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Transient Neurologic Symptoms After Spinal Anesthesia  

Microsoft Academic Search

- We recently reported several cases consistent with tran- sient radicular irritation after spinal anesthesia with hy- perbaric 5% lidocaine. The present prospective, blind, nonrandomized study was performed to determine the incidence of these transient neurologic symptoms and to identify factors that might be associated with their occurrence. We studied 270 patients scheduled for gy- necologic or obstetric procedures under

Karl F. Hampl; Markus C. Schneider; Wolfgang Ummenhofer; Jurgen Drewe



Recurrent takotsubo cardiomyopathy in the setting of transient neurological symptoms: a case report  

PubMed Central

Introduction First described in Japan, takotsubo cardiomyopathy is increasingly becoming recognized worldwide as a cause of sudden and reversible diminished left ventricular function characterized by left apical ballooning and hyperkinesis of the basal segments, often with symptoms mimicking a myocardial infarction. Associated with physical or emotional stress, its exact pathogenesis has not been established, though evidence supports a neurohumoral etiology. Additionally, recurrence of this condition is rare. In this report, we present a rare case of recurrent takotsubo cardiomyopathy in a post-menopausal woman who presented with transient neurological complaints on both occasions. Case presentation We present a rare case of a 76-year-old Caucasian woman with no history of congestive heart failure who presented to our emergency department twice with transient neurological complaints. On the first occasion, she was found to have transient aphasia which resolved within 24 hours, yet during that period she also developed symptoms of congestive heart failure and was noted to have a new, significantly depressed ejection fraction with apical akinesis and possible apical thrombus. One month after her presentation a repeat echocardiogram revealed complete resolution of all wall motion abnormalities and a return to baseline status. Seven months later she presented with ataxia, was diagnosed with vertebrobasilar insufficiency, and again developed symptoms and echocardiography findings similar to those of her first presentation. Once again, at her one-month follow-up examination, all wall motion abnormalities had completely resolved and her ejection fraction had returned to normal. Conclusion Though the exact etiology of takotsubo cardiomyopathy is unclear, a neurohumoral mechanism has been proposed. Recurrence of this disorder is rare, though it has been reported in patients with structural brain abnormalities. This report is the first to describe recurrent takotsubo cardiomyopathy in a patient with transient neurological symptoms. In our patient, as expected in patients with this condition, complete resolution of all left ventricular abnormalities occurred within a short period of time. It is important for clinicians to be aware of this increasingly recognized syndrome, including its association with recurrence, especially in the clinical setting of neurologic dysfunction.



[Neurological symptoms in psychiatry].  


Certain psychiatric diseases have biological pathomechanisms, and as a result they are accompanied by various neurological symptoms. Neurological examination is a simple method to assess these symptoms. Neurological signs come in two varieties; they are either of the hard or the soft type. Hard symptoms appear primarily in organic psychiatric disorders or as side effects of psychiatric therapy. They can also be encountered during neurological diseases of psychiatric patients. Their use in diagnostics and therapy is widely accepted. In contrast, soft neurological symptoms often stay unnoticed, even though they may contain important pieces of information. For this reason they will form the focus of our discussion. Soft neurological symptoms have been studied in different psychiatric disorder-groups. Up to now most attention has been devoted to schizophrenia. The study suggests that the soft symptoms are trait markers of schizophrenia. Furthermore they also signal disease activity and predict the outcome of the disease. Neurological symptoms are also important pointers for psychiatry. However, more systematic studies may increase the theoretical and practical implications of soft symptoms. PMID:21876223

Salacz, Pál; Hidasi, Zoltán; Csibri, Eva



Diagnosis and management of transient neurologic symptoms following subarachnoid block with single-shot isobaric 2% lidocaine.  


Hyperbaric 5% lidocaine has been used extensively for spinal anesthesia for the last 50 yr. The implication of lidocaine as specifically etiologic for transient neurologic symptoms (TNS) has led to increasing focus on lidocaine spinal anesthesia and reports of TNS with single-shot, hyperbaric lidocaine. We report the details of a case of TNS associated with single-shot, isobaric 2% lidocaine in a 69-year-old female, scheduled for outpatient hysteroscopy, dilatation and curettage, and endometrial biopsy while placed in the lithotomy position. PMID:11704452

Farid, I; Youssef, G; Banoub, M; Gottlieb, A; Tetzlaff, J E



Symptoms of transient ischemic attack.  


Transient ischemic attack (TIA) is a cerebrovascular disease with temporary (<24 h) neurological symptoms. The symptoms of TIA patients are largely similar to those of ischemic stroke patients and include unilateral limb weakness, speech disturbances, sensory symptoms, visual disturbances, and gait difficulties. As these symptoms are transient, they are frequently evaluated based on patients' subjective reports, which are less precise than those of patients with stroke whose longer-lasting symptoms and signs can be reliably assessed by physicians. Some symptoms, such as monocular blindness, are much more common in TIA than in stroke, and limb shaking occurs almost exclusively in TIA patients. On the other hand, symptoms like hemivisual field defects or limb ataxia are underappreciated in TIA patients. These transient neurological symptoms are not necessarily caused by cerebrovascular diseases, but can be produced by a variety of non-vascular diseases. Careful history taking, examination, and appropriate imaging tests are needed to differentiate these TIA mimics from TIA. Each TIA symptom has a different specificity and sensitivity, and there has been an effort to assess the outcome of the patients through the use of specific clinical features. On top of this, recent developments in imaging techniques have greatly enhanced our ability to predict the outcomes of TIA patients. Perception or recognition of TIA symptoms may differ according to the race, sex, education, and specialty of physicians. Appropriate education of both the general population and physicians with regard to TIA symptoms is important as TIAs need emergent evaluation and treatment. PMID:24157558

Kim, Jong S



Neurological Signs and Symptoms in Fibromyalgia  

PubMed Central

Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM.

Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.



Delayed Transient Worsening of Neurological Deficits after Ischaemic Stroke  

Microsoft Academic Search

Background: Although the causes of stroke recurrence are well known, no particular study deals with the specific issue of late-onset transient worsening of the neurological deficit (TWND) after an ischaemic stroke. Patients and Methods: In this retrospective study the aetiology of the TWNDs in 101 patients was compared to the causes of transient ischaemic attacks (TIAs) in 115 patients. All

J. De Reuck; L. De Groote; G. Van Maele



Does exercise evoke neurological symptoms in healthy subjects?  

Microsoft Academic Search

Concussion is a common injury in collision sports and is evidenced by a variety of signs and symptoms. The recording of neurological symptoms is an important component of screening for a concussion and in return-to-play decisions. However similar symptoms are prevalent in the general population and are reported to be associated with participation in physical activities. The purpose of this

Sridhar Alla; S. John Sullivan; Paul McCrory; Anthony G. Schneiders; Phil Handcock



Initial Neurologic Symptoms Among Bangladeshi Multiple Sclerosis Patients  

Microsoft Academic Search

This study was undertaken in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2002 to December 2003. The objective of this study was to determine the initial neurologic symptoms of multiple sclerosis among Bangladeshi patients. A total of 25 respondents of multiple sclerosis patients as cases selected by McDonald et al. (2001) diagnostic criteria for




Neurological symptoms among dental assistants: a cross-sectional study  

PubMed Central

Background Dental assistants help the dentist in preparing material for filling teeth. Amalgam was the filling material mostly commonly used in Norway before 1980, and declined to about 5% of all fillings in 2005. Amalgam is usually an alloy of silver, copper, tin and mercury. Copper amalgam, giving particularly high exposure to mercury was used in Norway until 1994. Metallic mercury is neurotoxic. Few studies of the health of dental assistants exist, despite their exposure to mercury. There are questions about the existence of possible chronic neurological symptoms today within this working group, due to this exposure. The aim of this study was to compare the occurrence of neurological symptoms among dental assistants likely to be exposed to mercury from work with dental filling material, compared to similar health personnel with no such exposure. Methods All dental assistants still at work and born before 1970 registered in the archives of a trade union in Hordaland county of Norway were invited to participate (response rate 68%, n = 41), as well as a similar number of randomly selected assistant nurses (response rate 87%, n = 64) in the same age group. The participants completed a self-administered, mailed questionnaire, with questions about demographic variables, life-style factors, musculoskeletal, neurological and psychosomatic symptoms (Euroquest). Results The dental assistants reported significant higher occurrence of neurological symptoms; psychosomatic symptoms, problems with memory, concentration, fatigue and sleep disturbance, but not for mood. This was found by analyses of variance, adjusting for age, education, alcohol consumption, smoking and personality traits. For each specific neurological symptom, adjusted logistic regression analyses were performed, showing that these symptoms were mainly from arms, hands, legs and balance organs. Conclusion There is a possibility that the higher occurrence of neurological symptoms among the dental assistants may be related to their previous work exposure to mercury amalgam fillings. This should be studied further to assess the clinical importance of the reported symptoms.

Moen, BE; Hollund, BE; Riise, T



Occurrence of Cognitive and Neurological Symptoms in Norwegian Dentists  

PubMed Central

Objectives Previous investigations have presented some evidence of late cognitive effects in dental personnel exposed to metallic mercury. We wanted to examine if Norwegian dentists have an increased prevalence of symptoms consistent with neurological and/or cognitive malfunction. Methods The study group consisted of 406 dentists from central Norway and 217 controls from the general population, all under the age of 70. They had responded to a standardised postal questionnaire (Euroquest) inquiring about seven symptoms in regard to neurology, psychosomatics, memory, concentration, mood, sleep disturbances, and fatigue. A score was calculated for each symptom based on 4 to 15 single questions scored on a scale from 1 (seldom or never) to 4 (very often). Results The dentists and controls had a participation rate of 57.2% and 42.9% respectively. The dentists reported no more cognitive symptoms than the controls, with low average symptom scores from 1.16 for neurological symptoms in males to 1.73 for fatigue in females. Corresponding figures for the controls were 1.22 and 1.77. There were a total of 1.2% of the dentists and 1.8% of the controls who reported having three or more of the seven symptoms "often" or more frequently. Conclusion Norwegian dentists do not report more cognitive and neurological symptoms than controls from the general population.

Svendsen, Kristin; Syversen, Tore; Aas, Oddfrid; Qvenild, Torgunn



Thymolipoma combined with hyperthyroidism discovered by neurological symptoms.  


Thymolipomas are rare slow-growing mediastinal thymic neoplasms. Most cases are asymptomatic and are sometimes discovered as a huge mass on chest x-ray films. A few cases have been discovered during examinations for other diseases. We report the second case of thymolipoma combined with hyperthyroidism in the English language literature. Neurological symptoms suddenly appeared in a 45-year-old woman. Central nervous system disorder was suggested but no significant abnormalities were found on brain MR nor were there any neurological signs. Several months later, neurological and systemic examinations on admission revealed hyperthyroidism and an anterior mediastinal tumor, 9.0x5.0x3.0 cm in size on chest CT films. Despite treatment of hyperthyroidism by medication, her neurological symptoms remained. Neurologists recommended resection of the mediastinal tumor. Malignancy could not be ruled out because of the irregularity of the tumor appearance on contrast-enhanced chest CT. Furthermore, the tumor appeared to be attached to the ascending aorta, so cytological and/or pathological diagnosis by CT-guided needle biopsy before operation were contraindicated. Extended thymectomy was performed in May 2005. The pathological diagnosis was benign thymolipoma consisting of mature fatty tissue and thymic tissue structures with Hassall's corpuscles. Her neurological symptoms seemed slightly but not markedly improved. The relationship between thymolipoma and hyperthyroidism is still unknown. PMID:17505419

Takahashi, Hidenobu; Harada, Masahiko; Kimura, Masakazu; Kato, Harubumi



Autism spectrum symptoms in children with neurological disorders  

PubMed Central

Background The aims of the present study were to assess symptoms associated with an autism spectrum disorder (ASD) in children with neurological disorders as reported by parents and teachers on the Autism Spectrum Screening Questionnaire (ASSQ), as well as the level of agreement between informants for each child. Methods The ASSQ was completed by parents and teachers of the 5781 children (11–13 years) who participated in the second wave of the Bergen Child Study (BCS), an on-going longitudinal population-based study. Out of these children, 496 were reported to have a chronic illness, including 99 whom had a neurological disorder. The neurological disorder group included children both with and without intellectual disabilities. Results Children with neurological disorders obtained significantly higher parent and teacher reported ASSQ scores than did non-chronically ill children and those with other chronic illnesses (p<.01; ES = .50-1.01), and 14.1% were screened above the positive cutoff score for ASD according to their combined parent and teacher ASSQ scores. Parent/teacher agreement over ASSQ scores for children with neurological disorders was moderate to high for the total score and for three sub scores generated from a factor analysis, and low to moderate for single items. Conclusions The ASSQ identifies a high rate of ASD symptoms in children with neurological disorders, and a large number of children screened in the positive range for ASD. Although a firm conclusion awaits further clinical studies, the present results suggest that health care professionals should be aware of potential ASD related problems in children with neurological disorders, and should consider inclusion of the ASSQ or similar screening instruments as part of their routine assessment of this group of children.



Acute but transient neurological deterioration revealing adult polyglucosan body disease.  


Adult polyglucosan body disease (APBD) is a metabolic disorder usually caused by glycogen branching enzyme (GBE) deficiency. APBD associates progressive walking difficulties, bladder dysfunction and, in about 50% of the cases, cognitive decline. APBD is characterized by a recognizable leukodystrophy on brain MRI. We report here a novel presentation of this disease in a 35-year old woman who presented with an acute deterioration followed by an unexpected recovery. Enzymatic analysis displayed decreased GBE activity in leukocytes. Molecular analyses revealed that only one mutated allele was expressed, bearing a p.Arg515His mutation. This is the first observation reporting acute and reversible neurological symptoms in APBD. These findings emphasize the importance of searching GBE deficiency in patients presenting with a leukodystrophy and acute neurological symptoms mimicking a stroke, in the absence of cardiovascular risk factors. PMID:23146612

Billot, Ségolčne; Hervé, Dominique; Akman, Hasan O; Froissart, Roseline; Baussan, Christiane; Claeys, Kristl G; Piraud, Monique; Sedel, Frédéric; Mochel, Fanny; Laforęt, Pascal



Transient Global Amnesia and Neurological Events: The Framingham Heart Study  

PubMed Central

Background/objective: Transient global amnesia (TGA) is a temporary amnestic syndrome characterized by lack of other focal neurological deficits. Cerebrovascular disease, migraine and seizures have been suggested as underlying mechanisms. TGA may be a risk factor for cerebrovascular or other neurological events. We studied the relation of TGA, vascular risk factors, brain magnetic resonance imaging (MRI) indices of subclinical ischemia and neurological events in a community-based sample. Design/setting: A total of 12 TGA cases were ascertained using standard criteria by experienced neurologists, and matched to 41 stroke- and seizure-free controls. Vascular risk factors, brain MRI findings, and subsequent cerebrovascular or seizure events were compared in cases and controls. Participants: Framingham Heart Study (FHS) original and offspring cohort participants were included. Results: No significant differences between the groups were observed in the prevalence of vascular risk factors, or brain MRI measures. Few incident stroke/transient ischemic attacks (TIA) (one event among the cases and four in controls) or subsequent seizures occurred in either group. Head CT during the acute event (n?=?11) and brain MRI (n?=?7) were negative for acute abnormalities. Electroencephalograms (EEG) (n?=?5) were negative for epileptiform activity. Extracranial vascular studies were negative for significant stenosis in all cases. Conclusion: In our community-based study TGA was not related to traditional vascular risk factors, or cerebrovascular disease. However, our study is limited by small sample size and power, and larger studies are required to exclude an association.

Romero, Jose Rafael; Mercado, Melissa; Beiser, Alexa S.; Pikula, Aleksandra; Seshadri, Sudha; Kelly-Hayes, Margaret; Wolf, Philip A.; Kase, Carlos S.



Transient Adverse Neurologic Effects of Spinal Pain Blocks  

PubMed Central

Objective Chronic neck or back pain can be managed with various procedures. Although these procedures are usually well-tolerated, a variety of side effects have been reported. In this study we reviewed cases of unexpected temporary adverse events after blocks and suggest possible causes. Methods We reviewed the records of patients treated with spinal pain blocks between December 2009 and January 2011. The types of blocks performed were medial branch blocks, interlaminar epidural blocks and transforaminal epidural blocks. During the first eight months of the study period (Group A), 2% mepivacaine HCL and triamcinolone was used, and during the last six months of the study period (Group B), mepivacaine was diluted to 1% with normal saline. Results There were 704 procedures in 613 patients. Ten patients had 12 transient neurologic events. Nine patients were in Group A and one was in Group B. Transient complications occurred in four patients after cervical block and in eight patients after lumbar block. Side effects of lumbar spine blocks were associated with the concentration of mepivacaine (p<0.05). The likely causes were a high concentration of mepivacaine in five patients, inadvertent vascular injection in three patients, intrathecal leak of local anesthetics in one, and underlying conversion disorder in one. Conclusion Spinal pain blocks are a good option for relieving pain, but clinicians should always keep in mind the potential for development of inevitable complications. Careful history-taking, appropriate selection of the anesthetics, and using real-time fluoroscopy could help reduce the occurrence of adverse events.

Lee, Han-Il; Park, Yong-Sook; Cho, Tack-Geun; Park, Seung-Won; Kwon, Jeong-Taik



Stress, caffeine and ethanol trigger transient neurological dysfunction through shared mechanisms in a mouse calcium channelopathy.  


Several episodic neurological disorders are caused by ion channel gene mutations. In patients, transient neurological dysfunction is often evoked by stress, caffeine and ethanol, but the mechanisms underlying these triggers are unclear because each has diverse and diffuse effects on the CNS. Attacks of motor dysfunction in the Ca(V)2.1 calcium channel mouse mutant tottering are also triggered by stress, caffeine and ethanol. Therefore, we used the tottering mouse attacks to explore the pathomechanisms of the triggers. Despite the diffuse physiological effects of these triggers, ryanodine receptor blockers prevented attacks induced by all of them. In contrast, compounds that potentiate ryanodine receptors triggered attacks suggesting a convergent biochemical pathway. Tottering mouse attacks were both induced and blocked within the cerebellum suggesting that the triggers act locally to instigate attacks. In fact, stress, caffeine and alcohol precipitated attacks in Ca(V)2.1 mutant mice in which genetic pathology was limited to cerebellar Purkinje cells, suggesting that the triggers initiate dysfunction within a specific brain region. The surprising biochemical and anatomical specificity of the triggers and the discovery that the triggers operate through shared mechanisms suggest that it is possible to develop targeted therapies aimed at blocking the induction of episodic neurological dysfunction, rather than treating the symptoms once provoked. PMID:23009754

Raike, Robert S; Weisz, Catherine; Hoebeek, Freek E; Terzi, Matthew C; De Zeeuw, Chris I; van den Maagdenberg, Arn M; Jinnah, H A; Hess, Ellen J



A Patient with Systemic Lupus Erythematosus Complicated by Neurological Symptoms of Toluene Poisoning  

PubMed Central

We report a patient with systemic lupus erythematosus complicated by toluene poisoning. She had erythema, alopecia, arthralgia, and various neurological symptoms. Laboratory findings showed leukocytopenia, low levels of complements, and anti-dsDNA antibody. However, normal interleukin-6 level and IgG index of cerebrospinal fluid and brain magnetic resonance imaging and single photon emission computed tomography findings suggested that her neurological symptoms were caused by metabolic disorder but not neuropsychiatric systemic lupus erythematosus. Erythema, alopecia, and arthralgia improved rapidly after administration of prednisolone and tacrolimus, whereas neurological symptoms improved only gradually. Because of a history of exposure to toluene, her neurological symptoms were considered to be due to toluene poisoning. The differentiation of toluene poisoning from neuropsychiatric systemic lupus erythematosus based on symptoms is difficult because both induce various neuropsychiatric disorders. Laboratory findings of cerebrospinal fluid, radiological findings, and medical interview were useful for differentiation of toluene poisoning from neuropsychiatric systemic lupus erythematosus.

Takeuchi, Tohru; Makino, Shigeki; Hanafusa, Toshiaki



Household food insecurity and symptoms of neurologic disorder in Ethiopia: An observational analysis  

PubMed Central

Background Food insecurity (FI) has been shown to be associated with poor health both in developing and developed countries. Little is known about the relation between FI and neurological disorder. We assessed the relation between FI and risk for neurologic symptoms in southwest Ethiopia. Methods Data about food security, gender, age, household assets, and self-reported neurologic symptoms were collected from a representative, community-based sample of adults (N = 900) in Jimma Zone, Ethiopia. We calculated univariate statistics and used bivariate chi-square tests and multivariate logistic regression models to assess the relation between FI and risk of neurologic symptoms including seizures, extremity weakness, extremity numbness, tremors/ataxia, aphasia, carpal tunnel syndrome, vision dysfunction, and spinal pain. Results In separate multivariate models by outcome and gender, adjusting for age and household socioeconomic status, severe FI was associated with higher odds of seizures, movement abnormalities, carpal tunnel, vision dysfunction, spinal pain, and comorbid disorders among women. Severe FI was associated with higher odds of seizures, extremity numbness, movement abnormalities, difficulty speaking, carpal tunnel, vision dysfunction, and comorbid disorders among men. Conclusion We found that FI was associated with symptoms of neurologic disorder. Given the cross-sectional nature of our study, the directionality of these associations is unclear. Future research should assess causal mechanisms relating FI to neurologic symptoms in sub-Saharan Africa.



Midazolam Challenge Reinduces Neurological Deficits After Transient Ischemic Attack  

Microsoft Academic Search

Background and Purpose—A transient ischemic attack (TIA) in the brain is classically considered a syndrome lasting 24 hours. Having previously shown that an experimental challenge with the GABAA agonist midazolam in recovered stroke patients can reinduce the acute clinical state, we determined whether TIA patients would demonstrate a similar effect. Methods—Four right-handed patients participated: 3 with clinical TIA presumed to

Ronald M. Lazar; Brian-Fred Fitzsimmons; Randolph S. Marshall; J. P. Mohr; Mitchell F. Berman


Transient Neurologic Syndrome in One Thousand Forty-Five Patients After 3% Lidocaine Spinal Anesthesia  

Microsoft Academic Search

Recent reports have discussed the potential risk of transient radicular irritation (TRI) after spinal anes- thesia with lidocaine. Because we have not encoun- tered such neurologic sequelae with the high inci- dence reported, we prospectively examined the incidence of TRI after spinal anesthesia with lido- Caine. One thousand forty-five adult patients (aged 47 -C 15 yr) receiving spinal anesthesia with

Hiroshi Morisaki; Junichi Masuda; Shinichi Kaneko; Makoto Matsushima; Junzo Takeda



Copper in disorders with neurological symptoms: Alzheimer’s, Menkes, and Wilson diseases  

Microsoft Academic Search

Copper is an essential element for the activity of a number of physiologically important enzymes. Enzyme-related malfunctions may contribute to severe neurological symptoms and neurological diseases: copper is a component of cytochrome c oxidase, which catalyzes the reduction of oxygen to water, the essential step in cellular respiration. Copper is a cofactor of Cu\\/Zn-superoxide-dismutase which plays a key role in

Daniel Strausak; Julian F. B Mercer; Hermann H Dieter; Wolfgang Stremmel; Gerd Multhaup



Paraneoplastic Neurological Syndromes: Severe Neurological Symptoms Resulting from Relatively Benign or Occult Tumours--Two Case Reports  

PubMed Central

Introduction. Paraneoplastic syndromes represent rare symptom complexes resulting from the ability of tumour cells to disrupt the homeostatic processes of various bodily systems. Here we present two cases to demonstrate how such tumours may evade detection even after extensive investigation and how even relatively benign tumours can produce severe neurological symptoms. Case 1. A 69-year-old female was admitted with a subacute onset of dysarthria, ataxia, and cerebellar signs. Workup revealed a relatively benign Non-Hodgkin's Lymphoma. Case 2. A 64-year-old female was admitted with acute leg weakness, which progressed to quadriplegia and was eventually fatal over the ensuing months. Her Ca-125 was elevated, though three different CT views of her pelvis and surgical exploration failed to demonstrate any malignancy. Discussion. These cases highlight how even relatively benign or very small tumours may result in severe neurological symptoms. Suspecting and investigating paraneoplastic syndromes (PNSs) are crucial as up to 80% of patients present with PNS before there is any other indication of malignancy. A PET scan and regular surveillance may reveal occult malignancies better than CT or MRI. Neuromodulatory therapies and treatment of the underlying malignancy remain the best management options in these patients.

Ghadiri-Sani, M.; Smith, Dave; Doran, Mark



Depressive symptoms in Parkinson's disease and in non-neurological medical illnesses  

PubMed Central

Background Patients with neurological and non-neurological medical illnesses very often complain of depressive symptoms that are associated with cognitive and functional impairments. We compared the profile of depressive symptoms in Parkinson’s disease (PD) patients with that of control subjects (CS) suffering from non-neurological medical illnesses. Methods One-hundred PD patients and 100 CS were submitted to a structured clinical interview for identification of major depressive disorder (MDD) and minor depressive disorder (MIND), according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR), criteria. The Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) were also administered to measure depression severity. Results When considering the whole groups, there were no differences in depressive symptom frequency between PD and CS apart from worthlessness/guilt, and changes in appetite reduced rates in PD. Further, total scores and psychic and somatic subscores of HDRS and BDI did not differ between PD and CS. After we separated PD and CS in those with MDD, MIND, and no depression (NODEP), comparing total scores and psychic/somatic subscores of HDRS and BDI, we found increased total depression severity in NODEP PD and reduced severity of the psychic symptoms of depression in MDD PD, with no differences in MIND. However, the severity of individual symptom frequency of depression was not different between PD and CS in MDD, MIND, and NODEP groups. Conclusion Although MDD and MIND phenomenology in PD may be very similar to that of CS with non-neurological medical illnesses, neurological symptoms of PD may worsen (or confound) depression severity in patients with no formal/structured DSM-IV-TR, diagnosis of depressive mood disorders. Thus, a thorough assessment of depression in PD should take into consideration the different impacts of neurological manifestations on MDD, MIND, and NODEP.

Assogna, Francesca; Fagioli, Sabrina; Cravello, Luca; Meco, Giuseppe; Pierantozzi, Mariangela; Stefani, Alessandro; Imperiale, Francesca; Caltagirone, Carlo; Pontieri, Francesco E; Spalletta, Gianfranco



One Stage Correction Surgery of Scoliosis Associated With Syringomyelia: Is it Safe to Leave Untreated a Syrinx Without Neurological Symptom?  


STUDY DESIGN:: Retrospective study. OBJECTIVE:: To investigate the safety to leave a syrinx untreated in one stage correction surgery of scoliosis associated with syringomyelia without progressive neurologic symptom. BACKGROUND MATERIAL:: The present protocol for patients with scoliosis secondary to syringomyelia advocated to treat the syrinx first because of the increased risk in correction surgery. However, in daily life, these patients could still do lateral bending, in which spinal cord distracted albeit without any neurologic symptom occurred. METHOD:: 21 consecutive patients with scoliosis associated with syringomyelia with or without Chiari malformation underwent surgery in our department from 2003 to 2010 were included in this study. Patients with progressive neural deficits were excluded. Every patient received detailed neurological and radiological examination before the surgery, including whole spine films, lateral bending and fulcrum bending films, 3-dimention CT scan and MRI. All the patients underwent one stage correction surgery without treatment of syrinx. During the surgery, Spinal Cord Monitor and wake up test were used to prevent serious neurologic complications. At follow up, patients received neurological examination and whole spine X-ray films. RESULT:: There were 13 male and 8 female patients. Before the surgery, 3 patients complained wasting of the intrinsic muscles of hand, one complained numbness of left upper extremity, and four complained back pain. Negative abdomen reflex occurred on 12 out of 21 patients. All the patients were single major curve, including 14 thoracic curves and 7 thoracolumbar curves. The mean preoperative Cobb angle of scoliosis was 68.05±20.1°, on bending films was 39.48±21.56°, postoperative was 23.19±14.14°, at final follow up was 25.76±14.46°. The mean flexibility was 0.452±0.158, correction ratio was 0.685±0.140. During the operation, spinal cord monitor showed MEP lost transiently in 2 patients, and SEP was normal in all the patients. Wake-up test was normal for all the patients. No neurological complication was observed after the surgery and at follow up, two patients complaint back pain and one patient got early postoperative infection. The mean follow up time was 4.5 years (1.6?8.5?y). CONCLUSION:: For scoliosis patients associated with syringomyelia without neurological deficits, it might be safe and could be an option to leave a syrinx untreated before one stage correction surgery. Besides, a residual scoliosis was important to make sure the neural safety. The correction procedure during the surgery should be controlled by about 15 degree or 50 percent more than on the bending film. Never placing pedicle screw in the apical region was beneficial for controlling the correction rate. PMID:23249885

Wang, Guodong; Sun, Jianmin; Jiang, Zhensong; Cui, Xingang; Cui, Jiangchao



Relevance of Transient Ischemic Attack to Early Neurological Recovery after Nonlacunar Ischemic Stroke  

Microsoft Academic Search

Background: We hypothesized that previous transient ischemic attack (TIA) had a favorable effect on early outcome after acute nonlacunar ischemic stroke. Methods: Data of 1,753 consecutive patients with ischemic stroke collected from a prospective hospital-based stroke registry were studied. A comparison was made of the groups with and without previous TIA. Favorable outcome included spontaneous neurological recovery or grades 0–2

A. Arboix; N. Cabeza; L. García-Eroles; J. Massons; M. Oliveres; C. Targa; M. Balcells



Solitary spinal epidural cavernous angiomas in children presenting with acute neurological symptoms caused by hemorrhage.  


Spinal solitary epidural cavernous angiomas are rare benign vascular malformations, which occur even less frequently in children than in adults. It is uncommon to find such lesions without adjacent vertebral involvement. Occasionally, these lesions can lead to neurological symptoms through growth or due to intralesional hemorrhage. In this report the authors describe 2 children presenting with acute symptoms and neurological deficits caused by hemorrhage within solitary spinal epidural cavernous angiomas. A 13-year-old girl and a 9-year-old girl, previously healthy, were admitted to the authors' department due to acute radicular pain and neurological deficits. In both cases MR imaging revealed a solitary epidural mass with signs of bleeding and compression of the spinal cord. Complete resection of the lesion via a dorsal approach was performed in both patients. The histological examination of the lesions revealed the characteristic structures of a cavernous angioma with hemosiderin deposits and acute hemorrhage. Both patients recovered fully after surgical removal of the lesions. Review of the literature confirmed that spinal epidural cavernous angiomas are extremely rare in the pediatric patient population, described currently in only 2 instances, but without acute hemorrhage. These cases suggest that epidural cavernous angiomas also have to be considered in the pediatric patient population in the differential diagnosis of intraspinal lesions with acute or progressive neurological symptoms. Microsurgical resection of these cavernous malformations is an effective and curative treatment option. PMID:20043742

Sarikaya-Seiwert, Sevgi; Gierga, Kristin; Wessalowski, Rüdiger; Steiger, Hans-Jakob; Hänggi, Daniel



Quantitative measurement of neurological deficit after mild (30 min) transient middle cerebral artery occlusion in rats.  


Although 30-min transient middle cerebral artery occlusion (30-min tMCAo) causes reproducible subcortical infarction in rats, it is difficult to evaluate the resulting neurological deficit using common behavioral tests such as the rota-rod test, adhesive-removal test, or narrow beam test. Establishment of a method of quantitative evaluation would help to develop a novel therapeutic approach to treat cerebral infarction. To solve this problem, we examined whether the neurological deficit could be detected by the Montoya staircase test or methamphetamine-induced rotation, which are commonly used in a Parkinson disease model induced by intrastriatal injection of 6-hydroxydopamine (6-OHDA). From 10 to 14 days after tMCAo, the Montoya staircase test showed significant clumsiness in forelimb tasks contralateral to the lesion side, whereas sham-operated rats showed no significant clumsiness in both forelimbs. The number of ipsilateral rotations induced by methamphetamine was also increased in tMCAo-rats at 21 days after tMCAo. Although Pearson's correlations coefficient showed that the results of these tests were correlated with the infarction volume, there was no significant correlation between the results of these two tests. These findings imply that the neurological deficit detected by both tests might reflect the severity of ischemic injury, but each test might evaluate different aspects of neurological deficit. Thus, the Montoya staircase test and methamphetamine-induced rotation are useful to evaluate neurological deficit in the chronic stage of subcortical infarction induced by 30-min tMCAo. PMID:17173875

Wakayama, Kouji; Shimamura, Munehisa; Sata, Masataka; Sato, Naoyuki; Kawakami, Koji; Fukuda, Hirotsugu; Tomimatsu, Takuji; Ogihara, Toshio; Morishita, Ryuichi



Synaptic mutant huntingtin inhibits synapsin-1 phosphorylation and causes neurological symptoms.  


Many genetic mouse models of Huntington's disease (HD) have established that mutant huntingtin (htt) accumulates in various subcellular regions to affect a variety of cellular functions, but whether and how synaptic mutant htt directly mediates HD neuropathology remains to be determined. We generated transgenic mice that selectively express mutant htt in the presynaptic terminals. Although it was not overexpressed, synaptic mutant htt caused age-dependent neurological symptoms and early death in mice as well as defects in synaptic neurotransmitter release. Mass spectrometry analysis of synaptic fractions and immunoprecipitation of synapsin-1 from HD CAG150 knockin mouse brains revealed that mutant htt binds to synapsin-1, a protein whose phosphorylation is critical for neurotransmitter release. We found that polyglutamine-expanded exon1 htt binds to the C-terminal region of synapsin-1 to reduce synapsin-1 phosphorylation. Our findings point to a critical role for synaptic htt in the neurological symptoms of HD, providing a new therapeutic target. PMID:24081492

Xu, Qiaoqiao; Huang, Shanshan; Song, Mingke; Wang, Chuan-En; Yan, Sen; Liu, Xudong; Gaertig, Marta A; Yu, Shan Ping; Li, He; Li, Shihua; Li, Xiao-Jiang



Neurologic Symptoms Associated With Raising Poultry and Swine Among Participants in the Agricultural Health Study  

PubMed Central

Objective Guillain-Barré Syndrome (GBS) is the leading cause of acute peripheral neuropathy worldwide, often associated with recent foodborne infection with Campylobacter jejuni. In this cross-sectional analysis of data from the Agricultural Health Study, we tested whether swine and poultry exposure were associated with increased prevalence of GBS-like neurologic symptoms. Methods Using multivariate analysis, we tested the symptoms such as numbness and weakness, relevant to inflammatory peripheral neuropathies, among farmers with self-reported occupational poultry or swine exposure compared with farmers who reported no occupational animal exposure. Results Among swine farmers/workers, prevalence of weakness and numbness were increased (P< 0.05). Among poultry farmers/workers, prevalence of weakness and numbness were increased, but increased prevalence of weakness was not statistically significant. Conclusions Occupational contact with live poultry or swine, potentially related to C. jejuni exposure, was associated with increased reporting of GBS-like symptoms.

Davis, Meghan F.; Kamel, Freya; Hoppin, Jane A.; Alavanja, Michael CR; Freeman, Laura Beane; Gray, Gregory C.; Nelson, Kenrad; Silbergeld, Ellen



Neurologic Symptoms in Licensed Private Pesticide Applicators in the Agricultural Health Study  

PubMed Central

Exposure to high levels of many pesticides has both acute and long-term neurologic consequences, but little is known about the neurotoxicity of chronic exposure to moderate levels of pesticides. We analyzed cross-sectional data from 18,782 white male licensed private pesticide applicators enrolled in the Agricultural Health Study in 1993–1997. Applicators provided information on lifetime pesticide use and 23 neurologic symptoms typically associated with pesticide intoxication. An indicator of more symptoms (?10 vs. < 10) during the year before enrollment was associated with cumulative lifetime days of insecticide use: odds ratios (95% confidence intervals) were 1.64 (1.36–1.97) for 1–50 days, 1.89 (1.58–2.25) for 51–500 days, and 2.50 (2.00–3.13) for > 500 days, compared with never users. A modest association for fumigants [> 50 days, 1.50 (1.24–1.81)] and weaker relationships for herbicides [> 500 days, 1.32 (0.99–1.75)] and fungicides [> 50 days, 1.23 (1.00–1.50)] were observed. Pesticide use within the year before enrollment was not associated with symptom count. Only associations with insecticides and fumigants persisted when all four pesticide groups were examined simultaneously. Among chemical classes of insecticides, associations were strongest for organophosphates and organochlorines. Associations with cumulative exposure persisted after excluding individuals who had a history of pesticide poisoning or had experienced an event involving high personal pesticide exposure. These results suggest that self-reported neurologic symptoms are associated with cumulative exposure to moderate levels of fumigants and organophosphate and organochlorine insecticides, regardless of recent exposure or history of poisoning.

Kamel, Freya; Engel, Lawrence S.; Gladen, Beth C.; Hoppin, Jane A.; Alavanja, Michael C. R.; Sandler, Dale P.



Neurological symptoms and signs in HTLV-1 patients with overactive bladder syndrome  

PubMed Central

Objective Compare neurological symptoms and signs in Human T-lymphotropic virus type 1 (HTLV-1) asymptomatic carriers and HTLV-1 patients with overactive bladder (OB) syndrome. Methods We studied 102 HTLV-1 positive individuals without HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) divided into two groups according to the presence or absence of OB syndrome. Clinical interview, neurological exam and proviral load was performed in all patients. Results and conclusions Individuals with OB were more commonly female (84.3% vs. 60.8% of asymptomatics, P=0.01). The prevalence of neurological complaints was higher in OB group, especially hand or foot numbness and arm or leg weakness. There was no difference between the groups in neurological strength and reflexes. Weakness complaint remained strongly associated with OB in multivariate logistic regression analysis adjusting for sex and age [adjusted odds ratio and 95% CI 3.59(1.45–8.88) in arms and 6.68(2.63–16.93) in legs]. Proviral load was also different between the two groups with higher level on OB individuals.

Tanajura, Davi; Santos, Andre Muniz; Castro, Neviton; Siqueira, Isadora; de Carvalho, Edgar M.; Glesby, Marshall J.




