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Sivera Mascaró R, García Sobrino T, Horga Hernández A, Pelayo Negro AL, Alonso Jiménez A, Antelo Pose A, Calabria Gallego MD, Casasnovas C, Cemillán Fernández CA, Esteban Pérez J, Fenollar Cortés M, Frasquet Carrera M, Gallano Petit MP, Giménez Muñoz A, Gutiérrez Gutiérrez G, Gutiérrez Martínez A, Juntas Morales R, Ciano-Petersen NL, Martínez Ulloa PL, Mederer Hengstl S, Millet Sancho E, Navacerrada Barrero FJ, Navarrete Faubel FE, Pardo Fernández J, Pascual Pascual SI, Pérez Lucas J, Pino Mínguez J, Rabasa Pérez M, Sánchez González M, Sotoca J, Rodríguez Santiago B, Rojas García R, Turon-Sans J, Vicent Carsí V, Sevilla Mantecón T. Clinical practice guidelines for the diagnosis and management of Charcot-Marie-Tooth disease. Neurologia 2024:S2173-5808(24)00047-6. [PMID: 38431252 DOI: 10.1016/j.nrleng.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/03/2023] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Charcot-Marie-Tooth (CMT) disease is classified considering the neurophysiological and histological findings, the inheritance pattern and the underlying genetic defect. In recent years, with the advent of next generation sequencing, genetic complexity has increased exponentially, expanding the knowledge about disease pathways, and having an impact in clinical management. The aim of this guide is to offer recommendations for the diagnosis, prognosis, monitoring and treatment of this disease in Spain. MATERIAL AND METHODS This consensus guideline has been developed by a multidisciplinary panel encompassing a broad group of professionals including neurologists, neuropediatricians, geneticists, rehabilitators, and orthopaedic surgeons. RECOMMENDATIONS The diagnosis is based in the clinical characterization, usually presenting with a common phenotype. It should be followed by an appropriate neurophysiological study that allows for a correct classification, specific recommendations are established for the parameters that should be included. Genetic diagnosis must be approached in sequentially, once the PMP22 duplication has been ruled out if appropriate, a next generation sequencing should be considered taking into account the limitations of the available techniques. To date, there is no pharmacological treatment that modifies the course of the disease, but symptomatic management is important, as are the rehabilitation and orthopaedic considerations. The latter should be initiated early to identify and improve the patient's functional impairments, including individualised exercise guidelines, orthotic adaptation, and assessment of conservative surgeries such as tendon transpositions. The follow-up of patients with CMT is exclusively clinical, ancillary testing are not necessary in routine clinical practice.
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Affiliation(s)
- R Sivera Mascaró
- Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; CIBER de Enfermedades Raras (CIBERER), Madrid, Spain
| | - T García Sobrino
- Servicio de Neurología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
| | - A Horga Hernández
- Servicio de Neurología, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - A L Pelayo Negro
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, Spain; Center for Biomedical Research in the Neurodegenerative Diseases (CIBERNED) Network, Madrid, Spain
| | - A Alonso Jiménez
- Neuromuscular Reference Center, Neurology Department, University Hospital of Antwerp, Amberes, Belgium
| | - A Antelo Pose
- Servicio de Rehabilitación, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - C Casasnovas
- Unitat de Neuromuscular, Servicio de Neurología, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | - J Esteban Pérez
- Servicio de Neurología, Unidad de ELA y Enfermedades Neuromusculares, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Fenollar Cortés
- Genética Clínica, Servicio de Análisis Clínicos, Instituto de Medicina del Laboratorio, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - M Frasquet Carrera
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurología, Hospital Universitari Dr. Peset, Valencia, Spain
| | - M P Gallano Petit
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Genética, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Giménez Muñoz
- Servicio de Neurología, Hospital Royo Villanova, Zaragoza, Spain
| | - G Gutiérrez Gutiérrez
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain; Facultad de Medicina, Universidad Europea de Madrid, Madrid, Spain
| | - A Gutiérrez Martínez
- Servicio de Neurología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - R Juntas Morales
- Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - N L Ciano-Petersen
- Servicio de Neurología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| | - P L Martínez Ulloa
- Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Mederer Hengstl
- Servicio de Neurología, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - E Millet Sancho
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurofisiología, Hospital Universitari i Politécnic La Fe, Instituto de Investigación Sanitaria la Fe, Valencia, Spain
