878 results on '"Benito-León J"'
Search Results
202. Deciphering seizure semiology in corpus callosum injuries: A comprehensive systematic review with machine learning insights.
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Mondal R, Deb S, Shome G, Chowdhury A, Ghosh K, Benito-León J, and Lahiri D
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- Humans, Brain Injuries complications, Brain Injuries diagnostic imaging, Brain Injuries physiopathology, Brain Injuries diagnosis, Corpus Callosum diagnostic imaging, Seizures physiopathology, Machine Learning
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Introduction: Seizure disorders have often been found to be associated with corpus callosum injuries, but in most cases, they remain undiagnosed. Understanding the clinical, electrographic, and neuroradiological alternations can be crucial in delineating this entity., Objective: This systematic review aims to analyze the effects of corpus callosum injuries on seizure semiology, providing insights into the neuroscientific and clinical implications of such injuries., Methods: Adhering to the PRISMA guidelines, a comprehensive search across multiple databases, including PubMed/Medline, NIH, Embase, Cochrane Library, and Cross-ref, was conducted until September 25, 2023. Studies on seizures associated with corpus callosum injuries, excluding other cortical or sub-cortical involvements, were included. Machine learning (Random Forest) and deep learning (1D-CNN) algorithms were employed for data classification., Results: Initially, 1250 articles were identified from the mentioned databases, and additional 350 were found through other relevant sources. Out of all these articles, 41 studies met the inclusion criteria, collectively encompassing 56 patients The most frequent clinical manifestations included generalized tonic-clonic seizures, complex partial seizures, and focal seizures. The most common callosal injuries were related to reversible splenial lesion syndrome and cytotoxic lesions. Machine learning and deep learning analyses revealed significant correlations between seizure types, semiological parameters, and callosal injury locations. Complete recovery was reported in the majority of patients post-treatment., Conclusion: Corpus callosum injuries have diverse impacts on seizure semiology. This review highlights the importance of understanding the role of the corpus callosum in seizure propagation and manifestation. The findings emphasize the need for targeted diagnostic and therapeutic strategies in managing seizures associated with callosal injuries. Future research should focus on expanding the data pool and exploring the underlying mechanisms in greater detail., Competing Interests: Declaration of Competing Interest None of the authors have any financial or personal relationships that could inappropriately influence or bias the work presented in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)
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- 2024
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203. Congenital myasthenia syndrome with demyelinating sensorimotor neuropathy responsive to salbutamol monotherapy: a novel clinical phenotype of CHRNE mutation.
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Ghosh R, Dubey S, Roy D, Mayo S, and Benito-León J
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- Humans, Demyelinating Diseases drug therapy, Demyelinating Diseases genetics, Male, Female, Receptors, Cholinergic genetics, Adrenergic beta-2 Receptor Agonists therapeutic use, Myasthenic Syndromes, Congenital drug therapy, Myasthenic Syndromes, Congenital genetics, Phenotype, Albuterol therapeutic use, Mutation
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- 2024
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204. An Intriguing Case of Expanded Dengue Syndrome With Co-existing Encephalitis, Pancreatitis, and Hepatitis: The Classic Thalamic "Double-Doughnut" Sign Revisited.
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Biswas U, León-Ruiz M, Ghosh R, Joarder U, Islam KM, Bheeman R, and Benito-León J
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Background: Dengue neuro-infection can present with symptoms ranging from mild to severe. Atypical presentations, such as expanded dengue syndrome, pose diagnostic and therapeutic challenges. Neuroimaging findings, particularly the "double-doughnut" sign on brain magnetic resonance imaging (MRI), have emerged as one of the most valuable aids in diagnosing complex cases of central nervous system infection by dengue virus., Case Presentation: We report the case of a 35-year-old female from rural West Bengal, India, with expanded dengue syndrome. The patient presented with fever, headaches, body aches, and sudden disorientation over minutes, which progressed to a coma. Neurological examination revealed profound unconsciousness and nuchal rigidity. Laboratory findings were consistent with dengue infection, including altered liver and pancreatic enzyme levels. The diagnosis was facilitated by identifying the "double-doughnut" sign on the brain MRI, which suggested dengue encephalitis. This finding and clinical and serological evidence guided the treatment strategy., Discussion: The "double-doughnut" sign, though not exclusive to dengue encephalitis, proved crucial in this case, aiding in differentiating from other causes of encephalitis. Recognition of this sign can be pivotal in diagnosing expanded dengue syndrome, facilitating timely and appropriate intervention, and improving patient outcomes. This case also underscores the importance of considering dengue in the differential diagnosis of encephalitis, especially in endemic areas. Also, this case's excellent outcome (both clinically and radiologically) was noteworthy., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)
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- 2024
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205. Cognitive Impairment in Neurological Diseases.
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Benito-León J and Papaliagkas V
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- Humans, Cognitive Dysfunction etiology, Nervous System Diseases complications
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The complex link between cognitive impairment and neurological disorders underscores the intricacies of neurological sciences [...].
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- 2024
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206. Exploring Cognitive Dysfunction in Long COVID Patients: Eye Movement Abnormalities and Frontal-Subcortical Circuits Implications via Eye-Tracking and Machine Learning.
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Benito-León J, Lapeña J, García-Vasco L, Cuevas C, Viloria-Porto J, Calvo-Córdoba A, Arrieta-Ortubay E, Ruiz-Ruigómez M, Sánchez-Sánchez C, and García-Cena C
- Abstract
Background: Cognitive dysfunction is regarded as one of the most severe aftereffects following coronavirus disease 2019 (COVID-19). Eye movements, controlled by several brain areas, such as the dorsolateral prefrontal cortex and frontal-thalamic circuits, provide a potential metric for assessing cortical networks and cognitive status. We aimed to examine the utility of eye movement measurements in identifying cognitive impairments in long COVID patients., Methods: We recruited 40 long COVID patients experiencing subjective cognitive complaints and 40 healthy controls and used a certified eye-tracking medical device to record saccades and antisaccades. Machine learning was applied to enhance the analysis of eye movement data., Results: Patients did not differ from the healthy controls regarding age, sex, and years of education. However, the patients' Montreal Cognitive Assessment total score was significantly lower than healthy controls. Most eye movement parameters were significantly worse in patients. These included the latencies, gain (computed as the ratio between stimulus amplitude and gaze amplitude), velocities, and accuracy (evaluated by the presence of hypermetric or hypometria dysmetria) of both visually and memory-guided saccades; the number of correct memory saccades; the latencies and duration of reflexive saccades; and the number of errors in the antisaccade test. Machine learning permitted distinguishing between long COVID patients experiencing subjective cognitive complaints and healthy controls., Conclusion: Our findings suggest impairments in frontal subcortical circuits among long COVID patients who report subjective cognitive complaints. Eye-tracking, combined with machine learning, offers a novel, efficient way to assess and monitor long COVID patients' cognitive dysfunctions, suggesting its utility in clinical settings for early detection and personalized treatment strategies. Further research is needed to determine the long-term implications of these findings and the reversibility of cognitive dysfunctions., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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207. A Novel Adult Case of Recurrent Acute Pancreatitis Caused by Hypercalcemia With Concurrent Manifestation of Posterior Reversible Encephalopathy Syndrome Revealing Undiagnosed Primary Hyperparathyroidism due to an Underlying Parathyroid Adenoma.
