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Background: There are severe neurological conditions in patients with COVID-19, such as: cerebrovascular disease, Guillain-Barré syndrome, encephalitis, acute hemorrhagic necrotizing encephalopathy and myelitis. Objective: We describe that the patient with SARS-CoV 2 with respiratory symptoms has subtle or subclinical neurological manifestations. Material and methods: Observational, cross-sectional, analytical study, which included patients aged 18-65 years with respiratory symptoms and a confirmed diagnosis of COVID-19. Intubated patients with chronic neurodegenerative diseases or pre-existing neurological compromise were excluded. Semiology of the headache and neurological examination were performed; Serum levels of glucose, protein, electrolytes, lactate, C-reactive protein, lactic dehydrogenase, and D-dimer were measured. Cerebrospinal fluid (CSF) analysis and electroencephalogram (EEG) were also performed in patients who accepted the risks. Results: A high prevalence of subtle neurological manifestations was found in patients with COVID-19 with only a respiratory clinical picture. Headache, anosmia, dysgeusia, and hypopalesthesia predominated in the early stages, with frequent abnormal findings in the CSF (> 70%) and less frequently in the EEG (< 20%). Conclusions: Headache, anosmia, dysgeusia and hypoesthesia were frequent at the beginning of the infection, together with abnormal findings in CSF and EEG, without other neurological symptoms or neurological disease. [ABSTRACT FROM AUTHOR]

Objective: To translate, culturally adapt, and validate a version of the ID Migraine into Latin American Spanish. Background: Although still considered a common diagnosis, half of the patients with migraine in Latin America experience diagnostic delay. The ID Migraine is a test developed in 2003 as a valuable tool for the early diagnosis of migraine at the primary care level; however, there is no validated Spanish or culturally adapted version for the Spanish‐speaking population. Methods: This is an analytical, translation, and test‐validation study. We performed back translation and cross‐cultural adaptation. The Latin American Spanish version ID Migraine MX was applied to headache clinic patients from March 2021 to January 2022 to perform a validation process against the gold standard: blinded expert diagnosis according to the International Classification of Headache Disorders, 3rd edition (ICHD‐3), criteria. Results: One hundred seventeen patients from the headache clinic of the National Institute of Neurology and Neurosurgery of Mexico City were screened. We found 62/117 (53%) patients positive for screening with ID Migraine MX, and 47/117 (40%) positive for migraine according to ICHD‐3 criteria. A sensitivity (95% CI) of 0.91 (0.80–0.97), specificity of 0.73 (0.61–0.82), positive predictive value of 0.694 (0.57–0.794), and negative predictive value of 0.93 (0.83–0.97) were obtained. The positive likelihood ratio was 3.38 (2.27–4.99), and the negative likelihood ratio was 0.12 (0.04–0.30). After calling the patients 1 month after the first interview, the calculated Kappa test–retest was 0.75 (p = 0.001). Conclusion: A translated and cross‐culturally adapted version into Spanish of the ID Migraine was obtained, with a diagnostic performance similar to the original instrument. Clinicians may use this test at the first level of care to reduce the rate of misdiagnosis and the time from onset of symptoms to diagnosis and treatment of migraine. [ABSTRACT FROM AUTHOR]

Introduction: Kambo is the skin secretion of the toxic Brazilian frog Phyllomedusa bicolor, and its inoculation to human skin is globally practiced, especially in South America, out of interest or to cure multiple diseases. Objective: A case report of poisoning with Kambo frog poison during a ritual. Results: 41-year-old male, marijuana user, who reported a last consumption three months ago, and used Kambo for generalized anxiety disorder with panic attacks and claustrophobia. The patient suffered complications, including neuropathy, that we associate to the toxic effect of Kambo, and received oral prednisone, diphenidol and paroxetine as treatment, showing improvement. Discussion: The substances that could be related to neuropathy are tachykinin, mediated through B receptors that participate in mechanisms linked to pain, dermorphins and deltorphins, as well as Mu opioid agonists, that act on Mu and Delta receptors of the central nervous system involved in analgesic effects. Two phases have been described in Kambo intoxication: the first phase, that lasts usually 15-30 minutes, and the second phase, which includes persistent acute symptoms, syndrome of inappropriate antidiuretic hormone secretion, acute toxic hepatitis, and dermatomyositis. Conclusion: Clinicians need to be aware of the complications of this shamanic ritual expanding worldwide. [ABSTRACT FROM AUTHOR]