Microsoft Academic Search

Objective: The objective of this study was to investigate the occurrence of pelvic asymmetry in neurologic patients with symptoms not explained by their neurologic diagnosis. Methods: We analyzed 150 consecutive neurologic patients referred to physiatric consultation based on their clinical examination findings. Results: We observed pelvic asymmetry associated with either C-type or S-type scoliosis and apparent leg-length difference in 87%

Jussi Timgren; Seppo Soinila


Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics  

Microsoft Academic Search

OBJECTIVES: To determine (a) the proportion of patients referred to general neurology outpatient clinics whose symptoms are medically unexplained; (b) why they were referred; (c) health status and emotional disorder in this group compared with patients whose symptoms are explained by \\

Alan J Carson; Brigitte Ringbauer; Jon Stone; Lesley McKenzie; Charles Warlow; Michael Sharpe



Association of Low PON1 Type Q (Type A) Arylesterase Activity with Neurologic Symptom Complexes in Gulf War Veterans  

Microsoft Academic Search

Previously Haley et al. described six possible syndromes identified by factor analysis of symptoms in Gulf War veterans and demonstrated that veterans with these symptom complexes were more neurologically impaired than age–sex–education-matched well controls. They also uncovered strong associations (relative risks 4–8) suggesting that these symptom complexes were related to wartime exposure to combinations of organophosphate pesticides, chemical nerve agents,

Robert W. Haley; Scott Billecke; Bert N. La Du



Victoria Symptom Validity Test performance in children and adolescents with neurological disorders.  


It is becoming increasingly more important to study, use, and promote the utility of measures that are designed to detect non-compliance with testing (i.e., poor effort, symptom non-validity, response bias) as part of neuropsychological assessments with children and adolescents. Several measures have evidence for use in pediatrics, but there is a paucity of published support for the Victoria Symptom Validity Test (VSVT) in this population. The purpose of this study was to examine the performance on the VSVT in a sample of pediatric patients with known neurological disorders. The sample consisted of 100 consecutively referred children and adolescents between the ages of 6 and 19 years (mean = 14.0, SD = 3.1) with various neurological diagnoses. On the VSVT total items, 95% of the sample had performance in the "valid" range, with 5% being deemed "questionable" and 0% deemed "invalid". On easy items, 97% were "valid", 2% were "questionable", and 1% was "invalid." For difficult items, 84% were "valid," 16% were "questionable," and 0% was "invalid." For those patients given two effort measures (i.e., VSVT and Test of Memory Malingering; n = 65), none was identified as having poor test-taking compliance on both measures. VSVT scores were significantly correlated with age, intelligence, processing speed, and functional ratings of daily abilities (attention, executive functioning, and adaptive functioning), but not objective performance on the measure of sustained attention, verbal memory, or visual memory. The VSVT has potential to be used in neuropsychological assessments with pediatric patients. PMID:23037621

Brooks, Brian L



Autistic Traits, ADHD Symptoms, Neurological Soft Signs and Regional Cerebral Blood Flow in Adults with Autism Spectrum Disorders  

ERIC Educational Resources Information Center

|The resting regional cerebral blood flow (rCBF) patterns related to co-occurring symptoms such as inattention, hyperactivity, neurological soft signs and motor problems have not yet been disclosed in autism spectrum disorders (ASD). In this study thirteen adults with ASD and ten matched neurotypical controls underwent PET. The scores of rating…

Manouilenko, Irina; Pagani, Marco; Stone-Elander, Sharon; Odh, Richard; Brolin, Fredrik; Hatherly, Robert; Jacobsson, Hans; Larsson, Stig A.; Bejerot, Susanne



Stage Progression and Neurological Symptoms in Trypanosoma brucei rhodesiense Sleeping Sickness: Role of the CNS Inflammatory Response  

PubMed Central

Background Human African trypanosomiasis progresses from an early (hemolymphatic) stage, through CNS invasion to the late (meningoencephalitic) stage. In experimental infections disease progression is associated with neuroinflammatory responses and neurological symptoms, but this concept requires evaluation in African trypanosomiasis patients, where correct diagnosis of the disease stage is of critical therapeutic importance. Methodology/Principal Findings This was a retrospective study on a cohort of 115 T.b.rhodesiense HAT patients recruited in Eastern Uganda. Paired plasma and CSF samples allowed the measurement of peripheral and CNS immunoglobulin and of CSF cytokine synthesis. Cytokine and immunoglobulin expression were evaluated in relation to disease duration, stage progression and neurological symptoms. Neurological symptoms were not related to stage progression (with the exception of moderate coma). Increases in CNS immunoglobulin, IL-10 and TNF-? synthesis were associated with stage progression and were mirrored by a reduction in TGF-? levels in the CSF. There were no significant associations between CNS immunoglobulin and cytokine production and neurological signs of disease with the exception of moderate coma cases. Within the study group we identified diagnostically early stage cases with no CSF pleocytosis but intrathecal immunoglobulin synthesis and diagnostically late stage cases with marginal CSF pleocytosis and no detectable trypanosomes in the CSF. Conclusions Our results demonstrate that there is not a direct linkage between stage progression, neurological signs of infection and neuroinflammatory responses in rhodesiense HAT. Neurological signs are observed in both early and late stages, and while intrathecal immunoglobulin synthesis is associated with neurological signs, these are also observed in cases lacking a CNS inflammatory response. While there is an increase in inflammatory cytokine production with stage progression, this is paralleled by increases in CSF IL-10. As stage diagnostics, the CSF immunoglobulins and cytokines studied do not have sufficient sensitivity to be of clinical value.

MacLean, Lorna; Reiber, Hansotto; Kennedy, Peter G. E.; Sternberg, Jeremy M.



Transient epileptic amnesia: the contribution of the british neurological surveillance unit.  


Transient Epileptic Amnesia (TEA) is a subtype of temporal lobe epilepsy characterised by recurrent episodes of transient amnesia, usually in middle aged people, often occurring on waking, which prove to be due to epilepsy. Attacks are sometimes accompanied by other more familiar manifestations of epilepsy, especially olfactory hallucinations. The epilepsy typically responds very well to anticonvulsant treatment but interictal memory disturbance often persists despite abolition of the seizures, in particular an extensive autobiographical amnesia (AA), and a tendency for memories to fade more rapidly than usual over days to weeks (accelerated long-term forgetting, ALF). The TIME project (The Impairment of Memory in Epilepsy: see was established in 2003 to study TEA and its associated interictal memory disturbance. It has since generated around 20 publications describing the clinical, neuropsychological and radiological features of TEA, AA and ALF.(1-4) The British Neurological Surveillance Unit (BNSU) contributed to patient recruitment in 2003-2005 and again recently (2011-present). In 2003-5, 32 patients were referred via the BNSU. 16 were included in the patient cohort described in our 2007 report,(1) nine were excluded as they did not satisfy our diagnostic criteria, seven were potentially suitable but study resources did not allow us to assess them fully. 22 cases have been referred recently. Details are awaited for 13, one refused consent, four have been assessed, three await assessment, one was excluded after assessment. The BNSU has made a major contribution to the success of the TIME project. The recruitment process would work more smoothly if participating neurologists i) asked patients for consent to pass on demographical and clinical details at the time of the clinic visit on which they are identified, ii) communicated these immediately to the researcher or iii) kept a note of patient details if i) and ii) are not feasible. The current system works well, and helps greatly in the recruitment of series of cases of moderately rare disorders, but its efficiency could be improved. PMID:24109050

Zeman, Adam; Dewar, Bethan; Butler, Chris



Suppression of neuropil aggregates and neurological symptoms by an intracellular antibody implicates the cytoplasmic toxicity of mutant huntingtin  

PubMed Central

Mutant huntingtin accumulates in the neuronal nuclei and processes, which suggests that its subcellular localization is critical for the pathology of Huntington's disease (HD). However, the contribution of cytoplasmic mutant huntingtin and its aggregates in neuronal processes (neuropil aggregates) has not been rigorously explored. We generated an intracellular antibody (intrabody) whose binding to a unique epitope of human huntingtin is enhanced by polyglutamine expansion. This intrabody decreases the cytotoxicity of mutant huntingtin and its distribution in neuronal processes. When expressed in the striatum of HD mice via adenoviral infection, the intrabody reduces neuropil aggregate formation and ameliorates neurological symptoms. Interaction of the intrabody with mutant huntingtin increases the ubiquitination of cytoplasmic huntingtin and its degradation. These findings suggest that the intrabody reduces the specific neurotoxicity of cytoplasmic mutant huntingtin and its associated neurological symptoms by preventing the accumulation of mutant huntingtin in neuronal processes and promoting its clearance in the cytoplasm.

Wang, Chuan-En; Zhou, Hui; McGuire, John R.; Cerullo, Vincenzo; Lee, Brendan; Li, Shi-Hua; Li, Xiao-Jiang



Neurological disorders in essential thrombocythemia  

PubMed Central

Patients with essential thrombocythemia often complain of various subjective neurological symptoms. This prospective study aims to assess their incidence and response to therapy. Among 37 consecutive patients with essential thrombocythemia, 11 presented with neurological symptoms. Among them 4 had thrombotic events, 7 complained of transient or fluctuating subjective symptoms, and one had both. Brain magnetic resonance imagery failed to detect any substratum in patients with subjective symptoms. JAK2V617F mutation was found in 9 of 11 patients with neurological symptoms versus 14 of 26 patients without symptoms. Ten patients received low-dose aspirin for these symptoms: complete resolution was observed in 3, improvement with persisting episodes in 2, and resistance to aspirin in 2 patients, in whom addition of cytoreductive therapy became necessary to resolve those disabling symptoms. In this prospective cohort, 30% of patients with essential thrombocythemia presented neurological symptoms. Aspirin was fully efficient in only 30% of cases. JAK2V617F mutation could be a risk factor for such symptoms.

Billot, Segolene; Kouroupi, Eirini G.; Le Guilloux, Johan; Cassinat, Bruno; Jardin, Caroline; Laperche, Thierry; Fenaux, Pierre; Carpentier, Antoine F.; Kiladjian, Jean-Jacques



Adolescence spinal epidural abscess with neurological symptoms: case report, a lesson to be re-learnt  

PubMed Central

Epidural abscess of the spinal column is a rare condition that can be fatal if left untreated. It promptly progresses and can cause neurologic paralysis, urinary retention or cauda equina syndrome. Compromised immune system that occurs in patients with diabetes mellitus, AIDS, chronic renal failure, alcoholism, or cancer is a predisposing factor. It mostly occurs in adults. Here we would like to report a case of spontaneous pyogenic lumbar epidural abscess with neurological deficit diagnosed in a 15 year old boy. We treated this case successfully with surgical microscopic decompression and drainage.

Sales, Jafar Ganjpour; Elmi, Asghar; Soleimanpour, Jafar; Gavidel, Ehsan



Pentoxifylline treatment improves neurological and neurochemical deficits in rats subjected to transient brain ischemia  

Microsoft Academic Search

The possible neuroprotector effects of pentoxifylline (P), a methylxanthine derivative and phosphodiesterase inhibitor, were studied on male Wistar rats subjected to a model of transient brain ischemia. One group was treated, 1 h before ischemia (ISC) and 1 h after, with pentoxifylline (P), 50 and 100 mg\\/kg, i.p. (ISC+P). The other groups were ischemic, ISC; sham operated, SO; P100; SO+P100; and normal controls,

Renata de Barros Bruno; Tiago Fontenele Marques; Tiago Melo Teixeira Batista; Júlio César Sá Silveira Lima; Karla Gleice de Arruda; Priscili Fortaleza Souza Fiúza Lima; Nilton da Silva Santos; Geanne M. A. Cunha; Helio Vitorino Nobre Vitor; Glauce Socorro de Barros Viana



Maraviroc-containing regimen suppresses HIV replication in the cerebrospinal fluid of patients with neurological symptoms.  


We report the concentrations of maraviroc in the cerebrospinal fluid (CSF) and plasma of six HIV-1-infected patients with both neurological impairment and detectable HIV-1 replication in CSF. One month after starting maraviroc, the viral load in the CSF decreased significantly (P = 0.005). The median (range) maraviroc concentration in plasma was 347 ng/ml (123-2678). Four patients had CSF concentrations above the protein-adjusted inhibitory concentration (IC90) of 0.57 ng/ml (0.06-10.7) with a median of 102 ng/ml (35-173). PMID:20601852

Melica, Giovanna; Canestri, Ana; Peytavin, Gilles; Lelievre, Jean D; Bouvier-Alias, Magali; Clavel, Cyril; Calvez, Vincent; Lascaux, Anne S; Katlama, Christine; Levy, Yves



Pyrrolidine dithiocarbamate attenuates brain A? increase and improves long-term neurological outcome in rats after transient focal brain ischemia  

PubMed Central

Evidence suggests an association between brain ischemia and Alzheimer’s disease (AD) development. Amyloid plaques consisted of ?-amyloid peptide (A?) in the brain are a pathological hallmark of AD. Little is known about how brain ischemia induces AD-like neuropathology. Strategy effective to block such brain changes has not been reported. Here, adult male Sprague-Dawley rats were subjected to a 90-min right middle cerebral artery occlusion (MCAO). Pyrrolidine dithiocarbamate (PDTC) at various doses was given daily via gastric gavage with the first dose given at 10 min after the onset of reperfusion. The MCAO increased A?1-42 concentrations in the ischemic brain tissues. PDTC attenuated this increase. PDTC also decreased the ischemia-reduced expression of neprilysin, an A? degrading enzyme. A?1-42 levels were negatively correlated with neprilysin protein abundance. Brain ischemia decreased the expression of ?-amyloid converting enzyme 1, a key enzyme to produce A?, and increased the expression of insulin-degrading enzyme, another A? degrading enzyme. Animals had impaired learning and memory at 2 months after the MCAO. PDTC attenuated this impairment. PDTC also improved long-term neurological outcomes. Our findings suggest that PDTC improves long-term neurological outcome of rats after transient focal brain ischemia. PDTC reduces ischemia-induced A? accumulation, possibly via preserving neprilysin expression.

Li, Jiejie; Sheng, Wenli; Feng, Chenzhuo; Zuo, Zhiyi



Diagnostic accuracy of the neurological upper limb examination II: Relation to symptoms of patterns of findings  

PubMed Central

Background In a sample of patients in clinical occupational medicine we have demonstrated that an upper limb neurological examination can reliably identify patterns of findings suggesting upper limb focal neuropathies. This further study aimed at approaching the diagnostic accuracy of the examination. Methods 82 limbs were semi-quantitatively assessed by two blinded examiners (strength in 14 individual muscles, sensibility in 7 homonymous territories, and mechanosensitivity at 10 locations along nerves). Based on the topography of nerves and their muscular and sensory innervation we defined 10 neurological patterns each suggesting a localized nerve affliction. Information on complaints (pain, weakness and/or numbness/tingling) collected by others served as a reference for comparison. The relation between the presence of pattern(s) and complaints was assessed by ?-statistics. Sensitivity, specificity, and positive/negative predictive values were calculated, and pre-test odds were compared to post-test probability. Results The two examiners identified pattern(s) suggesting focal neuropathy in 34/36 out of 38 symptomatic limbs, respectively (? = 0.70/0.75), with agreement in 28 limbs. Out of 44 non-symptomatic limbs the examiners agreed on absence of any pattern in 38 limbs. With concordance between the examiners with regard to the presence or absence of any pattern, the sensitivity, specificity, positive and negative predictive values were 0.73, 0.86, 0.93 and 0.90, respectively. While the pre-test odds for a limb to be symptomatic amounted to 0.46 the post-test probability was 0.81. For each examiner the post-test probability was 0.87 and 0.88, respectively. Conclusion The improved diagnostic confidence is an indication of one aspect of construct validity of the physical examination. For determination of clinical feasibility of the examination further studies are required, most importantly 1) studies of validity by means of comparison with additional references and 2) studies of the potential benefit that can be attained from its use.

Jepsen, J?rgen R; Laursen, Lise H; Hagert, Carl-Goran; Kreiner, Svend; Larsen, Anders I



Neurologic aspects of cobalamin deficiency.  


We reviewed 153 episodes of cobalamin deficiency involving the nervous system that occurred in 143 patients seen over a recent 17-year period at 2 New York City hospitals. Pernicious anemia was the most common underlying cause of the deficiency. Neurologic complaints, most commonly paresthesias or ataxia, were the first symptoms of Cbl deficiency in most episodes. The median duration of symptoms before diagnosis and treatment with vitamin B12 was 4 months, although long delays in diagnosis occurred in some patients. Diminished vibratory sensation and proprioception in the lower extremities were the most common objective findings. A wide variety of neurologic symptoms and signs were encountered, however, including ataxia, loss of cutaneous sensation, muscle weakness, diminished or hyperactive reflexes, spasticity, urinary or fecal incontinence, orthostatic hypotension, loss of vision, dementia, psychoses, and disturbances of mood. Multiple neurologic syndromes were often seen in a single patient. In 42 (27.4%) of the 153 episodes, the hematocrit was normal, and in 31 (23.0%), the mean corpuscular volume was normal. Neutropenia and thrombocytopenia were unusual even in anemic patients. In nonanemic patients in whom diagnosis was delayed, neurologic progression frequently occurred although the hematocrit remained normal. In 27 episodes, the serum cobalamin concentration was only moderately decreased (in the range of 100-200 pg/ml) and in 2 the serum level was normal. Neurologic impairment, as assessed by a quantitative severity score, was judged to be mild in 99 episodes, moderate in 39 and severe in 15. Severity of neurologic dysfunction before treatment was clearly related to the duration of symptoms prior to diagnosis. In addition, the hematocrit correlated significantly with severity, independent of the longer duration of symptoms in nonanemic patients. Four patients experienced transient neurologic exacerbations soon after beginning treatment with cyanocobalamin, with subsequent recovery. Followup evaluation was adequate to assess the neurologic response to vitamin B12 therapy in 121 episodes. All patients responded, and in 57 (47.1%), recovery was complete, with no remaining symptoms or findings on examination. The severity score was reduced by 50% or greater after treatment in 91% of the episodes. Residual long-term moderate or severe neurologic disability was noted following only 7 (6.3%) episodes. The extent of neurologic involvement after treatment was strongly related to that before therapy as well as to the duration of symptoms. The percent improvement over baseline neurologic status after treatment was inversely related to duration of symptoms and hematocrit. Some evidence of response was always seen during the first 3 months of treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1648656

Healton, E B; Savage, D G; Brust, J C; Garrett, T J; Lindenbaum, J



Dysmyelination not demyelination causes neurological symptoms in preweaned mice in a murine model of Cockayne syndrome.  


Cockayne syndrome (CS) is a rare autosomal recessive neurodegenerative disease that is associated with mutations in either of two transcription-coupled DNA repair genes, CSA or CSB. Mice with a targeted mutation in the Csb gene (Cs-b(m/m)) exhibit a milder phenotype compared with human patients with mutations in the orthologous CSB gene. Mice mutated in Csb were crossed with mice lacking Xpc (Xp-c(-/-)), the global genome repair gene, to enhance the pathological symptoms. These Cs-b(m/m).Xp-c(-/-) mice were normal at birth but exhibited progressive failure to thrive, whole-body wasting, and ataxia and died at approximately postnatal day 21. Characterization of Cs-b(m/m).Xp-c(-/-) brains at postnatal stages demonstrated widespread reduction of myelin basic protein (MBP) and myelin in the sensorimotor cortex, the stratum radiatum, the corpus callosum, and the anterior commissure. Quantification of individual axons by electron microscopy showed a reduction in both the number of myelinated axons and the average diameter of myelin surrounding the axons. There were no significant differences in proliferation or oligodendrocyte differentiation between Cs-b(m/m).Xp-c(-/-) and Cs-b(m/+).Xp-c(-/-) mice. Rather, Cs-b(m/m).Xp-c(-/-) oligodendrocytes were unable to generate sufficient MBP or to maintain the proper myelination during early development. Csb is a multifunctional protein regulating both repair and the transcriptional response to reactive oxygen through its interaction with histone acetylase p300 and the hypoxia-inducible factor (HIF)1 pathway. On the basis of our results, combined with that of others, we suggest that in Csb the transcriptional response predominates during early development, whereas a neurodegenerative response associated with repair deficits predominates in later life. PMID:22393014

Revet, Ingrid; Feeney, Luzviminda; Tang, Amy A; Huang, Eric J; Cleaver, James E



Transient Ischemic Attack Patients with Fluctuations Are at Highest Risk for Early Stroke  

Microsoft Academic Search

Background: The management and risk of early stroke are unclear in patients with fluctuating neurological symptoms. We aimed to evaluate the clinical course of these patients presenting within 24 h after onset of acute cerebral ischemia symptoms. Methods: All patients with transient ischemic signs\\/symptoms consecutively admitted to our Emergency Stroke Unit were recruited. Patients were neurologically examined and underwent prompt

Anastasios Chatzikonstantinou; Olaf Willmann; Theo Jäger; K. Szabo; Michael G. Hennerici



Neurological complications of vasculitis.  


The vasculitides are a group of disorders that include the polyarteritis nodosa group of systemic necrotizing vasculitides, hypersensitivity vasculitis, Wegener's granulomatosis, lymphomatoid granulomatosis, giant cell arteritis, Behçet's disease, and isolated angiitis of the central nervous system. Classification is based on clinical, angiographic, and histological features. The frequency and distribution of neurological involvement vary with the underlying disorder and may provide the initial symptoms. Polyarteritis nodosa and Wegener's granulomatosis may affect both the central and peripheral nervous systems, whereas isolated angiitis of the central nervous system and Behçet's disease affect the central nervous system alone. Neurological dysfunction occurs in 80% of patients with polyarteritis nodosa and fewer than 10% of patients with hypersensitivity vasculitis. The mechanism of neurological dysfunction in the vasculitides is tissue ischemia. The clinical effects of ischemia vary, and symptoms may be transient or prolonged. Mononeuritis multiplex, polyneuropathy, and stroke are frequent complications, but encephalopathies, cranial neuropathies, and brachial plexopathies are seen as well. The occurrence of symptoms late in the course of a disease suggests ischemia resulting from healed, scarred vessels as well as from those that are acutely inflamed; this is the case in Takayasu's arteritis and possibly also in polyarteritis nodosa. Treatment is based on identifying and removing the sensitizing agent when possible. Wegener's granulomatosis requires therapy with cyclophosphamide; temporal arteritis, with corticosteroids. In other vasculitides a balance must be reached between the progression of the disease and the side effects of immunosuppression. PMID:6137994

Moore, P M; Cupps, T R



Clinical course of children with a depressive spectrum disorder and transient manic symptoms  

PubMed Central

Objective To assess rates of conversion to bipolar spectrum disorder (BPSD) and risk factors associated with conversion in children with depressive spectrum disorders (DSD) and transient manic symptoms (TMS) over 18 months. TMS are manic-like symptoms of insufficient duration or number to warrant a diagnosis of BPSD. Methods Participants were 165 children (mean = 9.9 years, SD = 1.3) with mood disorders from the Multi-Family Psychoeducational Psychotherapy (MF-PEP) treatment study; 37 with DSD+TMS, 13 with DSD, and 115 with BPSD. All were assessed with standardized instruments on four occasions over 18-months, with half receiving MF-PEP after their baseline assessment and half receiving MF-PEP after a one-year wait-list condition. Results At baseline, the Children’s Global Assessment Scale scores did not differ significantly between the DSD+TMS, DSD, and BPSD groups. Conversion rates to BPSD were significantly higher for the DSD+TMS group (48.0%) compared to the DSD group (12.5%). Conversion was significantly more frequent for participants in the one-year wait-list control group (60%) compared to the immediate treatment group (16%). Clinical presentation, family environment, and family history did not differ significantly between the small subset of DSD+TMS participants who did convert to BPSD at follow-up and those who did not convert. Baseline functional impairment was greater for the converted group than the non-converted group. Conclusions Transient manic symptoms are a risk factor for eventual conversion to BPSD; psychoeducational psychotherapy may be protective. As this exploratory study had a small sample size and did not correct for multiple comparisons, additional studies with larger sample sizes are needed.

Nadkarni, Radha B; Fristad, Mary A



Bax deletion prevents neuronal loss but not neurological symptoms in a transgenic model of inherited prion disease  

PubMed Central

Transgenic Tg(PG14) mice express a mutant prion protein containing 14 octapeptide repeats, whose human homologue is associated with an inherited prion dementia. These mice develop a progressive neurological disorder characterized by ataxia and cerebellar atrophy, with massive apoptotic degeneration of granule neurons. Bax, a proapoptotic gene of the Bcl-2 family, plays a key role in regulating cell death in the nervous system. To analyze the role of Bax in the Tg(PG14) phenotype, we crossed Tg(PG14) mice with Bax-/- mice to obtain Tg(PG14)/Bax-/- offspring. Bax deletion effectively rescued cerebellar granule neurons from apoptosis, implying that these cells die via a Bax-dependent process. Surprisingly, however, the age at which symptoms began and the duration of the clinical phase of the illness were not altered in Tg(PG14)/Bax-/- mice. In addition, Bax deletion failed to prevent shrinkage of the molecular layer of the cerebellum and loss of synaptophysin-positive synaptic endings. Our analysis indicates that synaptic loss makes a critical contribution to the Tg(PG14) phenotype. These results provide insights into the pathogenesis of prion diseases and have important implications for the treatment of these disorders.

Chiesa, Roberto; Piccardo, Pedro; Dossena, Sara; Nowoslawski, Lisa; Roth, Kevin A.; Ghetti, Bernardino; Harris, David A.



Imatinib therapy blocks cerebellar apoptosis and improves neurological symptoms in a mouse model of Niemann-Pick type C disease.  


Niemann-Pick type C (NPC) disease is a fatal autosomal recessive disorder characterized by the accumulation of free cholesterol and glycosphingolipids in the endosomal-lysosomal system. Patients with NPC disease have markedly progressive neuronal loss, mainly of cerebellar Purkinje neurons. There is strong evidence indicating that cholesterol accumulation and trafficking defects activate apoptosis in NPC brains. The purpose of this study was to analyze the relevance of apoptosis and particularly the proapoptotic c-Abl/p73 system in cerebellar neuron degeneration in NPC disease. We used the NPC1 mouse model to evaluate c-Abl/p73 expression and activation in the cerebellum and the effect of therapy with the c-Abl-specific inhibitor imatinib. The proapoptotic c-Abl/p73 system and the p73 target genes are expressed in the cerebellums of NPC mice. Furthermore, inhibition of c-Abl with imatinib preserved Purkinje neurons and reduced general cell apoptosis in the cerebellum, improved neurological symptoms, and increased the survival of NPC mice. Moreover, this prosurvival effect correlated with reduced mRNA levels of p73 proapoptotic target genes. Our results suggest that the c-Abl/p73 pathway is involved in NPC neurodegeneration and show that treatment with c-Abl inhibitors is useful in delaying progressive neurodegeneration, supporting the use of imatinib for clinical treatment of patients with NPC disease. PMID:18591368

Alvarez, Alejandra R; Klein, Andrés; Castro, Juan; Cancino, Gonzalo I; Amigo, Julio; Mosqueira, Matías; Vargas, Lina M; Yévenes, L Fernanda; Bronfman, Francisca C; Zanlungo, Silvana



Genetic Variation in the HN and SH Genes of Mumps Viruses: A Comparison of Strains from Mumps Cases with and without Neurological Symptoms  

PubMed Central

Background It is known that mumps virus (MuV) strains may vary in their neurovirulent capacity, and certain MuV strains may be highly neurotropic. In animal models and epidemiological studies, mutations at specific amino acids (aa) have been proposed to be associated with neurovirulence. To assess whether these genetic variations can be observed in clinical samples from patients and if they correlate with neurovirulence as determined by clinical symptoms, 39 mumps patients with or without neurological symptoms were investigated. Principal Findings Respiratory samples, oral fluids, throat swabs, and neurological and cerebrospinal fluid samples were tested by RT-PCR and products sequenced. Sequences of the entire small hydrophobic (SH) gene and the partial hemagglutinin-neuraminidase (HN) gene were compared. Conclusions The results showed there was no significant difference between the samples of the two groups of patients at the aa sites in either the HN protein or the SH protein, which have previously been hypothesized to be associated with neurovirulence or antigenicity. The occurrence of neurological symptoms of mumps does not appear to be due to a single point mutation in either the HN or SH gene.

Cui, Aili; Brown, David W. G.; Xu, Wenbo; Jin, Li




National Technical Information Service (NTIS)

The lecture includes typical transients to be analyzed, the requirements put on computer codes and a description of the computer codes as well as results obtained with these codes. Transients analysis is necessary within the licensing of reactors, in risk...

W. Frisch



Genetic screening for Niemann-Pick disease type C in adults with neurological and psychiatric symptoms: findings from the ZOOM study  

PubMed Central

Niemann–Pick disease type C (NP-C) is a rare, autosomal-recessive, progressive neurological disease caused by mutations in either the NPC1 gene (in 95% of cases) or the NPC2 gene. This observational, multicentre genetic screening study evaluated the frequency and phenotypes of NP-C in consecutive adult patients with neurological and psychiatric symptoms. Diagnostic testing for NP-C involved NPC1 and NPC2 exonic gene sequencing and gene dosage analysis. When available, results of filipin staining, plasma cholestane-3?,5?,6?-triol assays and measurements of relevant sphingolipids were also collected. NPC1 and NPC2 gene sequencing was completed in 250/256 patients from 30 psychiatric and neurological reference centres across the EU and USA [median (range) age 38 (18–90) years]. Three patients had a confirmed diagnosis of NP-C; two based on gene sequencing alone (two known causal disease alleles) and one based on gene sequencing and positive filipin staining. A further 12 patients displayed either single mutant NP-C alleles (8 with NPC1 mutations and 3 with NPC2 mutations) or a known causal disease mutation and an unclassified NPC1 allele variant (1 patient). Notably, high plasma cholestane-3?,5?,6?-triol levels were observed for all NP-C cases (n = 3). Overall, the frequency of NP-C patients in this study [1.2% (95% CI; 0.3%, 3.5%)] suggests that there may be an underdiagnosed pool of NP-C patients among adults who share common neurological and psychiatric symptoms.

Bauer, Peter; Balding, David J.; Klunemann, Hans H.; Linden, David E. J.; Ory, Daniel S.; Pineda, Merce; Priller, Josef; Sedel, Frederic; Muller, Audrey; Chadha-Boreham, Harbajan; Welford, Richard W. D.; Strasser, Daniel S.; Patterson, Marc C.



Genetic screening for Niemann-Pick disease type C in adults with neurological and psychiatric symptoms: findings from the ZOOM study.  


Niemann-Pick disease type C (NP-C) is a rare, autosomal-recessive, progressive neurological disease caused by mutations in either the NPC1 gene (in 95% of cases) or the NPC2 gene. This observational, multicentre genetic screening study evaluated the frequency and phenotypes of NP-C in consecutive adult patients with neurological and psychiatric symptoms. Diagnostic testing for NP-C involved NPC1 and NPC2 exonic gene sequencing and gene dosage analysis. When available, results of filipin staining, plasma cholestane-3?,5?,6?-triol assays and measurements of relevant sphingolipids were also collected. NPC1 and NPC2 gene sequencing was completed in 250/256 patients from 30 psychiatric and neurological reference centres across the EU and USA [median (range) age 38 (18-90) years]. Three patients had a confirmed diagnosis of NP-C; two based on gene sequencing alone (two known causal disease alleles) and one based on gene sequencing and positive filipin staining. A further 12 patients displayed either single mutant NP-C alleles (8 with NPC1 mutations and 3 with NPC2 mutations) or a known causal disease mutation and an unclassified NPC1 allele variant (1 patient). Notably, high plasma cholestane-3?,5?,6?-triol levels were observed for all NP-C cases (n = 3). Overall, the frequency of NP-C patients in this study [1.2% (95% CI; 0.3%, 3.5%)] suggests that there may be an underdiagnosed pool of NP-C patients among adults who share common neurological and psychiatric symptoms. PMID:23773996

Bauer, Peter; Balding, David J; Klünemann, Hans H; Linden, David E J; Ory, Daniel S; Pineda, Mercč; Priller, Josef; Sedel, Frederic; Muller, Audrey; Chadha-Boreham, Harbajan; Welford, Richard W D; Strasser, Daniel S; Patterson, Marc C





... at increased risk for having type 2 diabetes . Gestational Diabetes Women with gestational diabetes often have no symptoms , which is why it's ... the proper time during pregnancy. Learn more about gestational diabetes. Symptoms of Diabetes Complications Have you already been ...


Efavirenz-induced neurological symptoms in rare homozygote CYP2B6 *2/*2 (C64T).  


Some of the HIV-1-infected patients who were given highly active anti-retroviral therapy (HAART) including efavirenz (EFV) presented adverse central nervous system (CNS) symptoms such as fatigue and insomnia. The incidence of adverse CNS symptoms is associated with hepatic cytochrome P450 isozymes (CYP2B6) polymorphisms. For example, CYP2B6 *6 (G516T and A785G) and *7 (G516T, A785G and C1459T) prolonged the EFV half-life despite discontinuation of EFV. CYP2B6 *2/*2 (C64T) is extremely rare and there have been no data describing the EFV plasma concentrations in C64T homozygous patients, who developed adverse CNS symptoms. C64T homozygous possibly has some catalytic defects. PMID:17686225

Usami, Osamu; Ashino, Yugo; Komaki, Yuichi; Tomaki, Masafumi; Irokawa, Toshiya; Tamada, Tsutomu; Hayashida, Tsunefusa; Teruya, Katsuji; Hattori, Toshio



Neurological syndromes of brucellosis.  

PubMed Central

Eleven patients with brucellosis presented with neurological features closely simulating transient ischaemic attacks, cerebral infarction, acute confusional state, motor neuron disease, progressive multisystem degeneration, polyradiculoneuropathy, neuralgic amyotrophy, sciatica and cauda equina syndrome. Most patients improved quickly after adequate antibiotic treatment but chronic cases responded poorly. These protean neurological manifestations of brucellosis indicate that the underlying pathological mechanisms are diverse.

Bahemuka, M; Shemena, A R; Panayiotopoulos, C P; al-Aska, A K; Obeid, T; Daif, A K



An atypical case of nephrolithiasis with transient remission of symptoms following spinal manipulation  

PubMed Central

Objective Nephrolithiasis is a common condition with symptoms similar to common mechanical lesions of the lumbar spine and pelvis. The purpose of this report is to outline a case of nephrolithiasis that closely mimicked sacroiliac joint syndrome in subjective report, objective findings, and reduction of symptoms with spinal manipulation. Clinical Features A 41-year-old obese male patient with mild pain over the left posterior sacroiliac joint, penile paresthesia, and the penile sensation of urinary urgency presented for chiropractic care. Subjective history and objective evaluation suggested sacroiliac joint syndrome. Intervention and Outcome A trial of conservative management including spinal manipulation was initiated. Following each treatment, the patient reported temporary relief of all symptoms (4 hours to 2 days). After unsuccessful permanent resolution of symptoms, a urinalysis was performed; and a follow-up computerized tomography scan revealed a large renal calculus obstructing the left ureter. Laser lithotripsy produced obliteration of the stone and complete resolution of symptoms. Conclusions This report outlines the potential overlap of symptoms of visceral and somatic lesions in both presentation and response to care. In this case, a favorable response to spinal manipulation masked the most likely underlying symptom generator. This encounter demonstrates the potential need for further clinical examination in the instance of the unresponsive mechanical lesion. This report also supports the need for future research into spinal manipulation as a possible adjunct for visceral pain management.

Wolcott, Christopher C.



Invasion by human herpesvirus 6 and human herpesvirus 7 of the central nervous system in patients with neurological signs and symptoms  

PubMed Central

METHODS—A total of 43 children with neurological signs and symptoms were enrolled in the study. All children were suspected of having meningitis, and lumbar punctures were performed. Human herpesvirus 6 (HHV-6) and HHV-7 DNA was detected in cerebrospinal fluid (CSF) and peripheral blood mononuclear cells (PBMC) by nested polymerase chain reaction.?RESULTS—Most patients had detectable serum antibody to both HHV6 and 7. HHV6 DNA was detected in PBMC of 15 patients and in CSF cell pellet of seven. Corresponding figures for HHV7 were 28 and 6.2/7, and 5/6 with CSF viral DNA also had it in PBMC, respectively. No viral DNA was detected in CSF supernatants. The seven HHV6 CSF viruses were all variant B.?CONCLUSION—These data suggest that HHV-7 may invade the CNS.??

Yoshikawa, T.; Ihira, M.; Suzuki, K.; Suga, S.; Matsubara, T.; Furukawa, S.; Asano, Y.





... Advanced MS Pediatric MS Related Conditions Symptoms In multiple sclerosis , damage to the myelin in the central nervous ... Depression Depression is common during the course of multiple sclerosis. In fact, studies have suggested that clinical depression, ...


Transient increase in symptoms associated with cytokine release in patients with multiple sclerosis  

Microsoft Academic Search

Summary Fourteen patients with multiple sclerosis were treated with the humanized monoclonal antibody CAMPATH-1H which targets the CD52 antigen present on all lymphocytes and some monocytes; four also received anti-CD4 antibody. Lymphopaenia developed rapidly and was sustained for at least 1 year. In 12 patients, the first infusion of antibody was characterized by significant exacerbation or re-awakening of pre-existing symptoms

Thibault Moreau; Alasdair Coles; Mark Wing; John Isaacs; Geoffrey Hale; Herman Waldmann; Alastair Compston



Molecular characterisation of the 22q13 deletion syndrome supports the role of haploinsufficiency of SHANK3/PROSAP2 in the major neurological symptoms  

PubMed Central

Methods: The 22q13 deletion syndrome (MIM 606232) is characterised by moderate to profound mental retardation, delay/absence of expressive speech, hypotonia, normal to accelerated growth, and mild dysmorphic features. We have determined the deletion size and parent of origin in 56 patients with this syndrome. Results: Similar to other terminal deletion syndromes, there was an overabundance of paternal deletions. The deletions vary widely in size, from 130 kb to over 9 Mb; however all 45 cases that could be specifically tested for the terminal region at the site of SHANK3 were deleted for this gene. The molecular structure of SHANK3 was further characterised. Comparison of clinical features to deletion size showed few correlations. Some measures of developmental assessment did correlate to deletion size; however, all patients showed some degree of mental retardation and severe delay or absence of expressive speech, regardless of deletion size. Conclusion: Our analysis therefore supports haploinsufficiency of the gene SHANK3, which codes for a structural protein of the postsynaptic density, as a major causative factor in the neurological symptoms of 22q13 deletion syndrome.

Wilson, H; Wong, A; Shaw, S; Tse, W; Stapleton, G; Phelan, M; Hu, S; Marshall, J; McDermid, H



Chapter 38: American neurology.  