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Ghosh R, León-Ruiz M, Bole K, Dubey S, and Benito-León J
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Background: Hypercalcemia-induced posterior reversible encephalopathy syndrome (PRES) is a rare entity primarily associated with iatrogenic vitamin D/calcium overdose, malignancy, or, infrequently, primary hyperparathyroidism., Case Report: We present a novel case of an adult male from rural India who experienced recurrent acute pancreatitis caused by hypercalcemia with concurrent manifestation of PRES. Diagnostic evaluation revealed markedly elevated serum calcium levels and parathyroid hormone concentrations, consistent with primary hyperparathyroidism. Imaging studies identified a parathyroid adenoma near the right thyroid lobe, subsequently surgically excised., Discussion: This case underscores the importance of considering primary hyperparathyroidism as an underlying cause of PRES, especially in the absence of acute arterial hypertension or autonomic dysfunction. Early recognition and intervention are essential in mitigating the morbidity and mortality of PRES., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2024
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208. Triphasic waves in COVID-19 patients: Going further.
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León-Ruiz M, Benito-León J, and Castañeda-Cabrero C
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- Humans, COVID-19 epidemiology
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Competing Interests: Declaration of competing interest The authors do not have a financial interest or relationship to disclose regarding this letter to the Editor.
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- 2024
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209. Cerebral and spinal neurocysticercosis with extensive myocysticercosis presenting with new-onset convulsive status epilepticus and myopathic symptoms.
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Ghosh R, León-Ruiz M, Dubey S, and Benito-León J
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- Humans, Neurocysticercosis complications, Neurocysticercosis diagnostic imaging, Neurocysticercosis drug therapy, Status Epilepticus drug therapy, Status Epilepticus etiology, Status Epilepticus diagnosis
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- 2024
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210. Diabetic striatopathy and other acute onset de novo movement disorders in hyperglycemia.
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Chatterjee S, Ghosh R, Biswas P, Das S, Sengupta S, Dubey S, Ray BK, Pandit A, Benito-León J, and Bhattacharjee R
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- Humans, Diabetes Complications, Prognosis, Hyperglycemia, Movement Disorders etiology
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Background and Aims: Acute onset de novo movement disorder is an increasingly recognized, yet undereported complication of diabetes. Hyperglycemia can give rise to a range of different movement disorders, hemichorea-hemiballism being the commonest. This article delves into the current knowledge about this condition, its diverse presentations, ongoing debates regarding its underlying mechanisms, disparities between clinical and radiological findings, and challenges related to its management., Methods: PubMed and Google Scholar were searched with the following key terms- "diabetes", "striatopathy", "hyperglycemia", "striatum", "basal ganglia", "movement disorder", "involuntary movement". Case reports, systematic reviews, meta-analysis, and narrative reviews published in English literature related to the topic of interest from January 1, 1950, to October 20, 2023, were retrieved. The references cited in the chosen articles were also examined, and those considered relevant were included in the review., Results: Diabetic striatopathy is the prototype of movement disorders associated with hyperglycemia with its characteristic neuroimaging feature (contralateral striatal hyperdensitity on computed tomography or hyperintensity on T1-weighted magnetic resonance imaging). Risk factors for diabetic striatopathy includes Asian ethnicity, female gender, prolonged poor glycemic control, and concurrent retinopathy. Several hypotheses have been proposed to explain the pathophysiology of movement disorders induced by hyperglycemia. These hypotheses are not mutually exclusive; instead, they represent interconnected pathways contributing to the development of this unique condition. While the most prominent clinical feature of diabetic striatopathy is a movement disorder, its phenotypic expression has been found to extend to other manifestations, including stroke, seizures, and cognitive and behavioral symptoms. Fortunately, the prognosis for diabetic striatopathy is generally excellent, with complete resolution achievable through the use of anti-hyperglycemic therapy alone or in combination with neuroleptic medications., Conclusion: Hyperglycemia is the commonest cause of acute onset de novo movement disorders presenting to a range of medical specialists. So, it is of utmost importance that the physicians irrespective of their speciality remain aware of this clinical entity and check blood glucose at presentation before ordering any other investigations. Prompt clinical diagnosis of this condition and implementation of intensive glycemic control can yield significant benefits for patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Research Trust of DiabetesIndia (DiabetesIndia) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Published by Elsevier Ltd. All rights reserved.)
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- 2024
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211. Spinal Segmental Myoclonus in Primary Progressive Multiple Sclerosis.
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Ruiz-Ortiz M and Benito-León J
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- Female, Humans, Middle Aged, Myoclonus drug therapy, Myoclonus etiology, Multiple Sclerosis complications, Multiple Sclerosis, Chronic Progressive complications, Multiple Sclerosis, Chronic Progressive drug therapy, Spinal Cord Diseases, Movement Disorders
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Background: A wide variety of associated movement disorders has been described in multiple sclerosis., Phenomenology Shown: A 57-year-old woman with primary progressive multiple sclerosis developed spinal segmental myoclonus associated with focal myelitis., Educational Value: Movement disorders in multiple sclerosis are phenomenologically diverse and have varied pathophysiological mechanisms, making it essential to identify them to initiate appropriate treatment., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)
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- 2024
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212. Reported head trauma and odds of acute ischemic stroke or transient ischemic attack: A population-based study (NEDICES).
