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Abenza-Abildua MJ, Suárez-Gisbert E, Lores-Gutiérrez V, Algarra-Lucas C, Gómez-Aceña Á, Navacerrada-Barrero FJ, González-Martín L, Pérez-Villena A, Pérez-López C. Anxiety and depression in patients with narcolepsy. J Sleep Res 2022:e13812. [PMID: 36564940 DOI: 10.1111/jsr.13812] [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: 08/20/2022] [Revised: 11/10/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022]
Abstract
We analysed the co-existence of psychopathology in patients with narcolepsy at our centre. We performed an observational retrospective descriptive analysis of patients with a diagnosis of narcolepsy, with and without psychopathology, who attended our sleep disorders unit from October 2012 to October 2021. A total of 51patients with narcolepsy (mean [SD] age 41.10 [14.71] years; 23 [45.1%] males and 28 [54.90%] females) were included. In all, 27 patients (52.94%) and 24 patients (47.06%) had narcolepsy with and without cataplexy, respectively. Of the total, 18 (33.33%) had a mood disorder: 18 with anxiety disorder (33.33%). Of these patients 14 (27.45%) had major depression, two (4%) had attempted suicide, one (2%) had manic outbreak, and one (2%) had substance abuse. Of the 18 patients with anxiety and depression, 10 (55.55%) and eight (44.44%) had narcolepsy with and without cataplexy, respectively. In the comparative analysis, a statistically significant relationship was found between younger age and the presence of anxiety. The prevalence of anxiety and depression in patients with narcolepsy was triple that of the general population, especially in younger patients. Psychopathology precedes the diagnosis of narcolepsy in most patients, not being reactive to diagnosis. This high prevalence suggests a possible biological relationship between both disorders, which should be assessed with larger studies.
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Affiliation(s)
- María José Abenza-Abildua
- Neurology Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Foundation for Biomedical Research and Innovation of the Infanta Sofía University Hospital and Henares University Hospital, Madrid, Spain
| | - Eugenio Suárez-Gisbert
- Psychiatry Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Madrid, Spain
| | - Vanesa Lores-Gutiérrez
- Pneumology Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Madrid, Spain
| | - Carmen Algarra-Lucas
- Neurology Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Foundation for Biomedical Research and Innovation of the Infanta Sofía University Hospital and Henares University Hospital, Madrid, Spain
| | - Ángeles Gómez-Aceña
- Pneumology Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Madrid, Spain
| | - Francisco José Navacerrada-Barrero
- Neurology Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Foundation for Biomedical Research and Innovation of the Infanta Sofía University Hospital and Henares University Hospital, Madrid, Spain
| | - Laura González-Martín
- Neurology Department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Foundation for Biomedical Research and Innovation of the Infanta Sofía University Hospital and Henares University Hospital, Madrid, Spain
| | - Ana Pérez-Villena
- Pediatrics department, Multidisciplinary Sleep Unit, Infanta Sofía University Hospital, Madrid, Spain
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Abenza-Abildúa MJ, Ramírez-Prieto MT, Moreno-Zabaleta R, Arenas-Valls N, Salvador-Maya MA, Algarra-Lucas C, Rojo Moreno-Arrones B, Sánchez-Cordón B, Ojeda-Ruíz de Luna J, Jimeno-Montero C, Navacerrada-Barrero FJ, Borrue-Fernández C, Malmierca-Corral E, Ruíz-Seco P, González-Ruano P, Palmí-Cortés I, Fernández-Travieso J, Mata-Álvarez de Santullano M, Almarcha-Menargues ML, Gutierrez-Gutierrez G, Palacios-Castaño JA, Alonso-Esteban R, Gonzalo-García N, Pérez-López C. Neurological complications in critical patients with COVID-19. Neurología (English Edition) 2020. [PMID: 32912745 PMCID: PMC7546232 DOI: 10.1016/j.nrleng.2020.07.012] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Introduction We analysed the neurological complications of patients with severe SARS-CoV-2 infection who required intensive care unit (ICU) admission. Patients and methods We conducted a retrospective, observational, descriptive study of consecutive patients admitted to the ICU due to severe respiratory symptoms secondary to SARS-CoV-2 infection between 1 April and 1 June 2020. Results We included 30 patients with neurological symptoms; 21 were men (72.40%), and mean age (standard deviation [SD]) was 57.41 years (11.61). The mean duration of ICU stay was 18.83 days (14.33). The neurological conditions recorded were acute confusional syndrome in 28 patients (93.33%), neuromuscular disease in 15 (50%), headache in 5 (16.66%), cerebrovascular disease in 4 (13.33%), and encephalopathies/encephalitis in 4 (13.33%). CSF analysis results were normal in 6 patients (20%). Brain MRI or head CT showed alterations in 20 patients (66.6%). EEG was performed in all patients (100%), with 8 (26.66%) showing abnormal findings. In 5 of the 15 patients with clinical myopathy, diagnosis was confirmed with electroneuromyography. We found a correlation between older age and duration of ICU stay (P = 0.002; 95% CI, 4.032–6.022; OR). Conclusions Severe COVID-19 mainly affects men, as observed in other series. Half of our patients presented acute myopathy, and almost all patients left the ICU with acute confusional syndrome, which fully resolved; no correlation was found with EEG or neuroimaging findings. Older age is associated with longer ICU stay.