| | - F J Navacerrada Barrero
- Servicio de Neurología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - F E Navarrete Faubel
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - J Pardo Fernández
- Servicio de Neurología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | | | - J Pérez Lucas
- Servicio de Neurología, Hospital del Tajo, Aranjuez, Madrid, Spain
| | - J Pino Mínguez
- Servicio de Cirugía Ortopédica y Traumatología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - M Rabasa Pérez
- Servicio de Neurología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - M Sánchez González
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - J Sotoca
- Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - R Rojas García
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Departamento de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - J Turon-Sans
- CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Servicio de Neurofisiología, Hospital de la Santa Creu i Sant Pau, Departamento de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - V Vicent Carsí
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitari i Politécnic La Fe, Valencia, Spain
| | - T Sevilla Mantecón
- Servicio de Neurología, Hospital Universitari i Politécnic La Fe, Instituto de Investigación Sanitaria La Fe, Valencia, Spain; CIBER de Enfermedades Raras (CIBERER), Madrid, Spain; Universidad de Valencia, Valencia, Spain
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López-Moreno Y, Cabezudo-García P, Ciano-Petersen NL, García-Martín G, Serrano-Castro PJ. Epileptic and neurodevelopmental encephalopathy associated to SYNGAP1 mutation: Description of a case and treatment response to cannabidiol. Neurologia 2024; 39:101-103. [PMID: 38056595 DOI: 10.1016/j.nrleng.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/01/2023] [Indexed: 12/08/2023] Open
Affiliation(s)
- Y López-Moreno
- Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain.
| | - P Cabezudo-García
- Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain; Red Andaluza de Investigación Clínica y Traslacional en Neurología (NeuroRECA), Málaga, Spain; Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - N L Ciano-Petersen
- Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain; Red Andaluza de Investigación Clínica y Traslacional en Neurología (NeuroRECA), Málaga, Spain; Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - G García-Martín
- Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain; Red Andaluza de Investigación Clínica y Traslacional en Neurología (NeuroRECA), Málaga, Spain; Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - P J Serrano-Castro
- Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain; Red Andaluza de Investigación Clínica y Traslacional en Neurología (NeuroRECA), Málaga, Spain; Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, Spain
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Cabezudo-García P, Mena-Vázquez N, Ciano-Petersen NL, Oliver-Martos B, Serrano-Castro PJ. Functional outcomes of patients with NORSE and FIRES treated with immunotherapy: A systematic review. Neurologia 2022:S2173-5808(22)00095-5. [PMID: 36155099 DOI: 10.1016/j.nrleng.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine the frequency of good functional outcomes in patients with NORSE and FIRES treated with immunotherapy. METHODS We performed a systematic search of the MedLine and EMBASE databases to gather studies including at least 5 patients with NORSE or FIRES and at least one patient treated with immunotherapy, and reporting functional outcomes. Good functional outcome was defined as a modified Rankin Scale (mRS) score ≤ 2 (or an equivalent measure) at the last available follow-up assessment. Only patients with known functional outcomes were included in the analysis. RESULTS We analyzed 16 studies including a total of 161 patients with NORSE. Six studies were carried out only with FIRES patients (n = 64). Of the 161 patients with NORSE, 141 (87.5%) received immunotherapy. Outcome data were available for 135, 56 of whom (41.4%) achieved good functional outcomes. Twenty-four of the 58 patients with FIRES treated with immunotherapy and for whom outcome data were available achieved good functional outcomes (41.3%). Mortality rates in patients with NORSE and FIRES treated with immunotherapy were 20/121 (16.5%) and 6/58 (10.3%), respectively. By type of immunotherapy, good functional outcomes were achieved in 36/89 patients receiving glucocorticoids (40.4%), 27/71 patients receiving IV immunoglobulins (38%), 11/37 patients treated with plasma exchange (29.7%), 5/17 patients receiving rituximab (29.4%), and 2/13 patients receiving cyclophosphamide (15.3%). CONCLUSION Despite the lack of randomised clinical trials, immunotherapy is frequently prescribed to patients with NORSE and FIRES. However, rates of functional dependence and mortality remain high in these patients. Second-line therapies achieved lower rates of good outcomes, probably because they were administered to patients with more severe, refractory disease.