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Ghosh R, Bermejo-Pareja F, Dubey S, and Benito-León J
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- Humans, Spain epidemiology, Risk Factors, Ischemic Attack, Transient complications, Ischemic Stroke, Stroke epidemiology, Stroke complications, Craniocerebral Trauma complications, Craniocerebral Trauma epidemiology
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Background: Six previous observational studies have found a higher risk for stroke among traumatic head injury survivors. However, these studies have used record linkage systems, which could lead to underestimating stroke numbers. This study aims to reexamine the relationship between head trauma and the risk of ischemic stroke/transient ischemic attack (TIA) in an older population using data from the Neurological Disorders in Central Spain (NEDICES) study, a population-based study that includes rigorous clinical examinations for patients with suspected neurological diseases., Methods: We asked participants if they had ever experienced head trauma that was severe enough to warrant a consult with a physician, leading, among others, to visiting the emergency room, hospitalization, or resulting in loss of consciousness. The history of head trauma was evaluated in 196 (5.7%) acute ischemic stroke/TIA cases and 3256 controls in the NEDICES study., Results: Among the final sample of 3452 participants, 354 (10.3%) subjects had a history of head trauma. Twenty-nine (14.8%) of 196 acute ischemic stroke/TIA cases vs. 325 (10.0%) of 3256 controls reported a history of head trauma (p = 0.039). In a regression analysis that adjusted for several variables (age in years, sex, educational level, ever smoker, ever drinker, diabetes mellitus, arterial hypertension, and heart disease), the odds ratio was 1.54 (95% CI = 1.02-2.35, p = 0.042)., Conclusions: The reported head injury was associated with a 54% higher probability of acute ischemic stroke/TIA. More research is needed to confirm these findings, especially using population-based longitudinal studies., Competing Interests: Declaration of Competing Interest Dr. Ghosh reports that there are no conflicts of interest. Dr. Bermejo-Pareja that there are no conflicts of interest. Dr. Dubey reports that there are no conflicts of interest. Dr. Benito-León reports that there are no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)
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- 2024
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213. Amantadine and/or transcranial magnetic stimulation for fatigue associated with multiple sclerosis (FETEM): study protocol for a phase 3 randomised, double-blind, cross-over, controlled clinical trial.
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Matias-Guiu JA, González-Rosa J, Hernández MÁ, Martínez-Ginés ML, Portolés A, Pérez-Macías N, Benito-León J, Padrón I, Prieto J, and Matias-Guiu J
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- Adult, Humans, Transcranial Magnetic Stimulation, Quality of Life, Amantadine therapeutic use, Double-Blind Method, Fatigue therapy, Fatigue chemically induced, Treatment Outcome, Randomized Controlled Trials as Topic, Multicenter Studies as Topic, Clinical Trials, Phase III as Topic, Multiple Sclerosis complications, Multiple Sclerosis drug therapy
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Introduction: Fatigue is one of the most disabling symptoms of multiple sclerosis (MS), and effective treatments are lacking. Amantadine is one of the most used treatments, although its efficacy is under debate. Transcranial magnetic stimulation (TMS) is a promising intervention that has shown positive effects in some preliminary investigations. We aim to investigate the effect of 6 weeks of amantadine and/or TMS in fatigue due to MS., Methods and Analysis: The study is a national, multicentre, phase 3, randomised, double-blind, cross-over, placebo-controlled and sham-controlled clinical trial. Adult patients with relapsing-remitting MS, Expanded Disability Status Scale score of 1.5-4.5 and Fatigue Severity Score>4 are eligible for the trial. Participants will be randomised to one of the sequences of the study. Each sequence consists of four periods of 6 weeks of treatment and three washout periods of 12-18 weeks. All patients will receive all the combinations of therapies. The primary outcome is the Modified Fatigue Impact Scale. The secondary outcomes are the Symbol Digit Modalities Test (cognition), Beck Depression Inventory-II (depressive symptoms) and Short-Survey 12 (quality of life). Safety and cost-effectiveness will also be evaluated. An exploratory substudy including MRI and blood biomarkers will be conducted., Ethics and Dissemination: The study is approved by the Ethics Committee of the Hospital Clinico San Carlos and the Spanish Agency of Medications and Medical Devices. All study findings will be published in scientific peer-reviewed journals and presented at relevant scientific conferences., Trial Registration Number: EudraCT 2021-004868-95; NCT05809414., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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214. More about nonconvulsive status epilepticus in children.
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León-Ruiz M, Benito-León J, and Castañeda-Cabrero C
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- Child, Humans, Electroencephalography, Status Epilepticus diagnosis
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Competing Interests: Declaration of Competing Interest The authors do not have a financial interest or relationship to disclose regarding this letter to the Editor.
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- 2024
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215. Approach to non-compressive myeloneuropathy through a rendezvous of 11 cases from an Indian backdrop.
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Ghosh R, Roy D, Mandal A, León-Ruiz M, Das S, Dubey S, Jana A, Purkait S, Ghosh T, and Benito-León J
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Introduction: Myeloneuropathy is a diagnosis ascribed to disorders that concomitantly affect the spinal cord and peripheral nerves. Recognizing this syndrome may sometimes be arduous, even for the most consummate clinicians, because symptomatology can mimic either spinal cord or peripheral nerve disease. Besides, examination findings suggest a predominantly myelopathic or neuropathic picture. This article reports a rendezvous of rare cases of clinically diagnosed myeloneuropathy with different etiological backgrounds and therapeutic responses., Methods: Eleven cases of non-compressive myeloneuropathy were admitted to the Department of General Medicine of Burdwan Medical College and Hospital, Burdwan, West Bengal, India, between May 2018 and May 2022., Results: We report the cases of 11 patients (6 men and 5 women) who presented with myeloneuropathy of different etiologies (vitamin B12, copper, and vitamin E deficiencies, organophosphate poisoning, chronic alcohol abuse, illicit substances abuse, anti-thyroid peroxidase/anti-thyroglobulin antibody-related neurologic disorder responsive to steroids, Sjögren syndrome, chikungunya infection, paraneoplastic, and hereditary)., Conclusion: Meticulous historical analysis, careful clinical examination, and apposite utilization and interpretation of biochemical, electrophysiological, and neuroimaging findings are sine-qua-non for an accurate and consistent approach to evaluating a suspected case of myeloneuropathy, facilitating early treatment and recovery. Differential identification of these disorders needs an in-depth perception of the mode of onset of symptoms, the course of progression of the disease, the pattern of myelopathic/neuropathic findings, and recognition of other neurological or systemic manifestations. For untroubled understanding, etiologies of myeloneuropathies should be subdivided into a few broad categories, e.g., metabolic (nutritional), toxic (toxin-induced), infectious, inflammatory (immune-mediated), paraneoplastic, and hereditary disorders., Competing Interests: Declaration of Competing Interest Dr. Ritwik Ghosh (ritwikmed2014@gmail.com) reports no conflict of interest. Dr. Dipayan Roy (dipayan.1993@yahoo.in) reports no conflict of interest. Dr. Arpan Mandal (arpan0602@gmail.com) reports no conflict of interest. Dr. Moisés León-Ruiz (pistolpete271285@hotmail.com) reports no conflict of interest. Dr. Shambaditya Das (drshambadityadas@gmail.com) reports no conflict of interest. Dr. Souvik Dubey (drsouvik79@gmail.com) reports no relevant disclosures. Dr. Arijeet Jana (arijeet.jana.009@gmail.com) reports no relevant disclosures. Dr. Siktha Purkait (sikthapurkait@gmail.com) reports no relevant disclosures. Dr. Tapas Ghosh (dr.ghoshtapas@gmail.com) reports no relevant disclosures. Dr. Julián Benito-León (jbenitol67@gmail.com reports no relevant disclosures.
