Último número

Volumen 69 (06)
Ver número actual
Ver todos

Números anteriores

Vol. 69 (05)
Vol. 69 (04)
Vol. 69 (03)
Vol. 69 (02)

Otros números

Suplementos Congresos English Versions

Sobre la Revista

Comité Científico Viguera Editores Proceso de revisión Sociedades oficiales e indexación

Información para autores

Enviar manuscrito Normas de publicación Consultar estado de artículo

Información para revisores

Recomendaciones para revisor
Factor Impacto 20180,485

Porcentaje de rechazo en 2017: 66%

50% de artículos reciben respuesta definitiva en 12 días

Media de tiempo a respuesta definitiva: 38 días

Web Médica Acreditada. Ver más información

Revista de Neurología (24 números al año) fomenta y difunde el conocimiento generado en lengua española sobre neurociencia, tanto clínica como experimental.

Másteres online

Master in Neuroimmunology

Máster en Neurología Tropical y Enfermedades Infecciosas

Máster en Epilepsia

Máster en Trastornos del Espectro Autista

Máster en Trastornos del Movimiento

Máster en Psicobiología y Neurociencia Cognitiva

Máster en Sueño: Fisiología y Medicina

Máster en Neuropsicología de las Altas Capacidades Intelectuales

Máster en Neurociencia Experimental y Clínica

Universidades

iNeurocampus Formación online

Listado de Másteres impartidos por Viguera Editores S.L.U. a través del portal www.ineurocampus.com en colaboración con distintas universidades del país

Noticias del día

Un buen control de la presión arterial reduciría el riesgo de un segundo ictus Fecha 18/09/2019 ● Lecturas 15
Ver todas las noticias

 

Nueva diana terapéutica para el tratamiento de la enfermedad de Alzhéimer Fecha 18/09/2019 ● Lecturas 14

Entrevistas

Entrevista con el profesor Luis de Lecea con ocasión de la reunión de la Asociación Española de Narcolepsia para pacientes y médicos (Día Europeo de la Narcolepsia. Madrid, 2019)

12/03/2019 ● Lecturas 7.061
Ver todas las entrevistas

Listado de noticias de interés relacionadas con las neurociencias

Septiembre 19 2019

14th European Association of Neurooncology (EANO) annual meeting

Lyon, France

Septiembre 19 2019

2º Congreso de la Asociación Mexicana de Cefaleas y Migraña

San Luís Potosí, México

Septiembre 19 2019

Congreso Liga Argentina contra la Epilepsia (LACE) 2019

Buenos Aires, Argentina

Septiembre 20 2019

World Sleep 2019

Vancouver, Canadá

Septiembre 20 2019

NEUROPhyCS 2019

Viena, Austria

Septiembre 21 2019

48th Meeting of the European Brain Behavior Society (EBBS)

Praga, República Checa

Ver Agenda

Listado de eventos del sector y fechas de interés relacionadas con los Másteres de www.ineurocampus.com

Listado de palabras clave de la página web. Pulse en una categoría para acceder a la búsqueda de todo el contenido web (artículos, noticias, autores, entrevistas etc.) relacionado con dicha categoría

Sobre Revista de Neurología

Información Comité Científico Proceso de revisión Sociedades e indexación Contacto

¿Cómo publicar con nosotros?

Enviar manuscrito Normas para autores Información para revisores

Sobre Viguera Editores

Información

Sobre iNeurocampus

Información

Redes sociales

Facebook Twitter
Web Médica Acreditada. Ver más información

Neurologia.com es una comunidad de conocimiento alrededor de la neurología en habla hispana, compuesta por millones de profesionales, desde estudiantes a instituciones médicas o académicas. Esta comunidad se dota de diferentes herramientas de interrelación y difusión del conocimiento en neurociencia

Entrevista

English Castellano

Interview to Dr. Soňa Nevšímalová, 1st European narcolepsy day

18/03/2010 ● Lecturas 41.756


Dra. Soňa Nevšímalová President of the nEUroped project for the study of narcolepsy in children. Professor of Neurology. Faculty of Medicine, Department of Neurology. Charles University. Prague, Czech Republic
Question. Do you believe that narcolepsy in children is commonly under-recognized or misdiagnosed?
Answer. According to some clinicians and epidemiologists, only 1 out of 10 narcoleptic patients is correctly diagnosed and treated. The diagnosis certainly depends on the level of pediatric, neurological and psychiatric knowledge in different countries. Thanks to Prof. Roth and the long tradition of clinical and scientific research in this field, I believe, most of the patients in the Czech Republic –including children– are diagnosed correctly. However, just recently, I came across the opinion –even among respected European pediatric neurologists– that narcolepsy, if it does exist in children, is extremely rare. This idea documents that a great many pediatric cases are missed even in EU countries.