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Affiliation(s)
- M J Abenza-Abildúa
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España.
| | - M T Ramírez-Prieto
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - R Moreno-Zabaleta
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - N Arenas-Valls
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - M A Salvador-Maya
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - C Algarra-Lucas
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - B Sánchez-Cordón
- Sección de Neurorradiología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - C Jimeno-Montero
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - C Borrue-Fernández
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | - E Malmierca-Corral
- Sección de Enfermedades Infecciosas, Hospital Universitario Infanta Sofía, Madrid, España
| | - P Ruíz-Seco
- Sección de Enfermedades Infecciosas, Hospital Universitario Infanta Sofía, Madrid, España
| | - P González-Ruano
- Sección de Enfermedades Infecciosas, Hospital Universitario Infanta Sofía, Madrid, España
| | - I Palmí-Cortés
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | | | | | | | | | - R Alonso-Esteban
- Hospitalización a Domicilio, Hospital Universitario Infanta Sofía, Madrid, España
| | - N Gonzalo-García
- Servicio de Rehabilitación, Hospital Universitario Infanta Sofía, Madrid, España
| | - C Pérez-López
- Servicio de Neurocirugía, Complejo Universitario La Paz-Cantoblanco-CarlosIII, Madrid, España
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Abenza-Abildúa MJ, Ramírez-Prieto MT, Moreno-Zabaleta R, Arenas-Valls N, Salvador-Maya MA, Algarra-Lucas C, Rojo Moreno-Arrones B, Sánchez-Cordón B, Ojeda-Ruíz de Luna J, Jimeno-Montero C, Navacerrada-Barrero FJ, Borrue-Fernández C, Malmierca-Corral E, Ruíz-Seco P, González-Ruano P, Palmí-Cortés I, Fernández-Travieso J, Mata-Álvarez de Santullano M, Almarcha-Menargues ML, Gutierrez-Gutierrez G, Palacios-Castaño JA, Alonso-Esteban R, Gonzalo-García N, Pérez-López C. [Neurological complications in critical patients with COVID-19]. Neurologia 2020; 35:621-627. [PMID: 38620654 PMCID: PMC7402100 DOI: 10.1016/j.nrl.2020.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction We analysed the neurological complications of patients with severe SARS-CoV-2 infection who required intensive care unit (ICU) admission. Patients and methods We conducted a retrospective, observational, descriptive study of consecutive patients admitted to the ICU due to severe respiratory symptoms secondary to SARS-CoV-2 infection between 1 April and 1 June 2020. Results We included 30 patients with neurological symptoms; 21 were men (72.40%), and mean age (standard deviation [SD]) was 57.41 years (11.61). The mean duration of ICU stay was 18.83 days (14.33). The neurological conditions recorded were acute confusional syndrome in 28 patients (93.33%), neuromuscular disease in 15 (50%), headache in 5 (16.66%), cerebrovascular disease in 4 (13.33%), and encephalopathies/encephalitis in 4 (13.33%). CSF analysis results were normal in 6 patients (20%). Brain MRI or head CT showed alterations in 20 patients (66.6%). EEG was performed in all patients (100%), with 8 (26.66%) showing abnormal findings. In 5 of the 15 patients with clinical myopathy, diagnosis was confirmed with electroneuromyography. We found a correlation between older age and duration of ICU stay (P = .002; 95% CI: 4.032-6.022; OR: 3,594). Conclusions Severe COVID-19 mainly affects men, as observed in other series. Half of our patients presented acute myopathy, and almost all patients left the ICU with acute confusional syndrome, which fully resolved; no correlation was found with EEG or neuroimaging findings. Older age is associated with longer ICU stay.