The great formative event in the history of North America, the Civil War of 1861 to 1865, was the stimulus for the development of clinical neurology and the neurosciences. The first neurological research center on the continent was the US Army hospital at Turner's Lane, Philadelphia, PA. Silas Weir Mitchell and his colleagues described causalgia (reflex sympathetic dystrophy), phantom limb sensation, and Horner's syndrome (before Horner). The medical leader of the Northern army was William Hammond. After the conclusion of hostilities, he began a huge clinical practice in New York City. In the United States, clinical neurology began in private practice, unlike Europe, where neurology began in institutions. Hammond's textbook, which first used the term athetosis, was used by a generation of physicians who encountered patients with neurological signs and symptoms. Early in the 20th century, neurological institutions were formed around universities; probably the most famous was the Montreal Neurological Institute founded by Wilder Penfield. The US federal government sponsored extensive research into the function and dysfunction of the nervous system through the Neurological Institute of Neurological Diseases and Blindness, later called the National Institute of Neurological Diseases and Stroke. The government officially classified the final 10 years of the 20th century as the Decade of the Brain and provided an even greater level of research funding. PMID:19892141

Freemon, Frank R



[Neurological appearances of primary antiphospholipid syndrome].  


Neurological disturbances frequently emerge in antiphospholipid syndrome (APS). One hundred and twenty four patients (100 women, 24 men, mean age 37.5 +/- 11.3 years) with primary APS (PAPS), including 76 patients with Sneddon's syndrome and positive antibodies to phospholipids (aPL), have been studied. A structure of neurological disturbances was as follows: ischemic lesions of cerebral blood flow (LCBF) which comprised stroke and transient LCBF (91%); thrombosis of brain venous sinuses (3%); epileptic seizures (24%); headache (65%); chorea (15%); visual neuropathy (9%); peripheral neuropathy (6%); multiple-sclerosis-like syndrome (10%); myasthenia syndrome (1%); syndrome of parkinsonism of non-vascular genesis (1%) and psychotic disorders (2%). 84% patients had main systemic APS symptoms (fetal loss, thrombosis), which preceded neurological appearances in 78% cases. All the patients had aPL: aPL to cardiolipin (aCL) and/or lupus coagulant (LC) and/or aPL to phosphatidyl serine, phosphatidyl inositol, phosphatidyl ethanolamine. In some patients, aCL titres ranged from positive to negative values and LC was not consistently detected. Thus, the presence of clinical symptoms of PAPS including neurological disturbances demands an investigation of different aPL types as well as a replicate study for immunological confirmation of PAPS. PMID:15986822

Kalashnikova, L A; Dobrynina, L A; Aleksandrova, E N; Novikov, A A



A frameshift mutation in the mouse alpha 1 glycine receptor gene (Glra1) results in progressive neurological symptoms and juvenile death  

Microsoft Academic Search

The neurologic mutant mouse, oscillator, is characterized by a fine motor tremor and muscle spasms that begin at 2 weeks of age and progressively worsen, resulting in death by 3 weeks of age. We report the localization of the oscillator mutation to the central region of mouse Chr 11, and demonstrate its allelism with spasmodic, a recessive viable neurological mutation

M S Buckwalter; S A Cook; M T Davisson; W F White; S A Camper



Neurologic deficit  


A neurologic deficit is a functional abnormality of a body area due to a decrease in the function of ... RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Schafer AI, eds. Cecil ...


Neurologic melioidosis.  


Melioidosis is an important cause of morbidity and mortality in northern Australia and Southeast Asia. Diagnosis is best made by isolation of Burkholderia pseudomallei from clinical specimens. A variety of clinical presentations are described, including neurologic disease. The aim of this study was to review admissions with confirmed neurologic melioidosis to a regional hospital in a region to which melioidosis is endemic during 1995-2011. There were 12 culture-confirmed cases of neurologic melioidosis, of which two were detected by analysis of cerebrospinal fluid. Four of these cases were in children. Significant clinical features were fever, headache, and ataxia. Common changes on magnetic resonance imaging T2-weighted scans included ring-enhancing lesions and leptomeningeal enhancement. There were four deaths and an additional four patients had significant long-term neurologic sequelae. When considering the etiology of undifferentiated neurologic disease, an awareness of the possibility of neurologic melioidosis is important in disease-endemic regions. PMID:23836574

Deuble, Martin; Aquilina, Chloe; Norton, Robert



Plasma exchange as a therapeutic option in patients with neurologic symptoms due to antibodies to voltage-gated potassium channels: a report of five cases and review of the literature.  


Antibodies to voltage-gated potassium channels (VGKC) are associated with acquired neuromyotonia, limbic encephalitis, and Morvan's syndrome. The antibodies are often not associated with malignancy and have shown good clinical response to immunomodulatory therapies. A record review identified five patients with laboratory evidence of antibodies to VGKC who underwent plasma exchange (PE) as part of their immunosuppressive therapy for neurologic disease. Four of the patients presented with limbic encephalitis and one with neuromyotonia. Symptoms included memory impairment, seizures, and personality changes. All PE were 1.0 volume and were performed on an every-other-day schedule. Replacement fluid was 5% normal serum albumin except when a bleeding risk was identified and then fresh frozen plasma was added. Four of five patients were also receiving concurrent immunosuppressive therapy including corticosteroids. Of the five patients treated with PE, three had sustained improvement in symptoms for 6-17 months following PE. Two patients did not have signs of improvement at a limited follow-up. One patient had recurrence of her symptoms, which responded to additional PE. These cases, as well as the reports in the literature, suggest that PE could be a useful adjunctive therapy for patients with VGKC antibodies and neurologic symptoms. PMID:22532193

Jaben, Elizabeth A; Winters, Jeffrey L



[Neurological disorders in pregnancy].  


Preeclampsia is characterized by hypertension, peripheral edema and proteinuria, but very often also includes neurologic complications. Neurologic complications of severe preeclampsia are indentical to those of hypertensive encephalopathy. The most common neurologic symptoms are headache, vomiting, mental disorders, visual disturbances, sensorimotor deficits and seizures. Endothelial cell dysfunction is the main cause of multiorgan failure. It is of utmost importance to recognize these symptoms and initiate apropriate therapy. Systemic blood presure must not exceed the cerebrovascular autoregulatory capacity. Serum magnesium level is significantly decreased in pregnant women with severe preeclampsia and cerebral edema. Magnesium has been shown to be effective in reducing the occurrence of seizures in preeclampsia by decreasing neuronal excitability, protecting the endothelium against free radicals and reducing cerebral perfusion. PMID:23088092

Brozovi?, Gordana; Sklebar, Ivan; Sunko, Branka Mazul; Blagai?, Vladimir



Current neurology  

SciTech Connect

The topics covered in this book include: Duchenne muscular dystrophy: DNA diagnosis in practice; Central nervous system magnetic resonance imaging; and Magnetic resonance spectroscopy of neurologic diseases.

Appel, S.H. (Dept. of Neurology, Baylor College of Medicine, Houston, TX (US))



Enhanced Neurogenesis Following Neurological Disease  

Microsoft Academic Search

Neurological diseases are disorders of the nervous system that have biological origins, and impair one’s ability to live a\\u000a normal life. Neurological diseases originate from neurochemical alterations or the loss of specific cell populations of the\\u000a nervous system. The causes for these disorders remain poorly understood. Their symptoms span from psychiatric to neurological\\u000a to physical impairments. For decades, finding a

Philippe Taupin


Familial idiopathic basal ganglia calcification (Fahr's disease) without neurological, cognitive and psychiatric symptoms is not linked to the IBGC1 locus on chromosome 14q  

Microsoft Academic Search

Idiopathic basal ganglia calcification (IBGC) is characterised by radiological, neurological, cognitive and psychiatric abnormalities. The associations between these abnormal phenotypes and abnormal genes remain unclear despite the recent mapping to chromosome 14q of a susceptibility locus for IBGC (IBGC1). We identified two siblings, from a large multigenerational pedigree, who had both been diagnosed with radiological IBGC, dementia, bipolar affective disorder

Henry Brodaty; Philip Mitchell; Georgina Luscombe; John B. J. Kwok; Renee F. Badenhop; Rod McKenzie; Peter R. Schofield



Neurology and Don Quixote.  


Don Quixote de la Mancha, which is considered one of the most important and influential works of Western modern prose, contains many references of interest for almost all of the medical specialties. In this regard, numerous references to neurology can be found in Cervantes' immortal work. In this study, we aimed to read Don Quixote from a neurologist's point of view, describing the neurological phenomena scattered throughout the novel, including tremors, sleep disturbances, neuropsychiatric symptoms, dementia, epilepsy, paralysis, stroke, syncope, traumatic head injury, and headache; we relate these symptoms with depictions of those conditions in the medical literature of the time. We also review Cervantes' sources of neurological information, including the works by renowned Spanish authors such as Juan Huarte de San Juan, Dionisio Daza Chacón and Juan Valverde de Amusco, and we hypothesize that Don Quixote's disorder was actually a neurological condition. Although Cervantes wrote it four centuries ago, Don Quixote contains plenty of references to neurology, and many of the ideas and concepts reflected in it are still of interest. PMID:23006630

Palma, Jose-Alberto; Palma, Fermin



Adverse neurological outcomes in Nigerian children with sickle cell disease.  


Sickle cell disease (SCD) is reported to be the most common genetic disorder affecting Nigerians. Children with SCD are at a high risk of neurological morbidity. The main objective of this study was to determine the pattern of adverse neurological outcomes among a cohort of Nigerian children with SCD. All children with SCD seen in the Department of Paediatrics, University College Hospital, Ibadan, Nigeria, over a period of 2 years were carefully evaluated for symptoms and signs of neurological complications, defined as clinical outcomes referable to the central nervous system. Of the 214 children evaluated, 187 were diagnosed with Hb SS disease and 27 with Hb SC disease. Neurological complications were identified in 78 (36.4 %) of the cases. The most common complications were headache (17.8 %), seizure (9.3 %) and stroke (8.4 %). Other less frequent complications included bacterial meningitis (2.8 %), spontaneous visual loss (1.4 %), paraplegia (0.9 %) and transient ischaemic attacks (0.9 %). Neurological complications occurred more frequently in children with sickle cell anaemia than in those with Hb SC disease (P = 0.002, 95 % CI 1.450-82.870). Adverse neurological events are common in Nigerian children with SCD, with a significantly higher risk in Hb SS than Hb SC disease. Stroke represents a major underlying cause of symptomatic epilepsy in SCD. Institution of primary preventive measures for stroke in SCD will significantly reduce the burden of stroke and epilepsy associated with SCD in Nigeria. PMID:23129067

Lagunju, I A; Brown, B J



Transient tetraplegia and vegetative dysfunction depending on cervical positioning caused by a cervical spinal chordoma.  


A 39-year-old man with acquired torticollis suffering from cervicobrachialgia and neurological deficits is presented. Due to a change in head position a transient reproducible tetraplegia and severe vegetative dysfunctions were caused. The origin of this uncommon serious combination of symptoms and signs was a chordoma of the upper cervical spine. After surgical decompression the patient was free of neurological deficit and pain. Review of the literature did not reveal any similar case. PMID:16328772

Schulte, T L; Hammersen, S; Heidenreich, J O; Pietilä, T A



Transient spinal cord injuries in the young athlete.  


Spinal cord injuries are be potentially devastating. Despite initial presentation, they may be permanent or transient. A small percentage of spinal cord patients with motor or sensory dysfunction recover rapidly and completely with no neurological sequelae. Cervical cord neurapraxia is a frequent cause of transient neurologic symptoms. This transient neurological phenomenon involves bilateral motor paralysis and/or sensory manifestations that appear in the absence of any structural deficiencies of the cervical spine as evidence by negative diagnostic imaging. All patients with any history of neurologic deficits should be assessed thoroughly and rendered care appropriately to avoid secondary injury. This article will present a case study of a 15-year-old high school football player who complained of motor and sensory deficits after tackling another player. Treatment was provided and his neurological symptoms resolved completely. The pathophysiology of cellular injury related to the spinal cord and cervical cord neurapraxia is reviewed. In addition treatment modalities such as high dose steroids to reduce secondary spinal cord injury are discussed. PMID:16602338

Perks, Diane H


[Neurologic aspects of eclampsia].  


The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless, eclampsia isn't just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used--fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs. PMID:14608866

Jovanovi?, Dejana; Besla?-Bumbaserevi?, Ljiljana; Ercegovac, Marko; Stosi?-Opin?al, Tatjana


Neurological effects of deep diving.  


Deep diving is defined as diving to depths more than 50 m of seawater (msw), and is mainly used for occupational and military purposes. A deep dive is characterized by the compression phase, the bottom time and the decompression phase. Neurological and neurophysiologic effects are demonstrated in divers during the compression phase and the bottom time. Immediate and transient neurological effects after deep dives have been shown in some divers. However, the results from the epidemiological studies regarding long term neurological effects from deep diving are conflicting and still not conclusive. Prospective clinical studies with sufficient power and sensitivity are needed to solve this very important issue. PMID:21377169

Grřnning, Marit; Aarli, Johan A



Neurologic running injuries.  


Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:18295096

McKean, Kelly A



Neurologic running injuries.  


Neurologic running injuries account for a small number of running injuries. This may be caused by misdiagnosis or underdiagnosis. Nerve injuries that have been reported in runners include injuries to the interdigital nerves and the tibial, peroneal, and sural nerves. In this article, the etiology, symptoms, diagnosis, and treatment of these injuries are reviewed. Differences between nerve injury and more common musculoskeletal injury have been presented to aid in differential diagnosis. PMID:19084775

McKean, Kelly A



Neurological channelopathies  

PubMed Central

Ion channels are membrane-bound proteins that perform key functions in virtually all human cells. Such channels are critically important for the normal function of the excitable tissues of the nervous system, such as muscle and brain. Until relatively recently it was considered that dysfunction of ion channels in the nervous system would be incompatible with life. However, an increasing number of human diseases associated with dysfunctional ion channels are now recognised. Such neurological channelopathies are frequently genetically determined but may also arise through autoimmune mechanisms. In this article clinical, genetic, immunological, and electrophysiological aspects of this expanding group of neurological disorders are reviewed. Clinical situations in which a neurological channelopathy should enter into the differential diagnosis are highlighted. Some practical guidance on how to investigate and treat this complex group of disorders is also included.

Graves, T; Hanna, M



Are There More Bowel Symptoms in Children with Autism Compared to Normal Children and Children with Other Developmental and Neurological Disorders?: A Case Control Study  

ERIC Educational Resources Information Center

There is considerable controversy as to whether there is an association between bowel disorders and autism. Using a bowel symptom questionnaire we compared 51 children with autism spectrum disorder with control groups of 35 children from special school and 112 from mainstream school. There was a significant difference in the reporting of certain…

Smith, R. A.; Farnworth, H.; Wright, B.; Allgar, V.



A longitudinal study of differences in late- and early-onset geriatric depression: Depressive symptoms and psychosocial, cognitive, and neurological functioning  

Microsoft Academic Search

Objectives: Studies suggest early-onset depression (EOD) is associated with a more severe course of the depressive disorder, while late-onset depression (LOD) is associated with more cognitive and neuroimaging changes. This study examined if older adults with EOD, compared with those with LOD, would exhibit more severe symptoms of depression and, consistent with the glucocorticoid cascade hypothesis, have more hippocampal volume

Natalie Sachs-Ericsson; Elizabeth Corsentino; Jerad Moxley; Jennifer L. Hames; Nicole C. Rushing; Kathryn Sawyer; Thomas Joiner; Edward A. Selby; Steven Zarit; Ian H. Gotlib; David C. Steffens



Neurological melioidosis  

Microsoft Academic Search

Neurological abnormalities have long been recognised in animals with melioidosis, including laboratory rodents and sheep in the first Australian outbreak in 1949. Autopsies in animals have shown microabscesses and lymphocytic infiltration to be present on occasion in the same animal, but Burkholderia pseudomallei is usually able to be grown from central nervous system (CNS) tissue. In humans CNS melioidosis is

Bart J Currie; Dale A Fisher; Diane M Howard; James N. C Burrow



Acute, transient hemorrhagic hypotension does not aggravate structural damage or neurologic motor deficits but delays the long-term cognitive recovery following mild to moderate traumatic brain injury  

PubMed Central

Objectives Posttraumatic hypotension is believed to increase morbidity and mortality in traumatically brain-injured patients. Using a clinically relevant model of combined traumatic brain injury with superimposed hemorrhagic hypotension in rats, the present study evaluated whether a reduction in mean arterial blood pressure aggravates regional brain edema formation, regional cell death, and neurologic motor/cognitive deficits associated with traumatic brain injury. Design Experimental prospective, randomized study in rodents. Setting Experimental laboratory at a university hospital. Subjects One hundred nineteen male Sprague-Dawley rats weighing 350-385 g. Interventions Experimental traumatic brain injury of mild to moderate severity was induced using the lateral fluid percussion brain injury model in anesthetized rats (n = 89). Following traumatic brain injury, in surviving animals one group of animals was subjected to pressure-controlled hemorrhagic hypotension, maintaining the mean arterial blood pressure at 50-60 mm Hg for 30 mins (n = 47). The animals were subsequently either resuscitated with lactated Ringer’s solution (three times shed blood volume, n = 18) or left uncompensated (n = 29). Other groups of animals included those with isolated traumatic brain injury (n = 34), those with isolated hemorrhagic hypotension (n = 8), and sham-injured control animals receiving anesthesia and surgery alone (n = 22). Measurements and Main Results The withdrawal of 6-7 mL of arterial blood significantly reduced mean arterial blood pressure by 50% without decreasing arterial oxygen saturation or Pao2. Brain injury induced significant cerebral edema (p < .001) in vulnerable brain regions and cortical tissue loss (p < .01) compared with sham-injured animals. Neither regional brain edema formation at 24 hrs postinjury nor the extent of cortical tissue loss assessed at 7 days postinjury was significantly aggravated by superimposed hemorrhagic hypotension. Brain injury-induced neurologic deficits persisted up to 20 wks after injury and were also not aggravated by the hemorrhagic hypotension. Cognitive dysfunction persisted for up to 16 wks postinjury. The superimposition of hemorrhagic hypotension significantly delayed the time course of cognitive recovery. Conclusions A single, acute hypotensive event lasting 30 mins did not aggravate the short- and long-term structural and motor deficits but delayed the speed of recovery of cognitive function associated with experimental traumatic brain injury.

Schutz, Christian; Stover, John F.; Thompson, Hilaire J.; Hoover, Rachel C.; Morales, Diego M.; Schouten, Joost W.; McMillan, Asenia; Soltesz, Kristie; Motta, Melissa; Spangler, Zachery; Neugebauer, Edmund; McIntosh, Tracy K.



[Neurological aspects of infantile autism].  


Childhood autism is not usually considered as a neurological disease although frequent antecedents of ante, peri and postnatal injuries are found in its antecedents. Several symptoms of autism particularly in the early development, resemble the signs observed in frontal, temporal, striatal and brainstem dysfunctioning. These cerebral structures are connected with the central dopaminergic system which may be disturbed in autistic children. Such hypotheses suggest the necessary elaboration of an infant and child "behavioral neurology". PMID:3527686

Lelord, G; Garreau, B; Barthelemy, C; Bruneau, N; Sauvage, D


[Epidural analgesia is not the only cause of peripartum central neurologic symptoms. Report of one case of posterior reversible encephalopathy syndrome].  


A young woman without any significant medical history received an epidural analgesia for labour. She suddenly presented headache, vision loss, nausea and arterial hypertension a few minutes after a 4-ml ropivacaine 0.75% bolus. The catheter was withdrawn and symptoms completely disappeared within 15 minutes. A new epidural catheter was inserted. Thereafter, the patient gave birth to a healthy newborn infant. Half an hour later, while the epidural catheter was still infusing, she presented generalized tonicoclonic seizure. Potential diagnoses were systemic toxicity of local anaesthetics and eclampsia. Accordingly, the patient received intravenous lipid emulsion and magnesium sulphate. There was no biological abnomabilities. A final diagnosis of posterior reversible encephalopathy syndrome was made with MRI showing bilateral hyperintensity areas involving the cortex of the occipital and frontal areas asymmetrically. On the sixth day, after delivery, the patient was discharged seizure-free. Repeated MRI 4 weeks after discharge was unremarkable. PMID:21146952

Etesse, B; Letouzey, V; Roger, C; Lefauconnier, A; Ripart, J



Neurological diseases and pain.  


Chronic pain is a frequent component of many neurological disorders, affecting 20-40% of patients for many primary neurological diseases. These diseases result from a wide range of pathophysiologies including traumatic injury to the central nervous system, neurodegeneration and neuroinflammation, and exploring the aetiology of pain in these disorders is an opportunity to achieve new insight into pain processing. Whether pain originates in the central or peripheral nervous system, it frequently becomes centralized through maladaptive responses within the central nervous system that can profoundly alter brain systems and thereby behaviour (e.g. depression). Chronic pain should thus be considered a brain disease in which alterations in neural networks affect multiple aspects of brain function, structure and chemistry. The study and treatment of this disease is greatly complicated by the lack of objective measures for either the symptoms or the underlying mechanisms of chronic pain. In pain associated with neurological disease, it is sometimes difficult to obtain even a subjective evaluation of pain, as is the case for patients in a vegetative state or end-stage Alzheimer's disease. It is critical that neurologists become more involved in chronic pain treatment and research (already significant in the fields of migraine and peripheral neuropathies). To achieve this goal, greater efforts are needed to enhance training for neurologists in pain treatment and promote greater interest in the field. This review describes examples of pain in different neurological diseases including primary neurological pain conditions, discusses the therapeutic potential of brain-targeted therapies and highlights the need for objective measures of pain. PMID:22067541

Borsook, David



Neurological diseases and pain  

PubMed Central

Chronic pain is a frequent component of many neurological disorders, affecting 20–40% of patients for many primary neurological diseases. These diseases result from a wide range of pathophysiologies including traumatic injury to the central nervous system, neurodegeneration and neuroinflammation, and exploring the aetiology of pain in these disorders is an opportunity to achieve new insight into pain processing. Whether pain originates in the central or peripheral nervous system, it frequently becomes centralized through maladaptive responses within the central nervous system that can profoundly alter brain systems and thereby behaviour (e.g. depression). Chronic pain should thus be considered a brain disease in which alterations in neural networks affect multiple aspects of brain function, structure and chemistry. The study and treatment of this disease is greatly complicated by the lack of objective measures for either the symptoms or the underlying mechanisms of chronic pain. In pain associated with neurological disease, it is sometimes difficult to obtain even a subjective evaluation of pain, as is the case for patients in a vegetative state or end-stage Alzheimer's disease. It is critical that neurologists become more involved in chronic pain treatment and research (already significant in the fields of migraine and peripheral neuropathies). To achieve this goal, greater efforts are needed to enhance training for neurologists in pain treatment and promote greater interest in the field. This review describes examples of pain in different neurological diseases including primary neurological pain conditions, discusses the therapeutic potential of brain-targeted therapies and highlights the need for objective measures of pain.



Transient Ischemic Attack  


A transient ischemic attack (TIA) is a stroke that comes and goes quickly. It happens when the blood supply to part of the brain stops briefly. Symptoms of a TIA are like other stroke symptoms, but do not ...


British neurological surveillance unit.  


The British Neurological Surveillance Unit (BNSU) is a longstanding resource to support surveillance for neurological diseases in the UK. Case ascertainment is achieved by monthly emails to ABN members, 50% of whom currently respond. In 2012, surveillance stopped for Mitochondrial Disease (37 cases), began for demyelination complicating anti-TNF therapy (seven cases), and continued for Familial Alzheimer's Disease and Familial Frontotemporal Dementia (23 cases), Transient Epileptic Amnesia (23 cases), Severe Hypersensitivity Reactions to Antiepileptic Drugs (15 cases), Drug-induced Liver Injury Reactions to Antiepileptic Drugs (14 cases), Lambert-Eaton Myasthenic Syndrome (11 cases), Myoclonus Dystonia Syndrome (nine cases), Neurological problems occurring within one month of influenza infection in adults (eight cases), and Congenital Cranial Dysinnervation Disorders (six cases). Annual reports indicated that the proportions of responses received from ABN members to questionnaires sent following the notification of a case to BNSU ranged from 50-100%, although these percentages are based on small numbers. Of the 101 patients ascertained by studies submitting annual reports, 30 patients were successfully recruited to the studies. The BNSU has the potential to be even more user-friendly, engage more of the ABN membership, and achieve even more than incomplete surveillance of rare neurological diseases. Attendees at the ABN annual meeting are encouraged to visit the posters being displayed by surveillance studies supported by the BNSU, and send any suggestions for improving the BNSU to the ABN office. Poster presentations on current BNSU projects will be made during the Thursday ABN poster session. BNSU posters can be found in the section 021-029. PMID:24108891

Al-Shahi Salman, Rustam



Neurologic Manifestations of Infective Endocarditis  

Microsoft Academic Search

Background: Many previous studies have endeavored to find appropriate means to reduce the occurrence of neu- rologic manifestations in patients with infective endocar- ditis (IE). We evaluated patients with IE-associated neu- rologic complications and compared them with patients with IE who did not have neurologic symptoms. Particu- lar attention was focused on assessing the impact of car- diac surgery and

Maija Heiro; Jukka Nikoskelainen; Erik Engblom; Esa Kotilainen; Reijo Marttila; Pirkko Kotilainen


Radiological examinations of transient ischemic attack.  


Neuroimaging is critical in the evaluation of patients with TIA. CT and MRI are the two available options for imaging. Head CT is more widely available and commonly used. Diffusion MRI is the recommended modality to image an ischemic lesion. The presence of a diffusion lesion in a patient with transient neurological symptoms is an indicator of a high risk of recurrent stroke. Perfusion imaging with perfusion MRI or CT perfusion may improve the detection of ischemic lesions. Noninvasive vessel imaging may detect a symptomatic vessel lesion associated with an increased risk of stroke. PMID:24157560

Tung, Christie E; Olivot, Jean Marc; Albers, Gregory W



Neurological issues.  


The case histories of two patients who had had a spinal cord injury (SCI) were selected by the senior author and sent to four experts in the field of SCI. Based on the 1992 American Spinal Injury Association (ASIA) and International Medical Society of Paraplegia (IMSOP) standards, the four participants plus the senior author recorded the motor and sensory scores, the ASIA impairment scale (AIS), the neurological level (NL) and the zone of partial preservation (ZPP). Several minor scoring errors occurred among the participants, especially with motor scores when key muscles could not be tested due to pain, or external immobilization devices. Difficulties with interpretation occurred with the motor levels and the ZPP for the patient with a complete injury. This exercise points to the need for all examiners of SCI patients to thoroughly familiarize themselves with the standards and to use the motor and sensory scores to arrive at a NL and ZPP. They also indicate a need to revise the standards to clarify the determination of sensory levels and how to score muscles whose strength is inhibited by pain. PMID:9160450

Donovan, W H; Brown, D J; Ditunno, J F; Dollfus, P; Frankel, H L



Neurologic Manifestations of Leishmania spp. Infection  

PubMed Central

When listing common clinical signs of the spectra of Leishmania-derived diseases, neurologic malfunctions are not commonly included. Despite this, there are multiple reported instances both in human and veterinary medicine where neurologic manifestations, whether central or peripheral, are described. In this review, we describe neurologic manifestations seen during infection with Leishmania spp. with some discussion of the implicit effect of inflammation on the blood brain barrier in both medical and veterinary cases. Taken together, the material discussed here suggests that in patients from Leishmania-endemic areas, when observing neurologic symptoms, causation secondary to infection with Leishmania spp. should be highly considered.

Petersen, Christine Anne; Greenlee, M. Heather West



[Prognosis of the neurological bladders].  


Numerous neurological diseases may hurt the neurological command of the miction and thus provoke the dysfunctions of the bladder and/or the urinary sphincter. These dysfunctions leads to annoying symptoms (incontinence, retention or both) but can also cause grave complications (renal infections, calculations, renal insufficiency, tumor of bladder). The forecast of the neurological bladders consists to prevent the urinary complications and to improve the comfort/quality of life. The initial care must be early and multidisciplinary. The objective of a low-pressure bladder emptied regularly without permanent drainage is common to all the situations. The objective of a dry and autonomous patient for the elimination of the urine is the main goal for the optimization of the quality of life. The restoration of a sexuality, a fertility, a control of the continence and the faecal exemption are also important parameters to improve of the quality of life. PMID:24176407

Boissier, R; Karsenty, G



Neurologic complications of scuba diving.  


Recreational scuba diving has become a popular sport in the United States, with almost 9 million certified divers. When severe diving injury occurs, the nervous system is frequently involved. In dive-related barotrauma, compressed or expanding gas within the ears, sinuses and lungs causes various forms of neurologic injury. Otic barotrauma often induces pain, vertigo and hearing loss. In pulmonary barotrauma of ascent, lung damage can precipitate arterial gas embolism, causing blockage of cerebral blood vessels and alterations of consciousness, seizures and focal neurologic deficits. In patients with decompression sickness, the vestibular system, spinal cord and brain are affected by the formation of nitrogen bubbles. Common signs and symptoms include vertigo, thoracic myelopathy with leg weakness, confusion, headache and hemiparesis. Other diving-related neurologic complications include headache and oxygen toxicity. PMID:11417773

Newton, H B



Contraceptive methods for women with neurologic disorders.  


Sex steroids in oral contraceptives exert several effects on the central nervous system and are therefore of concern when used by neurologically compromised women. In general, oral contraceptives do not aggravate epileptic seizures and are not contraindicated in cases of tension headache. Oral contraceptives can be used in cases of migraine without focal neurologic symptoms as long as headache symptoms do not worsen. Levels of sex steroids can be diminished through enzyme induction by antiepileptic drugs, giving rise to the possibility of contraceptive failure and exposure of the fetus to the teratogenic properties of antiseizure medications. Women with common migraine (without focal neurologic symptoms) who are taking oral contraceptives should be monitored for possible exacerbation of their symptoms. Women who do experience worsening of headache symptomatology when taking the pill should consider alternate means of contraception. PMID:8512048

Mattson, R H; Rebar, R W



Neurological manifestations of human babesiosis.  


Babesiosis is a worldwide emerging infectious disease caused by intraerythrocytic protozoa that are transmitted by Ixodid ticks, or less commonly through blood transfusion or transplacentally. Although headache and lethargy are common symptoms, babesiosis is uncommonly associated with specific neurological dysfunction in humans. Decreased level of consciousness or coma are rare complications that are associated with severe and often fatal disease but the pathogenesis is unclear. PMID:23829910

Usmani-Brown, Sahar; Halperin, John J; Krause, Peter J



Classical diseases revisited: transient global amnesia  

PubMed Central

Transient global amnesia usually affects patients between the ages of 40 and 80. Patients with this condition are often described – wrongly – as being confused. It presents classically with an abrupt onset of severe anterograde amnesia. It is usually accompanied by repetitive questioning. The patient does not have any focal neurological symptoms. Patients remain alert, attentive, and cognition is not impaired. However, they are disoriented to time and place. Attacks usually last for 1–8 h but should be less than 24 h. It is possible that it may result from different mechanisms such as venous congestion with valsalva-like activities before symptom onset, arterial thromboembolic ischaemia and vasoconstriction due to hyperventilation. Diagnosis may be made safely in the presence of a characteristic collateral history. No specific treatment is indicated for a typical episode.

Owen, D; Paranandi, B; Sivakumar, R; Seevaratnam, M



Acute and subacute symptoms among workers in the printing industry  

Microsoft Academic Search

The study population comprised 52 male printers and 52 controls. Each person was interviewed about job history, general health, and work-related symptoms. Symptoms from eyes and airways, neurological symptoms, and general symptoms were recorded. A lung function test and a measurement of the sense of smell were also carried out. The printers had significantly more eye, airway, and neurological symptoms

J Baelum; I Andersen; L Mřlhave



Neurological disorders in the elderly at home  

Microsoft Academic Search

Eight hundred and eight subjects participated in three surveys of random samples of people aged 65 years or more living in their own homes. Neurological history and examination showed the prevalence of completed stroke to be 73 per 1000. Eighty-seven subjects per 1000 gave a history of transient cerebral ischaemic attacks. These prevalence rates were unaffected by age or sex.

G A Broe; A J Akhtar; G R Andrews; F I Caird; A J Gilmore; W J McLennan



Introduction to Aerospace Neurology.  

National Technical Information Service (NTIS)

The bottom line in aerospace neurology is the evaluation for the: (1) potential of sudden incapacitation, e.g., post traumatic seizures; (2) possibility of a sudden neurological deficit which would prevent the aircrew member from performing their job and ...

M. S. Katchen



Differential Diagnosis of Transient Amnesia  

PubMed Central

In a group of 39 consecutive patients attending neurological clinics with transient amnesia patients with transient global amnesia formed the largest group; others suffered from epilepsy, migraine, temporal lobe encephalitis, or psychogenic fugues. In most cases the clinical features suggested the aetiology, but an electroencephalogram recorded as soon after the attack as possible may help in distinguishing amnesia due to temporal lobe epilepsy.

Croft, P. B.; Heathfield, K. W. G.; Swash, M.



Avoiding Misdiagnosis in Patients with Neurological Emergencies  

PubMed Central

Approximately 5% of patients presenting to emergency departments have neurological symptoms. The most common symptoms or diagnoses include headache, dizziness, back pain, weakness, and seizure disorder. Little is known about the actual misdiagnosis of these patients, which can have disastrous consequences for both the patients and the physicians. This paper reviews the existing literature about the misdiagnosis of neurological emergencies and analyzes the reason behind the misdiagnosis by specific presenting complaint. Our goal is to help emergency physicians and other providers reduce diagnostic error, understand how these errors are made, and improve patient care.

Pope, Jennifer V.; Edlow, Jonathan A.



Hodgkin's Lymphoma: A Review of Neurologic Complications  

PubMed Central

Hodgkin's lymphoma is a hematolymphoid neoplasm, primarily of B cell lineage, that has unique histologic, immunophenotypic, and clinical features. Neurologic complications of Hodgkin's Lymphoma can be separated into those that result directly from the disease, indirectly from the disease, or from its treatment. Direct neurologic dysfunction from Hodgkin's Lymphoma results from metastatic intracranial spinal disease, epidural metastases causing spinal cord/cauda equina compression, leptomeningeal metastases, or intradural intramedullary spinal cord metastases. Indirect neurologic dysfunction may be caused by paraneoplastic disorders (such as paraneoplastic cerebellar degeneration or limbic encephalitis) and primary angiitis of the central nervous system. Hodgkin's lymphoma treatment typically includes chemotherapy or radiotherapy with potential treatment-related complications affecting the nervous system. Neurologic complications resulting from mantle-field radiotherapy include the “dropped head syndrome,” acute brachial plexopathy, and transient ischemic attacks/cerebral infarcts. Chemotherapy for Hodgkin's lymphoma may cause cerebral infarction (due to emboli from anthracycline-induced cardiomyopathy) and peripheral neuropathy.

Grimm, Sean; Chamberlain, Marc



Hodgkin's Lymphoma: A Review of Neurologic Complications.  


Hodgkin's lymphoma is a hematolymphoid neoplasm, primarily of B cell lineage, that has unique histologic, immunophenotypic, and clinical features. Neurologic complications of Hodgkin's Lymphoma can be separated into those that result directly from the disease, indirectly from the disease, or from its treatment. Direct neurologic dysfunction from Hodgkin's Lymphoma results from metastatic intracranial spinal disease, epidural metastases causing spinal cord/cauda equina compression, leptomeningeal metastases, or intradural intramedullary spinal cord metastases. Indirect neurologic dysfunction may be caused by paraneoplastic disorders (such as paraneoplastic cerebellar degeneration or limbic encephalitis) and primary angiitis of the central nervous system. Hodgkin's lymphoma treatment typically includes chemotherapy or radiotherapy with potential treatment-related complications affecting the nervous system. Neurologic complications resulting from mantle-field radiotherapy include the "dropped head syndrome," acute brachial plexopathy, and transient ischemic attacks/cerebral infarcts. Chemotherapy for Hodgkin's lymphoma may cause cerebral infarction (due to emboli from anthracycline-induced cardiomyopathy) and peripheral neuropathy. PMID:20975772

Grimm, Sean; Chamberlain, Marc



Transient cortical blindness as a manifestation of solitary cysticercus granuloma.  


Neurocysticercosis is recognised as a significant cause of neurological morbidity in endemic regions. The wide range of pleomorphic and non-specific neurological manifestations of neurocysticercosis must be kept in mind by physicians, as the disease has shown resurgence in developed countries. When an atypical presentation of an unusual tropical disease occurs in non-endemic regions, the diagnosis is often missed. We describe a case of a 4-year-old girl who presented with a history of transient bilateral loss of vision with headache and vomiting. Brain MRI revealed the presence of a single cysticercus granuloma in the occipital lobe. A diagnosis of symptomatic occipital lobe seizure secondary to neurocysticercosis was made. She was given a course of albendazole. There was no recurrence of symptoms at 3 years follow-up. Occipital seizures that are associated with ictal amaurosis closely mimic basilar migraine. Such cases benefit from neuroimaging in order to rule out the underlying structural causes. PMID:23230251

Hussain, Shabbir; Hussain, Kosar; Hussain, Sahar




PubMed Central

It is a myth that electroconvulsive therapy (ECT) produces greater side effects and worsens the neurological condition when used in neurologically ill patients. With the advancement and sophistication in ECT practice standards and modification procedures, it can be safely administered either to treat selected neurological conditions or the co-morbid psychiatric illnesses without additional risks. However ECT should be administered only after thorough evaluation of risks and benefits in such individuals.

Girish, K.; Gangadhar, B.N.; Janakiramaiah, N.