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- 2024
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216. Familial cerebral cavernous malformation presenting with cerebellopontine angle syndrome in a patient with autosomal dominant polycystic kidney disease.
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Ghosh R, León-Ruiz M, Roy D, and Benito-León J
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- 2024
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217. Comments to the article "First reported case of imported scrub typhus in Spain: A disease to consider in travellers".
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León-Ruiz M, Ghosh R, and Benito-León J
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- Humans, Spain, Travel, Scrub Typhus diagnosis
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- 2024
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218. Expanding the Spectrum of Diabetic Striatopathy: Insights from a Case of Hyperglycemia-Induced Propriospinal Myoclonus.
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Mukherjee D, Chatterjee S, Sarkar P, Ghosh R, Das S, Ray BK, Pandit A, Benito-León J, and Dubey S
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- Female, Humans, Middle Aged, Blood Glucose, Myoclonus diagnostic imaging, Myoclonus etiology, Movement Disorders, Dyskinesias diagnostic imaging, Dyskinesias etiology, Diabetes Mellitus, Hyperglycemia complications
- Abstract
This video abstract delves into the expanded definition of diabetic striatopathy, linked initially to hyperglycemia-induced choreoballism and striatal hyperintensity on magnetic resonance imaging, but now recognized to encompass a broader range of acute onset, non-choreoballistic movement disorders in diabetes mellitus, including tremors, hemifacial spasm, parkinsonism, different types of myoclonus, dystonia, restless leg syndrome, ataxia, and dyskinesias. We report the case of a 45-year-old female patient with type-2 diabetes mellitus who developed propriospinal myoclonus, characterized by painless, involuntary jerky movements of the bilateral lower limbs in a supine position after admission for suspected rhino-orbital mucormycosis. The abnormal movements resolved entirely following the control of her blood glucose levels, suggesting a direct correlation between hyperglycemia and the clinical picture. This case highlights the importance of considering a wide range of differential diagnoses for abnormal lower limb movements in diabetic patients, emphasizing the need for accurate identification of movement semiology, routine bedside capillary blood glucose checks, and prompt hyperglycemia management to resolve such movement disorders effectively., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)
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- 2023
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219. Headache as the presenting manifestation of Gorlin-Goltz syndrome with diastematomyelia: A case report.
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Ghosh R, León-Ruiz M, Purkait S, Roy D, Ghosh T, and Benito-León J
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Gorlin-Goltz syndrome (GGS) is an autosomal dominant multisystemic disease with high penetrance. Headache heralding GGS has been previously reported but without discussing potential sources. We report a patient with headache and a novel association (diastematomyelia), which helped with the diagnosis. A 46-year-old woman presented with persistent holocranial headache. On examination, countless hyperpigmented basal cell nevi over the face, pits over the palmar/plantar surface, and palmar and plantar keratosis were observed. A magnetic resonance imaging (MRI) of the spinal cord revealed diastematomyelia. Diagnosis of GGS was finally made. Headache and diastematomyelia should be included in the clinical picture of GGS., Competing Interests: CONFLICT OF INTEREST STATEMENT There are no conflicts of interest from the authors of this manuscript.
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- 2023
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220. Mapping Essential Tremor to a Common Brain Network Using Functional Connectivity Analysis.
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Younger E, Ellis EG, Parsons N, Pantano P, Tommasin S, Caeyenberghs K, Benito-León J, Romero JP, Joutsa J, and Corp DT
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- Humans, Brain Mapping, Cerebellum pathology, Magnetic Resonance Imaging, Neural Pathways, Tremor, Brain Diseases pathology, Connectome, Essential Tremor diagnostic imaging, Sensorimotor Cortex
- Abstract
Background and Objectives: The cerebello-thalamo-cortical circuit plays a critical role in essential tremor (ET). However, abnormalities have been reported in multiple brain regions outside this circuit, leading to inconsistent characterization of ET pathophysiology. Here, we test whether these mixed findings in ET localize to a common functional network and whether this network has therapeutic relevance., Methods: We conducted a systematic literature search to identify studies reporting structural or metabolic brain abnormalities in ET. We then used 'coordinate network mapping,' which leverages a normative connectome (n = 1,000) of resting-state fMRI data to identify regions commonly connected to findings across all studies. To assess whether these regions may be relevant for the treatment of ET, we compared our network with a therapeutic network derived from lesions that relieved ET. Finally, we investigated whether the functional connectivity of this ET symptom network is abnormal in an independent cohort of patients with ET as compared with healthy controls., Results: Structural and metabolic brain abnormalities in ET were located in heterogeneous regions throughout the brain. However, these coordinates were connected to a common functional brain network, including the cerebellum, thalamus, motor cortex, precuneus, inferior parietal lobe, and insula. The cerebellum was identified as the hub of this network because it was the only brain region that was both functionally connected to the findings of over 90% of studies and significantly different in connectivity compared with a control data set of other movement disorders. This network was strikingly similar to the therapeutic network derived from lesions improving ET, with key regions aligning in the thalamus and cerebellum. Furthermore, positive functional connectivity between the cerebellar network hub and the sensorimotor cortices was significantly reduced in patients with ET compared with healthy controls, and connectivity within this network was correlated with tremor severity and cognitive functioning., Discussion: These findings suggest that the cerebellum is the central hub of a network commonly connected to structural and metabolic abnormalities in ET. This network may have therapeutic utility in refining and informing new targets for neuromodulation of ET., (© 2023 American Academy of Neurology.)
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- 2023
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221. Black rash in dark-skinned people: do not forget dermatomyositis.
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Ghosh R, Dubey S, and Benito-León J
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- Humans, Dermatomyositis diagnosis, Exanthema etiology
- Abstract
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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- 2023
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222. Obstructive sleep apnea induced bilateral tonic- clonic seizure of unknown origin: A case series of a novel association.