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Affiliation(s)
- P Cabezudo-García
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain; UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain.
| | - N Mena-Vázquez
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - N L Ciano-Petersen
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain; UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - B Oliver-Martos
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain; UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - P J Serrano-Castro
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain; UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
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Cabezudo-García P, Vidal Denis M, Ciano-Petersen NL, Irigoyen-Oyarzábal MV, Serrano-Castro PJ. FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures (FLAMES) in a patient with Crohn's disease on anti-TNF treatment. Neurologia 2022; 37:304-306. [PMID: 34294495 DOI: 10.1016/j.nrl.2021.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/27/2021] [Indexed: 02/05/2023] Open
Affiliation(s)
- P Cabezudo-García
- Instituto de Investigación Biomédica de Málaga (IBIMA), Servicio de Neurología, UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain.
| | - M Vidal Denis
- Servicio de Radiología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - N L Ciano-Petersen
- Instituto de Investigación Biomédica de Málaga (IBIMA), Servicio de Neurología, UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - M V Irigoyen-Oyarzábal
- Instituto de Investigación Biomédica de Málaga (IBIMA), Servicio de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - P J Serrano-Castro
- Instituto de Investigación Biomédica de Málaga (IBIMA), Servicio de Neurología, UGC de Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
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Ciano-Petersen NL, Muñiz-Castrillo S, Vogrig A, Joubert B, Honnorat J. Immunomodulation in the acute phase of autoimmune encephalitis. Rev Neurol (Paris) 2022; 178:34-47. [PMID: 35000790 DOI: 10.1016/j.neurol.2021.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022]
Abstract
Autoimmune encephalitides constitute an emerging group of diseases for which the diagnosis and management may be challenging, and are usually associated with antibodies against neuroglial antigens used as biomarkers. In this review, we aimed to clarify the diagnostic approach to patients with encephalitis of suspected autoimmune origin in order to initiate early immunotherapy, and to summarize the evidence of current immunotherapies and alternative options assessed for refractory cases. Currently, the general therapeutic approach consists of steroids, IVIG, and/or plasma exchange as first-line medications, which should be prescribed once a diagnosis of possible autoimmune encephalitis is established. For patients not responding to these treatments, rituximab and cyclophosphamide are used as second-line immunotherapy. Additionally, alternative therapies, chiefly tocilizumab and bortezomib, have been reported to be useful in particularly refractory cases. Although the aforementioned approach with first and second-line immunotherapy is widely accepted, the best therapeutic strategy is still unclear since most available evidence is gathered from retrospective non-controlled studies. Moreover, several predictors of good long-term prognosis have been proposed such as response to first-line therapies, modified Rankin score lesser than 4 at the worst neurologic status, no need for admission in intensive care unit, and early escalation to second-line immunotherapy. Thus, the lack of solid evidence underlines the necessity of future well-conducted trials addressing both the best therapeutic regimen and the outcome predictors, but since autoimmune encephalitides have a relatively low incidence, international collaborations seem imperative to reach a reasonable study population size.