The Neurologic Manifestations of Mitochondrial Disease  

ERIC Educational Resources Information Center

The nervous system contains some of the body's most metabolically demanding cells that are highly dependent on ATP produced via mitochondrial oxidative phosphorylation. Thus, the neurological system is consistently involved in patients with mitochondrial disease. Symptoms differ depending on the part of the nervous system affected. Although almost…

Parikh, Sumit



The Neurologic Manifestations of Mitochondrial Disease  

ERIC Educational Resources Information Center

|The nervous system contains some of the body's most metabolically demanding cells that are highly dependent on ATP produced via mitochondrial oxidative phosphorylation. Thus, the neurological system is consistently involved in patients with mitochondrial disease. Symptoms differ depending on the part of the nervous system affected. Although…

Parikh, Sumit



Effect of yoga therapy on anxiety and depressive symptoms and quality-of-life among caregivers of in-patients with neurological disorders at a tertiary care center in India: A randomized controlled trial  

PubMed Central

Context: The concerns of caregivers of patients with neurological disorders have been a felt need for a long time, with many of them experiencing significant psychiatric morbidity. Aims: This study aimed to find the effect of yoga in reducing anxiety and depression, as well as improving quality-of-life in caregivers of patients with neurological disorders. Settings and Design: The study was conducted using a randomized controlled design, with yoga intervention and waitlisted controls. Methodology: Sixty consenting caregivers of inpatients in neurology wards were randomized into two groups: Yoga and control. Demographic variables except years of education and length of caretaking were comparable in the two groups, as also baseline scores of anxiety, depression and quality-of-life. A specific yoga module comprising yog?sanas, pr???y?ma, and chanting was taught to the participants in the yoga group by the researcher. At follow-up 43 patients (yoga n=20 and control group n=23) were available. Two-way repeated measures analysis of variance was used to test the change from pre-test to post-test scores within and between groups. Analysis of covariance was performed to compare the post-test scores between the groups adjusting for education and length of caretaking. Results: Following one month intervention of yoga therapy, there was a significant (P<0.001) decrease in anxiety and depression scores, as well as improved quality-of-life among the participants in the yoga group as compared with the control group. Conclusion: This study highlights the usefulness of a yoga intervention for caregivers of inpatients with neurological problems. The small sample size and lack of blinding were some of the limitations of this study.

Umadevi, P.; Ramachandra; Varambally, S.; Philip, M.; Gangadhar, B. N.



Contagious Weakness in an Elderly Couple with Neurologic Emergencies  

PubMed Central

We present an unusual neurologic emergency in an elderly male patient. Given his presentation and risk factors, we presumed the initial symptoms to be secondary to a cerebrovascular accident. As the case evolved, however, it became apparent that a more unusual pathology was present. This case report showcases a rare condition masquerading as a common neurologic emergency.

Matthews, Cari E.; Garg, Vikram K.; Sanyal, Pallabi; Baban, Kandan; Grudko, Kenneth; Field, Adam G.



Pediatric neurological syndromes and inborn errors of purine metabolism  

Microsoft Academic Search

This review is devised to gather the presently known inborn errors of purine metabolism that manifest neurological pediatric syndromes. The aim is to draw a comprehensive picture of these rare diseases, characterized by unexpected and often devastating neurological symptoms. Although investigated for many years, most purine metabolism disorders associated to psychomotor dysfunctions still hide the molecular link between the metabolic

Marcella Camici; Vanna Micheli; Piero Luigi Ipata; Maria Grazia Tozzi



A Cross-Sectional Study of Individuals Seeking Information on Transient Ischemic Attack and Stroke Symptoms Online: A Target for Intervention?  

PubMed Central

Background Individuals with TIA/stroke symptoms often do not seek urgent medical attention. We assessed the feasibility of identifying individuals searching for information on TIA/stroke symptoms online as a target for future interventions to encourage urgent evaluation and we evaluated the performance of a self-reported risk score to identify subjects with true TIA or stroke. Methodology/Principal Findings We placed online advertisements to target English-speaking adults in the United States searching for TIA/stroke-related keywords. After completing an online questionnaire, participants were telephoned by a vascular neurologist to assess the likelihood of TIA/stroke. We used logistic regression and the c-statistic to assess associations and model discrimination respectively. Over 122 days, 251 (1%) of 25,292 website visitors completed the online questionnaire and 175 were reached by telephone (mean age 58.5 years; 63% women) for follow-up. Of these participants, 37 (21%) had symptoms within 24 hours, 60 (34%) had not had a medical evaluation yet, and 68 (39%) had TIA/stroke. Applying a modified ABCD2 score yielded a c-statistic of 0.66, but 2 of 12 with a zero score had a TIA/stroke. Those with new symptoms were more likely to have TIA/stroke (OR 4.90, 95% CI 2.56?9.09). Conclusions/Significance Individuals with TIA/stroke that are seeking real-time information on symptoms online can be readily identified, in some cases before they have sought formal medical evaluation. Although a simple self-reported risk score was unable to identify a low-risk population in this selected group, this population may still present an attractive target for future interventions designed to encourage urgent medical evaluation.

Kim, Anthony S.; Poisson, Sharon N.; Easton, J. Donald; Johnston, S. Claiborne



Mania in neurologic disorders.  


Neurologic disorders can produce "secondary" mania. Clinicians must distinguish secondary mania from primary, idiopathic manic-depressive illness (MBI). In addition to medical and drug-induced causes of secondary mania, neurologic causes usually develop in older patients who may lack a strong family history of MDI. Neurologic causes of mania include focal strokes in the right basotemporal or inferofrontal region, strokes or tumors in the perihypothalamic region, Huntington's disease and other movement disorders, multiple sclerosis and other white matter diseases, head trauma, infections such as neurosyphilis and Creutzfeldt-Jakob disease, and frontotemporal dementia. Patients with new-onset mania require an evaluation that includes a thorough history, a neurologic examination, neuroimaging, and other selected tests. The management of patients with neurologic mania involving correcting the underlying disorder when possible and the judicious use of drugs such as the anticonvulsant medications. PMID:11122994

Mendez, M F



Neurology and orthopaedics  

PubMed Central

Neurology encompasses all aspects of medicine and surgery, but is closer to orthopaedic surgery than many other specialities. Both neurological deficits and bone disorders lead to locomotor system abnormalities, joint complications and limb problems. The main neurological conditions that require the attention of an orthopaedic surgeon are disorders that affect the lower motor neurones. The most common disorders in this group include neuromuscular disorders and traumatic peripheral nerve lesions. Upper motor neurone disorders such as cerebral palsy and stroke are also frequently seen and discussed, as are chronic conditions such as poliomyelitis. The management of these neurological problems is often coordinated in the neurology clinic, and this group, probably more than any other, requires a multidisciplinary team approach.

Houlden, Henry; Charlton, Paul; Singh, Dishan



Neurological disease, emotional disorder, and disability: they are related: a study of 300 consecutive new referrals to a neurology outpatient department  

Microsoft Academic Search

OBJECTIVESTo determine the prevalence of anxiety and depressive disorders in patients referred to general neurology outpatient clinics, to compare disability and number of somatic symptoms in patients with and without emotional disorder, the relation to neurological disease, and assess the need for psychiatric treatment as perceived by patients and doctors.METHODSA prospective cohort study set in a regional neurology service in

Alan J Carson; Brigitte Ringbauer; Lesley MacKenzie; Charles Warlow; Michael Sharpe



Neurological long term consequences of deep diving.  

PubMed Central

Forty commercial saturation divers, mean age 34.9 (range 24-49) years, were examined one to seven years after their last deep dive (190-500 metres of seawater). Four had by then lost their divers' licence because of neurological problems. Twenty seven (68%) had been selected by neurological examination and electroencephalography before the deep dives. The control group consisted of 100 men, mean age 34.0 (range 22-48) years. The divers reported significantly more symptoms from the nervous system. Concentration difficulties and paraesthesia in feet and hands were common. They had more abnormal neurological findings by neurological examination compatible with dysfunction in the lumbar spinal cord or roots. They also had a larger proportion of abnormal electroencephalograms than the controls. The neurological symptoms and findings were highly significantly correlated with exposure to deep diving (depth included), but even more significantly correlated to air and saturation diving and prevalence of decompression sickness. Visual evoked potentials, brainstem auditory evoked potentials, and magnetic resonance imaging of the brain did not show more abnormal findings in the divers. Four (10%) divers had had episodes of cerebral dysfunction during or after the dives; two had had seizures, one had had transitory cerebral ischaemia and one had had transitory global amnesia. It is concluded that deep diving may have a long term effect on the nervous system of the divers.

Todnem, K; Nyland, H; Skeidsvoll, H; Svihus, R; Rinck, P; Kambestad, B K; Riise, T; Aarli, J A



Adverse neurologic effects of metoclopramide.  

PubMed Central

Metoclopramide hydrochloride is now commonly prescribed for a variety of gastrointestinal disorders. Over a 2-year period 18 patients with neurologic disorders induced by metoclopramide were assessed at the Parkinson's disease clinic of the Ottawa Civic Hospital. During metoclopramide therapy acute transient dystonic reactions were seen in 4 patients, and parkinsonism, which was frequently misdiagnosed and treated as classic Parkinson's disease, was seen in 12 patients. After treatment with metoclopramide was stopped, tardive dyskinesia appeared in seven patients and has persisted for up to 15 months in three patients. Parkinsonism and tardive dyskinesia occurred in older patients undergoing long-term therapy with metoclopramide. This experience, therefore, suggests that such treatment, especially in older patients, should be avoided.

Grimes, J. D.; Hassan, M. N.; Preston, D. N.



Neurology and international organizations.  


A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas. PMID:23877795

Mateen, Farrah J



Amalgam exposure and neurological function.  


Concerns regarding the safety of silver-mercury amalgam fillings continue to be raised in the absence of any direct evidence of harm. The widespread population exposure to amalgam mandated that a thorough investigation be conducted of its potential effects on the nervous system. The National Institute of Dental and Craniofacial Research and U.S. Air Force investigators collaborated in the ongoing Air Force Health Study (AFHS) of Vietnam era veterans. The primary study question involved adverse health effects associated with exposure to herbicides or dioxin. An assessment of exposure to dental amalgam fillings was added to the 1997-1998 health examination to investigate possible associations between amalgam exposure and neurological abnormalities. Our study population consisted of 1663 dentate AFHS participants, comprised of 986 AFHS controls and 677 Ranch Hand veterans who were exposed to dioxin in Vietnam. Two hundred and fifty-two of the participants had confirmed diabetes mellitus. Study outcomes included clinical neurological signs, vibrotactile thresholds, and summary variables for different levels of peripheral neuropathy. A limitation of our study is that our database did not include more sensitive continuous measures such as nerve conduction studies. No significant associations were found between amalgam exposure and clinical neurological signs of abnormal tremor, coordination, station or gait, strength, sensation, or muscle stretch reflexes or for any level of peripheral neuropathy among our study participants. A statistically significant association was detected between amalgam exposure and the continuous vibrotactile sensation response for the combined non-diabetic participants and separately for non-diabetic AFHS controls. No significant association in this measure was detectable for non-diabetic Ranch Hand veterans or among the combined diabetic participants. The association is a sub-clinical finding that was not associated with symptoms, clinically evident signs of neuropathy, or any functional impairment. Overall, we found no association between amalgam exposure and neurological signs or clinically evident peripheral neuropathy. Our findings do not support the hypothesis that exposure to amalgam produces adverse, clinically evident neurological effects. PMID:15713345

Kingman, Albert; Albers, James W; Arezzo, Joseph C; Garabrant, David H; Michalek, Joel E



Neurological Sequelae of Lupus  


... Page Synonym(s): Lupus - Neurological Sequelae, Systemic Lupus Erythematosus Table of Contents (click to jump to sections) What ... health problems and have a normal lifespan with periodic doctor visits and treatments with various drugs. What ...


Haematology and neurology  

Microsoft Academic Search

This review aims to update the reader on advances in the understanding of haematological conditions that may arise in neurological practice. Thrombophilia, antiphospholipid antibody syndrome, thrombotic thrombocytopenic purpura, sickle cell and clonal disorders associated with neuropathy are discussed.

Steven Austin; Hannah Cohen; Nick Losseff



Managing Paraneoplastic Neurological Disorders  

Microsoft Academic Search

Paraneoplastic neurological syndromes (PNS) are remote effects of cancer that are not caused by invasion of the tumor or its metastases. Immunologic factors appear important in the pathogenesis of PNS because antineuronal autoantibodies and T-cell responses

Janet W. de Beukelaar; Peter A. Sillevis Smitt


Neurological Effects of INH.  

National Technical Information Service (NTIS)

Isoniazid (INH) was given for one year to a group of 28 volunteer civilian aviators. Neurological examinations, mental status examinations, EEG's and visual evoked potentials were monitored at control, six months and twelve months. Minor changes were obse...

D. Bochneak J. E. Jordan S. Sheilds



Neurologic Complications of Sarcoma  

Microsoft Academic Search

Sarcomas are a heterogeneous group of tumors that rarely involve the nervous system. Neurologic effects of sarcoma are more\\u000a often due to tumors outside of the central nervous system. However, as long-term survival rates in childhood sarcoma improves,\\u000a reports of late neurologic complications have increased. With recent advances in treating local sarcomas with targeted molecular\\u000a therapies, the incidence of late

Santosh Kesari; Lara J. Kunschner


Acanthocytosis and neurological disorders  

Microsoft Academic Search

Acanthocytosis occurs because of ultrastructural abnormalities of the erythrocyte membranous skeleton resulting in reduced\\u000a membrane fluidity. At least three hereditary neurological conditions are associated with it, although as yet the pathogenesis\\u000a of the neurological features is unknown. In abetalipoproteinaemia, an autosomal recessive condition, vitamin E deficiency\\u000a results in a progressive spinocerebellar syndrome associated with peripheral neuropathy and retinitis pigmentosa. Neuroacanthocytosis

Valerie L. Stevenson; Richard J. Hardie



Neurological manifestations of osteoid osteoma.  

PubMed Central

The clinical and radiological features of 38 children with osteoid osteomas were analysed retrospectively. Twenty nine patients had lesions of the femur (n = 17) or tibia (n = 12). The mean duration from the onset of symptoms to diagnosis was 13.8 months. In seven patients the history of pain and abnormalities on examination suggested a possible neurological disorder. Fourteen of 29 patients (48%) with femoral or tibial osteomas had localised muscle atrophy, and 10 patients (34%) had diminished or absent deep tendon reflexes in the affected limb. Two patients had painless lesions. Six patients had normal plain radiographs. Delay in the diagnosis of osteoid osteoma may be prevented by the knowledge that pain may be referred or radicular, that the concomitant occurrence of muscle atrophy and depressed deep tendon reflexes are relatively common findings, and that the characteristic radiological features may only appear late in the course of the disease. Images Figure 1 Figure 2

Kiers, L; Shield, L K; Cole, W G



Spontaneous neurological improvement in anti-Hu associated encephalomyelitis.  

PubMed Central

Symptoms of anti-Hu associated paraneoplastic encephalomyelitis (PEM) and sensory neuropathy (PSN) are usually severe and irreversible. Two patients are reported whose symptoms improved spontaneously, and in one of them they resolved after resection of an inflammatory lesion of the lung. Spontaneous neurological improvement, although rare, should be considered in the evaluation of therapies for PEM/PSN.

Byrne, T; Mason, W P; Posner, J B; Dalmau, J



Late Consequences of the Neurological Forms of Decompression Sickness  

Microsoft Academic Search

Various neurological forms of decompression sickness are classified and an inquiry two and a half to five and a half years after the acute illness is reported.One hundred subjects with decompression sickness of the central nervous system were examined.In more than half of the cases the clinical picture was that of chronic encephalomyelopathy, vegetative neurosis, or psychosomatic symptoms. Symptoms were

I. Rózsahegyi



Neurological complications of beta-thalassaemia major.  

PubMed Central

Neurological complications in beta-thalassaemia major are uncommon, with cerebral ischaemic episodes related to severe anaemia or convulsions as the most usual manifestations. Two such cases of children of 6 and 8 years are reported. Cerebral venous infarction is advanced as the probable cause of the symptoms. Caution should be exercised in giving rapid, large blood transfusions to thalassaemic patients adapted to long-standing severe anaemia.

Sinniah, D; Vignaendra, V; Ahmad, K



A Proposed Roadmap for Inpatient Neurology Quality Indicators  

PubMed Central

Background/Purpose: In recent years, there has been increasing pressure to measure and report quality in health care. However, there has been little focus on quality measurement in the field of neurology for conditions other than stroke and transient ischemic attack. As the number of evidence-based treatments for neurological conditions grows, so will the demand to measure the quality of care delivered. The purpose of this study was to review essential components of hospital performance measures for neurological disease and propose potential quality indicators for commonly encountered inpatient neurological diagnoses. Methods: We determined the most common inpatient neurological diagnoses at a major tertiary care medical center by reviewing the billing database. We then searched PubMed and the National Guidelines Clearinghouse to identify treatment guidelines for these conditions. Guideline recommendations with class I/level A evidence were evaluated as possible quality indicators. Results: We found 94 guidelines for 14 inpatient neurological conditions other than stroke and transient ischemic attack. Of these, 36 guidelines contained at least 1 recommendation with class I evidence. Based on these, potential quality indicators for intracerebral hemorrhage, subarachnoid hemorrhage, pneumococcal meningitis, coma following cardiac arrest, encephalitis, Guillain-Barre syndrome, multiple sclerosis, and benign paroxysmal positional vertigo are proposed. Conclusions: There are several inpatient neurological conditions with treatments or diagnostic test routines supported by high levels of evidence that could be used in the future as quality indicators.

Douglas, Vanja C.; Josephson, S. Andrew



Are aluminium potroom workers at increased risk of neurological disorders?  

PubMed Central

OBJECTIVE: To determine whether long term potroom workers in an aluminium smelter are at increased risk of neurological disorders. METHODS: Cross sectional study of 63 current and former aluminium potroom workers first employed before 1970 and with at least 10 years of service. A group of 37 cast house and carbon plant workers with similar durations of employment and starting dates in the same smelter were used as controls. The prevalence of neurological symptoms was ascertained by questionnaire. Objective tests of tremor in both upper and lower limbs, postural stability, reaction time, and vocabulary were conducted. All subjects were examined by a neurologist. RESULTS: No significant differences in age, race, or education were found between the two groups. Although the potroom group had higher prevalences for all but one of the neurological symptoms, only three odds ratios (ORs) were significantly increased; for incoordination (OR 10.6), difficulty buttoning (OR 6.2), and depression (OR 6.2). Tests of arm or hand and leg tremor in both the visible and non-visible frequencies did not show any significant differences between the two groups. Testing of postural stability showed no definitive pattern of neurologically meaningful differences between the groups. There were no significant differences between the two groups in reaction time, vocabulary score, or clinical neurological assessment. CONCLUSIONS: The objective measures of neurological function provided little support for the finding of increased neurological symptom prevalences in the potroom workers, although increased symptoms may be an indicator of early, subtle neurological changes. The results provide no firm basis for concluding that neurological effects among long term potroom workers are related to the working environment, in particular aluminium exposure, in potrooms. These findings should be treated with caution due to the low participation of former workers and the possibility of information bias in the potroom group.

Sim, M; Dick, R; Russo, J; Bernard, B; Grubb, P; Krieg, E; Mueller, C; McCammon, C



Nanoimaging and neurological surgery.  


Over 32 million surgical procedures are performed in the United States each year. Increasingly, image guidance is used in order to aid in the surgical localization of pathology, minimization of incisions, and improvement of surgical intervention outcomes. A variety of imaging modalities using different portions of the electromagnetic spectrum are used in neurological surgery. These include wavelengths used in ultrasonography, optical, infrared, ionizing radiation, and magnetic resonance. The use of currently available image-guidance tools for neurological surgery is reviewed. Advances in nanoparticulates and their integration into the neurosurgical operating room environment are discussed. PMID:20669333

Grosu, Ion Dan; Toms, Madalina Alexandra; Toms, Steven A


Neurological complications in AIDS.  


Neurological complications in the acquired immunodeficiency syndrome (AIDS) are an important aspect of this new infectious disease and occur frequently. The existence of neurotropic variants of the human immunodeficiency virus (HIV), the causative agent of AIDS, is probable. Direct infection of the nervous system with HIV leads to a variety of HIV-induced neurological syndromes, the AIDS dementia complex being its most important representative. In addition, a large number of opportunistic infections and malignancies of the nervous system may complicate the disease. Major aspects of the clinical pictures, rational diagnostic approaches and treatment options of the most important sequels of HIV infection of the nervous system are discussed. PMID:3302120

Fischer, P A; Enzensberger, W



Transient and permanent neonatal diabetes  

Microsoft Academic Search

Neonatal diabetes, which may be transient or permanent, is rare. Most patients are full-term but small- for-date infants. Typical symptoms of diabetes mellitus occur within the first 4 weeks of life, requiring insulin therapy and very strict blood glucose monitoring. Subsequent growth and psychomotor development are usually normal. In about 33% of these patients the diabetes remains permanent; the transient

Stephan Fösel



Neurology Practice Study Report.  

National Technical Information Service (NTIS)

This is a report of a study on the practice of Neurology in the United States. The study, is intended to provide practice-relevant information to guide decision making in both educational program development and manpower planning. This report describes th...

R. C. Mendenhall



Neurology of ciguatera  

Microsoft Academic Search

Ciguatera is a widespread ichthyosarcotoxaemia with dramatic and clinically important neurological features. This severe form of fish poisoning may present with either acute or chronic intoxication syndromes and constitutes a global health problem. Ciguatera poisoning is little known in temperate countries as a potentially global problem associated with human ingestion of large carnivorous fish that harbour the bioaccumulated ciguatoxins of

J Pearn



[Transient cortical blindness--a complication after coronary angiography--case report].  


Transient cortical blindness is a very rare complication of cardiovascular and cerebral angiography procedures. We present a case of 63-years-old woman, who developed cortical blindness after coronary angiography. Computed tomography (CT) done immediately after blindness appearance showed bilateral hyperintensive areas (probably due to a leakage of contrast medium) in the occipital and parietal cerebral lobes. All visual symptoms disappeared during 48 hours and CT scan repeated after sight recovery did not show any focal lesions in the brain. A breakdown of the blood-brain barrier with direct contrast neurotoxicity seems to be the causal factor of neurological changes observed in our patient after coronary angiography. PMID:18634388

Borowik, Helena; Ku?akowska, Alina; Drozdowski, Wies?aw; Dubicki, Artur; Kra?nicki, Pawe?



Diffusion- and perfusion-weighted MRI in a patient with a prolonged reversible ischaemic neurological deficit.  


We report acute and follow-up diffusion- and perfusion-weighted MRI (DWI, PWI) findings in a patient with a prolonged reversible ischaemic neurological deficit. PWI 12 h after the patient was last seen to be without symptoms revealed a large perfusion deficit in the left posterior MCA territory with a relatively inconspicuous and much smaller abnormality on DWI. Follow-up showed resolution of abnormalities on both DWI and PWI, and conventional MRI was normal, apart from a very slight abnormality, visible only on FLAIR images, at the centre of the initially DWI-positive region. These findings demonstrate the utility of PWI when be used in combination with DWI to investigate the pathophysiology of transient ischemic syndromes. PMID:10929306

Neumann-Haefelin, T; Wittsack, H J; Wenserski, F; Li, T Q; Moseley, M E; Siebler, M; Freund, H J



Neurological and psychological findings in patients with Cohen syndrome: a study of 18 patients aged 11 months to 57 years.  


Our purpose was to perform the first systematic neurological, neurophysiological and psychological study of 18 patients with Cohen syndrome (MIM no 216550), aged 11 months to 57 years (median 27 years). All the patients had the essential features of this syndrome, i.e., typical facial and structural findings, mental retardation, microcephaly, ophthalmologic symptoms, granulocytopenia and a cheerful psychic disposition. Children with the syndrome were considered normal at birth, but upwards of 6 to 12 months, psychomotor retardation became obvious. The first symptoms were microcephaly, which manifested itself by the age of 6 months to 1 year, as well as hypotonia and delayed developmental milestones. Cohen children learned to walk at 2 to 5 years of age. Language development varied markedly. Neurological symptoms did not progress. All patients had normal EMGs. The three youngest (aged 11 months, 3 and 5 years) had normal EEGs, whereas the remainder had low-voltage EEGs. No irritative spikes or epileptoformic foci were found. Nine patients had quick beta transients. Of the 18 patients examined, 4 were profoundly, 11 severely, 1 moderately and 2 mildly retarded. On the AADM scale, Cohen patients had high scores in the positive domains, viz., self-direction, responsibility and socialisation. Maladaptive behaviour, on the other hand, was almost completely absent, except for stereotyped behaviours and odd mannerisms. Withdrawal, sexually aberrant behaviour, untrustworthy and rebellious behaviour as well as antisocial behaviour were rare. These findings are consistent with the cheerful and sociable disposition characteristic of those with Cohen syndrome. PMID:10569209

Kivitie-Kallio, S; Larsen, A; Kajasto, K; Norio, R



[Biopterin and child neurologic disease].  


Tetrahydrobiopterin (BH4) deficiencies are disorders affecting phenylalanine metabolism in the liver and neurotransmitter biosynthesis in the brain. BH4 is the essential cofactor in the enzymatic hydroxylation of 3 aromatic amino acids (phenylalanine, tyrosine, and tryptophan). BH4 is synthesized from guanosine triphosphate (GTP), catalyzed by GTP cyclohydrolase I (GTPCH), 6-pyruvoyl-tetrahydropterin synthase, and sepiapterin reductase (SR), and in aromatic amino acids, the hydoxylating system is regenerated by pterin-4a-carbinolamine dehydrolase and dihydropteridine reductase (DHPR). BH4 deficiency has been diagnosed in patients with hyperphenylalaninemia (HPA) by neonatal mass-screening based on BH4 oral-loading tests, analysis of urinary or serum pteridines, and measurement of DHPR activity in blood using a Guthrie card. BH4 deficiency without treatment causes combined symptoms of HPA and neurotransmitter (dopamine, norepinephrine, epinephrine, and serotonin) deficiency, such as red hair, psychomotor retardation, and progressive neurological deterioration. However, autosomal dominant GTPCH deficiency and autosomal recessive SR deficiency leads to BH4 and neurotransmitter deficiency without HPA and may not be detected by neonatal screening for phenylketonuria. The former is Segawa's disease, which is characterized by dopa-responsive dystonia with marked diurnal fluctuation and is caused by a defect of GTPCH, and the latter is SR deficiency, which is characterized by progressive psychomotor retardation, dystonia, and severe dopamine and serotonin deficiencies. Biochemical diagnosis is performed by the measurement of neopterin and biopterin levels, since both are low in Segawa disease, and the biopterin level is high in SR deficiency in cerebrospinal fluid. We must consider metabolic disorders of biopterin in child neurologic diseases with dystonia. PMID:19172809

Shintaku, Haruo



Neurologic Complications of Leukemia  

Microsoft Academic Search

Leukemia affects both the central and peripheral nervous systems. Neurological complications are a consequence of both direct\\u000a leukemic infiltration, as occurs with leukemic meningitis, and complications of either antileukemic treatment (e.g., thrombocytopenic\\u000a or DIC-related intracranial hemorrhage, steroid myopathy, vinca alkaloid peripheral neuropathy, posterior reversible encephalopathy\\u000a syndrome, multifocal necrotizing leuko-encephalopathy) or immune compromise (e.g., Herpes zoster shingles or Aspergillus infection).

Marc C. Chamberlain


Pediatric Neurological Emergencies  

Microsoft Academic Search

Acute encephalopathy in childhood may vary in its presentation, aetiology and imaging compared with the adult population.\\u000a Emergent neuroimaging, while often performed in order to exclude infection or neoplasia as a cause of acute neurological deterioration,\\u000a may reveal imaging findings peculiar to a number of specific conditions. The radiologist may be the first to recognise and\\u000a suggest conditions such as

J. W. J. McCann; E. Phelan


The Neurological Exam  

NSDL National Science Digital Library

This website features a complete neurological exam with the following elements: 1) cranial nerves, 2) motor exam, 3) sensory exam, 4) stance & gait. Video demonstrations are used for each part of the exam. Text describes the examination technique, expected normal findings and common abnormal findings. A helpful glossary of terms is available in a separate frame at the bottom of the page for reference. A high bandwidth is recommended and a QuickTime player is necessary.Annotated: false

Hohol, Marika



[Clinical reasoning in neurology].  


There is much neurological literature on clinical, pathological, technical aspects of diagnostic or therapeutic aspects, however there are few articles about clinical-neurological reasoning. This paper analyzes the psychological processes by which neurologists solve complicated diagnostic problems. Clinicians can use a variety of reasoning, such as model (pattern), exhaustive, probabilistic, deterministic (categorical), and hypothetical-deductive reasoning mechanisms. The neurologist must be aware of what kind of reasoning is being used at a given time as well as the errors that can occur. Most of these errors are found in the probabilistic setting and can be grouped into three categories: representativeness errors, availability or adjustment and anchoring biases. Most of them occur due to an inadequate intuitive judgement by the physician to handle the probabilities. There are other sources of error, related with the diagnostic process or with the environmental circumstances in which they develop. The most important ones as well as their theoretical and practical implications are described. In the evidence based medicine era, it is important for the clinical neurologists to be aware of this terminology and concepts for an adequate practice of neurology. PMID:15372335

Diaz Guzmán, J



After the fall: symptoms in bungee jumpers.  


A survey of 100 professionally supervised bungee jumpers who used an ankle harness in a single leap from a platform reveals that 42 jumpers had a total of 59 minor medical complaints or symptoms after their jumps. Immediate symptoms included musculoskeletal pain in the ankle, neck, back, and chest, neurologic complaints such as dizziness and headache, and blurred vision. Dizziness was the most common symptom, and neurologic complaints outnumbered musculoskeletal symptoms. All complaints resolved within 1 week of the jump except for lacerations sustained by one person who tried to grab the platform as he was jumping. PMID:20086815

Young, C C; Raasch, W G; Boynton, M D



Can educational psychology be neurologized?  

Microsoft Academic Search

Proposes that a synthesis of clinical neurology and educational knowledge is useful in solving practical educational problems. Surveys of teachers, of references made in educational journals, and of statements in educational texts reveal not only ignorance of neurology but recommendations against its being studied by teachers. It is asserted that some basic neurological knowledge may be useful for regular classroom

W. H. Gaddes



Nature, incidence and prognosis of neurological involvement in the acquired immunodeficiency syndrome in central London.  

PubMed Central

Clinical neurological involvement at various times throughout the illness was recorded in 52% of 122 patients seen in central London who died from acquired immunodeficiency syndrome (AIDS). Various metabolic encephalopathies, dementias, focal encephalopathies, retinopathies and peripheral nerve pathology were the most frequent manifestations. Seven of 9 patients with a neurological presentation had no other major systemic illness. The median time from diagnosis of AIDS to death was 9 months and from onset of neurological symptoms to death 4 months. Human immunodeficiency virus dementia, central nervous system opportunistic infections, presence of Kaposi sarcoma, neurological presentations and minor symptoms were not associated with major change in survival time.

Guiloff, R. J.; Fuller, G. N.; Roberts, A.; Hargreaves, M.; Gazzard, B.; Scaravilli, F.; Harcourt-Webster, J. N.



Paediatric Neurology in Africa: A Ugandan Report  

PubMed Central

The findings in 138 children attending a neurology clinic in Uganda are presented. In contrast with findings in developed countries, only 25 had an abnormal birth and history dating from birth compared with 63 who had a normal birth and early development with symptoms of postnatal onset. The commonest mode of onset in the postnatal period was a catastrophic, feverish illness. Effective and usually easily achieved drug control of epilepsy and hyperkinesis enabled most parents to cope with disabled children. Simple explanation to parents and teachers can reduce the rejection and educational retardation associated with epilepsy. Primary prevention lies in earlier diagnosis and treatment of cerebral malaria, meningitis, and encephalitis and improved obstetric services. Secondary prevention requires closer follow-up of potentially brain-damaged children and the education of doctors in neurological and behavioural assessment and the more efficient treatment of epilepsy and hyperkinesis.

Egdell, H. G.; Stanfield, J. P.



Neurological Complications of Biologic Therapy in Psoriasis  

PubMed Central

Biologic agents have been a significant advancement in the management of psoriasis. Along with significant clinical improvement, there have been concerns for emerging side effects with the use of biologics. Reports have emerged showing the association between efalizumab and the development of progressive multifocal leukoencephalopathy and other demyelinating disorders. Tumor necrosis factor-alpha inhibitors have been associated with various demyelinating disorders. As such, it is imperative for dermatologists to be well informed regarding how to notify patients about the risks of biologic treatment. Dermatologists must be able to identify the signs and symptoms of neurological complications and recognize when to refer patients to neurologists for diagnostic workup, disease confirmation, and any necessary treatment. This review is a compilation of evidence showing the association between biologic therapy and neurological complications, as well as an overview of the clinical presentation and diagnosis of such diseases.

Sanders, Catherine; Bechtel, Ann



Delayed neurologic sequelae in carbon monoxide intoxication.  


Of 2,360 victims of acute carbon monoxide intoxication examined between 1976 and 1981, delayed neurologic sequelae were diagnosed in 65 (2.75% of the total group, 11.8% of those admitted). There were 25 men and 40 women. Ages ranged from 34 to 80 years (mean, 56.1 years), with the peak incidence in the sixth and seventh decades. The lucid interval before appearance of neurologic sequelae varied from two to 40 days (mean, 22.4 days). The most frequent symptoms were mental deterioration, urinary or fecal incontinence, gait disturbance, and mutism; the most frequent signs were masked face, glabella sign, grasp reflex, increased muscle tone, short-step gait, and retropulsion. There were no important contributory factors except age and the severity of anoxia. Previous associated disease did not hasten the development of sequelae. Of 36 patients followed up for two years, 27 (75%) recovered within one year. PMID:6860181

Choi, I S



Neurological complications of anderson-fabry disease.  


Characteristic clinical manifestations of AFD such as acroparesthesias, angiokeratoma, corneal opacity, hypo/ and anhidrosis, gastrointestinal symptoms, renal and cardiac dysfunctions can occur in male and female patients, although heterozygous females with AFD usually seem to be less severely affected. The most prominent CNS manifestations consist of cerebrovascular events such as transient ischaemic attacks (TIAs) and (recurrent) strokes. For the most part, CNS complications in AFD have been attributed to cerebral vasculopathy, including anatomical abnormalities. The natural history of Fabry patients includes transitory cerebral ischaemia and strokes, even in very young persons of both genders. The mechanism is partly due to vascular endothelial accumulation of Gb-3. White matter lesions (WML) on occur MRI. Both males and females can be safely treated with enzyme replacement; and thus screening for Fabry disease of young stroke populations should be considered. There are, however, no hard data of treatment effect on mortality and morbidity. Stroke in Anderson-Fabry disease study of 721 patients with cryptogenic stroke, aged 18-55 years, showed a high prevalence of Fabry disease in this group: 5% (21/432) of men and 3% (7/289) of women. Combining results of both sexes showed that 4% of young patients with stroke of previously unknown cause had Fabry disease, corresponding to about 1-2% of the general population of young stroke patients. Cerebral micro- and macro-vasculopathy have been described in Fabry disease. Neuronal globotriaosylceramide accumulation in selective cortical and brain stem areas including the hippocampus has been reported by autopsy studies in FD, but clinical surrogates as well as the clinical relevance of these findings have not been investigated so far. Another Neurologic hallmark of Fabry disease (FD) includes small fiber neuropathy as well as cerebral micro- and macroangiopathy with premature stroke. Cranial MRI shows progressive white matter lesions (WML) at an early age, increased signal intensity in the pulvinar, and tortuosity and dilatation of the larger vessels. Conventional MRI shows a progressive load of white matter lesions (WMLs) due to cerebral vasculopathy in the course of FD. Another study has been conducted to quantify brain structural changes in clinically affected male and female patients with FD. The peripheral neuropathy in Fabry disease manifests as neuropathic pain, reduced cold and warm sensation and possibly gastrointestinal disturbances. Patients with Fabry disease begin having pain towards the end of the first decade of life or during puberty. Children as young as 6 years of age have complained of pain often associated with febrile illnesses with reduced heat and exercise tolerance. The patients describe the pain as burning that is often associated with deep ache or paresthesiae. Some patients also have joint pain. A high proportion of patients with Fabry disease is at increased risk of developing neuropsychiatric symptoms, such as depression and neuropsychological deficits. Due to both somatic and psychological impairment, health-related quality of life (QoL) is considerably reduced in patients with Fabry disease. Targeted screening for Fabry disease among young individuals with stroke seems to disclose unrecognized cases and may therefore very well be recommended as routine in the future. Furthermore, ischemic stroke is related to inflammation and arterial stiffness and no study had addressed this relationship in patients with AF disease and cerebrovascular disease, so this topic could represent a possible future research line. PMID:23448452

Tuttolomondo, Antonino; Pecoraro, Rosaria; Simonetta, Irene; Miceli, Salvatore; Arnao, Valentina; Licata, Giuseppe; Pinto, Antonio




PubMed Central

Neurology, neurosurgery and psychiatry over the past few decades have become more and more segregated in spite of their common foundation in the basic sciences of neuroanatomy, physiology, neurophysiology and neurochemistry. The reasons leading to this unhealthy dichotomy or trichotomy of these specialties dealing with disorders of the nervous system (including behavior) are discussed. Recent advances in the neurobiological sciences are reviewed from the point of view of encouraging and justifying a more healthy integration and working together of these three closely related specialties.

Finley, Knox H.



Neurology and the kidney  

PubMed Central

Renal failure is relatively common, but except in association with spina bifida or paraplegia it is unlikely to occur as a result of disease of the CNS. Renal failure, however, commonly affects the nervous system. The effects of kidney failure on the nervous system are more pronounced when failure is acute. In addition to the important problems related to renal failure there are both acquired and genetically determined diseases which may affect the kidney and the brain. Those acquired diseases include the vasculitides, the paraproteinaemias, and various granulomatous conditions (considered in other chapters of Neurology and Medicine). In two of the most commonly encountered genetically determined diseases, Von Hippel-Lindau disease and polycystic kidney disease, location of pathogenic mutations will provide improved screening programmes and, possibly, allow therapeutic intervention. Uraemia may affect both the central and peripheral nervous systems. Whereas the clinical features of uraemia are well documented, the pathophysiology is less well understood and probably multifactorial. Uraemic encephalopathy, which classically fluctuates, is associated with problems in cognition and memory and may progress to delirium, convulsions, and coma. The encephalopathy may initially worsen with periods of dialysis and almost certainly relates to altered metabolic states in association with ionic changes and possibly impaired synaptic function. Renal failure may affect the peripheral nervous system, resulting in a neuropathy which shows a predilection for large diameter axons. This may be reversed by dialysis and transplantation. The myopathy seen in renal failure, often associated with bone pain and tenderness, is similar to that encountered in primary hyperparathyroidism and osteomalacia.? Dialysis itself is associated with neurological syndromes including the dysequilibrium syndrome, subdural haematoma, and Wernicke's encephalopathy. Dialysis dementia, which was prevalent during the 1970s, has reduced in frequency with the use of aluminium free dialysate. With the introduction of transplantation and the concomitant use of powerful immunosuppressive drugs, the pattern of neurological problems encountered in renal replacement therapy has shifted. Five per cent of patients develop nerve injuries during renal transplantation, and up to 40% of patients experience neurological side effects from cyclosporine. Furthermore, CNS infections, often fungal in type, have been reported in up to 45% of transplant patients coming to postmortem. The nature of the involvement of neurologists with their nephrology colleagues is therefore evolving.??