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Mondal R, Maitra A, Saha S, Deb S, Roy AG, Mahata M, Lahiri D, and Benito-León J
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Background: Obstructive sleep apnea is a highly prevalent disorder, characterized by recurrent events of upper airway obstruction during sleep and associated with recurrent cycles of desaturation and re-oxygenation, sympathetic hyperactivity, and intra-thoracic pressure fluctuations, resulting in fragmentation of sleep and subsequent daytime fatigue with excessive sleepiness. Obstructive sleep apnea-induced bilateral tonic-clonic seizures are unheard of. We aimed to report 3 patients with previously undiagnosed obstructive sleep apnea who presented to the emergency department with new onset bilateral tonic-clonic seizure without any evidential neurological or metabolic cause., Methods: Patient data were obtained from medical records from the Department of Internal Medicine, IPGMER and SSKM Hospital, Kolkata, and Belle Vue Clinic, Kolkata, India., Results: Three male patients (67, 58, and 44 years old) presented with bilateral tonic-clonic seizure disorder without any underlying cause of seizures after rigorous investigations except for moderate to severe obstructive sleep apnea on polysomnography. All 2 patients were seizure-free after being treated with levetiracetam, chronic continuous positive airway pressure therapy in 2, and only continuous positive airway pressure in the other. The patients remained seizure-free on continuous positive airway pressure, even when levetiracetam was withdrawn, suggesting obstructive sleep apnea's causality in their new-onset acute seizures., Conclusion: Although further investigation is required to clarify this association, underlying obstructive sleep apnea should be ruled out in patients with a first-ever bilateral tonic-clonic seizure. Whether or not continuous positive airway pressure alone could effectively treat hypoxia and deranged cortical excitability, which may lead to seizures in cases with longstanding obstructive sleep apnea, is yet to be explored., Competing Interests: Disclosures and Conflict of Interests None of the authors has a conflict of interest. Ritwick Mondal reports no relevant disclosures. Arindam Maitra reports no relevant disclosures. Somesh Saha reports no relevant disclosures. Shramana Deb reports no relevant disclosures. Aakash Guha Roy reports no relevant disclosures. Manoj Mahata reports no relevant disclosures. Durjoy Lahiri reports no relevant disclosures. Julián Benito-León reports no relevant disclosures.
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- 2023
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223. Bálint syndrome in a patient with drug-resistant epilepsy having underlying X-linked lissencephaly with subcortical band heterotopia/"double cortex" syndrome.
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Ghosh R, León-Ruiz M, Jana A, Roy D, Ghosh T, and Benito-León J
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- 2023
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224. Polyneuropathy in a pregnant woman with hyperemesis gravidarum: Do not forget dry beriberi.
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Ghosh R, León-Ruiz M, Mondal AS, Dubey S, and Benito-León J
- Abstract
Competing Interests: Conflicts of interests The authors do not have any conflict of interest.
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- 2023
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225. Abnormal functional connectivity in radiologically isolated syndrome: A resting-state fMRI study.
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Benito-León J, Del Pino AB, Aladro Y, Cuevas C, Domingo-Santos Á, Galán Sánchez-Seco V, Labiano-Fontcuberta A, Gómez-López A, Salgado-Cámara P, Costa-Frossard L, Monreal E, Sainz de la Maza S, Matías-Guiu JA, Matías-Guiu J, Delgado-Álvarez A, Montero-Escribano P, Martínez-Ginés ML, Higueras Y, Ayuso-Peralta L, Malpica N, and Melero H
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- Humans, Brain pathology, Gyrus Cinguli, Parietal Lobe, Neural Pathways diagnostic imaging, Brain Mapping methods, Magnetic Resonance Imaging methods
- Abstract
Background: Radiologically isolated syndrome (RIS) patients might have psychiatric and cognitive deficits, which suggests an involvement of major resting-state functional networks. Notwithstanding, very little is known about the neural networks involved in RIS., Objective: To examine functional connectivity differences between RIS and healthy controls using resting-state functional magnetic resonance imaging (fMRI)., Methods: Resting-state fMRI data in 25 RIS patients and 28 healthy controls were analyzed using an independent component analysis; in addition, seed-based correlation analysis was used to obtain more information about specific differences in the functional connectivity of resting-state networks. Participants also underwent neuropsychological testing., Results: RIS patients did not differ from the healthy controls regarding age, sex, and years of education. However, in memory (verbal and visuospatial) and executive functions, RIS patients' cognitive performance was significantly worse than the healthy controls. In addition, fluid intelligence was also affected. Twelve out of 25 (48%) RIS patients failed at least one cognitive test, and six (24.0%) had cognitive impairment. Compared to healthy controls, RIS patients showed higher functional connectivity between the default mode network and the right middle and superior frontal gyri and between the central executive network and the right thalamus ( p
FDR < 0.05; corrected). In addition, the seed-based correlation analysis revealed that RIS patients presented higher functional connectivity between the posterior cingulate cortex, an important hub in neural networks, and the right precuneus., Conclusion: RIS patients had abnormal brain connectivity in major resting-state neural networks and worse performance in neurocognitive tests. This entity should be considered not an "incidental finding" but an exclusively non-motor (neurocognitive) variant of multiple sclerosis., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.- Published
- 2023
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226. Subacute Sclerosing Panencephalitis in a 63-Year-Old Woman Presenting as Generalized Choreoathetosis.
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Mondal R, Deb S, Mahata M, Saha S, Lahiri D, and Benito-León J
- Abstract
The persistence of measles virus infection in childhood and early adolescence can rarely lead to a fatal progressive neurodegenerative disorder known as subacute sclerosing panencephalitis (SSPE), characterized by behavioral disturbances and intellectual disability followed by myoclonic jerks and occasional negative myoclonus. Movement disorders are rarely presenting manifestations in SSPE. We herein report a 63-year-old woman with generalized choreoathetosis as the presenting manifestation of stage-I SSPE. Our case was atypical for the patient's age and clinical presentation with generalized choreoathetosis and bilateral putaminal and caudate nucleus signal hyperintensity. Though highly uncommon, neurologists should keep SSPE as a differential diagnosis among patients with movement disorders. Measles-endemic countries should be more vigilant to the atypical and rare presentations of SSPE, such as generalized choreoathetosis., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)
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- 2023
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227. Alice in Wonderland syndrome heralding posterior reversible encephalopathy syndrome in a patient with undiagnosed multiple myeloma.
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Ghosh R, León-Ruiz M, Roy D, Bole K, and Benito-León J
- Subjects
- Humans, Alice in Wonderland Syndrome, Posterior Leukoencephalopathy Syndrome diagnostic imaging, Multiple Myeloma complications, Multiple Myeloma diagnosis
- Published
- 2023
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228. Higher-level gait disorder as a presenting manifestation of progressive supranuclear palsy: a video case report.