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Affiliation(s)
- N L Ciano-Petersen
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Biomedical Research Institute of Málaga-IBIMA, Málaga, Spain; Neurology Department, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - S Muñiz-Castrillo
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - A Vogrig
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - B Joubert
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - J Honnorat
- French Reference Center for Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France; Inserm U1217/CNRS UMR 5310, SynatAc Team, Institute NeuroMyoGène, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
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Aliaga-Gaspar P, Hurtado-Guerrero I, Ciano-Petersen NL, Urbaneja P, Brichette-Mieg I, Reyes V, Rodriguez-Bada JL, Alvarez-Lafuente R, Arroyo R, Quintana E, Ramió-Torrentà L, Alonso A, Leyva L, Fernández O, Oliver-Martos B. Soluble Receptor Isoform of IFN-Beta (sIFNAR2) in Multiple Sclerosis Patients and Their Association With the Clinical Response to IFN-Beta Treatment. Front Immunol 2021; 12:778204. [PMID: 34975865 PMCID: PMC8716373 DOI: 10.3389/fimmu.2021.778204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/29/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Interferon beta receptor 2 subunit (IFNAR2) can be produced as a transmembrane protein, but also as a soluble form (sIFNAR2) generated by alternative splicing or proteolytic cleavage, which has both agonist and antagonist activities for IFN-β. However, its role regarding the clinical response to IFN-β for relapsing-remitting multiple sclerosis (RRMS) is unknown. We aim to evaluate the in vitro short-term effects and after 6 and 12 months of IFN-β therapy on sIFNAR2 production and their association with the clinical response in MS patients. Methods Ninety-four RRMS patients were included and evaluated at baseline, 6 and 12 months from treatment onset. A subset of 41 patients were classified as responders and non-responders to IFN-β therapy. sIFNAR2 serum levels were measured by ELISA. mRNA expression for IFNAR1, IFNAR2 splice variants, MxA and proteases were assessed by RT-PCR. The short-term effect was evaluated in PBMC from RRMS patients after IFN-β stimulation in vitro. Results Protein and mRNA levels of sIFNAR2 increased after IFN-β treatment. According to the clinical response, only non-responders increased sIFNAR2 significantly at both protein and mRNA levels. sIFNAR2 gene expression correlated with the transmembrane isoform expression and was 2.3-fold higher. While MxA gene expression increased significantly after treatment, IFNAR1 and IFNAR2 only slightly increased. After short-term IFN-β in vitro induction of PBMC, 6/7 patients increased the sIFNAR2 expression. Conclusions IFN-β administration induces the production of sIFNAR2 in RRMS and higher levels might be associated to the reduction of therapeutic response. Thus, levels of sIFNAR2 could be monitored to optimize an effective response to IFN-β therapy.
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Affiliation(s)
- Pablo Aliaga-Gaspar
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Isaac Hurtado-Guerrero
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Neuroinflammation Unit, Biotech Research and Innovation Centre (BRIC), Faculty of Health and Medical Sciences, Copenhagen Biocentre, University of Copenhagen, Copenhagen, Denmark
| | - Nicolas Lundahl Ciano-Petersen
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Red Andaluza de Investigación Clínica y Traslacional en Neurología (Neuro-Reca), Málaga, Spain
| | - Patricia Urbaneja
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Red Andaluza de Investigación Clínica y Traslacional en Neurología (Neuro-Reca), Málaga, Spain
| | - Isabel Brichette-Mieg
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Virginia Reyes
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Red Andaluza de Investigación Clínica y Traslacional en Neurología (Neuro-Reca), Málaga, Spain
| | - Jose Luis Rodriguez-Bada
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Roberto Alvarez-Lafuente
- Grupo de Investigación de Factores Ambientales en Enfermedades Degenerativas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
| | - Rafael Arroyo
- Servicio de Neurología, Hospital Universitario Quirónsalud, Madrid, Spain
| | - Ester Quintana
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
- Servicio de Neurología, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
| | - Lluis Ramió-Torrentà
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
- Servicio de Neurología, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain
- Medical Sciences Department, University of Girona, Girona, Spain
| | - Ana Alonso
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Red Andaluza de Investigación Clínica y Traslacional en Neurología (Neuro-Reca), Málaga, Spain
| | - Laura Leyva
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
