was 3.3% in the first 30 days. Long-term mortality and recurrence was 9.2% and 11.9% at a median of 10.1 years of follow-up. The most frequent cause of death in the short term was of Neurovascular origin and in the long term was cancer. Having a NIHSS &gt; 15 was associated with higher short-term mortality. Arterial hypertension, diabetes mellitus, excessive alcohol consumption, atrial fibrillation and peripheral vascular disease were associated with long-term mortality. A history of previous stroke, diabetes mellitus, and atherothrombotic aetiology were associated with a higher cumulative risk of stroke recurrence.</div></div><div><h3>Conclusions</h3><div>Mortality and recurrence of ischaemic stroke in young adults in Aragon, although lower than that described by other studies, is by no means negligible and is associated with the presence of traditional vascular risk factors.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 333-343"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059503","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}

{"title":"DRESS syndrome and flare-up due to antiepileptics: how to solve the problem","authors":"Ochando Díez-Canseco M.,&nbsp;Reguero Capilla M.,&nbsp;Domínguez-Romero I.,&nbsp;Menéndez-Rivero E.,&nbsp;Prados-Castaño M.","doi":"10.1016/j.nrleng.2025.04.004","DOIUrl":"10.1016/j.nrleng.2025.04.004","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 406-408"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046679","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}

{"title":"Guidelines: Basic principles of pain management in acquired brain injury. Recommendations of the Spanish Society of Neurorehabilitation","authors":"A. Juárez-Belaúnde ,&nbsp;C. Colomer ,&nbsp;R. Dorado ,&nbsp;S. Laxe ,&nbsp;X. Miguens ,&nbsp;J. Ferri ,&nbsp;R. Rodríguez ,&nbsp;T. Pérez ,&nbsp;C. López ,&nbsp;M. Ríos ,&nbsp;C. González ,&nbsp;R. Pelayo ,&nbsp;M. Bernabeu ,&nbsp;E. Noé ,&nbsp;A. Gómez ,&nbsp;I. Quemada","doi":"10.1016/j.nrleng.2025.04.005","DOIUrl":"10.1016/j.nrleng.2025.04.005","url":null,"abstract":"<div><h3>Introduction</h3><div>We present the guidelines for pain management in neurorehabilitation of brain injury in adults of the Spanish Society of Neurorehabilitation based on the review and analysis of the available literature on the subject. We establish recommendations according to the level of evidence offered by the reviewed studies.</div></div><div><h3>Development</h3><div>The methodology followed by the Spanish Society of Neurorehabilitation for the elaboration of the present guide is based on the analysis of the national and international clinical practice guidelines of the last seven years, carried out according to the management considerations dictated by the evidence for the usual types of pain in the population of people who have suffered an acquired brain injury.</div></div><div><h3>Conclusions</h3><div>Pain is a common symptom in patients who have suffered brain damage, having a negative impact on quality of life and adherence to the rehabilitation process. When classifying the type of pain according to etiological characteristics, in order to optimise the type of therapeutic approach, we usually refer to pain as nociceptive, and neuropathic pain, although pain in such patients often has “mixed” characteristics. The most common type of pain is nociceptive ahead of neuropathic. The most common pain syndromes in this population are headache, hemiplegic shoulder pain and poststroke central pain. As pain is a subjective experience, people with impaired level of consciousness, severe cognitive impairment and/or severe language problems may have greater difficulty or even being unable to communicate it. An adequate clinical history and a directed physical examination, as well as the use of specific scales for its correct diagnosis are therefore important. Finally, many of the drugs used for its management have a negative impact on rehabilitation, affecting cognitive processes, and/or worsening other neurological symptoms. Furthermore, these patients often have several comorbidities and are frequently on several drugs which means that the approach to pain management must be carefully elaborated by a multidisciplinary team approach.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 380-405"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013326","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}