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Ghosh R, León-Ruiz M, Dubey S, Chakraborty A, and Benito-León J
- Subjects
- Female, Humans, Middle Aged, Gait, Walking, Atrophy, Supranuclear Palsy, Progressive, Apraxias
- Abstract
Introduction: Frontal gait disorder/gait apraxia is a higher-order motor deficit with various causes, characterized by difficulties with gait initiation, such as freezing or ignition failure. We aimed to report a patient who presented with progressive higher-level gait disorder and fall episodes as the initial manifestations of progressive supranuclear palsy (PSP). Patient data were obtained from medical records from the Department of General Medicine, Burdwan Medical College and Hospital (Burdwan, West Bengal, India)., Case Report: A 58-year-old previously healthy woman presented with a gait disorder and fall episodes. Detailed neurological examination highlighted characteristic facial appearance (wide-eyed staring, furrowing of the forehead with a frowning expression, and fixed expression of the lower face). She was hypokinetic-rigid with symmetrical signs and predominant axial rigidity with retrocolic trunk and neck posture. Gait examination revealed a higher-level gait pattern characterized by an exhibition of profound start hesitation requiring assistance from nearby objects/persons. Once walking was underway, steps became relatively better, but ineffective gait re-emerged when she attempted turning. She had short strides, freezing, broad stance base, disequilibrium, slow leg movement, shuffling, and loss of normal fluidity of trunk and limbs. Postural reflexes were impaired. Brain magnetic resonance imaging revealed atrophy of the midbrain, dilated aqueduct of Sylvius and third ventricle, atrophy of frontal lobes and typical hummingbird sign. Diagnosis of probable PSP was finally made., Conclusions: Several etiologies, including PSP, should be considered in appropriate clinical contexts if gait examination demonstrates a higher-order gait disorder.
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- 2023
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229. Correction to: Cerebellar Cognitive Affective Syndrome in a Case of Cerebrotendinous Xanthomatosis.
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Ghosh R, León-Ruiz M, Sardar SS, Naga D, Ghosh T, Dutta S, and Benito-León J
- Published
- 2023
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230. Norovirus-associated neurological manifestations: summarizing the evidence.
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Deb S, Mondal R, Lahiri D, Shome G, Roy AG, Sarkar V, Sarkar S, and Benito-León J
- Subjects
- Humans, Seizures complications, Norovirus genetics, Caliciviridae Infections complications, Gastroenteritis complications, Brain Diseases complications
- Abstract
Norovirus, a positive-stranded RNA virus, is one of the leading causes of acute gastroenteritis among all age groups worldwide. The neurological manifestations of norovirus are underrecognized, but several wide-spectrum neurological manifestations have been reported among infected individuals in the last few years. Our objective was to summarize the features of norovirus-associated neurological disorders based on the available literature. We used the existing PRISMA consensus statement. Data were collected from PubMed, EMBASE, Web of Science, and Scopus databases up to Jan 30, 2023, using pre-specified searching strategies. Twenty-one articles were selected for the qualitative synthesis. Among these, seven hundred and seventy-four patients with norovirus-associated neurological manifestations were reported. Most cases were seizure episodes, infection-induced encephalopathy, and immune-driven disorders. However, only a few studies have addressed the pathogenesis of norovirus-related neurological complications. The pathogenesis of these manifestations may be mediated by either neurotropism or aberrant immune-mediated injury, or both, depending on the affected system. Our review could help clinicians to recognize these neurological manifestations better and earlier while deepening the understanding of the pathogenesis of this viral infection., (© 2023. The Author(s).)
- Published
- 2023
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231. Cerebellar Cognitive Affective Syndrome in a Case of Cerebrotendinous Xanthomatosis.
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Ghosh R, León-Ruiz M, Sardar SS, Naga D, Ghosh T, Dutta S, and Benito-León J
- Subjects
- Humans, Brain, Cognition, Xanthomatosis, Cerebrotendinous complications, Xanthomatosis, Cerebrotendinous diagnostic imaging, Cerebellar Diseases
- Published
- 2023
- Full Text
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232. Snakebite envenomation-induced posterior reversible encephalopathy syndrome presenting with Bálint syndrome.
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Ghosh R, León-Ruiz M, Das S, Dubey S, and Benito-León J
- Subjects
- Humans, Snake Bites complications, Posterior Leukoencephalopathy Syndrome diagnostic imaging, Posterior Leukoencephalopathy Syndrome etiology, Apraxias, Brain Diseases
- Published
- 2023
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233. Internet of medical things. Measurement of respiratory dynamics using wearable sensors in post-COVID-19 patients.
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García Cena CE, Silva L, Diaz Palencia FH, Moríñigo MI, Santos CP, Pazmiño RS, Benito-León J, and Gómez-Andrés D
- Abstract
Nowadays, the measurement of respiratory dynamics is underrated at clinical setting and in the daily life of a subject and it still represents a challenge from a technical and medical point of view. In this article we propose a concept to measure some of its parameters, such as the respiratory rate (RR), using four inertial sensors. Two different experiments were performed to validate the concept. We analyzed the most suitable placement of each sensor to assess those features and we studied the reliability of the system to measure abnormal parameters of respiration (tachypnea, bradypnea and breath holding). Finally, we measured post-COVID-19 patients, some of them with breath alterations after more than a year of the diagnosis. Experimental results showed that the proposed system could be potentially used to measure the respiratory dynamics at clinical setting. Moreover, while RR can be easily calculated by any sensor, other parameters need to be measured with a sensor in a particular position., Competing Interests: Conflicts of interest The authors declare no conflict of interest.
- Published
- 2023
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234. Glucose-6-phosphate dehydrogenase deficiency and COVID-19 mortality.
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Romero JP and Benito-León J
- Subjects
- Humans, SARS-CoV-2, Risk Factors, Glucosephosphate Dehydrogenase Deficiency, COVID-19
- Published
- 2023
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235. Psychosocial Basis of Human Sufferings and Poverty in Patients with Neurological and Psychiatric Disorders.
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Dubey S, Ghosh R, Dubey MJ, Das S, Chakraborty AP, Santra A, Dutta A, Roy D, Pandit A, Roy BK, Das G, and Benito-León J
- Abstract
Neurological disorders and psychiatric ailments often lead to cognitive disabilities and low attainment of education, pivoting misconceptions, myths, and misbeliefs. Poverty and low educational attainment are intriguingly associated with poor awareness and perception of these diseases that add to the suffering. Poverty goes parallel with a low level of education and is intricately associated with neuropsychiatric ailments, which have the potential to spread transgenerationally. Robust education policies, proper government rules and regulations against the spread of disease-related myths and misconceptions, uplifting medical education in its true sense, voices against consanguinity, and programs to raise scientific perception about diseases can help to throw light at the end of this dark tunnel. In this article, the authors intend to 1) decipher the potential psychosocial basis of human suffering and poverty in patients with neurological and psychiatric disorders, and 2) discuss the apropos way-outs that would potentially mitigate suffering, and alleviate the economic burden and cognitive disabilities of families with neuropsychiatric diseases., Competing Interests: We wish to confirm that there are no known conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome.
