Juan Felipe Quintero-Moreno

Background: The right temporal variant of semantic dementia (rSD) is an anatomic variant characterized by a radiological pattern of asymmetric anterior temporal atrophy, with predominance of the right lobe. It constitutes a syndrome with primary progressive aphasia with differential cognitive and behavioral symptoms, the key manifestations being prosopagnosia, topographic agnosia, and impairment of socio-emotional functioning. Case presentation: We describe the case of a 59-year-old man who developed a progressive cognitive decline in a six-year period. The first clinical manifestation was semantic anomia and difficulty recognizing objects; he later developed prosopagnosia, topographic agnosia, and progressive deterioration of episodic memory. These cognitive symptoms were accompanied by behavioral changes. Brain magnetic resonance imaging revealed asymmetric atrophy in the temporal poles, predominantly in the right hippocampal formations. Discussion: The exposed case illustrates the clinical presentation of the right temporal variant of semantic dementia and how it correlates with specific neuroimaging findings. This correlation highlights the role of the right temporal lobe for developing multimodal concepts. Neuropathological and genetic characterization have been proposed as novel diagnostic approaches that might help distinguish right temporal variant of semantic dementia from other variants. Conclusions: Although the right temporal variant of semantic dementia presents distinctive clinical manifestations, clinical diagnosis alone may be challenging due to overlapping features with other variants of frontotemporal dementia (FTD), highlighting the limitations faced in settings with little access to neuropathological and genetic evaluations and the need for more comprehensive characterization of clinical diagnostic criteria through longitudinal studies.

Background: Autosomal Dominant Alzheimer’s disease (ADAD) is a subtype of AD in which the symptoms begin before age 65. ADAD is an important subtype of AD as it affects people at productive and reproductive age, has a genetic origin in most of the cases and is one of the 10 causes of years lost to disability (YDLs) (1). Colombia has the largest kindred family with ADAD due to PSEN1‐E280A genetic variant, we aimed to characterize the palliative care need in a subsample of individuals from these families.Methods: We performed an analytical observational study with one year follow‐up, data obtained from visit 1 (V1) is shown in this first report. Carriers of PSEN1‐E280A variant and GDS/FAST score above 4 were included. NECPAL and Edmonton surveys were conducted to the main carer to assess the need for palliative care and the frequency of symptoms. A complete medical evaluation was also performed.Results: 36 patients were included in V1. Median age was 53, most of the individuals were women (63.89%), lived in urban areas (88.89%) and the most common level of education was elementary‐middle school (47.22%). Clinical variables are listed in Table 2. Results of the poisson regression showed that dysphagia, pressure ulcers, asthenia perceived by the main carer, not being surprised if the patient died in the following 12 months (Surprise question of NECPAL scale), functional decline, use of medical services (2 visits in the past year), PAINAD scale and GDS/FAST scale were associated with the need for palliative care when adjusted by number of persons involved in caring, type of carer, hours of care per week and caregiver training.Conclusion: ADAD is a neurodegenerative disease that requires follow‐up by palliative care services. The health perception of the main carer should be taken into consideration when deciding the need for palliative care in these patients.

Introduction. Neurosyphilis is the Treponema pallidum infection of the central nervous system and can occur at any time after the initial infection. In the 21st century, the incidence of neurosyphilis has increased in the post-antibiotic era. The highest rates of neurosyphilis are from low-income countries and the published studies are limited. Aim. To determine the clinical and sociodemographic characteristics of neurosyphilis patients in a tertiary care center in Pereira, Colombia. Patients and methods. Retrospective study of diagnosed neurosyphilis patients in a tertiary care center in Pereira, Colombia, between 2012 to 2017. The diagnosis was established based on serologic treponemal tests, VDRL in CSF, and CSF analysis. Sociodemographic, clinical, and laboratory parameters variables were obtained. Results. Sixteen patients were included, 11 with definitive neurosyphilis and 5 with probable neurosyphilis. The median age was 59.50 +/- 13.78 years. Men accounted for 75% (n = 12) of the patients. Four patients were (25%) HIV-infected. All the patients had positive peripheral FTA-ABS and 11 had reactive VDRL in CSF. The most frequent form was late neurosyphilis (62.5%), being general paralysis the most common. The most frequently clinical manifestations were neuropsychiatric alterations (46.9%), predominantly disorientation, behavioral changes, and cognitive impairment, followed by motor changes (36.7%). Conclusions. Late neurosyphilis was the most prevalent form, predominantly neuropsychiatric alterations. Only a quarter of patients presented HIV coinfection.

Introduction: Parkinson's disease is considered the second cause of neurodegenerative disease, in which motor signs and symptoms such as tremor, bradykinesia, rigidity and postural instability are highlighted, accompanied by non-motor symptoms such as sleep, autonomic, cognitive, gastrointestinal among others disturbances. The pharmacological treatment of the disease at the beginning is usually useful, but when the symptoms persist, the treatment fails or its adverse reactions are not tolerated, it is necessary to consider alternatives such as deep brain stimulation. Methodology: This is a narrative review with emphasis on the clinical aspects of deep brain stimulation therapy in patients with Parkinson's disease. Discussion: Deep brain stimulation is a surgical technique in which electrodes are implanted in specific brain regions, usually the subthalamic nucleus, globus pallidus interna or ventral intermediate nucleus of the thalamus, and are connected to a subcutaneous pacemaker from which the activity of these areas is modulated electrically. This therapy has been shown to be cost-effective, provides considerable benefits in improving the symptoms of Parkinson's disease and has clinical evidence in patients who have been correctly selected.

To identify predictors of seizure related injuries in adult patients with epilepsy in Colombia. Case-control study. Patients with a diagnosis of epilepsy aged 16 years and older who attended the Neurocentro epilepsy center between 2013-2016 and were attended by a specialist in epilepsy were included. Patients with seizure related injuries were defined as the case. The control group was conformed by those without seizure related injuries. Odds ratios and 95% confidence intervals were calculated. A logistic regression was performed. A total of 101 (28.5%) patients were cases and 253 (71.5%) were controls. Patients with seizure related injuries were significantly younger than controls at the age of onset of epilepsy (9 vs 12 years; p = 0.017). The significant variables in the bivariate analysis were: some degree of cognitive impairment, drug resistant epilepsy, abnormal neurological examination, and seizures related with changes in the lunar phases. No protective factors were identified. In the multivariate analysis, two variables remained significant: drug resistant epilepsy and some degree of cognitive impairment. Drug-resistant epilepsy and cognitive impairment were predictors of seizure related injuries in adult patients with epilepsy. Adequate pharmacological control of epileptic seizures and prevention recommendations may reduce the risk of seizure related injuries in these patients.