{"title":"Complexity of neuro-oncological in-hospital consultations: a multicentre study","authors":"Jauregui Larrañaga C. ,&nbsp;Villagrán-García M. ,&nbsp;Cabello Murgui J. ,&nbsp;Barceló Artigues M.I. ,&nbsp;Bargay Pizarro E. ,&nbsp;Gil Alzueta M.C. ,&nbsp;Esparragosa Vázquez I. ,&nbsp;Bataller Alberola L. ,&nbsp;Velasco Fargas R. ,&nbsp;Erro Aguirre M.E.","doi":"10.1016/j.nrleng.2025.04.014","DOIUrl":"10.1016/j.nrleng.2025.04.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Oncological patients may require evaluation by a neurologist when they are admitted to hospital. The aim of our study was to determine the frequency and characteristics of hospital interconsultations (IC) received by the neurology department concerning oncology patients admitted to the hospital.</div></div><div><h3>Material and methods</h3><div>A retrospective multicentre study analysing IC with neurology concerning onco-haematological patients admitted over 5 consecutive years (2016-2020) in 4 tertiary hospitals in Spain was carried out.</div></div><div><h3>Results</h3><div>A total of 2091 IC from 1710 patients were analysed, most of them male (55.5%; 969/2091) with a median age of 60.5 years (range 15-92). Most of the ICs came from the medical oncology (43.2%; 904/2091) and hematology (42.2%; 882/2091) departments. Neuro-oncological ICs accounted for approximately 17% (2091/12 242) of the total number of ICs performed in the neurology department during the 5 years included in this study. The most frequent reasons for consultation were limb motor deficit (18.3%; 381/2077), confusional syndrome (14.1%; 292/2077), epileptic seizures (12.2%; 254/2077), and headache (8.1%; 169/2077). The most frequent associated tumours were lung cancer (18.3%; 383/2089), leukaemia (19%; 396/2089), lymphoma (17.1%; 357/2089), and primary brain tumor (12.1%; 353/2089). The majority (69.9%; 1460/2089) of patients were undergoing active or recent cancer treatment. Final neurological diagnoses included metabolic encephalopathy (11.2%; 234/2091), tumor progression (11%; 231/2091), cerebral vascular complications (10.1%%; 212/2091), metastases (9.1%%; 191/2091), and leptomeningeal dissemination (8.9%%; 186/2091). A total of 15.4% (323/2091) of the ICs were closed with an undetermined diagnosis. The median time that the ICs were open was 3 days (range, 1-152).</div></div><div><h3>Conclusions</h3><div>ICs concerning onco-haematological patients are heterogeneous, with an increasing incidence and complexity, requiring management by neurologists with experience in neuro-oncological patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 372-379"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059502","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}

{"title":"Cost analysis of treatment with therapeutic plasma exchange versus treatment with intravenous immunoglobulins in patients with immune-based neurological diseases. Proposal for optimising the use of plasmatic blood products","authors":"M. Luisa Antelo ,&nbsp;S. Zalba Marcos ,&nbsp;I. Jericó ,&nbsp;M. Sarobe ,&nbsp;L. Torné ,&nbsp;M. Elena Erro ,&nbsp;J.A. García-Erce","doi":"10.1016/j.nrleng.2025.04.003","DOIUrl":"10.1016/j.nrleng.2025.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Therapeutic plasma exchange (TPE) and/or the administration of endovenous immunoglobulins (IGEV) are considered the first line treatment for multiple autoimmune-based neurological diseases. According to the scientific evidence collected in several recent guidelines, the efficacy of both treatments is very similar for many of them, however, the current situation of non-self-sufficiency and the real risk of IGEV shortages make it essential to assess TPE as the first therapeutic option.</div><div>The objective of this work is to estimate the basic direct costs derived from treatment with RPT compared to treatment with IGEV in immune-mediated neurological diseases in a situation of supposed therapeutic equivalence.</div></div><div><h3>Material and methods</h3><div>Patients who are treated with IGEV receive a standard dose of 0.4 g/kg weight for 5 consecutive days. Patients treated with RPT with the Terumo-BCT® Optia model cell separator undergo between 5 and 7 sessions, every other day, with a substitution equivalent to 1–1.5 volumes, using 4%–5% albumin as replacement fluid. The calculation of the economic cost, for both types of treatments, in simulation of therapeutic equivalence and safety, has been carried out considering pharmaceutical expenses, calculation of the cost for each dose of IGEV, the detailed costs of consumables, replacement fluids and anticoagulant for RPT, in the worst-case scenario, with central venous catheter (CVC) placement. The price of albumin and immunoglobulins has been adjusted based on the situation of self-sufficiency or dependency and the average value of the last 4 years has been referenced for the calculations. The costs of personnel, hospitalisation, or complications derived from the treatments have not been considered. The prices are indicated in euros including VAT of 4% or 21% as appropriate.</div></div><div><h3>Results</h3><div>For a patient with a mean weight of 70 kg, the estimated final cost per TPR session, with CVC placement, was €612.66; while the cost for each dose of IGEV. (0.4 g/kg) was €1191. The difference is favorable to the RPT: €2279 [€1,666.4–€2,891.7]. The economic difference presented is probably greater in real clinical practice, since many of the patients do not require CVC placement to perform the TPR, and sessions were performed on an outpatient basis.</div></div><div><h3>Conclusions</h3><div>The use of TPE in the first line in pathologies in which the clinical results do not present significant differences with the IGEV, optimises the use of blood products and can lead to economic savings. It is necessary to expand this study by including an analysis of the efficacy in our series, as well as the adverse events associated with each type of treatment together with other expenses derived from personnel and hospital admission costs versus the use of outpatient resources (pheresis room).</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 4","pages":"Pages 344-352"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061777","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}