- Published
- 2023
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236. Pure alexia as a presenting manifestation of scrub typhus.
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Ghosh R, Dubey S, Roy D, and Benito-León J
- Subjects
- Humans, Scrub Typhus complications, Scrub Typhus diagnosis, Alexia, Pure
- Published
- 2023
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237. Multiple Myeloma-Induced Hyperammonemic Encephalopathy: Another Important Potential Cause of Triphasic Waves: Erratum.
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León-Ruiz M, Oliva-Navarro J, Alonso-Singer P, Castañeda-Cabrero C, and Benito-León J
- Published
- 2023
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238. Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study.
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Benito-León J, Ghosh R, Lapeña-Motilva J, Martín-Arriscado C, and Bermejo-Pareja F
- Subjects
- Humans, Aged, Smoking adverse effects, Cohort Studies, Prospective Studies, Spain epidemiology, Cognitive Dysfunction epidemiology, Cognitive Dysfunction etiology, Nervous System Diseases
- Abstract
Whether cumulative smoking exposure is associated with cognitive decline among older adults remains unresolved. To address this question, we used data from the Neurological Disorders in Central Spain (NEDICES) cohort study, in which 2624 older adults were evaluated at two-time points separated by three years. A 37-item version of the Mini-Mental State Examination (MMSE-37) was administered at two visits to assess cognitive change. Regarding smoking exposure, we calculated an individual baseline score based on pack-years (i.e., packs of cigarettes smoked per day multiplied by years of smoking) in current and former smokers. Thus, smoking exposure was categorized into tertiles (low: < 19.0, medium: 19.0-47.0, and high: > 47.0). We used multivariable generalized estimating equation models to assess associations between pack-years and smoking status with 37-MMSE total score change from baseline to follow-up. The MMSE-37 total score had a decline of 1.05 points (confidence interval [CI] 95% 0.62 to 1.48) in the lower tertile of pack-years, 1.16 (CI 95% 0.70 to 1.62) in the middle tertile and 1.17 (CI 95% 0.70 to 1.65) in the higher tertile compared to never smokers, after adjusting for several demographic and clinical variables. The same occurred with smoking status, i.e., a decline of 1.33 (CI 95% 0.87 to 1.79) in current smokers and 1.01 (CI 95% 0.63 to 1.40) in former smokers. Our study provides evidence of the cumulative effect of smoking on cognition in older adults. Using a prospective population-based design, we demonstrated that cumulative smoking exposure was associated with cognitive decline in non-demented older adults. More population-based evidence is required to elucidate this association in older adults without dementia., (© 2023. The Author(s).)
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- 2023
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239. Bálint syndrome as the presenting manifestation of adrenoleukodystrophy.
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Ghosh R, León-Ruiz M, Bole K, Bandyopadhyay S, Dubey S, and Benito-León J
- Abstract
Competing Interests: Conflict of Interest No.
- Published
- 2023
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240. Impact of a specific consultation for patients with progressive forms of multiple sclerosis on the response to their unmet care needs: a cross-sectional study.
- Author
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Gómez-López A, Benito-León J, Labiano-Fontcuberta A, Moreno-García S, and Salgado-Cámara P
- Subjects
- Humans, Caregivers, Cross-Sectional Studies, Health Services Needs and Demand, Referral and Consultation, Multiple Sclerosis therapy, Multiple Sclerosis, Chronic Progressive therapy
- Abstract
Background: As their disease evolves, most patients with progressive forms of multiple sclerosis (MS) develop particular healthcare needs that are not always addressed with usual follow-up. To adapt neurological care to these patients, we created a specific consultation for patients with progressive MS in our centre in 2019., Objectives: To explore the main unmet care needs of patients with progressive MS in our setting, and to establish the usefulness of the specific consultation to address them., Methods: Literature review and interviews with patients and healthcare professionals were conducted to identify the main unmet needs in routine follow-up. Two questionnaires were developed, assessing the importance of the unmet needs identified and the usefulness of the consultation to meet them, for patients under follow-up in the specific consultation and their informal caregivers., Results: Forty-one patients and nineteen informal caregivers participated. The most important unmet needs were the information about the disease, access to social services and coordination between specialists. A positive correlation was found between the importance of these unmet needs and the responsiveness to each of them in the specific consultation., Conclusions: The creation of a specific consultation may improve attention to the healthcare needs of patients with progressive MS., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023. Published by Elsevier B.V.)
- Published
- 2023
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241. Health-related quality of life and perceived stress of informal caregivers of children and adolescents with intellectual disabilities and ADHD.
- Author
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Dubey MJ, Ray P, Ghosh R, Bhattacharyya AK, Dhor P, Chatterjee S, Chatterjee S, Dubey S, Mitchell AJ, and Benito-León J
- Abstract
Introduction: Informal caregivers of children and adolescents with intellectual disabilities and attention deficit/hyperactivity disorder (ADHD) face numerous challenges. However, no study has yet compared the HRQoL of the caregivers of children and adolescents with these two conditions. We aimed to compare the HRQoL and perceived stress of caregivers of children and adolescents with intellectual disabilities and ADHD., Methods: The HRQoL and perceived stress of informal caregivers of children and adolescents with intellectual disabilities and ADHD (40 in each group) were compared using the perceived stress scale and the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form, respectively., Results: HRQoL was significantly worse in most dimensions in caregivers of children and adolescents with severe ADHD than in caregivers of children and adolescents with severe intellectual disabilities. However, perceived stress was similar., Conclusion: Differences in the impact of intellectual disability and ADHD on family members' HRQoL should be considered while developing educational programs for patients and their families., Competing Interests: Conflict of interest Dr. Jana Dubey reports no conflict of interest. Dr. Ray reports no conflict of interest. Dr. Ghosh reports no conflict of interest. Dr. Kumar Bhattacharyya reports no conflict of interest. Dr. Dhor reports no conflict of interest. Dr. Chatterjee reports no conflict of interest. Dr. Chatterjee reports no conflict of interest. Dr. Dubey reports no conflict of interest. Dr. Mitchell reports no conflict of interest. Dr. Benito-León reports no conflict of interest.
- Published
- 2023
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242. Downbeat Nystagmus as a Presenting Manifestation of Neurolisteriosis in a Pregnant Woman.
- Author
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Ghosh R, León-Ruiz M, Sardar SS, Lalsing D P, and Benito-León J
- Abstract
Listeria monocytogenes has tropism towards two immunologically "privileged" sites, the fetoplacental unit in pregnant women and the central nervous system (neurolisteriosis) in immunocompromised individuals. We report a case of neurolisteriosis in a previously asymptomatic pregnant woman from rural West Bengal, India, who presented with a subacute onset febrile illness with features of rhombencephalitis and a predominantly midline-cerebellopathy (slow and dysmetric saccades, florid downbeat nystagmus, horizontal nystagmus, and ataxia). With timely detection and the institution of prolonged intravenous antibiotic therapy, both the mother and the fetus were saved uneventfully., Competing Interests: No potential conflict of interest was reported by the authors., (© 2023 Taylor & Francis Group, LLC.)