Burn, D; Bates, D



Insomnia in Neurological Diseases and Disorders  

Microsoft Academic Search

\\u000a Insomnia is the most common sleep complaint. Insomnia is not a disease but a symptom arising from multiple environmental,\\u000a medical, and mental disorders. Insomnia can be transient, short-term, or chronic in its presentation. Degenerative and vascular\\u000a diseases involving the central nervous system (CNS) may impair sleep either as a result of the brain lesion or because of\\u000a illness-related personal discomfort.

Federica Provini; Carolina Lombardi; Elio Lugaresi


Neurophysiological assessment of divers with medical histories of neurological decompression illness.  

PubMed Central

OBJECTIVE--To examine the possibility that subclinical damage may persist after clinical recovery from neurological decompression illness. METHODS--The neuraxes of 71 divers with medical histories of neurological decompression illness and 37 non-diver controls were examined by recording the somatosensory evoked potentials produced on stimulation of the posterior tibial and median nerves. RESULTS--Although the tests gave some objective support for the presence of "soft" residual neurological symptoms and signs, no evidence was given for the presence of subclinical damage. CONCLUSIONS--The contention that neurological damage persists after full clinical recovery from the neurological decompression illness was not supported.

Murrison, A W; Glasspool, E; Pethybridge, R J; Francis, T J; Sedgwick, E M



A possible paradigm of functional neurology.  


The basic approach of classic neurology cannot fully explain certain clinical neurological phenomena. The explanation in these cases requires an extension of the conceptual borders of neurology. We set out to present a possible paradigm of functional neurology. PMID:9934575

Moldovanu, I; Vovc, V


Neurologic findings of nutritional vitamin B12 deficiency in children.  


We report herein our interesting case series of 15 infants admitting with neurological symptoms who were found to have vitamin B12 deficiency. Infants who were admitted to our hospital between 2004 and 2007 with neurological symptoms and were found to have vitamin B12 deficiency were included in this study. Data regarding clinical and laboratory features were obtained. Of 15 infants, 9 were boys (60%) and 6 were girls (40%). The mean age was 11.7 months. Anorexia, pallor, hypotonia, and neurodevelopmental retardation were present in all infants. Seizures and tremor were observed in 46.6% (7/15) and 33% (5/15) of patients, respectively. Seizures were generalized tonic-clonic in 4 patients, generalized tonic in 1 patient and focal in 2 patients. Four patients had tremor on admission and 1 patient had occurrence after vitamin B12 treatment. Vitamin B12 deficiency may lead to serious neurological deficits in addition to megaloblastic anemia. Persistent neurological damage can be prevented with early diagnosis and treatment. We believe that a thorough clinical and neurological assessment might prevent failure to notice rare but possible vitamin B12 deficiency in infants with neurological deficits and neurodevelopmental retardation. PMID:20402062

Incecik, Faruk; Hergüner, M Ozlem; Altunba?ak, Sakir; Leblebisatan, Göksel


[An expert system neurology--possibilities and limitations].  


We present an expert system Neurology, which was developed completely on basis of the commercial available data base program Filemaker-7.0. At present it covers approximately 400 diagnoses of neurological and psychiatric diseases. After the input of cardinal symptoms, course and localisation of the disease the program calculates a first set of possible differential diagnoses and asks for additional symptoms or the performance of apparative diagnostics to investigate the final diagnose. At first, the performance of the expert system was tested with 15 predetermined neurological case reports. Users with different previous knowledge of Neurology performed the input. In this test the program was able to identify the correct diagnose in nearly all cases and the diagnostic proposals were superior to those of the users with minor neurological training. In a second test with real patient data, the rate of correct diagnoses was approximately 80%. In summary, the used computer algorithms proved as appropriate for the aim of giving Neurological diagnoses. Possible additional applications could be student training or the use as interdisciplinary reference work. PMID:16972212

Bickel, A; Grunewald, M



The spectrum of neurological recovery.  


The equivalence of brain death with death is largely, although not universally accepted. Patients may have suffered insults such as cardiac arrest, vascular catastrophe, poisoning, or head trauma. Early identification of patients at greatest risk of poor neurologic outcome and management in the appropriate critical care setting is the key to maximizing neurological recovery. Recent technological advances and neuroimaging have made it possible to predict neurological reversibility with great accuracy. Significant improvements in therapy such as hypothermia, will improve outcomes in neurological catastrophies, particularly in anoxic-ischemic encephalopathy. The clinical spectrum and diagnostic criteria of minimally conscious and vegetative states is reviewed. The current understanding of the differences in prognosis and prediction of meaningful cognitive and functional recovery in each neurological state is described. Establishing an understanding of the ethical principles that guide medical decisions in clinical practice related to different neurological states is evolving into a new field called neuroethics. PMID:23610514

Mir, Tanveer P



Hither neurology: research.  

PubMed Central

Neurological disability may be prevented, or it may be alleviated if prevention is impossible or ineffective. Research into prevention and alleviation can be "laboratory" or "clinical", the latter being no less scientific than the former. All proposed treatments must be properly evaluated to ensure that effective interventions are widely adopted and ineffective ones abandoned. Unless an intervention has a major effect on outcome (which most do not), the most efficient assessment is by random allocation of patients to the new intervention versus the old. Although there were, and still are, forces opposed to the proper evaluation of treatment, there are strong economic clinical arguments in its favour, which will lead to appropriate targeting of scarce health resources.

Warlow, C P



Neurology in ancient faces  

PubMed Central

BACKGROUND—Clinical paleoneurology is almost non-existent, but recognition of neurological diseases in ancient people might be possible by scrutinising portraits apparently representing people as they appeared in life.?METHODS—About 200 mummy portraits painted in colour at the beginning of the first millennium were examined. Thirty two skulls excavated at Hawara in the Fayum (northern Egypt), where most of the portraits were found were measured, and nine caliper measures on each side of the skulls were taken. The right/left ratios were statistically analyzed by analysis of variance (ANOVA). One skull was subjected to 3D CT scanning and transilluminated.?RESULTS—Two patients were found with progressive facial hemiatrophy (Parry-Romberg syndrome), three with deviations of the visual axes (tropia) and one with oval pupils (corectopia).?CONCLUSIONS—Clinical paleoneurology is possible in the absence of a living nervous system. The patients probably had focal epilepsy, hemiplegic migraine, and autonomic nervous system dysfunction.??

Appenzeller, O; Stevens, J; Kruszynski, R; Walker, S



Neurology of volition.  


Neurological disorders of volition may be characterized by deficits in willing and/or agency. When we move our bodies through space, it is the sense that we intended to move (willing) and that our actions were a consequence of this intention (self-agency) that gives us the sense of voluntariness and a general feeling of being "in control." While it is possible to have movements that share executive machinery ordinarily used for voluntary movement but lack a sense of voluntariness, such as psychogenic movement disorders, it is also possible to claim volition for presumed involuntary movements (early chorea) or even when no movement is produced (anosognosia). The study of such patients should enlighten traditional models of how the percepts of volition are generated in the brain with regard to movement. We discuss volition and its components as multi-leveled processes with feedforward and feedback information flow, and dependence on prior expectations as well as external and internal cues. PMID:23329204

Kranick, Sarah M; Hallett, Mark




Microsoft Academic Search

In this report 50 subjects with multiple sclerosis are compared to 50 subjects with multiple personality disorder. The multiple sclerosis patients endorsed an average (1 3.0 somatic symptoms on structuredinterview, the multiple personality subjects an average of 14.5. The somatic symptoms characteristic of neurological illness were trouble walking, paralysis, and muscle weakness. Those characteristic of psychiatric illness were genitourinary and

Colin A. Ross; Geri Anderson; Anthony Auty; Judy Todd; Cohn A. Ross


Endovascular Treatment of Supra-Aortic Extracranial Stenoses in Patients with Vertebrobasilar Insufficiency Symptoms  

SciTech Connect

Purpose. Stenoses and thromboses of vessels feeding the vertebrobasilar territory can evoke serious disturbances including ischemic stroke. We present our experience of endovascular interventions for patients with signs of vertebrobasilar insufficiency (VBI) resulted from subclavian, vertebral and brachiocephalic arterial stenoses. Methods. Twenty-one patients (10 men) aged from 35 to 84 years (mean 64.3 years) with symptoms compatible with VBI underwent balloon angioplasty and stenting of subclavian (SA), innominate (IA) and vertebral (VA) arteries. Procedures were done by radiologists experienced in systematic stenting of the lesions. VBI was manifested by persistent signs in 15 patients, and by transitory ischemic attacks in the posterior circulatory territory in 4 (19%). Two patients (10%) experienced ischemic strokes (in the vertebrobasilar circulation in both cases). In 3 patients (14%) VBI was accompanied by upper limb vascular insufficiency symptoms. All cases were resistant to medical treatment. A neurologist assessed complaints, initial VBI signs and their alteration after intervention in all patients. Outcomes were measured with the 5-point scale suggested by Malek et al.: (1) excellent result (asymptomatic, no neurologic deficits and no symptoms of vertebrobasilar ischemia); (2) good (no neurologic deficits, at most one transient episode of vertebrobasilar ischemia over a period of 3 months after treatment); (3) fair (minimal neurologic deficit and at most one transient episode per month of vertebrobasilar ischemia); (4) poor (no improvement compared with neurologic status before treatment and/or persistent symptoms of vertebrobasilar ischemia); (5) death (regardless of cause). Endovascular treatment was performed for SA stenosis in 15 patients, for SA occlusion in 2, for IA stenosis in 2, and for VA stenosis in 2. There were 15 cases of atherosclerosis, 2 of aortoarteritis, 4 of proximal SA kinking. SA and IA stenoses ranged from 60% to 100% (mean 74.5%), VA stenoses were 90% in both cases. Results. Initial technical success was achieved in 96% of cases. There were no postprocedural complications or deaths. During 6-36 months (mean 21.3 months) of follow-up all patients showed improvement in VBI symptoms or upper limb ischemia. Within 36 months after the procedure outcomes were estimated as excellent and good in 13 patients (76%) and poor in 2 (12%), the last being attributed to atherosclerosis progression in other vascular areas. Restenosis in the stented area has developed in 1 patient (6%). Conclusions. Balloon angioplasty and stenting of extracranial vertebrobasilar arterial stenoses appeared to be effective in endovascular treatment of medically resistant VBI. Further investigations are required to clarify the role of subclavian artery kinking in VBI development and indications for various methods of its correction.

Zaytsev, A.Y., E-mail:; Stoyda, A.Y.; Smirnov, V.E. [I.M. Setchenov Moscow Medical Academy, Department of Angiography and Interventional Radiology (Russian Federation); Scherbyuk, A.N. [I.M. Setchenov Moscow Medical Academy, Department of Vascular Surgery (Russian Federation); Kondrashin, S.A [I.M. Setchenov Moscow Medical Academy, Department of Angiography and Interventional Radiology (Russian Federation); Artukchina, E.G. [I.M. Setchenov Moscow Medical Academy, Department of Vascular Surgery (Russian Federation); Kikevitch, V.A. [N.N. Burdenko Interventional Radiology Center, Department of Angiography and Interventional Radiology (Russian Federation)



Diagnosis of acute neurological emergencies in pregnant and post-partum women.  


Acute neurological symptoms in pregnant and post-partum women could be caused by exacerbation of a pre-existing neurological condition, the initial presentation of a non-pregnancy-related problem, or a new acute-onset neurological problem that is either unique to or occurs with increased frequency during or just after pregnancy. Pregnant and postpartum patients with headache and neurological symptoms are often diagnosed with pre-eclampsia; however, a range of other causes must also be considered, such as cerebral venous sinus thrombosis and reversible cerebral vasoconstriction syndrome. Precise diagnosis is essential to guide subsequent management. Our ability to differentiate between the specific causes of acute neurological symptoms in pregnant and post-partum patients is likely to improve as we learn more about the pathogenesis of these disorders. PMID:23332362

Edlow, Jonathan A; Caplan, Louis R; O'Brien, Karen; Tibbles, Carrie D



Manganese exposure: Neuropsychological and neurological symptoms and effects in welders  

Microsoft Academic Search

Manganese exposure reportedly may have an adverse effect on CNS function and mood. Sixty-two welders with clinical histories of exposure to manganese were compared to 46 matched regional controls chosen at random from a telephone directory. The following tests were given: Wechsler Adult Intelligence Scale (WAIS-III), Wechsler Memory Scale (WMS-III), Boston Naming, WRAT-3, Cancellation H, Trail Making Tests A and

Rosemarie M. Bowler; Sabine Gysens; Emily Diamond; Sanae Nakagawa; Marija Drezgic; Harry A. Roels



Rhabdomyolysis and concomitant neurological lesions after intravenous heroin abuse  

Microsoft Academic Search

Seven cases of rhabdomyolysis in heroin addicts are presented. All patients showed concomitant neurological symptoms suggesting mononeuropathy, incomplete plexus lesions or myelopathy. In most cases rhabdomyolysis occurred without preceding trauma to the muscles (for example tissue compression or coma). Five patients had a history of recently resumed heroin abuse after prolonged abstinence. An allergic or toxic reaction to heroin or

J de Gans; J Stam; G K van Wijngaarden



Chronic progressive neurological involvement in Borrelia burgdorferi infection  

Microsoft Academic Search

Five patients with chronic meningitis were hospitalized several times for progressive neurological symptoms. The clinical manifestations included cranial neuritis, radiculoneuritis, myelitis and encephalitis. In two cases cerebral infarction occurred. The course was commonly characterized by a tendency to deteriorate. From the clinical point of view, it was repeatedly difficult to exclude multiple sclerosis or tuberculous meningitis. Finally, specific antibodies against

B. Weder; P. Wiedersheim; L. Matter; A. Steck; F. Otto



Neurological soft signs in homicidal men with antisocial personality disorder  

Microsoft Academic Search

Neurological soft signs (NSS) are characterized by abnormalities in motor, sensory, and integrative functions. NSS have been regarded as a result of neurodevelopmental dysfunction, and as evidence of a central nervous system defect, resulting in considerable sociopsychological dysfunction. During the last decade there has been growing evidence of brain dysfunction in severe aggressive behavior. As a symptom, aggression overlaps a

Nina Lindberg; Pekka Tani; Jan-Henry Stenberg; Björn Appelberg; Tarja Porkka-Heiskanen; Matti Virkkunen



[Transient ischemic attack: past, present, and future].  


Transient ischemic attack (TIA) is a brief episode of reversible neurological deficits caused by focal and temporary central nervous system ischemia. TIA is associated with a high risk of recurrent ischemic stroke, but immediate evaluation and intervention for TIA lowers this risk of recurrent ischemic stroke. A new clinical concept termed acute cerebrovascular syndrome (ACVS) that includes TIA and acute ischemic stroke has been proposed. With the development of new neuroimaging modalities such as diffusion-weighted image (DWI), the definition of TIA used in the United States has shifted from time-based (less than 24 h) to tissue-based (without acute infarction). High ABCD2 score, carotid artery stenosis, and DWI lesions suggest that patients are at a high risk for early recurrence of ischemic stroke. Recently, it was reported that not only DWI or magnetic resonance angiography(MRA), but also fluid-attenuated inversion recovery (FLAIR) images are useful for evaluating TIA. In Japan, the definition of TIA has not been revised since 1990. To review the definition of TIA and establish a TIA management system that is suitable to domestic healthcare environment, the Japan TIA research group (PI, Kazuo Minematsu) was formed in 2009. The group conducted a nation-wide survey and a retrospective registration study to clarify the current status of clinical practice of TIA. In the group's opinion, TIA is defined as the presence of focal neurological symptoms ascribable to a vascular etiology lasting less than 24 h, irrespective of imaging findings, as classically defined. However, if acute ischemic lesions are found on DWI, it is diagnosed as "TIA with DWI lesions." The group also made recommendations for hospitalization policies and outpatient management. PMID:23832976

Sato, Shoichiro; Minematsu, Kazuo



Rate and Predictors of Serious Neurologic Causes of Dizziness in the Emergency Department  

PubMed Central

Objective To describe the rate and predictors of central nervous system (CNS) disease in emergency department (ED) patients with dizziness in the modern era of neuroimaging. Patients and Methods We retrospectively reviewed the medical records of all adults presenting between January 1, 2007, and December 31, 2009, to an academic ED for a primary triage complaint of dizziness, vertigo, or imbalance. The final diagnosis for the cause of dizziness was independently assigned by 2 neurologists, with a third neurologist resolving any disagreements. The primary outcome was a composite of ischemic stroke, intracranial hemorrhage, transient ischemic attack, seizure, brain tumor, demyelinating disease, and CNS infection. Univariate and multivariate logistic regression were used to assess the association between clinical variables and serious CNS causes of dizziness. Results Of 907 patients experiencing dizziness (mean age, 59 years; 58% women [n=529]), 49 (5%) had a serious neurologic diagnosis, including 37 cerebrovascular events. Dizziness was often caused by benign conditions, such as peripheral vertigo (294 patients [32%]) or orthostatic hypotension (121 patients [13%]). Age 60 years or older (odds ratio [OR], 5.7; 95% confidence interval [CI], 2.5-11.2), a chief complaint of imbalance (OR, 5.9; 95% CI, 2.3-15.2), and any focal examination abnormality (OR, 5.9; 95% CI, 3.1-11.2) were independently associated with serious neurologic diagnoses, whereas isolated dizziness symptoms were inversely associated (OR, 0.2; 95% CI, 0.0-0.7). Conclusion Dizziness in the ED is generally benign, although a substantial fraction of patients harbor serious neurologic disease. Clinical suspicion should be heightened for patients with advanced age, imbalance, or focal deficits.

Navi, Babak B.; Kamel, Hooman; Shah, Maulik P.; Grossman, Aaron W.; Wong, Christine; Poisson, Sharon N.; Whetstone, William D.; Josephson, S. Andrew; Johnston, S. Claiborne; Kim, Anthony S.



Clinical manifestations of neurological involvement in primary Sjögren’s syndrome  

Microsoft Academic Search

The aim of this study was to evaluate neurological manifestations of primary Sjögren’s syndrome (pSS) and investigate the\\u000a etiology and pathogenesis of peripheral and central nervous complications in pSS. Thirty-two patients with pSS were enrolled\\u000a in the present study, 20 of whom had neurological involvement plus sicca symptoms. The clinical features were evaluated by\\u000a neurological examinations including nerve conduction study,

Takahisa Gono; Yasushi Kawaguchi; Yasuhiro Katsumata; Kae Takagi; Akiko Tochimoto; Sayumi Baba; Yuko Okamoto; Yuko Ota; Hisashi Yamanaka



Syphilis Symptoms  


... the infection will move to the next stages. Latent syphilis The latent (hidden) stage of syphilis begins when symptoms of secondary syphilis are over. In early latent syphilis, you might notice that signs and symptoms ...


Recognizing Symptoms  


... My Cart | Register | Sign In Home What Is IBS? Introduction to IBS Facts About IBS Frequently Asked Questions Post-infectious IBS Other Disorders Signs & Symptoms Overview Recognizing Symptoms Pain ...


Visual Symptoms  


... that JavaScript is enabled in your browser. National Multiple Sclerosis Society Accessibility Navigation: Skip to resource navigation Skip ... Pages Assistance Animals Book: Managing the Symptoms of Multiple Sclerosis Optic Neuritis Visual Symptoms Related Documents Article - Low ...


Gonorrhea Symptoms  


... severe Swollen or painful testicles If left untreated, men could experience prostate complications and epididymitis (inflammation of the testicles). Symptoms of rectal infection include discharge, anal itching, and occasional painful bowel movements with fresh blood in the feces. Symptoms typically ...


History of neurology and education on neurology in Japan.  


The first medical society of Japanese neurologists and psychiatrists was founded in 1902, but psychiatrists gradually dominated in number. New "Japanese Society of Neurology" (JSN) was founded in 1960. The number of members was only 643 in 1960, while it rose up to 8,555 in 2009, including regular, junior, senior and associate members. JSN contributed much to solve the causes and treatment of the medicosocial and iatrogenic diseases such as Minamata disease and SMON (subacute myelopticoneuropathy) at its early period. In undergraduate education at medical school neurology is one of the core subjects in the curriculum, and almost all the 80 medical schools have at least one faculty neurologist. The Board of neurology of JSN was started in 1975, as the third earliest of the Japanese Medical Associations. It takes at least 6 years' clinical training after graduating from the medical school to take the neurology Board examinations. By 2009, 4,000 members passed the Board examinations. In 2002 JSN published evidence-based "Treatment Guidelines 2002" of 6 diseases: Parkinson's disease, stroke, chronic headache, dementia and ALS. As to the international issues, JSN hosted the 12th World Congress of Neurology in 1981, and international activities markedly increased after that. The first informal meeting with JSN and Korean Neurological Association (KNA) was held at the 48th JSN Annual Meeting in Nagoya in May 2007. In May 2008 the KNA-JSN 1st Joint symposium was held at the 49th Annual Meeting of JSN in Yokohama on "International comparison of neurological disorders: focusing on spinocerebellar atrophies (SCA) and epilepsies". In May 2009, KNA-JNS 2 nd Joint Symposium was held at the 50th JSN Annual Meeting in Sendai, inviting a speaker from Taiwan Neurological Society, on the subject "History and Education of Neurology in Japan, Korea and Taiwan". In this symposium, a strategy to make up the Northeast Asian Neurological Association was discussed. PMID:20030263

Kuzuhara, Shigeki



[Neurological disease and facial recognition].  


To discuss the neurological basis of facial recognition, we present our case reports of impaired recognition and a review of previous literature. First, we present a case of infarction and discuss prosopagnosia, which has had a large impact on face recognition research. From a study of patient symptoms, we assume that prosopagnosia may be caused by unilateral right occipitotemporal lesion and right cerebral dominance of facial recognition. Further, circumscribed lesion and degenerative disease may also cause progressive prosopagnosia. Apperceptive prosopagnosia is observed in patients with posterior cortical atrophy (PCA), pathologically considered as Alzheimer's disease, and associative prosopagnosia in frontotemporal lobar degeneration (FTLD). Second, we discuss face recognition as part of communication. Patients with Parkinson disease show social cognitive impairments, such as difficulty in facial expression recognition and deficits in theory of mind as detected by the reading the mind in the eyes test. Pathological and functional imaging studies indicate that social cognitive impairment in Parkinson disease is possibly related to damages in the amygdalae and surrounding limbic system. The social cognitive deficits can be observed in the early stages of Parkinson disease, and even in the prodromal stage, for example, patients with rapid eye movement (REM) sleep behavior disorder (RBD) show impairment in facial expression recognition. Further, patients with myotonic dystrophy type 1 (DM 1), which is a multisystem disease that mainly affects the muscles, show social cognitive impairment similar to that of Parkinson disease. Our previous study showed that facial expression recognition impairment of DM 1 patients is associated with lesion in the amygdalae and insulae. Our study results indicate that behaviors and personality traits in DM 1 patients, which are revealed by social cognitive impairment, are attributable to dysfunction of the limbic system. PMID:22764352

Kawamura, Mitsuru; Sugimoto, Azusa; Kobayakawa, Mutsutaka; Tsuruya, Natsuko



Cerebral metastases from lung carcinoma: neurological and CT correlation: work in progress  

SciTech Connect

To determine the role of brain CT in neurologically asymptomatic lung cancer patients a review was made of the CT and clinical findings in 279 patients. Brain metastases were found in 94.5% of patients with specific abnormal neurological findings, 26.6% of patients with vague neurological signs and symptoms, 11% of patients with oat cell carcinoma and a normal neurological examination, and 40% of patients with adenocarcinoma and a normal neurological examination. Brain metastasis was not seen on CT in the 29 patients with squamous cell carcinoma and a normal neurological examination. It is concluded that brain CT is useful for the detection of occult brain metastases, particularly oat cell carcinoma and adenocarcinoma, in neurologically asymptomatic lung cancer patients.

Tarver, R.D.; Richmond, B.D.; Klatte, E.C.



Falls in frequent neurological diseases  

Microsoft Academic Search

The prevalence of falls among neurological patients is unknown, although disturbances of gait and posture are common. Falls may lead to burdens for the patient, the caregivers and the health system. We designed a prospective study and investigated all patients for a history of falls admitted to a neurological hospital during a 100-day period. Clinical investigation was carried out and

Henning Stolze; Stephan Klebe; Christiane Zechlin; Christoph Baecker; Lars Friege; Günther Deuschl



Neurological Factors in Reading Disability  

PubMed Central

An overview is presented of that portion of the literature on reading disability wherein neurological defect is seen as causal or correlative. From the publication of Hinshelwood's “Congenital Word Blindness” (1917) to the present, investigators have considered the possible association of reading difficulty with genetically determined neurological defect, with cerebral damage, with biochemical imbalance inhibiting synaptic transmission, and with some form of maturational lag.

MacKinnon, F. A.




Microsoft Academic Search

To determine the frequency and the natural history of neurological manifestations of dengue infection in Thai children, 1,493 children diagnosed with dengue infection by serology and admitted to the Department of Pediatrics, Chulalongkorn Hospital, Bangkok, Thailand from 1987 to 1998 were reviewed from prospectively recorded medical charts. There were 80 chil- dren identified with neurological manifestations, an incidence of 5.4%

Chitsanu Pancharoen


Cerebral venous sinus thrombosis presenting as transient ischemic attacks in a case with homozygous mutations of MTHFR A1298C and CG677T.  


We report a case with recurrent, transient attacks of slurred speech, weakness, and numbness of the right half of the face and the right arm without seizure activity, accompanied by headache and double vision. Neurologic examination revealed bilateral papilledema and right abducens palsy. Brain magnetic resonance imaging revealed thrombosis of the dural venous sinuses and the cortical veins, with no evidence of parenchymal lesion. Homozygous mutations were found for methylenetetrahydrofolate reductase (MTHFR) A1298C and MTHFR CG677T. Anticoagulation with heparin and warfarin resulted in prompt cessation of the transient attacks, as well as the signs and symptoms of increased intracranial pressure. This report documents that, although rare, transient ischemic attacks can result from cerebral venous thrombosis. PMID:20833086

Yildiz, Ozlem Kayim; Cevik, Seyda; Cil, Gulsum; Oztoprak, Ibrahim; Bolayir, Ertugrul; Topaktas, Suat



[Neurological interpretation of dreams] .  


Cerebral cortical activity is constant throughout the entire human life, but substantially changes during the different phases of the sleep-wake cycle (wakefulness, non-REM sleep and REM sleep), as well as in relation to available information. In particular, perception of the environment is closely linked to the wake-state, while during sleep perception turns to the internal domain or endogenous cerebral activity. External and internal information are mutually exclusive. During wakefulness a neuronal mechanism allows attention to focus on the environment whereas endogenous cortical activity is ignored. The opposite process is provided during sleep. The function external attention-internal attention is coupled with the two modes of brain function during wakefulness and during sleep, providing two possible cortical status: thinking and dreaming. Several neurological processes may influence the declaration of the three states of being or may modify their orderly oscillation through the sleep-wake cycle. In addition, endogenous information and its perception (dreams) may be modified. Disturbances of dreaming may configurate in different general clinical scenarios: lack of dreaming, excess of dreaming (epic dreaming), paroxysmal dreaming (epileptic), nightmares, violent dreaming, daytime-dreaming (hallucinations), and lucid dreaming. Sensorial deprivation, as well as the emergence of internal perception may be the underlying mechanism of hallucinations. The probable isomorphism between hallucinations and dreaming is postulated, analyzed and discussed. PMID:11143502

Pareja, J A; Gil-Nagel, A



Neurological manifestations of human parvovirus B19 infection.  


Since its discovery, human parvovirus B19 has been linked with a broad spectrum of clinical syndromes. An aetiological role for the virus has been confirmed in erythema infectiosum, transient aplastic crisis, persistent infection manifesting as pure red cell aplasia in immunocompromised persons, non-immune hydrops fetalis and arthritis. Less commonly recognised, but receiving increasing attention recently, are the neurological manifestations, a variety of which have been described in patients with either clinically diagnosed or laboratory confirmed B19 infection. The purpose of this review is to summarise present knowledge of B19, its known and potential pathogenic mechanisms and its association with human diseases, particularly those with neurological manifestations. The outcome of the review supports an aetiological role of the virus in neurological disease. However, the pathogenesis remains unknown and elucidating this is a priority. PMID:12740833

Barah, Faraj; Vallely, Pamela J; Cleator, Graham M; Kerr, Jonathan R


[Neurological and psychiatric assessment of syncope].  


A transient loss of consciousness (TLOC) may have different causes. The term syncope is restricted to an underlying sudden decrease in cerebral perfusion. In most cases, syncopes or other causes of TLOC are recognizable by a basic diagnostic evaluation (history taking, physical examination, ECG, and supine and upright blood pressure measurements). Cues for epileptic seizures, e.g., delayed recovery, should prompt an extended search for an epileptic focus. Unusual features of the attacks without any hint for a syncopal or an epileptic origin require the psychiatric inspection of suspected dissociative (psychogenic) seizures. Neurogenic orthostatic hypotension results from sympathetic failure. The underlying disease (Parkinson's disease, pure autonomic failure, autonomic neuropathy, etc.) has to be identified by neurological examinations. PMID:21509599

Diehl, R R



Neurologic aspects and falls  

PubMed Central

Summary Falls are widely recognized as a social problem due to the related economic burden on public health budgets. Following the growing body of evidences on the physiopathology of postural control in humans, many factors leading to falls are already well established in the literature. Given the high prevalence of falls among elderly people, the present review focuses on parkinsonism and those “mild parkinsonian signs” frequently presented by elderly subjects. Parkinsonism is a good paradigm for the understanding of the pathophysiology of falling. Specifically, parkinsonian patients display specific features related to falls, such as axial motor symptoms, the impairment of executive functions and of the interplay between motion and cognition, as revealed by the disruption of automaticity.

Fasano, Alfonso; Plotnik, Meir



Neurologic complications associated with influenza vaccination: two adult cases.  


We describe two adult cases of neurologic complications occurring after influenza vaccination. The first case was a 62-year-old man who experienced convulsions 5 days after vaccination, and the second case was a 70-year-old man who exhibited paraplegia 7 days after vaccination. Diagnoses of acute disseminated encephalomyelitis and transverse myelitis with acute motor axonal neuropathy were made, respectively, and steroid pulse therapy and intravenous gamma globulin therapy alleviated the patients' symptoms. Although the efficacy and cost benefit of influenza vaccination have been widely accepted, such neurologic complications might occur in the elderly or even in adults. PMID:12636241

Nakamura, Naoko; Nokura, Kazuya; Zettsu, Takaaki; Koga, Hiroshi; Tachi, Masayuki; Terada, Masaki; Katoh, Hideshi; Itoh, Yuri; Osawa, Hiroyuki; Ozeki, Toshihiko; Yamamoto, Hiroko



Psychosis due to neurologic conditions  

Microsoft Academic Search

Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Psychosis arises with considerable frequency in a number of neurologic conditions. The treatment of such patients is often\\u000a challenging, as many of the treatments for psychosis pose some risk of worsening the underlying neurologic condition. Although\\u000a psychosis may emerge in the context of any neurologic condition that sufficiently disrupts the functioning of or connections\\u000a between limbic, paralimbic,

David B. Arciniegas; Jeannie L. Topkoff; Kerri Held; Lauren Frey



Animal models of neurological disease.  


The use of animal models to study human pathology has proved valuable in a number of fields. Animal models of neurological disease have successfully and accurately recreated many aspects of human illness allowing for in-depth study ofneuropathophysiology. These models have been the source of a plethora of information, such as the importance of certain molecular mechanisms and genetic contributions in neurological disease. Additionally, animal models have been utilized in the discovery and testing of possible therapeutic treatments. Although most neurological diseases are still not yet completely understood and reliable treatment is lacking, animal models provide a major step in the right direction. PMID:20455493

Shah, Amol; Garzon-Muvdi, Tomas; Mahajan, Rohit; Duenas, Vincent J; Quińones-Hinojosa, Alfredo



Physician Requirements - 1990 for Neurology.  

National Technical Information Service (NTIS)

This report presents the estimates obtained by applying the Graduate Medical Education National Advisory Committee (GMENAC) physician requirements model to the specialty of neurology. This report, together with a companion volume covering five hospital-ba...

L. P. Garrison



Diphtheria Symptoms  


... Basics Describes symptoms of infection as well as benefits and risks of vaccination. English [400 KB, 2 pages] | Spanish [170 KB, ... about recent diphtheria outbreaks. Describes symptoms of infection, benefits and risks of vaccination, details about the vaccine, and history of the ...


On the limits of effort testing: Symptom validity tests and severity of neurocognitive symptoms in nonlitigant patients  

Microsoft Academic Search

Modern symptom validity tests (SVTs) use empirical cutoffs for decision making. However, limits to the applicability of these cutoffs may arise when severe cognitive symptoms are present. The purpose of the studies presented here was to explore these limits of applicability. In Experiment 1, a group of 24 bona fide neurological patients without clinically obvious cognitive symptoms was compared to

Thomas Merten; Linda Bossink; Ben Schmand



Postconcussion symptoms.  


Research pertaining to the self-report of symptoms after traumatic brain injury was reviewed. Cognitive, emotional, and motivational factors have more relevance than demographic (except for female sex) and personality factors. Specific neuropsychological deficits in attention and memory have been found in the early stages after head injury of even mild severity. This is unlikely to be the only factor affecting symptom persistence. Exaggeration of cognitive dysfunction occurs in some cases, but appears unrelated to symptom overreport. Increased emotional distress typically accompanies symptom persistence. The psychological reaction of preoccupation with symptoms and emotional distress is not unique to concussion, but also occurs after severe head injury and back injury and relates more to the personal interpretation of the effect of the trauma than to objective indicators of brain injury severity. PMID:9253770

Gasquoine, P G



Neurological disorders of purine and pyrimidine metabolism.  


Purines and pyrimidines, regarded for a long time only as building blocks for nucleic acid synthesis and intermediates in the transfer of metabolic energy, gained increasing attention since genetically determined aberrations in their metabolism were associated clinically with various degrees of mental retardation and/or unexpected and often devastating neurological dysfunction. In most instances the molecular mechanisms underlying neurological symptoms remain undefined. This suggests that nucleotides and nucleosides play fundamental but still unknown roles in the development and function of several organs, in particular central nervous system. Alterations of purine and pyrimidine metabolism affecting brain function are spread along both synthesis (PRPS, ADSL, ATIC, HPRT, UMPS, dGK, TK), and breakdown pathways (5NT, ADA, PNP, GCH, DPD, DHPA, TP, UP), sometimes also involving pyridine metabolism. Explanations for the pathogenesis of disorders may include both cellular and mitochondrial damage: e.g. deficiency of the purine salvage enzymes hypoxanthine-guanine phosphoribosyltransferase and deoxyguanosine kinase are associated to the most severe pathologies, the former due to an unexplained adverse effect exerted on the development and/or differentiation of dopaminergic neurons, the latter due to impairment of mitochondrial functions. This review gathers the presently known inborn errors of purine and pyrimidine metabolism that manifest neurological syndromes, reporting and commenting on the available hypothesis on the possible link between specific enzymatic alterations and brain damage. Such connection is often not obvious, and though investigated for many years, the molecular basis of most dysfunctions of central nervous system associated to purine and pyrimidine metabolism disorders are still unexplained. PMID:21401501

Micheli, Vanna; Camici, Marcella; Tozzi, Maria G; Ipata, Piero L; Sestini, Sylvia; Bertelli, Matteo; Pompucci, Giuseppe



Identification of Patients at Risk for Periprocedural Neurological Deficits Associated With Carotid Angioplasty and Stenting  

Microsoft Academic Search

Background and Purpose—Transient or permanent neurological deficits can occur in the periprocedural period following carotid angioplasty and stenting (CAS), presumably due to distal embolization and\\/or hemodynamic compromise. We performed this study to identify predictors of neurological deficits associated with carotid angioplasty and stent placement. Methods—We reviewed medical records and angiograms in a consecutive series of patients who underwent CAS for

Adnan I. Qureshi; Andreas R. Luft; Vallabh Janardhan; M. Fareed; K. Suri; Mudit Sharma; Giuseppe Lanzino; Ajay K. Wakhloo; Lee R. Guterman; L. Nelson Hopkins


Neurological manifestation of methyl bromide intoxication.  


Methyl bromide is a highly toxic gas with poor olfactory warning properties. It is widely used as insecticidal fumigant for dry foodstuffs and can be toxic to central and peripheral nervous systems. Most neurological manifestations of methyl bromide intoxication occur from inhalation. Acute toxicity characterized by headache, dizziness, abdominal pain, nausea, vomiting and visual disturbances. Tremor, convulsion, unconsciousness and permanent brain damage may occur in severe poisoning. Chronic exposure can cause neuropathy, pyramidal and cerebellar dysfunction, as well as neuropsychiatric disturbances. The first case of methyl bromide intoxication in Thailand has been described. The patient was a 24-year-old man who worked in a warehouse of imported vegetables fumigated with methyl bromide. He presented with unstable gait, vertigo and paresthesia of both feet, for two weeks. He had a history of chronic exposure to methyl bromide for three years. His fourteen co-workers also developed the same symptoms but less in severity. Neurological examination revealed ataxic gait, decreased pain and vibratory sense on both feet, impaired cerebellar signs and hyperactive reflex in all extremities. The serum concentration of methyl bromide was 8.18 mg/dl. Electrophysilogical study was normal. Magnetic resonance imaging of the brain (MRI) revealed bilateral symmetrical lesion of abnormal hypersignal intensity on T2 and fluid-attenuation inversion recovery (FLAIR) sequences at bilateral dentate nuclei of cerebellum and periventricular area of the fourth ventricle. This incident stresses the need for improvement of worker education and safety precautions during all stages of methyl bromide fumigation. PMID:18575299

Suwanlaong, Kanokrat; Phanthumchinda, Kammant



Depression as a major symptom of multiple sclerosis  

Microsoft Academic Search

Thirty patients suffering from multiple sclerosis have been compared with 30 patients suffering from other chronic neurological diseases. The degree of disability was similar in these two groups. The patients with multiple sclerosis had experienced more episodes of severe depression both before and after the onset of neurological symptoms. The possible reasons for these episodes are discussed and it is

F A Whitlock; M M Siskind



Fibromyalgia Symptoms  


Donate | Join | Shop | eAlert | Contact Us About Fibromyalgia Symptoms Diagnosis Treatment Prevalence Causes Prognosis Science of FM Newly Diagnosed Patients FM Fact Sheet Economic Burden Research Abstract Clinical Trials Home > Fibromyalgia > ...