| | - Oscar Fernández
- Departmento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- *Correspondence: Begoña Oliver-Martos, ; Oscar Fernández,
| | - Begoña Oliver-Martos
- Neuroimmunology and Neuroinflammation Group, Instituto de Investigación Biomédica de Málaga (IBIMA), Unidad de Gestión Clínica (UGC) Neurociencias, Hospital Regional Universitario de Málaga, Málaga, Spain
- Red Andaluza de Investigación Clínica y Traslacional en Neurología (Neuro-Reca), Málaga, Spain
- Red Española de Esclerosis Múltiple (REEM), Madrid, Spain
- Departamento de Biología Celular, Genética y Fisiología, Área de Fisiología, Facultad de Ciencias, Universidad de Málaga, Málaga, Spain
- *Correspondence: Begoña Oliver-Martos, ; Oscar Fernández,
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Reyes-Bueno JA, García-Trujillo L, Urbaneja P, Ciano-Petersen NL, Postigo-Pozo MJ, Martínez-Tomás C, Serrano-Castro PJ. Miller-Fisher syndrome after SARS-CoV-2 infection. Eur J Neurol 2020; 27:1759-1761. [PMID: 32503084 PMCID: PMC7300794 DOI: 10.1111/ene.14383] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 02/05/2023]
Abstract
Introduction On March 11th, 2020, the WHO declared the SARS‐Cov‐2 pandemic. Syndromes have been detected in relation to COVID‐19 such as encephalitis, acute necrotizing hemorrhagic encephalopathy and cerebrovascular complications. There are also cases of peripheral nervous system involvement. Methods Our case would be the 3rd patient with MFS associated with COVID‐19 as far as we know. Results We present a 51 years old female diagnosed with MFS two weeks after COVID‐19. RTPCR to SARS‐CoV‐2 was negative but IgG was positive. Conclusion Most of the cases were mild or moderate with typical signs and symptoms. All were treated with IV immunoglobulin with good response in most cases. Despite the short evolution time of the cases surviving the current pandemic, the description of cases of post‐infectious neurological syndromes suggests that this is probably not an infrequent complication in the subacute stage of Covid‐19 disease.
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Affiliation(s)
- J A Reyes-Bueno
- Neurology Department, Regional University Hospital of Málaga, Málaga, Spain
| | - L García-Trujillo
- Neurology Department, Regional University Hospital of Málaga, Málaga, Spain
| | - P Urbaneja
- Neurology Department, Regional University Hospital of Málaga, Málaga, Spain
| | - N L Ciano-Petersen
- Neurology Department, Regional University Hospital of Málaga, Málaga, Spain
| | - M J Postigo-Pozo
- Neurophysiology Department, Regional University Hospital of Málaga, Málaga, Spain
| | - C Martínez-Tomás
- Neurology Department, Regional University Hospital of Málaga, Málaga, Spain
| | - P J Serrano-Castro
- Neurology Department, Regional University Hospital of Málaga, Málaga, Spain
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Reyes-Bueno JA, Mena-Vázquez N, Ojea-Ortega T, Gonzalez-Sotomayor MM, Cabezudo-Garcia P, Ciano-Petersen NL, Pons-Pons G, Castro-Sánchez MV, Serrano-Castro PJ. [Case fatality of COVID-19 in patients with neurodegenerative dementia]. Neurologia 2020; 35:639-645. [PMID: 38620303 PMCID: PMC7386259 DOI: 10.1016/j.nrl.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/12/2020] [Accepted: 07/19/2020] [Indexed: 02/08/2023] Open
Abstract
Introduction The elderly population is the group most threatened by COVID-19, with the highest mortality rates. This study aims to analyse the case fatality of COVID-19 in a cohort of patients with degenerative dementia. Methods We conducted a descriptive case-control study of a sample of patients diagnosed with primary neurodegenerative dementia. Results Twenty-four of the 88 patients with COVID-19 included in the study died: 10/23 (43.4%) patients diagnosed with dementia and 14/65 (21.5%) controls; this difference was statistically significant. Discussion Our results suggest that case fatality of COVID-19 is significantly higher among patients with primary degenerative dementia than in other patients with similar mean ages and comorbidities.
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Affiliation(s)
- J A Reyes-Bueno
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - N Mena-Vázquez
- Unidad de Gestión Clínica de Reumatología, Hospital Regional Universitario de Málaga, Málaga, España
| | - T Ojea-Ortega
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - M M Gonzalez-Sotomayor
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - P Cabezudo-Garcia
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - N L Ciano-Petersen
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - G Pons-Pons
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - M V Castro-Sánchez
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
| | - P J Serrano-Castro
- Unidad de Gestión Clínica de Neurociencias, Servicio de Neurología, Hospital Regional Universitario de Málaga, Málaga, España
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