- Published
- 2023
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243. Typhoid fever presenting with central and peripheral nervous system involvement.
- Author
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Ghosh R, Moreno-García S, Roy D, Dubey S, and Benito-León J
- Subjects
- Humans, Peripheral Nervous System, Typhoid Fever complications, Typhoid Fever diagnosis
- Published
- 2023
- Full Text
- View/download PDF
244. [The electroencephalogram: a complementary test that should not be forgotten to perform before a first seizure].
- Author
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León-Ruiz M, Benito-León J, and Castañeda-Cabrero C
- Subjects
- Humans, Electroencephalography, Seizures diagnosis, Memory Disorders
- Published
- 2023
- Full Text
- View/download PDF
245. The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia.
- Author
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Dubey S, Das S, Ghosh R, Dubey MJ, Chakraborty AP, Roy D, Das G, Dutta A, Santra A, Sengupta S, and Benito-León J
- Abstract
Background: Cognitive postscripts of COVID-19, codenamed as 'cognitive COVID' or 'brain fog,' characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied., Objective: We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia., Methods: Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer's disease, five with vascular dementia, three with Parkinson's disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later., Results: Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue ( p = 0.001) and depression ( p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p < 0.001) and Addenbrooke's Cognitive Examination ( p = 0.001) scores also significantly worsened., Conclusion: The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggest that previously compromised brains have little defense to withstand a new insult (i.e., 'second hit' like infection/dysregulated immune response, and inflammation). 'Brain fog' is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e. 'FADE-IN MEMORY' (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment)., Competing Interests: The authors have no conflict of interest to report., (© 2023 – The authors. Published by IOS Press.)
- Published
- 2023
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246. A Case of Parinaud Syndrome in a Patient with Parkinson's Disease: Causal Association or Co-incidental?
- Author
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Dubey S, Ghosh R, Ray BK, Gutiérrez-Ortiz C, and Benito-León J
- Subjects
- Male, Humans, Aged, Middle Aged, Tremor, Causality, India, Parkinson Disease complications, Ocular Motility Disorders etiology
- Abstract
Background: Parinaud syndrome is a dorsal mid-brain syndrome characterized by upgaze paralysis, convergence retraction nystagmus, and pupillary light-near dissociation. Infarctions or hemorrhages involving the mid-brain are the most frequent causes in older adults., Objective: To report a novel case of a patient who presented with classical parkinsonian signs and Parinaud syndrome., Material and Methods: Patient data were obtained from medical records from the Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India., Results: A 62-year-old previously healthy man presented with motor and non-motor symptoms of Parkinson's disease (PD) for the past 6 years. The neurological examination revealed an asymmetric resting tremor of the upper limbs with rigidity, bradykinesia, hypophonia, hypomimia, decreased blinking, and micrographia. The neuro-ophthalmological examination showed Parinaud syndrome. He was treated with levodopa-carbidopa and trihexyphenidyl. After 6 months and 1 year of follow-up, his neurological condition was re-assessed; motor symptoms improved substantially, but Parinaud syndrome persisted., Conclusions: Parinaud syndrome can be a potential manifestation of PD. A detailed neuro-ophthamological examination should be carried out even in patients having a diagnosis of classic PD in whom eye-movement abnormalities are distinctly infrequent., Competing Interests: None
- Published
- 2023
- Full Text
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247. [Alcohol as a rescue treatment for essential tremor: too risky to recommend].
- Author
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León-Ruiz M and Benito-León J
- Subjects
- Humans, Ethanol adverse effects, Alcohol Drinking, Essential Tremor drug therapy
- Published
- 2022
- Full Text
- View/download PDF
248. Association between LAG3/CD4 Genes Variants and Risk for Multiple Sclerosis.
- Author
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García-Martín E, Agúndez JAG, Gómez-Tabales J, Benito-León J, Millán-Pascual J, Díaz-Sánchez M, Calleja P, Turpín-Fenoll L, Alonso-Navarro H, García-Albea E, Plaza-Nieto JF, and Jiménez-Jiménez FJ
- Subjects
- Humans, Genetic Predisposition to Disease, Genotype, HLA-DRB1 Chains genetics, Polymorphism, Single Nucleotide, CD4 Antigens, Multiple Sclerosis genetics
- Abstract
Several recent works have raised the possibility of the contribution of the lymphocyte activation gene 3 (LAG3) protein in the inflammatory processes of multiple sclerosis (MS). Results of studies on the possible association between LAG3 gene variants and the risk of MS have been inconclusive. In this study, we tried to show the possible association between the most common single nucleotide variants (SNVs) in the CD4 and LAG3 genes (these two genes are closely related) and the risk of MS in the Caucasian Spanish population. We studied the genotypes and allelic variants CD4 rs1922452 , CD4 rs951818 , and LAG3 rs870849 in 300 patients diagnosed with MS and 400 healthy patients using specific TaqMan -based qPCR assays. We analyzed the possible influence of the genotype frequency on age at the onset of MS, the severity of MS, clinical evolutive subtypes of MS, and the HLADRB1*1501 genotype. The frequencies of the CD4 rs1922452 , CD4 rs951818 , and LAG3 rs870849 genotypes and allelic variants were not associated with the risk of MS and were unrelated to gender, age at onset and severity of MS, the clinical subtype of MS, and HLADRB1*1501 genotype. The results of the current study showed a lack of association between the CD4 rs1922452 , CD4 rs951818 , and LAG3 rs870849 SNVs and the risk of developing MS in the Caucasian Spanish population.
- Published
- 2022
- Full Text
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249. 'Wine Glass' sign following COVID-19 vaccination in a previously healthy adult.
- Author
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Ghosh R, Dutta S, Ghosh M, and Benito-León J
- Published
- 2022
- Full Text
- View/download PDF
250. Multiple Myeloma-Induced Hyperammonemic Encephalopathy: Another Important Potential Cause of Triphasic Waves.
- Author
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León-Ruiz M, Oliva-Navarro J, Alonso-Singer P, Castañeda-Cabrero C, and Benito-León J
- Subjects
- Humans, Electroencephalography, Multiple Myeloma complications, Brain Diseases etiology, Neurotoxicity Syndromes
- Abstract
Competing Interests: The authors have no funding or conflicts of interest to disclose.
- Published
- 2022
- Full Text
- View/download PDF
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