Neurologic Complications in Percutaneous Nephrolithotomy  

PubMed Central

Purpose Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection.

Basiri, Abbas; Soltani, Mohammad Hossein; Kamranmanesh, Mohammadreza; Tabibi, Ali; Mohsen Ziaee, Seyed Amir; Nouralizadeh, Akbar; Sharifiaghdas, Farzaneh; Poorzamani, Mahtab; Gharaei, Babak; Ozhand, Ardalan; Lashay, Alireza; Ahanian, Ali; Aminsharifi, Alireza; Sichani, Mehrdad Mohammadi; Asl-Zare, Mohammad; Ali Beigi, Faramarz Mohammad; Najjaran, Vahid; Abedinzadeh, Mehdi



Annual Meeting Offers Expanded Child Neurology Programming  

Microsoft Academic Search

The Academy has responded to member requests for more attention to pediatric neurology with the new Specialists in Focus: Child Neurology, which will provide a special, more intensive program for child neurology subspecialists. The new offerings will highlight the latest findings and progress in pediatric neurology. \\

Jonathan W. Mink



Micronutrient-Related Neurologic Complications Following Bariatric Surgery  

Microsoft Academic Search

Nearly two thirds of American adults are either overweight or obese. Accordingly, bariatric surgery experienced explosive\\u000a growth during the past decade. Current estimates place the worldwide volume of bariatric procedures at greater than 300,000\\u000a cases annually. Micronutrient deficiencies are well-described following bariatric surgery, and they may present with devastating\\u000a and sometimes irreversible neurologic manifestations. Clinical symptoms range from peripheral neuropathy

Ali Kazemi; Thomas Frazier; Matt Cave



Functional Problems in the Patient with a Neurological Disorder  

Microsoft Academic Search

Bowel dysfunction in patients with neurologic disorders is common. The symptoms of constipation and fecal incontinence have\\u000a a tremendous impact on the quality of life of these patients. In order to successfully manage patients with neurogenic bowel\\u000a dysfunction, one should take into account the unique needs and condition of each patient, along with the patient’s lifestyle,\\u000a level of activity, and

Jeanette Gaw; Walter E. Longo


[Neurological complications of neurooncological therapy].  


Neurological complications of therapeutic procedures for brain tumors are increasingly being recognized. These encompass the classic types of central and peripheral neurotoxicity, such as radiotherapy-induced leukoencephalopathy and platinum-induced neuropathy. However, the advent of novel protocols and targeted therapeutics has expanded the spectrum of neurological complications. A problem of considerable importance is pseudoprogression after radiochemotherapy with temozolomide. Among the new targeted drugs complications of therapy with bevacizumab are the subject of intense discussion. In this review article the neurotoxic potential of intrathecal chemotherapy, kinase inhibitors, immunological strategies and local therapies are summarized. Knowledge about neurological complications of brain tumor therapy procedures is important for risk assessment and patient information. PMID:20635073

Herrlinger, U; Steinbach, J P



The neurological basis of occupation.  


The purpose of the present paper was to survey the literature about the neurological basis of human activity and its relationship to occupation and health. Activities related to neurological function were organized into three categories: those that activate the brain's reward system; those that promote the relaxation response; and those that preserve cognitive function into old age. The results from the literature review correlating neurological evidence and activities showed that purposeful and meaningful activities could counter the effects of stress-related diseases and reduce the risk for dementia. Specifically, it was found that music, drawing, meditation, reading, arts and crafts, and home repairs, for example, can stimulate the neurogical system and enhance health and well-being, Prospective research studies are needed to examine the effects of purposeful activities on reducing stress and slowing the rate of cognitive decline. PMID:17623380

Gutman, Sharon A; Schindler, Victoria P



Neurologic complications of lightning injuries.  

PubMed Central

Over the past ten years, we have cared for 13 patients who suffered serious neurologic complications after being struck by lightning. The spectrum of neurologic lesions includes the entire neuraxis from the cerebral hemispheres to the peripheral nerves. We describe these various neurologic disorders with regard to the site of the lesion, severity of the deficit, and the outcome. Damage to the nervous system can be a serious problem for patients struck by lightning. Fatalities are associated with hypoxic encephalopathy in patients who suffered cardiac arrests. Patients with spinal cord lesions are likely to have permanent sequelae and paralysis. New technology for detecting lightning with wideband magnetic direction finders is useful in establishing lightning-flash densities in each state. Florida and the Gulf Coast states have the highest densities. Colorado and the Rocky Mountain states have the next highest. Images

Cherington, M; Yarnell, P R; London, S F



Exacerbation of preexisting neurological deficits by neuraxial anesthesia: report of 7 cases.  


We undertook this case series to determine if preexisting neurological disease is exacerbated by either spinal or epidural anesthesia. In the website of the Arachnoiditis Foundation, we posted an offer to advise anesthesiologists in cases of neurological problems after either of these techniques was used. Contacts were made first by way of the Internet, confirmed by telephone, and maintained by fax, e-mail, or by special mail. Patients here described were cared for and observed by one of the authors, in a hospital, in Argentina or in Mexico. A total of 7 adult, ASA physical status I and II patients, including 3 men and 4 women, with subtle symptoms of neurological disease before anesthesia, are described. Two patients had continuous lumbar epidural anesthesia, 3 had spinals; in 2 more, attempted epidural blocks led to accidental dural puncture and were converted to subarachnoid anesthetics. All patients accepted neuraxial anesthesia without informing the anesthesiologists that they had mild neurological symptoms before surgery. Because anesthesiologists did not specifically inquire about subclinical neurological symptoms or prior neurological disease, anesthesiologists are advised to carefully inquire about prior neurological disease whether neuraxial anesthesia techniques are considered. PMID:15950859

Aldrete, J Antonio; Reza-Medina, Marisela; Daud, Olga; Lalin-Iglesias, Silvia; Chiodetti, Gustavo; Guevara, Uriah; Wikinski, Jaime A; Torrieri, Alberto



Neurological Adverse Effects after Radiation Therapy for Stage II Seminoma.  


We report 3 cases of patients with testicular cancer and stage II seminoma who developed neurological symptoms with bilateral leg weakness about 4 to 9 months after radiation therapy (RT). They all received RT to the para-aortic lymph nodes with a total dose of 40 Gy (36 Gy + 4 Gy as a boost against the tumour bed) with a conventional fractionation of 2 Gy/day, 5 days per week. RT was applied as hockey-stick portals, also called L-fields. In 2 cases, the symptoms fully resolved. Therapeutic irradiation can cause significant injury to the peripheral nerves of the lumbosacral plexus and/or to the spinal cord. RT is believed to produce plexus injury by both direct toxic effects and secondary microinfarction of the nerves, but the exact pathophysiology of RT-induced injury is unclear. Since reported studies of radiation-induced neurological adverse effects are limited, it is difficult to estimate their frequency and outcome. The treatment of neurological symptoms due to RT is symptomatic. PMID:22949908

Ebbeskov Lauritsen, Liv; Meidahl Petersen, Peter; Daugaard, Gedske



Neurological Adverse Effects after Radiation Therapy for Stage II Seminoma  

PubMed Central

We report 3 cases of patients with testicular cancer and stage II seminoma who developed neurological symptoms with bilateral leg weakness about 4 to 9 months after radiation therapy (RT). They all received RT to the para-aortic lymph nodes with a total dose of 40 Gy (36 Gy + 4 Gy as a boost against the tumour bed) with a conventional fractionation of 2 Gy/day, 5 days per week. RT was applied as hockey-stick portals, also called L-fields. In 2 cases, the symptoms fully resolved. Therapeutic irradiation can cause significant injury to the peripheral nerves of the lumbosacral plexus and/or to the spinal cord. RT is believed to produce plexus injury by both direct toxic effects and secondary microinfarction of the nerves, but the exact pathophysiology of RT-induced injury is unclear. Since reported studies of radiation-induced neurological adverse effects are limited, it is difficult to estimate their frequency and outcome. The treatment of neurological symptoms due to RT is symptomatic.

Ebbeskov Lauritsen, Liv; Meidahl Petersen, Peter; Daugaard, Gedske



Influenza-associated neurological complications.  


While mostly diagnosed in the pediatric population, neurological complications of pandemic influenza A infection may affect young and previously healthy adults, and may follow a fulminant, severe, and occasionally fatal course. We reviewed severe neurological complications secondary to influenza infection reported in the literature, in attempt to outline recurrent syndromes that may assist the clinician in making a timely diagnosis. Vigilance and awareness of these clinical entities are key in the neurologist and intensivist's role in surveillance and early recognition of pandemic influenza, and in ensuring improved survival for affected patients. PMID:23138546

Tsai, Jenny P; Baker, Andrew J



Mood disorders in neurologic illness  

Microsoft Academic Search

Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Patients with neurologic illness frequently develop secondary mood disorders that are broadly categorized as unipolar or bipolar.\\u000a Accurate diagnosis is essential because the treatment of unipolar disorders is markedly different from that of bipolar disorders.\\u000a Aggressive treatment of mood disorders improves quality of life, reduces morbidity and mortality, and may prevent worsening\\u000a of both psychiatric and neurologic

Christopher D. Schneck; Randall D. Buzan



Midline shift, seizures and acute neurological deterioration due to cranial vault metastases from prostatic carcinoma.  


Intracranial metastases from prostatic cancer are rare, but cranial vault metastases are not. Most patients who have vault metastases present with local symptoms such as pain. We describe a patient who presented with acute neurological symptoms as well as a midline shift, seizures and secondary intracranial effects as a result of the extensive cranial vault metastases from prostate cancer; the symptoms mimicked those of intracranial metastases. PMID:19651516

Weerakkody, Y D; Feltham, R L; Leigh, A J



The Future of Child NeurologyA Profile of Child Neurology Residents  

Microsoft Academic Search

Current workforce projections estimate that there is a shortage of child neurologists. We surveyed child neurology residents to learn more about the entry point for a career in child neurology: what attracts current residents to the field of child neurology and what the future career plans of child neurology residents are. Most respondents (52%) were exposed to child neurology for

Daniel Polsky; Rachel M. Werner



The Neurological Concept of Behavior  

Microsoft Academic Search

It is misleading to place neurology in the center of the psychological picture for we know less about nerves than about mind. It is impossible to say what insight and control will be gained by further knowledge of the neural mechanisms. The position of the behaviorist is partly fallacious and his concept of behavior is meager to the point of

J. Jastrow



Neurological Aspects of Taste Disorders  

Microsoft Academic Search

he sense of taste is generally regarded as less important compared with vision and hear- ing. However, gustatory disorders considerably diminish the pleasures of life and can lead to work-related problems. At its worst, this deficit may become a life-threatening hazard. However, few studies are found in the medical literature on taste disorders, including authoritative textbooks of neurology and internal

Josef G. Heckmann; Siegfried M. Heckmann; Christoph J. G. Lang; Thomas Hummel



Neurological Decompression Illness in Swine.  

National Technical Information Service (NTIS)

Background: A porcine model of neurological decompression illness (DCI) and its treatment is described. Methods: Pigs (wt. 16-22 kg) underwent a simulated dive to 200 feet of seawater (fsw) (612.6 kPa) for 24 mn, then decompressed at 60 fsw/min% (183 kPa-...

J. R. Broome E. J. Dick



Stroke unit versus neurology ward  

Microsoft Academic Search

Introduction: Few studies have tested the hypothesis of whether the beneficial effect of Stroke Units (SUs) can be reproduced in routine clinical practice and whether SU are also superior to neurological wards [NWs]. We aimed to compare the outcomes of patients of a newly implemented SU to the outcomes of patients hospitalized in a NW. Methods: We made a before-after

Y. Krespi; M. E. Gurol; O. Coban; R. Tuncay; S. Bahar



Some Translations in Vascular Neurology  

Microsoft Academic Search

‘Translation’ in medicine immediately suggests ‘translational research’, but there are many other varieties of ‘translation’. I have selected 4 translations in the field of vascular neurology in which I have been involved in different respects: (1) the translation of results from men to women, taking the example of aspirin which, in primary prevention, decreases the risk of myocardial infarction in

Marie-Germaine Bousser



Neurological Aspects of Reading Disability.  

ERIC Educational Resources Information Center

The author, a neurologist, looks at the nature of reading disabilities. He suggests that many reading disabilities are the result of normal constitutional differences and that the term "minimal brain dysfunction" is rarely appropriate and does not help the remediation process. Noted are various theories which relate neurology and reading ability.…

Nelson, Louis R.


Neurological complications of childhood leukaemia  

Microsoft Academic Search

We have reviewed the neurological complications not directly attributable to leukaemic infiltration in a group of 438 children with leukaemia or lymphoma. 61 children had one or more complications due chiefly to bleeding, infection, or drug toxicity. Early death from intracranial haemorrhage occurred in 1% of children with lymphoblastic leukaemia and 7% of children with myeloblastic leukaemia. Measles and chicken

R H Campbell; W C Marshall; J M Chessells



The neurological complications of achondroplasia  

Microsoft Academic Search

The genetics of achondroplasia are discussed, and then the clinical features. The respiratory complications are only considered when related to the neurological ones which are the concern of this paper; and their effects on morbidity and mortality. Cervicomedullary compression can cause pain, ataxia, incontinence, apnea, and respiratory arrest. One of the signs can be progressive quadriparesis which can be a

Neil Gordon



Neurological Problems of Jazz Legends  

Microsoft Academic Search

A variety of neurological problems have affected the lives of giants in the jazz genre. Cole Porter courageously remained prolific after severe leg injuries secondary to an equestrian accident, until he succumbed to osteomyelitis, amputations, depression, and phantom limb pain. George Gershwin resisted explanations for uncinate seizures and personality change and herniated from a right temporal lobe brain tumor, which

Phillip L. Pearl



Temporary neurological dysfunction after deep hypothermic circulatory arrest: a clinical marker of long-term functional deficit  

Microsoft Academic Search

Background. With increasing clinical experience, it has become clear that two distinct forms of neurological injury occur after operations on the thoracic aorta that require temporary exclusion of the cerebral circulation. Traditionally, evaluation of neurological outcome was limited to reporting the incidence of postoperative stroke related to ischemic infarcts due to particulate embolization. More recently, the symptom complex defined as

M. Arisan Ergin; Suzan Uysal; David L Reich; Anil Apaydin; Steven L Lansman; Jock N McCullough; Randall B Griepp



Insomnia in central neurologic diseases--occurrence and management.  


The objective of this review is to highlight the impact of insomnia in central neurological disorders by providing information on its prevalence and give recommendations for diagnosis and treatment. Insomnia in neurological disorders is a frequent, but underestimated symptom. Its occurrence may be a direct consequence of the disease itself or may be secondary to pain, depression, other sleep disorders or the effects of medications. Insomnia can have a significant impact on the patient's cognitive and physical function and may be associated with psychological distress and depression. Diagnosis of insomnia is primarily based on medical history and validated questionnaires. Actigraphy is a helpful diagnostic tool for assessing the circadian sleep-wake rhythm. For differential diagnosis and to measure the duration of sleep full polysomnography may be recommended. Prior to initiating treatment the cause of insomnia must be clearly identified. First line treatment aims at the underlying neurologic disease. The few high quality treatment studies show that short term treatment with hypnotics may be recommended in most disorders after having ruled out high risk for adverse effects. Sedating antidepressants may be an effective treatment for insomnia in stroke and Parkinson's disease (PD) patients. Melatonin and light treatment can stabilize the sleep-wake circadian rhythm and shorten sleep latency in dementias and PD. Cognitive behavioral therapy (CBT) can be effective in treating insomnia symptoms associated with most of the central neurological diseases. The prevalence and treatment of insomnia in neurological diseases still need to be studied in larger patient groups with randomized clinical trials to a) better understand their impact and causal relationship and b) to develop and improve specific evidence-based treatment strategies. PMID:21481621

Mayer, Geert; Jennum, Poul; Riemann, Dieter; Dauvilliers, Yves



Recent advances in the management of transient ischaemic attack: a clinical review.  


Transient ischaemic attack (TIA) if untreated carries a high risk of early stroke and is associated with poorer long-term survival. There have been recent advances in the understanding of TIA, its investigations, management and organisation of services for patient care. Clinically, patients are diagnosed TIA if they have transient sudden-onset focal neurological symptoms which usually completely and rapidly resolve by presentation. Patients with residual symptoms should be evaluated as potentially having stroke, if they present within 4.5?h of onset, should be urgently evaluated for their potential eligibility for thrombolysis. TIA patients should receive rapid attention with essential investigations, including brain imaging, electrocardiograph and carotid ultrasound. Immediate administration of an antiplatelet agent is recommended after brain imaging, with subsequent attention to preventing or treating other mechanistic factors. There is emerging evidence that TIA patients can be managed safely in the outpatient setting after initial rapid management in emergency departments as part of a structured clinical pathway supervised by stroke specialists. Clinical systems of management may require approaches individualised to the healthcare setting, while adopting the central aspects of rapid management. PMID:23279020

Phan, T G; Sanders, L; Srikanth, V



The Use of Neuroimaging Studies and Neurological Consultation to Evaluate Dizzy Patients in the Emergency Department  

PubMed Central

Background and Purpose: Dizziness is a frequent reason for neuroimaging and neurological consultation, but little is known about the utility of either practice. We sought to characterize the patterns and yield of neuroimaging and neurological consultation for dizziness in the emergency department (ED). Methods: We retrospectively identified consecutive adults presenting to an academic ED from 2007 to 2009, with a primary complaint of dizziness, vertigo, or imbalance. Neurologists reviewed medical records to determine clinical characteristics, whether a neuroimaging study (head computed tomography [CT] or brain magnetic resonance imaging [MRI]) or neurology consultation was obtained in the ED, and to identify relevant findings on neuroimaging studies. Two neurologists assigned a final diagnosis for the cause of dizziness. Logistic regression was used to evaluate bivariate and multivariate predictors of neuroimaging and consultation. Results: Of 907 dizzy patients (mean age 59 years; 58% women), 321 (35%) had a neuroimaging study (28% CT, 11% MRI, and 4% both) and 180 (20%) had neurological consultation. Serious neurological disease was ultimately diagnosed in 13% of patients with neuroimaging and 21% of patients with neurological consultation, compared to 5% of the overall cohort. Headache and focal neurological deficits were associated with both neuroimaging and neurological consultation, while age ?60 years and prior stroke predicted neuroimaging but not consultation, and positional symptoms predicted consultation but not neuroimaging. Conclusion: In a tertiary care ED, neuroimaging and neurological consultation were frequently utilized to evaluate dizzy patients, and their diagnostic yield was substantial.

Navi, Babak B.; Kamel, Hooman; Shah, Maulik P.; Grossman, Aaron W.; Wong, Christine; Poisson, Sharon N.; Whetstone, William D.; Josephson, S. Andrew; Johnston, S. Claiborne; Kim, Anthony S.



Treating Psychotic Symptoms in Elderly Patients  

PubMed Central

Research has shown that elderly patients are especially at risk for the development of psychotic symptoms. A combination of factors contributes to the increased risk for psychosis in this patient population. Various DSM-IV diagnostic categories including delirium, schizophrenia, delusional disorder, mood disorders, dementia, substance abuse, and medical-neurologic conditions can be associated with psychotic symptoms. In general, medications are prescribed for specific target symptoms, started at low doses, and titrated gradually. Although buspirone, trazodone, valproic acid, and carbamazepine have been used with some success, antipsychotic medications have been the primary treatment of psychosis in the elderly. Because the atypical antipsychotics offer effective management of psychotic symptoms combined with low liability of extrapyramidal symptoms, these agents may be the current treatment of choice for psychotic symptoms in the elderly when used cautiously.

Targum, Steven D.



Community-Based Study of Neurological Disorders in Rural Central Ethiopia  

Microsoft Academic Search

Between 1986 and 1988 a door-to-door survey was conducted on a stable rural population of 60,820 in central Ethiopia. Trained lay health workers made a complete census and identified cases with symptoms -and signs of neurological disorders, using specially designed questionnaires which, in a previous pilot study, were found to have a sensitivity of 91% and specificity of 85%. Neurological

Redda Tekle-Haimanot; Mekonnen Abebe; Ayele Gebre-Mariam; Lars Forsgren; Jan Heijbel; Gösta Holmgren; Jan Ekstedt



Pediatric neurological syndromes and inborn errors of purine metabolism.  


This review is devised to gather the presently known inborn errors of purine metabolism that manifest neurological pediatric syndromes. The aim is to draw a comprehensive picture of these rare diseases, characterized by unexpected and often devastating neurological symptoms. Although investigated for many years, most purine metabolism disorders associated to psychomotor dysfunctions still hide the molecular link between the metabolic derangement and the neurological manifestations. This basically indicates that many of the actual functions of nucleosides and nucleotides in the development and function of several organs, in particular central nervous system, are still unknown. Both superactivity and deficiency of phosphoribosylpyrophosphate synthetase cause hereditary disorders characterized, in most cases, by neurological impairments. The deficiency of adenylosuccinate lyase and 5-amino-4-imidazolecarboxamide ribotide transformylase/IMP cyclohydrolase, both belonging to the de novo purine synthesis pathway, is also associated to severe neurological manifestations. Among catabolic enzymes, hyperactivity of ectosolic 5'-nucleotidase, as well as deficiency of purine nucleoside phosphorylase and adenosine deaminase also lead to syndromes affecting the central nervous system. The most severe pathologies are associated to the deficiency of the salvage pathway enzymes hypoxanthine-guanine phosphoribosyltransferase and deoxyguanosine kinase: the former due to an unexplained adverse effect exerted on the development and/or differentiation of dopaminergic neurons, the latter due to a clear impairment of mitochondrial functions. The assessment of hypo- or hyperuricemic conditions is suggestive of purine enzyme dysfunctions, but most disorders of purine metabolism may escape the clinical investigation because they are not associated to these metabolic derangements. This review may represent a starting point stimulating both scientists and physicians involved in the study of neurological dysfunctions caused by inborn errors of purine metabolism with the aim to find novel therapeutical approaches. PMID:20005278

Camici, Marcella; Micheli, Vanna; Ipata, Piero Luigi; Tozzi, Maria Grazia



[Neurological picture and selected diagnostic indices of vitamin b12 malabsorption syndrome].  


Funicular myelosis is considered to be the main neurological syndrome in vitamin B12 deficiency. However, many authors tend to think that sensory neuropathy is the most common neurological manifestation of vitamin B12 deficiency. The aim of this paper was to assess neurological condition of patients with vitamin B12 malabsorption. The absorption of vitamin B-12 was assessed by Schilling's test. Patients with abnormal results of this test underwent neurological and medical examinations as well as series of accessory investigations. 16 cases of deficient vitamin B12 absorption accompanied by neurological symptoms were presented. The results of the investigation showed that the most common clinical manifestation of vitamin B12 deficiency was sensory neuropathy. In over 93% of described cases pathologic changes in gastric mucous membrane were found. PMID:11556213

Tomczyk, A; Helewski, K; G?owacka, M; Konecki, J; Stepie?, M



Negative symptoms presenting as neuropsychiatric manifestation of vitamin B12 deficiency  

PubMed Central

Long lists of psychiatric illness or symptoms have been documented to be caused by vitamin B12 deficiency. We describe an atypical case of a young adult who presented with predominant negative symptoms followed by neurological symptoms consistent with vitamin B12 deficiency. The symptoms showed complete remission after vitamin B12 supplementation. The uniqueness of this case is that vitamin B12 deficiency presented with predominant negative symptoms without other psychotic and manic symptoms, which has not been reported previously.

Sahoo, Manoj Kumar; Avasthi, Ajit; Singh, Parampreet



[Application of psychophysics to neurology].  


Although psychophysics has already been used in many neurological evaluations including the visual and hearing tests, the use of psychophysics has been limited to the evaluation of sensory disorders. In this review paper, however, the author introduced recent attempts to apply psychophysics to the evaluation of higher cognitive functions such as perception of scenes and facial expressions. Psychophysics was also used to measure visual hypersensitivity in a patient with migraine. The benefits of the use of psychophysics in neurological and neuropsychological settings would be as follows. (1) We can evaluate higher cognitive functions quantitatively. (2) We can measure performance both above and below the normal range by the same method. (3) We can use the same stimulus and task as other research areas such as neuroscience and neuroimaging, and compare results between research areas. PMID:18421988

Koyama, Shinichi



Psychiatric morbidity and illness behaviour in female neurological in-patients.  

PubMed Central

Ninety three female neurological in-patients were assessed in a collaborative neurological and psychiatric study. An overall prevalence of definite psychiatric disorder of 34% was found, depression being the most common diagnosis. Psychiatric morbidity was most common when the neurologist felt that the presentation could not be explained by a neurological disorder. The majority of such patients had symptoms which could be explained by the psychiatric disorder but a substantial number could not be given a definite diagnosis. The General Health Questionnaire was not found to be a useful screening instrument in this setting.

Metcalfe, R; Firth, D; Pollock, S; Creed, F



Prevention of postoperative neurologic deficits after carotid endarterectomy. Is platelet inhibition beneficial?  


Aspirin (ASA) and dipyridamole (DIP) have been shown to reduce the incidence of transient ischemic attacks (TIAs), but aspirin's ability to reduce the incidence of postoperative neurologic deficits in patients who require carotid endarterectomy (CE) is controversial. To evaluate the role of adjunctive ASA/DIP in conjunction with CE, 908 CE cases were reviewed. Four hundred sixty-seven patients took ASA (650 mg/day) and DIP (150 mg/day) preoperatively, while 381 received no ASA/DIP. There was no statistical difference in the distribution of postoperative neurologic deficits. Twenty-six transient deficits occurred: 14 (53%) patients were taking ASA/DIP, whereas 12 (47%) were not. Seventeen permanent deficits occurred: ten (58%) patients were taking ASA/DIP and seven (42%) were not. ASA/DIP are useful medications in combating ischemic cerebrovascular disease, but ASA/DIP cannot replace precise operative technique which affords unequaled protection against a postendarterectomy neurologic deficit. PMID:3579047

Rosenthal, D; Lamis, P A; Stanton, P E; Clark, M D; Ellison, R G



Bravo! Neurology at the opera.  


Opera is a complex musical form that reflects the complexity of the human condition and the human brain. This article presents an introduction to the portrayal of medical professionals in opera, including one neurologist, as well as two characters in whom neurological disease contributes to the action of the musical drama. Consideration is also given to the neuroanatomy and neuropathology of opera singers with further speculation regarding the neural underpinnings of the passion of opera's audience. PMID:20375526

Matthews, Brandy R



[Neurologic complications of myocardial infarction].  


Investigated were 275 patients, 30 autopsies and 35 animals with experimental cardiac ischemia and myocardial infarction. Polymorphic neurological complications were detected among which most important were: 1. Cardiocerebral syndromes, crises, strokes; 2. Circulation disorders in anterior and posterior spinal, and posterior radicular arterial beds leading to cardio-spinal crises and spinal strokes; 3. Cardio-brachial, cardio-intercostal, radiculo-cardio-lumbo-sacral, cervico-thoracic, brachio-plantar, brachioscapular syndromes. PMID:2558472

Abdukhakimov, F T; Sadykova, G K



Neurological basis of skill learning  

Microsoft Academic Search

Skill-learning, i.e. anterograde memory of `procedures' has been separated from conventional declarative memory, or event- or data-related memory. This type of memory requires a concerted activity of various neural structures which are not assigned to the acquisition of declarative memory. We employed mirror reading task as a paradigm of skill acquisition memory and tried to elucidate possible neurological mechanisms involved

Atsushi Yamadori; Takashi Yoshida; Etsuro Mori; Hikari Yamashita



[Neurologic complications in hemodialysis patients].  


Various neurological complications may occur in patients under haemodialysis for end-stage chronic renal failure. Their frequency has clearly been reduced by improvements in the modalities and techniques of dialysis. Some of these complications are related to uremia and/or to the accumulation of endogenous toxic substances the nature of which has not been elucidated (e.g. uraemic encephalopathy, polyneuropathy), while others are directly due to the haemodialysis itself (e.g. dialysis disequilibrium syndrome, aluminum encephalopathy). PMID:2326590

Goulon-Goeau, C; Saďd, G



Transient osteoporosis of pregnancy.  


Transient osteoporosis of pregnancy (TOP) is a rare yet perhaps under-reported condition that has affected otherwise healthy pregnancies throughout the world. The condition presents suddenly in the third trimester of a usually uneventful pregnancy and progressively immobilizes the mother. Radiographic studies detect drastic loss of bone mass, elevated rates of turnover in the bone, and oedema in the affected portion. Weakness of the bone can lead to fractures during delivery and other complications for the mother. Then, within weeks of labour, symptoms and radiological findings resolve. Aetiology is currently unknown, although neural, vascular, haematological, endocrine, nutrient-deficiency, and other etiologies have been proposed. Several treatments have also been explored, including simple bed rest, steroids, bisphosphonates, calcitonin, induced termination of pregnancy, and surgical intervention. The orthopedist plays an essential role in monitoring the condition (and potential complications) as well as ensuring satisfactory outcomes for both the mother and newborn. PMID:22464203

Maliha, George; Morgan, Jordan; Vrahas, Mark



Transient cortical blindness after coronary angiography.  

PubMed Central

Transient visual loss lasting three days developed after transfemoral coronary angiography in a 62 year old man. Computed tomography (CT) showed bilateral leakage of contrast medium into the occipital cortex. A repeat CT scan after his sight recovered showed clearance of contrast with no underlying infarction. A breakdown of the blood-brain barrier with direct neurotoxicity of the contrast media seemed to be the cause of these neurological changes after coronary angiography which apparently have not been reported before. Images

Parry, R; Rees, J R; Wilde, P



Prospects for neurology and psychiatry.  


Neurological and psychiatric illnesses are among the most common and most serious health problems in developed societies. The most promising advances in neurological and psychiatric diseases will require advances in neuroscience for their elucidation, prevention, and treatment. Technical advances have improved methods for identifying brain regions involved during various types of cognitive activity, for tracing connections between parts of the brain, for visualizing individual neurons in living brain preparations, for recording the activities of neurons, and for studying the activity of single-ion channels and the receptors for various neurotransmitters. The most significant advances in the past 20 years have come from the application to the nervous system of molecular genetics and molecular cell biology. Discovery of the monogenic disorder responsible for Huntington disease and understanding its pathogenesis can serve as a paradigm for unraveling the much more complex, polygenic disorders responsible for such psychiatric diseases as schizophrenia, manic depressive illness, and borderline personality disorder. Thus, a new degree of cooperation between neurology and psychiatry is likely to result, especially for the treatment of patients with illnesses such as autism, mental retardation, cognitive disorders associated with Alzheimer and Parkinson disease that overlap between the 2 disciplines. PMID:11176865

Cowan, W M; Kandel, E R



[RNA pathologies in neurological disorders].  


RNA is not a simple intermediate between DNA and proteins. RNA is widely transcribed from a variety of genomic regions, and researchers are extensively exploring the functional roles and the regulations of non-coding RNAs and small RNAs including siRNAs and mRNAs. In addition, the human genome project disclosed that we humans carry as few as approximately 22,000 genes. Humans employ tissue-specific and developmental stage-specific alternative splicing to generate a large variety of proteins in a specific cell at a specific developmental stage. Neurological disorders are not the exceptions that can escape from aberrations of the splicing machinery. A large variety of neurological disorders is causally associated with RNA pathologies, but this lecture was mostly focused on aberrant splicings due to pathological alterations of splicing cis- and trans-elements. The neurological diseases covered include congenital myasthenic syndromes, genetic forms of Parkinson's disease, spastic paraplegia, myotonic dystrophy types 1 and 2, sporadic Alzheimer's disease, facioscapulohumeral dystrophy, fragile X-associated tremor/ ataxia syndrome, Rett syndrome, Prader-Willi syndrome, spinocerebellar atrophy type 8, and Waardenburg-Shah syndrome. Potential therapeutic modalities targeting RNA are addressed on congenital myasthenic syndromes, Duchenne muscular dystrophy, spinal muscular atrophy, and familial dysautonomia. PMID:18210802

Ohno, Kinji



[Is Huntington's disease a neurological or psychiatric disorder? case report].  


Huntington's disease is a rare, although commonly known neurodegenerative disease, caused by dynamic point mutation within the IT-15; it is inherited autosomally dominantly. IT-15 mutation includes multiple (36-250) repetitions of trinucleotide sequence (CAG) encoding a glutamine at the amino end of Huntington (mHtt). It is one of the nine polyglutamine diseases (PolyQ), characterized by a CAG repeat. The pathophysiology of Huntington's disease is associated with dysfunction and loss of neurons and gliosis within the striatum, particularly around the caudate nucleus and frontal lobes. Huntington's disease is characterised by the triad of symptoms: cognitive, motor and psychopathological disturbances. Approximately 80% of patients with HD show some of the mental disorders. The most common are affective disorders, in 30-40% symptoms of depression are present. Depression often precedes the onset of neurological symptoms. PMID:23394029

Dubas-Slemp, Halina; Tylec, Aneta; Micha?owska-Marmurowska, Halina; Spychalska, Katarzyna



PubMed Central

A case which initially presented with schizophrenic symptoms and was being managed as a patient of schizophrenic illness with tardive dyskinesia for 12 years, was on careful review of history and examination diagnosed as having Huntington's Disease. Clinical and theoretical aspects of Huntington's disease presenting with schizophrenic symptoms, and neurological deficits which are seen in schizophrenia are discussed.

Gupta, Vinay; Deswal, R.S.



Neurological complications of primary Sjögren's syndrome  

Microsoft Academic Search

Objective: To better delineate the spectrum of neurological complications of primary Sj?gren's syndrome (PSS). Methods: A detailed neurological investigation was prospectively performed in a group of 25 consecutive patients with PSS followed\\u000a in an internal medicine department between June 1996 and December 1997 (Internal Medicine group). In addition, eleven patients\\u000a with neurological complications of PSS were identified in the Neurological

C. Lafitte; Z. Amoura; P. Cacoub; P. Pradat-Diehl; C. Picq; F. Salachas; J. M. Léger; J. C. Piette; J. Y. Delattre



Transient Ischemic Attack  


NINDS Transient Ischemic Attack Information Page Synonym(s): Mini Stroke Table of Contents (click to jump to sections) What is Transient Ischemic ... Trials Organizations Additional resources from MedlinePlus What is Transient Ischemic Attack? A transient ischemic attack (TIA) is a transient ...


Intravenous immunoglobulin treatment of neurological autoimmune diseases  

Microsoft Academic Search

Intravenous immunoglobulin (IVIg) has been widely used in neurological diseases during the last decade. The current indications of IVIg in neurological diseases are reviewed and discussed on the basis of the available experimental data and clinical trials. Compared to other immunomodulating treatments used in neurological diseases, IVIg has only few side effects with a small risk of transmission of infectious

Martin Stangel; Hans-Peter Hartung; Peter Marx; Ralf Gold



The Neurological Examination in Family Practice  

PubMed Central

The family practitioner has the first opportunity and responsibility of making a diagnosis. Since a large portion of his work is concerned with neurological problems, he should be able to do a complete neurological examination. This examination should include evaluation of the gait, mental function, cranial nerves, motor system and sensory system. With practice, a routine neurological examination can be done rapidly and accurately.

Siemens, Peter



Neurological complications in obstetric regional anaesthesia  

Microsoft Academic Search

Neurological complications after obstetric central neural blocks are rare events. Although central neural blockade does cause neurological complications, there must be awareness that neurological deficits may either develop spontaneously (e.g. epidural abscess\\/haematoma) or as a result of the labour and delivery process (maternal obstetric palsies). We have attempted to review as completely as possible the published survey and case reports

C. C. Loo; G. Dahlgren; L. Irestedt




ERIC Educational Resources Information Center





ERIC Educational Resources Information Center




Neurological complications in renal failure: a review  

Microsoft Academic Search

Neurological complications whether due to the uremic state or its treatment, contribute largely to the morbidity and mortality in patients with renal failure. Despite continuous therapeutic advances, many neurological complications of uremia, like uremic encephalopathy, atherosclerosis, neuropathy and myopathy fail to fully respond to dialysis. Moreover, dialytic therapy or kidney transplantation may even induce neurological complications. Dialysis can directly or

R. Brouns; P. P. De Deyn



Neurological manifestations in systemic sclerosis (scleroderma).  


One hundred and twenty-five patients with systemic sclerosis were surveyed for neurological manifestations in a prospective study. Seven (5.6%) were found to have a defined neurologic lesion: 4 with carpal tunnel syndrome and one each with trigeminal neuralgia, mononeuritis multiplex and peripheral neuropathy. Neurological involvement occurs but is uncommon in this connective tissue disorder. PMID:6090661

Lee, P; Bruni, J; Sukenik, S



The Significance of Microembolic Signals and New Cerebral Infarcts on the Progression of Neurological Deficit in Acute Stroke Patients with Large Artery Stenosis  

Microsoft Academic Search

Background: Early neurological deterioration is common in the acute phase after stroke. We sought to investigate the correlation between the progression of microembolic signal (MES), ischemic infarcts and the neurological deficits in the acute phase of stroke patients with large artery occlusive disease. Methods: Transient ischemic attack or stroke patients with relevant significant large artery stenosis (?50% diameter reduction) and

Q. Hao; W. H. Leung; C. Leung; C. T. Mok; H. Leung; Y. Soo; X. Y. Chen; W. Lam; K. S. Wong



[Prognostic value of neurologic findings in the newborn infant for the obstetrician].  