Q. The spectrum of narcolepsy is quite broad in childhood; therefore, the delay between the onset of symptoms and accurate diagnosis is long. Treatment of the condition at onset could ameliorate the long-term effects and improve quality of life, even if treatment of narcolepsy remains limited and understudied in the pediatric population. What is your opinion?
A. Excessive daytime sleepiness (EDS) is usually the first symptom of narcolepsy in pediatric cases and, in the absence of cataplexy in the clinical picture, the diagnosis can sometimes be difficult. Doubt is justifiable mainly in those patients whose MSLT shows no convincing proof at the beginning of the disease and/or when the child is too young for classical MSLT examination. In such cases, polysomnographic monitoring, HLA examination and, particularly, hypocretin estimation in the cerebrospinal fluid (CSF) are really helpful. However, there are still cases of narcolepsy without cataplexy with negative HLA and hypocretin findings, where SOREMs in MSLT can appear with a delay. In my opinion, to start with modafinil treatment in such ‘unclear cases’ is a lesser mistake than the ‘wait-and-see’ approach. Treatment should start as early as possible. Sleepiness hampers progress at school and untreated narcolepsy and /or sleepiness of other etiology (e.g. idiopathic hypersomnia) can have a negative impact on further educational achievements.

Q. On the other hand, it seems that the clinical severity of narcolepsy does not depend on the age at onset (Nevsimalova S, Sleep Med 2009; 10: 967-72) and it evolves as a non progressive disease. Altogether this could suggest rather limited benefits of early treatment. In your view, would this be a right conclusion?
A. I am afraid not. According to our study, the maximum severity of the disease (excessive daytime sleepiness as well as cataplexy) appears at the beginning of the disease, and the first and most important peak of age at onset comes in adolescence. Children and particularly adolescents are, therefore, the most distressed population group. Epidemiological studies have shown that narcolepsy has a major negative impact on the quality of life (greater than epilepsy or sleep disorders such as sleep apnea). I believe the prognosis will improve in the future thanks to earlier diagnosis and better treatment (modafinil, sodium oxybate).

Q. You have participated in a recently published study (Hallmayer et al, Nature Genetics 2009; 41: 708-11) where you stated that narcolepsy is strongly associated with the T-cell receptor alpha locus. Could you hypothesize on the connection between this finding and the pathophysiology of the disease?
A. An autoimmune etiology of narcolepsy has long been suspected but never proved. Prof. Mignot with co-workers collected 807 HLA-DQB1*0602 positive cases of narcolepsy-cataplexy and 1,074 HLA-DQB1*0602 positive controls from 3 ethnic groups of the United States, Canada and Europe and, using genome-wide association (GWA), found a link between narcolepsy and polymorphism in the T-cell receptor alpha locus. This is the first documented genetic involvement of T-cell receptor (TCR); therefore, narcolepsy can provide new insights into how HLA-TCR interaction contributes to organ-specific autoimmune targeting and may serve as a model for other HLA-associated disorders.

In another important paper (Aran et al, Sleep 2009; 32: 879-983) Prof. Mignot’s group found that streptococcal infections are probably a significant environmental trigger for narcolepsy that can launch the autoimmune response.

Q. Could you tell us the goals of the nEUroped Project?
A. nEUroped (http://www.neuroped.eu/) is a project currently co-funded by the European Union Public Health Program (April 2008-2011) and devoted to three rare pediatric neurological diseases: alternating hemiplegia in childhood (AHC), rare surgically treatable epileptic syndromes (RSTES) and narcolepsy. 13 different organizations from 10 EU countries participate in this project with the aim to create registries, to improve awareness of these conditions within professional and social life (families, teachers, public), to facilitate research (pathogenesis, diagnosis, management and treatment), to improve services, and to provide insight into a number of rare nervous system disorders in children generally. The outcome of the project should cover data analysis and review designed to develop and disseminate relevant recommendations (Guidelines). The Network should bring benefit to patients and their families, patient organizations, research groups, and other interested parties across Europe.

Q. We know that the first step is focused on creating a European database of narcolepsy in children. Do you think is it convenient to have two separate databases for adults and for children?
A. You are right, surely not. But the decision depends on the nEUroped Steering Board Committee (SBC). It was decided to establish only one IT provider running a database with a common part for three different diseases (AHC, RSTES and narcolepsy), and with separate parts for each specific diagnosis. The common database should be focused on clinical history, medical needs, behavioral problems and education needs, social relations, quality of life and social support. The whole Registry should be simple and centered –as you can see– more on social needs. The still existing EU Narcolepsy Network is focused more specifically on scientific research and on the establishment of international research and cooperation.
Dra. Rosa Peraita-Adrados
Unidad de Sueño-Neurofisiología Clínica
Hospital General Universitario Gregorio Marañón


Prof. Dr. Juan V. Sánchez-Andrés
Depto. Médico, Viguera eds.
Sueño
Le puede interesar
Artículo en Castellano
Artículo con autoevaluación Efecto de las crisis epilépticas parciales y generalizadas sobre la arquitectura del sueño en ratas E. López-Ruiz, G. Vega-Flores, B. Contreras-Cisneros, A. Martínez, A.P. Rivera-García Fecha de publicación 01/04/2015 ● Descargas 333
Artículo en Castellano
Artículo con autoevaluación Bases anatómicas y neuroquímicas que explican la frecuente asociación de las cefaleas con el sueño: el paradigma de la c... A. Caminero, J.A. Pareja Fecha de publicación 16/09/2008 ● Descargas 1747