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Affiliation(s)
- M J Abenza-Abildúa
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | - M T Ramírez-Prieto
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - R Moreno-Zabaleta
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - N Arenas-Valls
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - M A Salvador-Maya
- Sección de Neumología, Hospital Universitario Infanta Sofía, Madrid, España
| | - C Algarra-Lucas
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - B Sánchez-Cordón
- Sección de Neurorradiología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - C Jimeno-Montero
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | - C Borrue-Fernández
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | - E Malmierca-Corral
- Sección de Enfermedades Infecciosas, Hospital Universitario Infanta Sofía, Madrid, España
| | - P Ruíz-Seco
- Sección de Enfermedades Infecciosas, Hospital Universitario Infanta Sofía, Madrid, España
| | - P González-Ruano
- Sección de Enfermedades Infecciosas, Hospital Universitario Infanta Sofía, Madrid, España
| | - I Palmí-Cortés
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
| | | | | | | | | | | | - R Alonso-Esteban
- Hospitalización a Domicilio, Hospital Universitario Infanta Sofía, Madrid, España
| | - N Gonzalo-García
- Servicio de Rehabilitación, Hospital Universitario Infanta Sofía, Madrid, España
| | - C Pérez-López
- Servicio de Neurocirugía, Complejo Universitario La Paz-Cantoblanco-Carlos III, Madrid, España
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Abenza-Abildúa MJ, Novo-Aparicio S, Moreno-Zabaleta R, Algarra-Lucas MC, Rojo Moreno-Arcones B, Salvador-Maya MÁ, Navacerrada-Barrero FJ, Ojeda-Ruíz de Luna J, Pérez-López C, Fraile-Vicente JM, Suárez-García I, Suarez-Gisbert E, Palacios-Castaño JA, Ramirez-Prieto MT. Encephalopathy in severe SARS-CoV2 infection: Inflammatory or infectious? Int J Infect Dis 2020; 98:398-400. [PMID: 32712426 PMCID: PMC7378010 DOI: 10.1016/j.ijid.2020.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/05/2020] [Accepted: 07/19/2020] [Indexed: 11/23/2022] Open
Abstract
Concerning the letter by Moriguchi et al., we describe our experience with a case of encephalopathy with and atypical damage on magnetic resonance imaging (MRI) in a patient with severe infection due to the SARS-CoV2 virus. A 56-year-old woman, without previous pathologies, developed cough, fever, and respiratory failure for five days, after returning from a 6-day trip to Venice. Chest radiography shows a large bilateral interstitial infiltrate. In the first 24 hours, she was admitted to the Intensive Care Unit (ICU) for severe respiratory failure and positive protein chain reaction-PCR in nasal exudate. She needed intubation for ten days. In the first 48 hours outside the ICU, she developed an acute confusional syndrome (hyperactive delirium). Neurological examination showed temporal-spatial disorientation and incoherent fluent speech. An electroencephalogram (EEG) showed generalized hypovoltaic activity. Cranial magnetic resonance imaging showed a bilateral and symmetrical increase in the supratentorial white matter's signal intensity, with a discrete thickening of both temporal lobes, with a slight increase in signal intensity and a sequence of normal diffusion. The lumbar puncture showed no changes (glucose 71 mg/dL, protein 30 mg/dL, 1 leukocyte). Within 72 hours of starting symptoms, she was neurologically asymptomatic. Our final diagnosis was an inflammatory encephalopathy related to a SARS-CoV2 infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Inés Suárez-García
- Internal Medicine-Infectious Diseases Department, Infanta Sofia University Hospital, Madrid, Spain.
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