Prognostic value of neurologic findings of the neonate. 1. Severe cerebral symptoms of the neonate persisting during some days leads in follow-up of the survivors in 20 to 30% to severe cerebral disorders like cerebral palsy, epilepsy, physical and mental handicap, behaviour disorders. 2. Moderate cerebral disorders during neonatal period are followed by severe cerebral handicaps only in about 10%. 3. Mild cerebral symptoms of the neonate, which are abating during 24 hours, most not will be followed of severe mental disorders. - On the strength of this statistical statement exactly recorded neurological findings of the newborn could be used as an evaluation of the performance of an obstetric department. PMID:566495

Issel, E P; Bilz, D



Validation of the M.D. Anderson Symptom Inventory Brain Tumor Module (MDASI-BT)  

Microsoft Academic Search

SummaryBackground  Symptom occurrence has been shown to predict treatment course and survival in patients with solid tumors. Primary brain tumor (PBT) patients are unique in the occurrence of neurologic symptoms. Currently, no instrument exists that measures both neurologic and cancer-related symptoms.Methods  Patients diagnosed with PBT participated in this study. Data was collected at one point in time and included demographic and clinical

T. S. Armstrong; T. Mendoza; I. Gring; C. Coco; M. Z. Cohen; L. Eriksen; Ming-Ann Hsu; M. R. Gilbert; C. Cleeland



[Role of electroencephalography in the neurological diagnosis of HIV].  


Neurological diagnosis in HIV patients is usually impeded by nonspecific technical findings and the multiplicity of AIDS-associated neuromanifestations. Despite its limited specificity EEG is of great diagnostic value in patients afflicted by the most common primary neuromanifestation, i.e., AIDS encephalopathy. In the setting of an advanced HIV-infection with typical symptoms and absence of focal neurological signs, parietooccipital slowing of the EEG basal activity may allow the diagnosis of AIDS encephalopathy. Additional advantages of the EEG method consist of its non-invasive nature and the feasibility of repeated examinations for follow-up. Although in secondary neuromanifestations the diagnosis will usually be established by CCT or MRI, focal EEG changes may be of additional diagnostic value. PMID:2514081

Enzensberger, W; Fischer, P A



[Acute strong headache in emergency neurology (diagnostic and treatment)].  


Acute, strong headache represent a frequent symptom with patients who report to the Emergency Neurology. Most of them have functional headaches from the group of primary headaches. However, a smaller number may have secondary headaches, due to structural changes of the cerebral parenchyma. Though the second group is considerably smaller, the secondary headaches, besides fast diagnostics require fast therapy, since they frequently imperil directly the patients life. The paper consider clinical and neurological predictions, indicating possible secondary headaches ("red flags") and diagnostic procedures, necessary to achieve their fast ethiological diagnosis. We consider also possibilities and limitations of certain additional methods (CT, cerebrospinal fluid examination, MR) with the aim to establish the examinations algorithm. Finally we offer procedures related to the therapy of acute primary as well as secondary strong headaches. PMID:15875472

Dimitrijevi?, Jovan; Dzirlo, Ka?usa; Loncarevi?, Nedim; Gordana, Buli?



Neurologic complication after a roller coaster ride.  


Neurologic complications after roller coaster rides are uncommon but potentially catastrophic. Physicians should have a high index of suspicion and prompt appropriate investigation. A 22-year-old healthy African American man presented with a 2-day history of constant occipital headache associated with vertigo, nausea, vomiting, and ambulatory dysfunction. Physical examination showed gait ataxia, slight dysmetria, and vertical nystagmus. Magnetic resonance imaging (MRI) of the brain showed early subacute ischemic infarct in the right cerebellum in the distribution of the right posterior inferior cerebellar artery. Magnetic resonance angiography of the neck showed focal dissection of the right vertebral artery at C1 through C2 level. On subsequent questioning, the patient recollected riding a roller coaster 2 weeks before the onset of symptoms. Anticoagulation with heparin was started, and the patient was bridged to oral warfarin. After a 5-day uneventful hospital course, symptoms improved and patient was discharged on oral anticoagulation. Cervicocephalic arterial dissections after roller coaster rides are rarely described in literature. The acceleration and abrupt changes of direction might lead to indirect trauma that is applied to mobile portions of the cervicocephalic arteries leading to intimal tears. Magnetic resonance angiography combined with axial T1-weighted cervical MRI is preferred because it is a high-sensitive, noninvasive test. The rationale for the use of anticoagulants or antiplatelets in patients with cervicocephalic arterial dissection is to prevent early recurrence and infarction. However, a meta-analysis failed to show significant difference in the rates of disability or death between both groups. Therefore, the decision for medical treatment should be made in a case-by-case basis. PMID:20980120

Sa Leitao, Davi; Mendonca, Dercio; Iyer, Harish; Kao, Cheng-Kai



Neurology of widely embedded free will.  


Free will is classically attributed to the prefrontal cortex. In clinical neurology, prefrontal lesions have consistently been shown to cause impairment of internally driven action and increased reflex-like behaviour. Recently, parietal contributions to both free selection at early stages of sensorimotor transformations and perception of specifically self-intended movements were demonstrated in the healthy brain. Such findings generated the concept that 'free will' is not a function restricted to the prefrontal cortex but is more widely embedded in the brain, indeed including the parietal cortex. In this paper, a systematic re-interpretation of parietal symptoms, such as apraxia and reduced sense of agency, is given with reference to the consequences of reduced freedom of selection at early stages of sensorimotor transformation. Failed selection between possible movement options is argued to represent an intrinsic characteristic of apraxia. Paradoxical response facilitation supports this view. Perception of self-intended movement corresponds with a sense of agency. Impaired parietal distinction between predicted and perceived movement sensations may thus equal a restricted repertoire for selection between possible movement options of which intention is attributed to either oneself, others or an alien hand. Sense of agency, and thus perception of free will, logically fits a model of the parietal cortex as a neuronal interface between the internal drive to reach a goal and a body scheme required to select possible effectors for motor preparation. PMID:21752362

de Jong, Bauke M



Cryptogenic transient ischemic attack after nose blowing: association of huge atrial septal aneurysm with patent foramen ovale as potential cause  

PubMed Central

Association of atrial septal aneurysm (ASA) with patent foramen ovale (PFO) is considered an important risk factor for cardioembolism frequently forwarding paradoxical embolism in patients with cryptogenic or unexplained cerebral ischemic events. We herein describe the case of a 69-year-old male patient reporting uncontrolled movements of the right arm due to a muscle weakness, slurred speech, and paresthesia in the oral region some seconds after he had blown his nose. These neurological symptoms had improved dramatically within a few minutes and were completely regressive at admission to our hospital about two hours later. On transesophageal echocardiography (TEE) a huge ASA associated with PFO was detected. Diagnosis of the large-sized ASA was also confirmed by cardiac magnetic resonance imaging. Due to the early complete recovery from his neurological symptoms, the patient was diagnosed with a transient ischemic attack (TIA). After nine days he was discharged in a good clinical condition under the treatment with oral anticoagulation. It is concluded that in cryptogenic or unexplained stroke or TIA TEE should always be performed to rule out ASA and PFO as potential sources for paradoxical embolism in those inconclusive clinical situations.

Lotze, Ulrich; Kirsch, Uwe; Ohlow, Marc-Alexander; Scholle, Thorsten; Leonhardi, Jochen; Lauer, Bernward; Oltmanns, Gerhard; Schmidt, Hendrik



Cryptogenic transient ischemic attack after nose blowing: association of huge atrial septal aneurysm with patent foramen ovale as potential cause.  


Association of atrial septal aneurysm (ASA) with patent foramen ovale (PFO) is considered an important risk factor for cardioembolism frequently forwarding paradoxical embolism in patients with cryptogenic or unexplained cerebral ischemic events. We herein describe the case of a 69-year-old male patient reporting uncontrolled movements of the right arm due to a muscle weakness, slurred speech, and paresthesia in the oral region some seconds after he had blown his nose. These neurological symptoms had improved dramatically within a few minutes and were completely regressive at admission to our hospital about two hours later. On transesophageal echocardiography (TEE) a huge ASA associated with PFO was detected. Diagnosis of the large-sized ASA was also confirmed by cardiac magnetic resonance imaging. Due to the early complete recovery from his neurological symptoms, the patient was diagnosed with a transient ischemic attack (TIA). After nine days he was discharged in a good clinical condition under the treatment with oral anticoagulation. It is concluded that in cryptogenic or unexplained stroke or TIA TEE should always be performed to rule out ASA and PFO as potential sources for paradoxical embolism in those inconclusive clinical situations. PMID:23861594

Lotze, Ulrich; Kirsch, Uwe; Ohlow, Marc-Alexander; Scholle, Thorsten; Leonhardi, Jochen; Lauer, Bernward; Oltmanns, Gerhard; Schmidt, Hendrik



Neurologic complications after liver transplantation.  


Neurologic complications are relatively common after solid organ transplantation and affect 15%-30% of liver transplant recipients. Etiology is often related to immunosuppressant neurotoxicity and opportunistic infections. Most common complications include seizures and encephalopathy, and occurrence of central pontine myelinolysis is relatively specific for liver transplant recipients. Delayed allograft function may precipitate hepatic encephalopathy and neurotoxicity of calcineurin inhibitors typically manifests with tremor, headaches and encephalopathy. Reduction of neurotoxic immunosuppressants or conversion to an alternative medication usually result in clinical improvement. Standard preventive and diagnostic protocols have helped to reduce the prevalence of opportunistic central nervous system (CNS) infections, but viral and fungal CNS infections still affect 1% of liver transplant recipients, and the morbidity and mortality in the affected patients remain fairly high. Critical illness myopathy may also affect up to 7% of liver transplant recipients. Liver insufficiency is also associated with various neurologic disorders which may improve or resolve after successful liver transplantation. Accurate diagnosis and timely intervention are essential to improve outcomes, while advances in clinical management and extended post-transplant survival are increasingly shifting the focus to chronic post-transplant complications which are often encountered in a community hospital and an outpatient setting. PMID:24023979

Zivkovi?, Saša A



Neurologic complications of renal disease.  


Renal failure and its treatment are associated with a number of neurologic complications that must be differentiated from the nervous system complications of the disease leading to renal failure. Uremic encephalopathy is characterized by clinical signs of depressed brain function coexisting with excitation, often in the form of generalized epileptic seizures. Peripheral neuropathy, due to axonal involvement, is common and is characterized by ascending sensory and motor dysfunction. The treatment of renal failure also may lead to the development of neurologic abnormalities in the form of dialysis disequilibrium characterized by headache, nausea, irritability that may progress to seizures, coma, and death, which is caused by the entry of free water into the brain and swelling. Dialysis dementia, caused by the toxic effects of aluminum, is now rare. Renal transplant recipients may develop cerebrovascular disease, infections by opportunistic organisms, or malignant neoplasms, particularly primary lymphoma of the brain. As transplant recipients live longer and more operations are performed, additional complications may be seen in the future. PMID:2549362

Lockwood, A H



Atlantic Conjunctures in Anglo-American Neurology:  

PubMed Central

Summary The emergence of neurology at Johns Hopkins presents a case study for reconsidering the international and institutional contexts of neurology generally. Using a variety of sources, Hopkins's interwar plans for neurology are presented and contextualized in the international environment of neurology, medical research, and philanthropy. During this period, neurology across the world, especially in Britain, was undergoing vast institutional changes. In order for Hopkins to remain at the forefront of excellence in both medicine and medical education, a program in neurology was deemed essential, and this would seem now to have been an unproblematic advance. Spearheading the project for the establishment of neurology at Hopkins was the dean of the medical school, Lewis H. Weed. Weed attempted from 1919 until 1942 to establish a department of neurology but had only limited success. The fact that finding support proved challenging for Weed and Johns Hopkins casts a provocative light on the broader historiography of neurology and illustrates the important role of the international context in defining neurology professionally.

Casper, Stephen T.



Non-lyme tick-borne diseases: a neurological perspective.  


Tick-borne diseases are prevalent throughout the world and present a diagnostic challenge owing to their nonspecific clinical symptoms. Many tick-borne diseases involve the central and peripheral nervous systems. Early diagnosis or at least suspicion of a tick-borne cause is necessary to institute early empiric treatment. After a brief review of tick biology, we present the most common tick-borne diseases. A brief discussion of epidemiology, the transmission route, and pathogenesis is followed by a discussion of the clinical manifestations, diagnosis and treatment options when available. The review emphasizes the infectious causes with a significant neurological manifestation. PMID:24014177

Seraji-Bozorgzad, Navid; Tselis, Alexandros C



Neurological immune-related adverse events of ipilimumab.  


Ipilimumab enhances the T lymphocyte mediated immune response to both tumour cells and healthy tissue, improving survival in patients with metastatic melanoma but also leads to more immune-related adverse events (irAEs) than previously used treatments, such as dacarbazine. We present three patients with neurological irAEs from ipilimumab treatment: hypophysitis, meningitis and Guillain-Barré syndrome. Once an irAE occurs, ipilimumab should be stopped and corticosteroids started. Usually, ipilimumab-induced irAE symptoms improve within days to weeks, but can be life-threatening if unrecognised. PMID:23487828

Bot, Ilja; Blank, Christian U; Boogerd, Willem; Brandsma, Dieta



Neurologic complications of polycythemia and their impact on therapy  

SciTech Connect

Polycythemia vera, a clonal stem cell disorder, produces neurologic problems in 50-80% of patients. Some symptoms, such as headache and dizziness, are related to hyperviscosity, and respond immediately to reduction of cell counts. Others seem to result from an associated coagulopathy. Patients with polycythemia tend to develop both arterial and venous thrombosis and are prone to hemorrhages. Treatments for polycythemia include phlebotomy, chlorambucil supplemented with phlebotomy, and {sup 32}P plus phlebotomy. Whatever treatment is chosen, the aim of therapy should be to reduce the hematocrit to approximately 40-45%.37 references.

Newton, L.K. (MD Anderson Cancer Center, Houston, TX (USA))



Schizo-obsessive and obsessive-compulsive disorder: Comparison of clinical characteristics and neurological soft signs  

Microsoft Academic Search

The purpose of the study was to examine whether schizophrenia with obsessive-compulsive disorder (OCD) represents a severe form of OCD-spectrum disorders on the basis of neurological soft signs (NSS) and obsessive-compulsive (OC) symptoms. Sixteen patients with OCD-schizophrenia, 25 OCD patients and 23 healthy controls (HC) were studied. Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS), Clinical Global

Levent Sevincok; Aybars Akoglu; Hülya Arslantas



Neurologic Consequences of Drug Abuse  

PubMed Central

This review draws attention to the adverse effects of drug abuse on the nervous system. Drug-induced neurotoxicity reflects impairment to the structural and functional integrity of the nervous system. Important signs and symptoms of neurotoxicity and their management are outlined.

Levitan, Maurice D.



Neurological deterioration in adult phenylketonuria  

Microsoft Academic Search

Summary A 28-year-old man with classical phenylketonuria had increased seizure frequency and rapidly progressive spasticity. There was a marked reduction of biogenic amine neutotransmitter metabolites in cerebrospinal fluid. Dietary therapy reduced serum phenylalanine levels, improved symptoms of hypertonicity, and cerebrospinal fluid neurotransmitter metabolites became normal. An adolescent male with classical phenylketonuria, treated by dietary restriction until age 6 years, was

D. Villasana; I. J. Butler; J. C. Williams; S. M. Roongta



Gene expression analysis of spontaneously hypertensive rat cerebral cortex following transient focal cerebral ischemia  

Microsoft Academic Search

Identification of novel modulators of ischemic neuronal death helps in developing new strategies to prevent the stroke- induced neurological dysfunction. Hence, the present study evaluated the gene expression changes in rat cerebral cortex at 6 and 24 h of reperfusion following transient middle cerebral artery occlusion (MCAO) by GeneChipanalysis. Transient MCAO resulted in selective increased mRNA levels of genes involved

Vemuganti L. Raghavendra Rao; Kellie K. Bowen; Vinay K. Dhodda; Guoqing Song; James L. Franklin; Narender R. Gavva; Robert J. Dempsey



Pediatric Asthma: Symptoms  


... MD Dept. of Pediatrics View full profile Pediatric Asthma: Symptoms Asthma symptoms can range from very mild ... for exercise Downward trend in peak flow numbers Asthma Symptoms Asthma symptoms indicate that an asthma episode ...


Determinants of neurologic deterioration and stroke-free survival after spontaneous cervicocranial dissections: a multicenter study.  


Patients with spontaneous cervicocranial dissection (SCCD) may experience new or recurrent ischemic events despite antiplatelet or anticoagulant therapy. Treatment with stent placement is an available option; however, the literature on patient selection is limited. Thus, identifying patients at high risk for neurologic deterioration after SCCD is of critical importance. The present study examined the rate of neurologic deterioration in medically treated patients with SCCD and evaluated demographic, clinical, and radiologic factors affecting this deterioration. We retrospectively identified consecutive patients with SCCD over a 7-year period from 3 medical institutions, and evaluated the relationships between demographic data, clinical characteristics, and angiographical findings and subsequent neurologic outcomes. Neurologic deterioration was defined as transient ischemic attack (TIA), ischemic stroke, or death occurring during hospitalization or within 1 year of diagnosis. Kaplan-Meier curves were used to determine neurologic event-free survival up to 12 months. A total of 69 patients (mean age, 47.8 ± 14 years; 45 males) with SCCD were included in the study. Eleven patients (16%) experienced in-hospital neurologic deterioration (TIA in 9, ischemic stroke in 1) or death (1 patient). An additional 8 patients developed neurologic deterioration within 1 year after discharge (TIA in 5, ischemic stroke in 2, and death in 1). The overall 1-year event-free survival rate was 72%. Women (P = .046), patients with involvement of both vertebral arteries (P = .02), and those with intracranial arterial involvement (P = .018) had significantly higher rates of neurologic deterioration. Our findings indicate that neurologic deterioration is relatively common after SCCD despite medical treatment in women, patients with bilateral vertebral artery involvement, and those with intracranial vessel involvement. PMID:22079562

Hassan, Ameer E; Jadhav, Vikram; Zacharatos, Haralabos; Chaudhry, Saqib A; Rodriguez, Gustavo J; Mohammad, Yousef M; Suri, M Fareed K; Tariq, Nauman; Vazquez, Gabriela; Tummala, Ramachandra P; Taylor, Robert A; Qureshi, Adnan I



Brain banking for neurological disorders.  


Brain banks are used to gather, store, and provide human brain tissue for research and have been fundamental to improving our knowledge of the brain in health and disease. To maintain this role, the legal and ethical issues relevant to the operations of brain banks need to be more widely understood. In recent years, researchers have reported that shortages of high-quality brain tissue samples from both healthy and diseased people have impaired their efforts. Closer collaborations between brain banks and improved strategies for brain donation programmes will be essential to overcome these problems as the demand for brain tissue increases and new research techniques become more widespread, with the potential for substantial scientific advances in increasingly common neurological disorders. PMID:24074724

Samarasekera, Neshika; Al-Shahi Salman, Rustam; Huitinga, Inge; Klioueva, Natasja; McLean, Catriona A; Kretzschmar, Hans; Smith, Colin; Ironside, James W



[Treatment for Pott's disease with neurological complication].  


Tuberculosis of the spine (Pott's disease) is the most common skeletal involvement in tuberculosis, and is often accompanied with neurological deficiency. Surgical treatment was previously the mainstay of therapy in cases of Pott's disease with neurological deficiency, but since clinical recovery was found in patients awaiting surgery, conservative management with antibiotic treatment as a first Line treatment has been advocated. This conservative approach may improve the patients' neurological status while avoiding the morbidity and mortality of surgical treatment. PMID:21678648

Avisar, Erez; Smorgick, Yossi; Mirovsky, Yigal; Gelfer, Yael; Lindner, Dror; Yoram, Anekstein



Neurological problems in the adolescent population.  


Adolescent patients pose a unique challenge to child neurologists. Although there are a number of neurological disorders that present in childhood and persist through adolescence, there are some disorders like juvenile myoclonic epilepsy (JME) that occur more commonly in this age group. We discuss common neurological disorders encountered by adolescent medicine physicians that have been affected by recent advances in the field of adolescent neurology. We also address the challenges of transitioning care to an adult neurologist. PMID:23705516

Parachuri, Venu; Inglese, Christopher



Transient Left Ventricular Apical Ballooning: A Review of the Literature  

Microsoft Academic Search

Transient left ventricular apical ballooning is a newly defined syndrome characterized by sudden onset of chest symptoms, electrocardiographic changes charac- teristic of myocardial ischemia, transient left ventricu- lar dysfunction—particularly in the apical region, low- grade troponin elevation, and no significant coronary stenosis by angiogram. This syndrome is also referred to as Takotsubo cardiomyopathy, \\

Brian Guttormsen; Lisa Nee; J. C. Makielski; Jon G. Keevil


Transient ischemic attack with infarction: A unique syndrome?  

Microsoft Academic Search

It is debated whether transient symptoms associated with infarction (TSI) are best considered a minor ischemic stroke, a subtype of transient ischemic attack (TIA), or a separate ischemic brain syndrome. We studied clinical and imaging features to establish similarities and differences among ischemic stroke, TIA without infarction, and TSI. 87 consecutive patients with TIA and 74 patients with ischemic stroke were studied.

Hakan Ay; Walter J. Koroshetz; Thomas Benner; Mark G. Vangel; Ona Wu; Lee H. Schwamm; A. Gregory Sorensen



Early Neurological Deterioration following Intravenous Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Lacunar Stroke  

Microsoft Academic Search

Background: The aim of this study was to examine the rate of early neurological deterioration (END) and favorable outcomes after acute lacunar stroke following the use of intravenous recombinant tissue plasminogen activator (IV rtPA). Methods: A total of 76 acute lacunar stroke patients (<12 h from symptom onset) were enrolled during a 1-year period (n = 76). Comparisons were made

Yang-Ha Hwang; Jong-Geun Seo; Ho-Won Lee; Sung-Pa Park; Chung-Kyu Suh



Analysis of abnormalities in purine metabolism leading to gout and to neurological dysfunctions in man  

Microsoft Academic Search

A modelling approach is used to analyse diseases associated with purine metabolism in man. The specific focus is on deficiencies in two enzymes, hypoxanthine:guanine phosphoribosyltransferase and adenylosuccinate lyase. These deficiencies can lead to a number of symptoms, including neurological dysfunctions and mental retardation. Although the biochemical mechanisms of dysfunctions associated with adenylosuccinate lyase deficiency are not completely understood, there is



Evidence of a neurologically based “denial of illness” in patients with Huntington's disease  

Microsoft Academic Search

Patients diagnosed with Huntington's Disease (HD) commonly show a denial of symptoms and an unawareness of the motoric, cognitive, and emotional changes that accompany this disease. To examine if this denial has a neurological component to it, 19 patients who received a positive diagnosis of HD from the presymptomatic HD clinic at the University of Connecticut Medical School, and 14

A. Wallace Deckel; Douglas Morrison



Reversal of Neurological Deficits by Levallorphan in Patients with Acute Ischemic Stroke  

Microsoft Academic Search

Summary: This study was conducted to examine the effect of the intramuscular injection of levallorphan tartrate (1.0 mg), a mixed agonist-antagonist opiate, on the neurological signs, symptoms, and vital signs in 19 patients with acute ischemic stroke. A temporary improvement of hemiplegia or hemiparesis was observed within several minutes after levallorphan injection in 13 of the patients. There were no

Nobuo Handa; Masayasu Matsumoto; Masaichi Nakamura; Shotaro Yoneda; Kazufumi Kimura; Yoshinori Sugitani; Kenji Tanaka; Takashi Takano; Takenobu Kamada



The Effects of Chiropractic Treatment on Students With Learning and Behavioral Impairments Due to Neurological Dysfunction.  

ERIC Educational Resources Information Center

The effects of chiropractic treatment on children with learning and behavioral problems was investigated with 24 elementary and secondary level students, 12 receiving regular chiropractic treatment and 12 receiving medication. Results indicated that chiropractic treatment was more effective for the wide range symptoms common in the neurological

Walton, E. V.; Brzozowski, Walter T.


Diagnosis of Plasmodium vivax malaria complicated by abnormal neurological imaging.  


The number of patients presenting with malaria in the United States has increased. This is attributable to the growing ease and popularity of overseas travel. We present a 41-year-old man diagnosed with Plasmodium vivax malaria after a 9-month symptom-free interval following return from an endemic area. The clinical picture was complicated by the results of neurological imaging that proved to be incidental and unrelated findings. Unfortunately, there are no pathognomonic signs or symptoms of malaria. The presenting complaints are often nonspecific and may be associated with a broad differential diagnosis. Thus, physicians must have a high index of suspicion and elicit a complete travel history to arrive at the correct diagnosis. PMID:12502181

Vest, Michael T; Laurence, Rose; Thompson, Jennifer C



Neurological risk profile in organic erectile impotence.  

PubMed Central

Thirty men who presented with erectile impotence to the urological department underwent a thorough urological, angiological, and neurological examination with complementary neurophysiological tests of somatosensory and sympathetic and parasympathetic function. Most had vascular and neurological abnormalities. Clinical findings and electrophysiological tests for autonomic dysfunction had the highest yield of abnormal results. Nerve conduction studies and pudendal nerve somatosensory evoked potentials were far less informative. The lack of correlation between vascular and general neurological abnormalities emphasises that patients must be screened for both vascular and neurological dysfunction to prevent unrewarding vascular operation in impotent men.

Kunesch, E; Reiners, K; Muller-Mattheis, V; Strohmeyer, T; Ackermann, R; Freund, H J



Challenges in neurological practice in developing countries.  


The burden of neurological illness is much higher in developing countries. Neurological disorders in these countries are mainly due to poverty and malnutrition. Spectrums of diseases are also different in comparison with developed countries. Lack of resources, ignorance, and overpopulation make it very difficult and challenging to tackle this problem. Majority of the patients are seen by general practitioners who have little knowledge about neurological illnesses. Most of the countries have very few or no neurologist. There is a greater need of taking neurological care at primary care level where majority of the patients struggle with epilepsy, stroke and neuroinfections. PMID:23229216

Pandey, Sanjay


Neurologic Diseases - Multiple Languages: MedlinePlus  


... Neurologic Diseases - Multiple Languages Chinese - Traditional (????) French (français) Hindi (??????) Japanese (???) Korean (???) Russian ( ... Chinese - Traditional) Bilingual PDF Health Information Translations French (français) ... EEG (Électroencéphalogramme) - français (French) Bilingual PDF ...


High Frequency Chest Wall Compression Therapy in Neurologically Impaired Children.  


BACKGROUND:: Children with neurological impairment often suffer from insufficient airway secretion clearance, which substantially increases their respiratory morbidity. The goal of the study was to assess the clinical feasibility of high frequency chest wall compression (HFCWC) therapy in neurologically impaired children with respiratory symptoms. METHODS:: This was a single-center, investigator initiated, prospective study. Twenty two patients were studied for 12 months before and 12 months after initiation of HFCWC therapy, 15 patients were followed up for additional 12 months. The threshold of compliance with HFCWC therapy was 70%. The amounts of pulmonary exacerbations, which required hospitalization, were recorded. RESULTS:: Forty five percent of study patients required hospital admission before initiation of HFCWC therapy. This rate decreased to 36% after the first year of treatment and to 13% after the second year of treatment. There was a statistically significant reduction of the number of hospital days at follow-up relative to before treatment. Use of either the cough assist device or tracheostomy did not significantly interact over time with hospitalization days. CONCLUSIONS:: Prolonged HFCWC therapy may reduce the number of hospitalizations in neurologically impaired children. PMID:23777653

Fitzgerald, Kathryn; Dugre, Jessica; Pagala, Sobhan; Homel, Peter; Marcus, Michael; Kazachkov, Mikhail



Pathology, clinical features and treatments of congenital copper metabolic disorders--focus on neurologic aspects.  


Genetic disorders of copper metabolism, including Menkes kinky hair disease (MD), occipital horn syndrome (OHS) and Wilson's disease (WD) are reviewed with a focus on the neurological aspects. MD and OHS are X-linked recessive disorders characterized by a copper deficiency. Typical features of MD, such as neurologic disturbances, connective tissue disorders and hair abnormalities, can be explained by the abnormally low activity of copper-dependent enzymes. The current standard-of-care for treatment of MD is parenteral administration of copper-histidine. When the treatment is initiated in newborn babies, neurologic degeneration can be prevented, but delayed treatment is considerably less effective. Moreover, copper-histidine treatment does not improve connective tissue disorders. Novel treatments targeting neurologic and connective tissue disorders need to be developed. OHS is the mildest form of MD and is characterized by connective tissue abnormalities. Although formal trials have not been conducted for OHS, OHS patients are typically treated in a similar manner to MD. WD is an autosomal recessive disorder characterized by the toxic effects of chronic exposure to high levels of copper. Although the hepatic and nervous systems are typically most severely affected, initial symptoms are variable, making an early diagnosis difficult. Because early treatments are often critical, especially in patients with neurologic disorders, medical education efforts for an early diagnosis should target primary care physicians. Chelating agents and zinc are effective for the treatment of WD, but neurologic symptoms become temporarily worse just after treatment with chelating agents. Neurologic worsening in patients treated with tetrathiomolybdate has been reported to be lower than rates of neurologic worsening when treating with other chelating agents. PMID:21112168

Kodama, Hiroko; Fujisawa, Chie; Bhadhprasit, Wattanaporn



Transient Global Amnesia: A Case Report  

PubMed Central

Introduction Transient global amnesia is a syndrome of temporary and reversible disruption of short-term memory accompanied by repetitive questioning. Although the etiology is unknown, the prognosis usually benign, and no particular treatment is required, it is important for all involved clinicians to recognize the diagnosis and possess knowledge about the evaluation of these affected patients. Case Presentation A middle-aged Caucasian woman presented for neurologic evaluation for acute forgetfulness. Neurologic examination disclosed repetitive questioning with preserved orientation and no focal motor, speech, sensory, coordination, or cranial nerve deficits. Neurologic investigations did not reveal any pathologic findings. Her memory improved and reverted to normal baseline over the course of a 24-hour hospital stay. Conclusion Transient global amnesia is an interesting syndrome of reversible anterograde amnesia associated with repetitive questioning that occurs with an unclear etiology in middle-aged and elderly individuals. Due clinical diligence is required in the investigation of these patients. Treatment is generally not required, and the condition usually does not recur. Clinicians, including neurologists, internists, family practice physicians, and psychiatrists, need awareness of this condition.

Rison, Richard Alan; Rosenheck, Rachel Ellen



Propranolol in the Control of Schizophrenic Symptoms  

Microsoft Academic Search

All schizophrenic symptoms remitted completely in six out of 14 adults who had not responded to phenothiazine drugs and who were then given propranolol. Another patient improved markedly and four improved moderately. Two had minimal or transient improvement, and one left hospital unchanged after a short, severe, toxic reaction. The six with complete remissions all began to improve within a

N. J. Yorkston; Saniha A. Zaki; M. K. U. Malik; R. C. Morrison; C. W. H. Havard



Is fibromyalgia a neurologic disease?  

Microsoft Academic Search

Fibromyalgia (FM) is characterized by abnormal pain sensitivity in response to diverse stimuli as well as persistent widespread\\u000a pain and other symptoms such as fatigue and sleep disturbance. Progress has been made in identifying factors that contribute\\u000a to the etiopathogenesis of abnormal pain sensitivity, but there is no single model of pathophysiology or treatment of FM that\\u000a has gained wide

Laurence A. Bradley; Nancy L. McKendree-Smith; Graciela S. Alarcón; Leanne R. Cianfrini



Transient Idiopathic Primary Penoscrotal Edema  

PubMed Central

We present the case of a male born prematurely at 32 weeks gestation by cesarean section following overt symptoms of maternal preeclampsia. He developed severe penoscrotal edema anew one month from birth. No remarkable exposure or trauma was identified. This unexplained swelling remained uniform till 4 months of age, while the penile edema resolved spontaneously. A small benign hydrocele remained unchanged, since onset of the edema and continued after the edema subsided. This is the first report of persistent, but transient penoscrotal edema resolving in a 3 months course, without any apparent explanation, a possible pathogenetic mechanism was suggested.

Namir, Sody A; Trattner, Akiva



Clinical evaluation of early cognitive symptoms.  


The etiology of cognitive impairment in older adults is almost always a clinical diagnosis without definitive biomarkers. The clinical evaluation, therefore, is indispensable. Evaluating cognitive symptoms requires a deliberate approach to define the onset, course, and nature of symptoms. An informant who knows the patient well is essential. The physician must have a working knowledge of the basics of cognitive function. The neurologic examination also is fundamental to defining the origin of cognitive impairment. Extraocular movements, speech, and gait are examples of high-yield examination findings that can be observed and tested quickly, adding to the clinical impression. PMID:24094297

McCarten, J Riley



Spinal cord decompression sickness associated with scuba diving: correlation of immediate and delayed magnetic resonance imaging findings with severity of neurologic impairment—a report on 3 cases  

Microsoft Academic Search

BackgroundThere are few reports detailing an association between immediate and delayed changes in MR imaging findings and severity of neurologic impairment in patients with spinal cord DCS. We report on the cases of 3 patients diagnosed with spinal cord DCS presenting with severe neurologic symptoms after scuba diving.

Mitsuharu Yoshiyama; Shunji Asamoto; Nobusuke Kobayashi; Hiroyuki Sugiyama; Hiroshi Doi; Hajime Sakagawa; Masahiro Ida



Neurological and cognitive impairments detected in older people without a diagnosis of neurological or cognitive disease  

Microsoft Academic Search

Advanced age is associated with the finding of abnormalities on neurological and cognitive assessment. This review aims to identify studies that evaluated community samples of patients without a history of neurological disease and attempts to combine these data. While neurological signs were common, they were not universal and should not be considered an inevitable component of ageing. Additionally, they are

Henry J Woodford; James George



Narcolepsy with cataplexy as presenting symptom of occult neuroblastoma.  


Neuroblastoma associated with the paraneoplastic syndrome of opsoclonus-myoclonus is well-described. However, presentation with narcolepsy-cataplexy is not well-documented in the literature. Narcolepsy with cataplexy is also rare in children younger than 5 years of age. Here we describe three patients, each presenting in early childhood with complex neurological symptoms including narcolepsy with cataplexy that were subsequently found to have paraspinal neuroblastoma. In two of the cases, neurological symptoms resolved with treatment of the tumor and/or immunosuppression, but in one case, the child persistently had a devastating course despite complete resection of the tumor and aggressive immunosuppression. PMID:23827430

Sinsioco, Claudine; Silver, Kenneth; Forrest, Katharine M; Gray, Juliet; Nechay, Alla; Sheldon, Stephen; Chelmicka Schorr, Ewa



Stem cell pathologies and neurological disease  

Microsoft Academic Search

The presence of stem and progenitor cells in the adult human brain suggests a putative and persistent role in reparative behaviors following neurological injury and neurological disease. Too few stem\\/progenitor cells (as in the case of Parkinson's disease) or too many of these cells (as in the case of Huntington's disease and glioma) could contribute to and even signal brain

Dennis A Steindler; Michael S Okun; Björn Scheffler



Spine fracture with neurological deficit in osteoporosis  

Microsoft Academic Search

The literature suggests that spinal fractures acquired after minimal trauma in osteoporotic patients cause neurological problems only extremely rarely. This report describes 9 patients with severe osteoporosis in whom minimal trauma led to a fracture of the thoracic or lumbar spine causing significant neurological deficit. All patients presented originally with isolated back pain after minimal trauma. Initial radiographs documented what

M. H. Heggeness



Mild hypothermia in neurologic emergency: An update  

Microsoft Academic Search

Induced hypothermia to treat various neurologic emergencies, which had initially been introduced into clinical practice in the 1940s and 1950s, had become obsolete by the 1980s. In the early 1990s, however, it made a comeback in the treatment of severe traumatic brain injury. The success of mild hypothermia led to the broadening of its application to many other neurologic emergencies.

Joji Inamasu; Kiyoshi Ichikizaki



Pteridines and mono-amines: relevance to neurological damage.  

PubMed Central

Patients with phenylalanine hydroxylase deficiency show increased concentrations of biopterins and neopterins, and reduced concentrations of serotonin and catecholamines, when phenylalanine concentrations are raised. The pterin rise reflects increased synthesis of dihydroneopterin and tetrahydrobiopterin, and the amine fall a reduction in amine synthesis due to inhibition by phenylalanine of tyrosine and tryptophan transport into neurones. The pterin and amine changes appear to be independent of each other and are present in the central nervous system as well as the periphery; they disappear when phenylalanine concentrations are reduced to normal. Patients with arginase deficiency show a similar amine disturbance but have normal pterin levels. The amine changes probably contribute neurological symptoms but pterin disturbance is not known to affect brain function. Patients with defective biopterin metabolism exhibit severely impaired amine synthesis due to tetrahydrobiopterin deficiency. Pterin concentrations vary with the site of the defect. Symptoms include profound hypokinesis and other features of basal ganglia disease. Neither symptoms nor amine changes are relieved by controlling phenylalanine concentrations. Patients with dihydropteridine reductase (DHPR) deficiency accumulate dihydrobiopterins and develop secondary folate deficiency which resembles that occurring in patients with defective 5,10-methylene tetrahydrofolate reductase activity. The latter disorder is also associated with Parkinsonism and defective amine and pterin turnover in the central nervous system, and a demyelinating illness occurs in both disorders. In DHPR deficiency cerebral calcification may develop in a similar distribution to that seen in congenital folate malabsorption and methotrexate toxicity. Symptoms are ameliorated by therapy with 5-formyltetrahydrofolate but exacerbated by folic acid.

Smith, I.; Howells, D. W.; Hyland, K.



[Registries for neurological drugs landscape].  


In Italy we can mention two experiences related to the use of registries for neurological drugs. The first one involved the use of cholinesterase inhibitors (donepezil, rivastigmine, galantamine) in the treatment of probable Alzheimer's dementia of mild-moderate level; the second, currently in progress, concerned the use of natalizumab for the treatment of multiple sclerosis. The registry of the use of cholinesterase inhibitors in Alzheimer's dementia produced an observational study, whereas the registry on the use of natalizumab in multiple sclerosis, a rare experience in the international, can be regarded as an opportunity not fully appreciated in terms of public health. Natalizumab is prescribed in current clinical practice in patients other than those included in registration studies. In this paper the two Italian experiences will be presented with the understanding that registries cannot make up for the lack of proper registration studies, but can provide, especially when they are conducted and planned as observational studies, new scientific evidence on the risk/benefit profile of the drugs in the real world. PMID:23801231

Vanacore, Nicola



Aberrant splicing in neurological diseases.  


Splicing of precursor messenger RNA (pre-mRNA) removes the intervening sequences (introns) and joins the expressed regions (exons) in the nucleus, before an intron-containing eukaryotic mRNA transcript can be exported and translated into proteins in the cytoplasm. While some sequences are always included or excluded (constitutive splicing), others can be selectively used (alternative splicing) in this process. Particularly by alternative splicing, up to tens of thousands of variant transcripts can be produced from a single gene, which contributes greatly to the proteomic diversity for such complex cellular functions as 'wiring' neurons in the nervous system. Disruption of this process leads to aberrant splicing, which accounts for the defects of up to 50% of mutations that cause certain human genetic diseases. In this review, we describe the different mechanisms of aberrant splicing that cause or have been associated with neurological diseases. WIREs RNA 2013, 4:631-649. doi: 10.1002/wrna.1184 For further resources related to this article, please visit the WIREs website. Conflict of interest: The authors have declared no conflicts of interest for this article. PMID:23821330

Feng, Dairong; Xie, Jiuyong



Neurological Complications of Solid Organ Transplantation  

PubMed Central

Solid organ transplantation (SOT) is the preferred treatment for an expanding range of conditions whose successful therapy has produced a growing population of chronically immunosuppressed patients with potential neurological problems. While the spectrum of neurological complications varies with the type of organ transplanted, the indication for the procedure, and the intensity of long-term required immunosuppression, major neurological complications occur with all SOT types. The second part of this 2-part article on transplantation neurology reviews central and peripheral nervous system problems associated with SOT with clinical and neuroimaging examples from the authors’ institutional experience. Particular emphasis is given to conditions acquired from the donated organ or tissue, problems specific to types of organs transplanted and drug therapy-related complications likely to be encountered by hospitalists. Neurologically important syndromes such as immune reconstitution inflammatory syndrome (IRIS), posterior reversible encephalopathy syndrome (PRES), and posttransplantation lymphoproliferative disorder (PTLD) are readdressed in the context of SOT.

Pruitt, Amy A.; Graus, Francesc; Rosenfeld, Myrna R.



Trends in Post-Concussive Symptom Reporting Following Mild Traumatic Brain Injury in Operation Iraqi Freedom.  

National Technical Information Service (NTIS)

Background: Post-concussive syndrome (PCS), which includes physical, neurological and cognitive complaints, frequently occurs following mild traumatic brain injury (TBI). Research in civilian populations has demonstrated PCS symptom recovery over the cour...

A. J. MacGregor A. L. Dougherty J. J. Tang M. R. Galarneau



Neurologic decompression sickness following cabin pressure fluctuations at high altitude.  


Decompression sickness (DCS) occurs in diving, altitude chamber exposures, and unpressurized or depressurized high-altitude flights. Because DCS takes many forms, in-flight cases may be misinterpreted as hypoxia, hyperventilation, or viral illness, with resulting failure to respond appropriately. In this case, a 28-yr-old male pilot of a single-seat, tactical aircraft experienced 12 rapid pressure fluctuations while flying at 43,000 ft above sea level. He had no symptoms and decided to complete the flight, which required an additional 2 h in the air. Approximately 1 h later he began to experience fatigue, lightheadedness, and confusion, which he interpreted as onset of a viral illness. However, symptoms progressed to visual, cognitive, motor, and sensory degradations and it was with some difficulty that he landed safely at his destination. Neurologic DCS was suspected on initial evaluation by flight line medical personnel because of the delayed onset and symptom progression. He was transferred to a local Emergency Department and noted to have altered mental status, asymmetric motor deficits, and non-dermatomal paresthesias of the upper and lower extremities. Approximately 3.5 h after the incident and 2.5 h after the onset of symptoms he began hyperbaric oxygen therapy. He received partial relief at 30 min of the Navy DiveTable 6 and full resolution at 90 min; there were no recurrent symptoms at a 1-yr follow-up. This case highlights the importance of early recognition of in-flight DCS symptoms and landing as soon as possible rather than as soon as practical in all likely scenarios. PMID:20377149

Auten, Jonathan D; Kuhne, Michael A; Walker, Harlan M; Porter, Henry O



Time Course of Sleep-relatedBreathing Disorders in First-Ever Stroke or Transient Ischemic Attack  

Microsoft Academic Search

To investigate the prevalence and behavior of sleep-related breathing disorders (SRBDs) associated with a first-ever stroke or transient ischemic attack (TIA), we prospectively studied 161 consecutive patients admitted to our stroke unit. Complete neurological assessment was performed to determine parenchymatous and vascular localization of the neurological lesion. Stroke subtype was categorized as TIA, ischemic (IS), or hemorrhagic (HS). A portable

Olga Parra; Adriá Arboix; Siraj Bechich; Luis García-eroles; Josep M. Montserrat; Josep Antoni López; Eugeni Ballester; Josep M. Guerra; Juan José Sopeńa


Transient drainage summary report  

SciTech Connect

This report summarizes the history of transient drainage issues on the Uranium Mill Tailings Remedial Action (UMTRA) Project. It defines and describes the UMTRA Project disposal cell transient drainage process and chronicles UMTRA Project treatment of the transient drainage phenomenon. Section 4.0 includes a conceptual cross section of each UMTRA Project disposal site and summarizes design and construction information, the ground water protection strategy, and the potential for transient drainage.




Lumbar Disc Herniation Associated with Contralateral Neurological Deficit: Can Venous Congestion Be the Cause?  

PubMed Central

Lumbar disc herniation (LDH) associated with a contralateral neurological deficit is sometimes encountered by surgeons. Compression against the opposite pedicle in case of a large discal herniation and prominent stenotic changes of contralateral side are held responsible for contralateral symptoms and findings. In this study, we report a case of LDH associated with a painless contralateral neurological deficit. Prominent venous engorgement and congestion at the contralateral side of discal herniation were detected during the operation. It's treatment with bipolar coagulation and significant improvement was seen after the operation.

Kizmazoglu, Ceren; Ozer, Ercan; Arda, Mehmet Nuri



Reversible neurological syndromes with atypical pneumonia  

PubMed Central

Simultaneous or sequential involvement of lungs is frequently encountered with neurological syndromes like meningoencephalitis, cerebellitis, aseptic meningitis, transverse myelitis, or multiple cranial nerve palsies. However, pulmonary involvement is frequently overlooked when all the attention of physician is diverted to neurological disorder. Prompt and early recognition of such potentially treatable association is required to improve diagnostic and therapeutic outcome. We report six patients presenting with various neurological manifestations like meningitis, meningoencephalitis, and myelits associated with atypical pneumonia. With proper clinical correlation and relevant investigations, all of them were diagnosed in time and had remarkable recovery with appropriate treatment.

Panagariya, Ashok; Sharma, A. K.; Dev, Amit; Kankane, Arvind; Sharma, Bhawna; Dubey, Parul



Second opinions and tertiary referrals in neurology  

Microsoft Academic Search

Background and objective\\u000a   The number of neurological second opinions (SO) and tertiary referrals (TR) is increasing. The main purpose of this study\\u000a was to assess whether a day-care admission made a meaningful contribution to standard neurological outpatient care, for a\\u000a wide range of second opinions and tertiary referrals.\\u000a \\u000a \\u000a \\u000a \\u000a Methods\\u000a   All new patients attending an academic neurological day-care clinic in a

L. Wieske; D. Wijers; E. Richard; M. D. I. Vergouwen; J. Stam



Symptoms of Ankylosing Spondylitis  


Ankylosing Spondylitis (AS): Quick Links Overview >>> Symptoms >>> Diagnosis >>> Treatment >>> Medication >>> Doctor Q&A From Spondylitis Plus >>> ANKYLOSING SPONDYLITIS Most Common Symptoms It is important to note ...


Cancer symptom clusters: old concept but new data.  


Individuals with cancer have multiple symptoms, which frequently co-occur. A nonrandom distribution of symptoms suggests a common mechanism. Symptom clusters (SCs) were considered part of various syndromes in the early years of medicine. The SC concept in clinical medicine is old. Symptom clusters were commonly described in the psychology/psychiatry and neurology literature. Symptom cluster may be defined either clinically or statistically. Statistically derived clusters can differ from clinically defined clusters. The clinical importance of statistically derived clusters is unclear. Pain-insomnia-fatigue and pain-depression-fatigue are commonly recognized clinical clusters. Nausea-vomiting and anxiety-depression are also statistically observed clusters. The longitudinal stability of clusters is unknown. Certain SCs, appear to have a greater adverse influence on outcomes (such as performance status and survival) than others. Comorbidities probably influence symptoms at different levels, but their effect on cancer clusters is unknown. Comprehensive symptom assessment is crucial to cluster identification. The potential use of the cluster concept to abbreviate symptom assessment tools needs validation. Symptom cluster can be disease and/or treatment related and may change as individuals undergo antitumor therapies. Polypharmacy in symptom management is frequent but could be minimized if 1 drug could be used to treat cluster symptoms. Symptom cluster appears to vary with the assessment tool, disease stage, symptom domain used to cluster, cluster methodology, and number of symptoms assessed. The validity and reliability of SCs need universally accepted statistical methods, assessment tools, and symptom domains. For now, nausea-vomiting is recognized as a consistent cluster across multiple studies. Pain-depression-fatigue and pain-insomnia-fatigue are also well recognized. Symptom clusters may help in cancer diagnosis, symptom management, and prognostication. However, the cluster method, reliability, and validity need to be established before assessment or treatment guidelines are established. Symptom clusters require further research before becoming part of routine medical symptom assessment and management. PMID:20351131

Kirkova, Jordanka; Walsh, Declan; Aktas, Aynur; Davis, Mellar P



Neurological Findings after 72 Hours Water Immersion.  

National Technical Information Service (NTIS)

Neurological changes caused by water immersion simulated microgravity were investigated in four male volunteers. All the investigations were performed in the space laboratories for ground based experiments of the Institute for Biomedical Problems, Moscow ...

F. Gerstenbrand I. B. Kozlovskaya M. Berger M. Marosi N. Burlacskova



14 CFR 67.109 - Neurologic.  

Code of Federal Regulations, 2013 CFR

...following: (1) Epilepsy; (2) A disturbance of consciousness without satisfactory medical explanation of the cause...cause. (b) No other seizure disorder, disturbance of consciousness, or neurologic condition that the Federal Air...



14 CFR 67.209 - Neurologic.  

Code of Federal Regulations, 2013 CFR

...following: (1) Epilepsy; (2) A disturbance of consciousness without satisfactory medical explanation of the cause...cause; (b) No other seizure disorder, disturbance of consciousness, or neurologic condition that the Federal Air...



14 CFR 67.309 - Neurologic.  

Code of Federal Regulations, 2013 CFR

...following: (1) Epilepsy; (2) A disturbance of consciousness without satisfactory medical explanation of the cause...cause. (b) No other seizure disorder, disturbance of consciousness, or neurologic condition that the Federal Air...



Premenstrual symptoms: another look.  

PubMed Central

A collection of over 200 symptoms has been labeled premenstrual syndrome. Common belief is that most women experience a marked increase in symptoms premenses. Cyclic variations in the prevalence of commonly cited perimenstrual symptoms were estimated from daily symptom recording. A community-based, multiethnic sample of 345 women recorded symptom severity from "not present" to "extreme" for 90 days. Maximum total reported symptom score occurred during menses, not during premenses. When individual symptoms are considered, the prevalence of those rated as moderate to extreme during menses is less than 15 percent. A method for identifying symptom severity patterns throughout the menstrual cycle is described. Six symptom severity patterns were identified. Only 13 percent of the women exhibited a pattern of increased symptom severity in the premenses. Another 13 percent had a pattern of decreased symptom severity in the premenses.

Woods, N F



Neurological dysfunction and childhood behavioral pathology  

Microsoft Academic Search

The relationship between neurological dysfunction and childhood behavioral pathology was examined in the case material of a 19-year child psychiatry consultation practice involving 1,400 patients, 838 boys and 562 girls, ranging in age from 13 weeks to 19 years at the time of initial consultation. Eighty-eight neurologically damaged children, 60 boys and 28 girls, and matched controls were compared for

Stella Chess



Unexpected neurological deficits following recovery from anaesthesia  

Microsoft Academic Search

Two cases of neurological dysfunction are presented. Neurological deficits after recovery from anaesthesia are unusual in\\u000a young women perioperatively. In the first case, a 39-yr-old woman presented at 36-wk gestation with antepartum haemorrhage\\u000a and in labour. Pregnancy had been complicated by pre-eclampsia and she underwent emergency Caesarean section under general\\u000a anaesthesia without complication. The trachea was extubated when she was

J. Porter; L. Lynch; S. Hart; C. Keohane



Hors d'oeuvres for neurology.  


From time to time, in the setting of lectures, rounds, or casual conversation, there is a need for hors d'oeuvres; small pieces, spices, and artifacts that generate a bit of thought and interest with a neurological twist. A potpourri of neurological trivia is herein presented for the purpose of stimulating the reader and serving as a brief reserve of questions and topics for use on rounds. PMID:10718544

Pascuzzi, R M



Neurological Monitoring for Congenital Heart Surgery  

Microsoft Academic Search

The incidence of neurological complications after pedi- atriccardiacsurgeryrangesfrom2%to25%.Thecauses are multifactorial and include preoperative brain mal- formations, perioperative hypoxemia and low cardiac output states, sequelae of cardiopulmonary bypass, and deep hypothermic circulatory arrest. Neurological monitoring devices are readily available and the anes- thesiologistcannowmonitorthebrainduringpediatric cardiacsurgery.Inthisreviewwediscussnear-infrared cerebral oximetry, transcranial Doppler ultrasound, and electroencephalographic monitors for use during congenitalheartsurgery.Afterreviewofthebasicprin- ciples of each monitoring modality,

Dean B. Andropoulos; Stephen A. Stayer; Laura K. Diaz; Chandra Ramamoorthy



Monogenic Mendelian disorders in general neurological practice.  


An observational study of monogenic Mendelian disorders seen in general neurology outpatient clinics over a 6-year period was undertaken. Fifty-three patients with 16 different diagnoses were identified, the commonest being Huntington's disease and neurofibromatosis type 1. This low frequency of monogenic Mendelian disorders has implications for both continuing medical education and for neurological training. All such patients are probably best referred to specialist clinics where expertise in diagnosis, genetic counselling and testing, and management has been developed. PMID:17362477

Larner, A J



Neurologic drug-psychotropic drug update  

Microsoft Academic Search

It is essential that both the neurologist and the psychiatrist be aware of the neurology drug-psychotropic drug interactions because neurologists prescribe many psychotropic medications and psychiatric consultants often recommend the use of psychotropic drugs for neurology patients. Six methods of examining drug-drug interactions were employed: 1) PubMed (MEDLINE); 2) Hanston’s Drug Interaction Analysis and Management Text (July 2001 quarterly updated

James J Strain; Anwarul Karim; Gina Caliendo; Matthew Brodsky; R. Sandlin Lowe; Carol Himelein



Neurologic drug-psychotropic drug update  

Microsoft Academic Search

It is essential that both the neurologist and the psychiatrist be aware of the neurology drug-psychotropic drug interactions because neurologists prescribe many psychotropic medications and psychiatric consultants often recommend the use of psychotropic drugs for neurology patients. Six methods of examining drug-drug interactions were employed: 1) PubMed (MEDLINE); 2) Hanston's Drug Interaction Analysis and Management Text (July 2001 quarterly updated

James J. Strain; Anwarul Karim; Gina Caliendo; Matthew Brodsky; R. Sandlin Lowe; Carol Himelein



Neurological long term consequences of deep diving  

Microsoft Academic Search

Forty commercial saturation divers, mean age 34.9 (range 24-49) years, were examined one to seven years after their last deep dive (190-500 metres of seawater). Four had by then lost their divers' licence because of neurological problems. Twenty seven (68%) had been selected by neurological examination and electroencephalography before the deep dives. The control group consisted of 100 men, mean

K Todnem; H Nyland; H Skeidsvoll; R Svihus; P Rinck; B K Kambestad; T Riise; J A Aarli



Neurological and neuropsychiatric syndromes associated with liver disease.  


The clinical presentation of acute liver failure and hepatic encephalopathy (HE) in patients with cirrhosis differs significantly. The most serious neurological complication of acute liver failure is the development of devastating brain oedema. Therefore, intracranial pressure monitoring is urgently needed in these patients. Brain oedema is amplified by hypoglycemia, hypoxia and seizures, which are also frequent complications of acute liver failure. Therefore, these parameters must also be monitored. In contrast to acute liver failure in which cerebral dysfunction progresses rapidly, cognitive decline may be clinically undetectable for a long time in cirrhotic patients, until clinically overt symptoms such as psychomotor slowing, disorientation, confusion, extrapyramidal and cerebellar symptoms or a decrease in consciousness occur. Clinically, overt HE is preceded by minimal alterations of cerebral function that can only be detected by neuropsychological or neurophysiological measures, but which nevertheless interfere with the patient's daily living. Rapidly progressing spastic paraparesis (hepatic myelopathy) is a rare complication of cirrhosis. In contrast to HE, it does not respond to blood ammonia lowering therapies but must be considered as an indication for urgent liver transplantation. Cognitive dysfunction has recently been detected in hepatitis C virus (HCV)-infected patients with normal liver function. The patients presented with severe fatigue, cognitive dysfunction and mood disorders. Alterations in brain metabolites, as detected by magnetic resonance spectroscopy, indicated central nervous system alteration in these patients. In contrast to patients with HE, HCV-infected patients did not show motor symptoms or deficits in visual perception, but considerable deficits in attention and concentration ability. PMID:16251835

Weissenborn, Karin; Bokemeyer, Martin; Krause, Jochen; Ennen, Jochen; Ahl, Björn



Detailed clinical assessment of neurological function in symptomatic shipyard workers.  


Forty eight patients with extensive occupational exposure to pneumatic grinding tools were evaluated at a university sponsored occupational health clinic. All patients were interviewed and examined by a physician and assessed neurologically with standard clinical, functional motor, quantitative vibrotactile, and electrodiagnostic tests. Sensorineural symptoms were nearly universal; 47 patients (98%) reported numbness and tingling of the hands and fingers. Among clinical tests, two point discrimination and 30 Hz vibration perception were most frequently abnormal. In order to evaluate associations between quantitative test results and sensorineural symptoms, patients were stratified into two groups of symptom severity according to a consensus sensorineural staging system. The tests that discriminated best between the groups of more and less symptomatic patients were hand strength dynamometry, and vibrotactile thresholds. Age standardised 120 Hz vibrotactile thresholds were significantly raised in digit II in 41% of hand measurements. Nerve conduction studies were neither significantly different between more and less symptomatic groups nor correlated with clinical and quantitative sensory tests. Twenty five per cent of the patients had slowing of sensory conduction velocities in the median nerve at the wrist (less than 48 m/s). Of this subset of patients only two showed abnormal slowing of the median nerve distal to the wrist, but half also showed ulnar nerve slowing (less than 47 m/s). This observation highlights the difficulty of differentiating median nerve entrapment from diffuse distal neuropathy in workers exposed to vibration and points to the need for concomitant quantitative sensory and functional motor assessment. PMID:2393637

Cherniack, M G; Letz, R; Gerr, F; Brammer, A; Pace, P



Chapter 50: history of tropical neurology.  


Tropical neurology began less than two centuries ago. Consumption of dietary toxins predominated at the beginning and gave birth to the geographic entity. The story moved from lathyrism through Jamaican neuropathy to cassava-induced epidemic neuropathy, which was contrasted with Konzo, also associated with cassava. Other tropical diseases enumerated with chronological details include: Chaga's diseases, kwashiorkor, Madras type of motor neuron disease, atlanto-axial dislocation, Burkitt's lymphoma and Kuru, associated with cannibalism among the Fore linguistic group in New Guinea. More recent documentation includes the Cuban neuropathy in 1991 with an epidemic of visual loss and neuropathy, Anaphe venata entomophagy in Nigeria presenting as seasonal ataxia, and neurological aspects of the human immunodeficiency virus infection complete the picture. With time, professional associations were formed and the pioneers were given prominence. The World Federation of Neurology featured Geographic Neurology as a theme in 1977 and Tropical Neurology was given prominence at its 1989 meeting in New Delhi, India. The situation remains unchanged with regards to rare diseases like Meniere's, multiple sclerosis, hereditary disorders. However, with westernization and continued urbanization, changing disease patterns are being observed and tropical neurology may depart from dietary toxins to more western world-type disorders. PMID:19892153

Ogunniyi, Adesola



Experimental Concussion: (Section of Neurology).  


The various hypotheses of the mechanism of coma resulting from cerebral trauma are discussed. Experimental evidence shows that there are two kinds of transient abolition of cerebral function by trauma-acceleration concussion, and compression concussion. The former is a passing paralysis which occurs in all brain-stem mechanisms examined and is brought about at and beyond a threshold value of change in velocity. A lesser degree of change causes momentary depression of function, a greater degree prolongs the phase of paralysis before recovery occurs. Movement of the head is necessary for the usual kind of concussion to occur, as also for contre-coup injury. Compression concussion has much more selective incidence on the respiratory centre, and appears to require an extreme crushing injury or penetration of the skull by a relatively large object. Acceleration concussion is that accompanying closed head injury and is not accompanied by any significant change in C.S.F. pressure. The cerebral blood flow is verv greatly increased in this variety owing to stimulation of the vagoglossopharyngeal nerves at the foramen magnum. With more severe blows subpial or intramedullary lesions may occur in this situation, indicating that distortion at the foramen magnum occurs. No evidence of vascular spasm or paralysis is found. An immediate brief rise of blood-pressure is due to stimulation of the vasomotor centre. Vagal effects may not appear until the traumatic paralysis of all centres begins to pass off. A delayed fall in blood-pressure lasting many minutes may follow severe vagal effects, and appears comparable to acute surgical shock as produced by intense stimulation of any other visceral nerve. Death occurs from failure of blood-pressure, an intensification of shock with shallow respiration and intense constriction of viscera.It is concluded that sudden failure of what has been called the veno-pressor system is important in death shortly following experimental concussion. No macroscopical lesions are found, and histological examination shows no change with ordinary tissue stains. The unconsciousness of coma is believed to be related to direct traumatic paralysis of the cortical neurones and if their sensitivity to physical violence is similar to that of anaesthetics, prolonged impairment of function from this cause alone is possible. Clinical observations were related in support of these conclusions. PMID:19992388

Denny-Brown, D E; Russell, W R



Workshop on neurologic complications of pertussis and pertussis vaccination.  


A multidisciplinary workshop held from September 29 to October 1, 1989, at Airlie House, Warrenton, Virginia, considered the neurologic complications of whooping cough and pertussis vaccine. Pertussis mortality in the U.S. in 2-3/1000 cases. Seizures occur in 1.9% of cases, and encephalopathy in 0.3%. Reviewing all data, it appears likely that a combination of one or more bacterial toxins, asphyxia, CO2 retention and loss of cerebral vascular autoregulation is responsible for neurologic symptoms. The timing of the encephalopathy suggests that it results from increased lysis of bacteria, and release of endotoxin. The encephalopathy is not confined to the paroxysmal phase. In evaluating side-reactions to the vaccine, the following must be kept in mind: 1. Vaccines are not standardized between manufacturers. 2. For a given manufacturer, vaccines are not standard from one batch to the next. 3. Unless the vaccine is properly prepared and refrigerated, its potency and reactivity varies with shelf life. In fact, the whole question of vaccine detoxification has never been systematically investigated. Listed in order of increasing severity, observed adverse reactions include irritability, persistent, unusually high pitched crying, somnolence, seizures, a shock-like "hypotensive, hyporesponsive" state, and an encephalopathy. Since the neurologic picture is not specific for pertussis vaccination, its temporal relationship to the vaccination is the critical variable for determining causation. Although the majority of seizures following pertussis vaccination are associated with fever, it was the consensus of the neurologists attending the workshop, that these do not represent febrile convulsions, but are non-benign convulsions. The incidence of post-vaccine encephalopathy is difficult to ascertain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1981251

Menkes, J H; Kinsbourne, M



A Clinical Study of ADHD Symptoms with Relation to Symptoms of Learning Disorders in Schoolchildren in Bogota, Colombia  

ERIC Educational Resources Information Center

|Objective: To investigate possible relationships between symptoms of ADHD and of learning disorder (LD) in a population geographically, culturally, and linguistically distinct from previous studies. Method: The authors evaluated a cross section of 834 Colombian schoolchildren for childhood neurological pathologies on the basis of a medical…

Talero-Gutierrez, Claudia; Van Meerbeke, Alberto Velez; Reyes, Rodrigo Gonzalez



Plasticity in neurological disorders and challenges for noninvasive brain stimulation (NBS)  

PubMed Central

There has been considerable interest in trialing NBS in a range of neurological conditions, and in parallel the range of NBS techniques available continues to expand. Underpinning this is the idea that NBS modulates neuroplasticity and that plasticity is an important contributor to functional recovery after brain injury and to the pathophysiology of neurological disorders. However while the evidence for neuroplasticity and its varied mechanisms is strong, the relationship to functional outcome is less clear and the clinical indications remain to be determined. To be maximally effective, the application of NBS techniques will need to be refined to take into account the diversity of neurological symptoms, the fundamental differences between acute, longstanding and chronic progressive disease processes, and the differential part played by functional and dysfunctional plasticity in diseases of the brain and spinal cord.

Thickbroom, Gary W; Mastaglia, Frank L



Possible therapeutic effect of lipid supplementation on neurological complications in liver transplant recipients.  


Neurological complications (NCs) represent a serious problem following liver transplantation and may develop either because of various peri-operative factors or the toxicity of immunosuppression. Although the causality assessment of NCs can be particularly difficult in the setting of organ transplantation, calcineurin inhibitors (CNIs) might influence NCs to a certain extent, regardless of the etiology. Therefore, minimizing the influence of CNIs could be a reasonable strategy for alleviating NCs. Based on our hypothesis that lipid supplementation prevents lipophilic CNIs from crossing the blood-brain barrier, soybean oil was administered to five liver transplant patients with NCs. In all of these patients, the neurological symptoms improved without discontinuing or reducing the dose of CNIs. Thus, lipid supplementation might be able to reduce the adverse neurological effects of CNIs. PMID:17442068

Ide, Kentaro; Ohdan, Hideki; Tahara, Hiroyuki; Ishiyama, Kohei; Shishida, Masayuki; Irei, Toshimitsu; Ohira, Masahiro; Tashiro, Hirotaka; Itamoto, Toshiyuki; Asahara, Toshimasa



A timed test of swallowing capacity for neurological patients.  


A timed test of swallowing capacity has been designed for use in patients with neurogenic dysphagia. Swallowing speed (ml/s) has been demonstrated to have high intra- and inter- rater and test- retest reliability, and to be essentially independent of flavour or temperature. "Guideline" normal values were established in individuals without a swallowing disorder: swallowing speed was less in females than males and declined in both groups with age. The validity of a swallowing speed less than 10 ml/s as an index of abnormal swallowing was tested by comparison with the complaint of abnormal swallowing in a group of 81 neurological patients. Swallowing speed had a sensitivity of 96% and specificity of 69%: some apparent false positive responses were found in patients with disordered swallowing, mainly due to multiple sclerosis. Using a standard questionnaire and examination a similar pattern of symptoms and signs were statistically associated with both the clinical complaint of abnormal swallowing and swallowing speed. It is concluded that swallowing speed is a reliable and valid index for assessing disordered swallowing in neurological patients and may be of value in monitoring response to therapy. PMID:1402974

Nathadwarawala, K M; Nicklin, J; Wiles, C M



Male sexual dysfunction and infertility associated with neurological disorders  

PubMed Central

Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation is managed by medications to reverse the condition in mild cases and in bladder harvest of semen after ejaculation in more severe cases. Anejaculation might also be managed by medication in mild cases while assisted ejaculatory techniques including penile vibratory stimulation and electroejaculation are used in more severe cases. If these measures fail, surgical sperm retrieval can be attempted. Ejaculation with penile vibratory stimulation can be done by some spinal cord injured men and their partners at home, followed by in-home insemination if circumstances and sperm quality are adequate. The other options always require assisted reproductive techniques including intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection. The method of choice depends largely on the number of motile sperm in the ejaculate.

Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L; Ohl, Dana A; Lynne, Charles M; S?nksen, Jens



[Autoantibodies to GAD and autoimmune-mediated neurological diseases].  


Autoantibodies to GAD (GAD-Ab) are associated with stiff-person syndrome and cerebellar ataxia. Recent physiological studies have clarified that GAD-Ab causes cerebellar ataxia in high-titer GAD-Ab-positive ataxia. In rat cerebellar slices, the cerebrospinal fluid (CSF) from GAD-Ab-positive ataxia acted on the terminals of GABAergic interneurons to depress the GABA release on Purkinje cells. Reduction of spill-over GABA simultaneously attenuated the inhibition of glutamate release from neighboring excitatory synapses. Such a dual synaptic impairment, the depression at GABA synapses and the potentiation at glutamate synapses, would elicit a marked excitation of Purkinje cells. These pathogenic actions were diminished by absorption of GAD-Ab using recombinant GAD. Furthermore, it is reported that intra-administration of the CSF depressed the cerebellum-mediated inhibition on motor cortex. GAD-Ab would cause neurological symptoms depending on the epitope specificity. PMID:23777105

Mitoma, Hiroshi; Mizusawa, Hidehiro



Transient Myeloproliferative Disorder and Down Syndrome  

PubMed Central

An extremely premature male neonate presented with an unusual multisystem dysfunction within the first 24 to 48 hours of life. The unfolding of clinical events and investigations revealed a transient myeloproliferative disorder (TMD). TMD was the main indication for karyotyping of this premature infant without clinical symptoms of Down syndrome. The awareness of TMD in a newborn warrants karyotype analysis to look for trisomy 21 and a close surveillance because of its potential progression to true leukaemia.

Reyes, Zenaida S.; Bashir, Wafa; Pathare, Anil



[Approaches to the therapy of neurological presentations in diabetes mellitus].  


A study included patients, aged from 30 to 70 years, with a verified diagnosis of compensated diabetes mellitus type 1 or type 2, diabetic polyneuropathy (DPN) or the syndrome of moderate cognitive disorders (MCD). Patients with DPN were stratified into two groups: 30 patients of the main group received the antioxidant drug tiolepta in tablets (600 mg) once a day during 60 days; 30 patients of the control group received only basic (sugar-reducing) therapy. Twenty patients with MCD were treated with the combined nootropic and vasoactive drug vinpotropil in dose 2 capsules, 3 times a day during 2 months in addition to the basic therapy (sugar-reducing, antihypertensive, antiaggregate drugs). To the end of treatment, the severity of DPN was lower in the main group treated with tiolepta that reflected in the normalization of NDS scores in 50% of patients compared to 30% in the controls and in the disappearance of neurological symptoms on the TSS in 30% of patients while these symptoms were present in the control group. The electroneuromyographic study showed the statistically non-significant trend (p>0,05) to the higher velocity of impulse conduction along the sensory and motor nerves as well as higher amplitudes of motor and sensory responses in the main group. To the end of the treatment, positive dynamics in the number of complaints and neurological status was found in patients with MCD. The neuropsychological study revealed the significant (p< or =0,05) improvement on the MMSE scale and in the delayed recall of words (the ten words test). Adverse effects that led to discontinuation of treatment were not found for both drugs. PMID:20517213

Baratsevich, E R; Posokhina, O V



Newer insights to the neurological diseases among biblical characters of old testament.  


Many people over the years have studied the Bible from a medical point of view offering diagnoses for the symptoms and signs that appear to have afflicted numerous individuals in the Bible. We review the biblical characters in the Old Testament and offer newer insights to their neurological diseases. We first look at the battle between Goliath and David. Interestingly, Goliath probably suffered from acromegaly. We propose autism as a diagnosis for Samson which would precede the first known case of autism by centuries. Isaac was a diabetic, and he probably had autonomic neuropathy. Few verses from the books of I Samuel, Psalms, and Ezekiel reveal symptoms suggestive of stroke. Jacob suffered from sciatica, and the child of the Shunnamite woman in II Kings had a subarachnoid hemorrhage. These instances among others found in the Old Testament of the Bible offer newer insights on the history of current neurological diseases. PMID:21085524

Mathew, Stephen K; Pandian, Jeyaraj D



Newer insights to the neurological diseases among biblical characters of old testament  

PubMed Central

Many people over the years have studied the Bible from a medical point of view offering diagnoses for the symptoms and signs that appear to have afflicted numerous individuals in the Bible. We review the biblical characters in the Old Testament and offer newer insights to their neurological diseases. We first look at the battle between Goliath and David. Interestingly, Goliath probably suffered from acromegaly. We propose autism as a diagnosis for Samson which would precede the first known case of autism by centuries. Isaac was a diabetic, and he probably had autonomic neuropathy. Few verses from the books of I Samuel, Psalms, and Ezekiel reveal symptoms suggestive of stroke. Jacob suffered from sciatica, and the child of the Shunnamite woman in II Kings had a subarachnoid hemorrhage. These instances among others found in the Old Testament of the Bible offer newer insights on the history of current neurological diseases.

Mathew, Stephen K.; Pandian, Jeyaraj D.



Psychogenic Movement Disorders and Motor Conversion: A roadmap for collaboration between Neurology and Psychiatry  

PubMed Central

BACKGROUND There are a host of vague terms to describe psychologically-mediated symptoms that mimic neurological disease, such as “functional,” “non-organic,” “psychogenic,” or “medically unexplained.” None of these terms have a direct translation in psychiatric classification, and psychiatrists are often faced with patients who do not believe in a psychological origin for their symptoms. OBJECTIVE Within the framework of psychogenic movement disorders, we discuss the roadblocks to effective collaboration and treatment in these patients and the current state of the literature regarding diagnosis and treatment. RESULTS We describe the approach to these patients from the perspective of neurology and psychiatry, illustrating the differences in terminology and categorization. CONCLUSION Psychogenic movement disorders represent a unique opportunity for these fields to collaborate in the care of a potentially curable but significantly disabling disorder.

Kranick, Sarah M.; Gorrindo, Tristan; Hallett, Mark



Enterovirus 71-induced neurological disorders in young gerbils, Meriones unguiculatus: development and application of a neurological disease model.  


A reliable disease model mimicking Enterovirus 71 (EV71) infection in humans is essential for understanding pathogenesis and for developing a safe and effective vaccine. Commonly used rodent models including mouse or rat models are not suitable for vaccine evaluation because the rodents are resistant to EV71 infection after they reach the age of 6 days. In this study, 21-day-old gerbils inoculated intraperitoneally (IP) with a non mouse-adapted EV71 strain developed neurological lesion-related signs including hind limb paralysis, slowness, ataxia and lethargy similar to those of central nervous system (CNS) infection of EV71 in humans. The infected gerbils eventually died of the neurological lesions and EV71 could be isolated from lung, liver, spleen, kidney, heart, spinal cord, brain cortex, brainstem and skeletal muscle. Significantly high virus replication was detected in spinal cord, brainstem and skeletal muscle by cellular analysis, real-time quantitative PCR (RT-PCR) and immunohistochemical staining. Histopathologic changes such as neuronal degeneration, neuronal loss and neuronophagia were observed in spinal cord, brain cortex, brainstem, and skeletal muscle along with necrotizing myositis and splenic atrophy. Gerbils that received two doses of inactive whole-virus vaccine showed no EV71-specific symptoms after challenged with EV71. In contrast, gerbils that received mock vaccination died of EV71-induced neuropathology after challenged with EV71. The result indicates that gerbils can serve as a reliable disease model for evaluating safety and efficacy of EV71 vaccine. PMID:23284845

Yao, Ping-Ping; Qian, Lei; Xia, Yong; Xu, Fang; Yang, Zhang-Nv; Xie, Rong-Hui; Li, Xiao; Liang, Wei-Feng; Huang, Xiao-Xiao; Zhu, Zhi-Yong; Zhu, Han-Ping



Unexpected neurological deficits following recovery from anaesthesia.  


Two cases of neurological dysfunction are presented. Neurological deficits after recovery from anaesthesia are unusual in young women perioperatively. In the first case, a 39-yr-old woman presented at 36-wk gestation with antepartum haemorrhage and in labour. Pregnancy had been complicated by pre-eclampsia and she underwent emergency Caesarean section under general anaesthesia without complication. The trachea was extubated when she was awake but almost immediately she became hypertensive, obtunded and reintubation was required. Her pupils became fixed and dilated but the Computerised Axial Tomogram (CT) was normal. A coagulopathy was evident. She made a full neurological recovery within 24 hr. On the same day, a previously healthy 41-yr-old woman who had undergone uneventful surgery for uterine prolapse 24 hr previously developed headache, nausea and over the next four hours signs of progressive brainstem ischaemia. The CT scan showed oedema of the mid- and hindbrain. Brainstem death was confirmed 12 hr later and the post-mortem revealed acute dissection of the vertebral artery secondary to cystic medial necrosis. Such dramatic neurological sequelae are rare but the importance of identifying "at risk" groups is underlined as is early recognition of neurological injury postoperatively. PMID:8004739

Porter, J; Lynch, L; Hart, S; Keohane, C



The spectrum of neurological disorders presenting at a neurology clinic in Yaound?, Cameroon  

PubMed Central

Introduction The burden of these neurological diseases is higher in developing countries. However, there is a paucity and scarcity of literature on neurological diseases in sub-Saharan Africa. This study was therefore undertaken to determine the pattern of neurological diseases in this setting and then, compare to those elsewhere in the African continent and also serve as a baseline for planning and care for neurological disorders in Cameroon. Methods The study was conducted at the Clinique Bastos, in Yaoundé, city capital of Cameroon, centre region. Over a period of six years, all medical records were reviewed by a neurologist and neurological diagnoses classified according to ICD-10. Results Out of 4526 admissions 912 patients (20.15%) were given a neurological diagnosis. The most frequent neurological disorders were headache (31.9%), epilepsy (9.86%), intervertebral disc disorder (7.67%), followed by lumbar and cervical arthrosis, polyneuropathy, stroke, Parkinson disease and dementia. According to ICD-10 classification, Episodic and paroxysmal disorders (headaches, epilepsy, cerebrovascular, sleep disorders) were observed on 424 (46.48%) patients; followed by nerve, nerve root and plexus disorders in 115 (12.6%) patients. Conclusion The above data emphasizes that neurological disease contributes substantially to morbidity in an urban African hospital. Headaches, epilepsy and intervertebral disc disorders are major causes of morbidity.

Tegueu, Callixte Kuate; Nguefack, Seraphin; Doumbe, Jacques; Fogang, Yannick Fogoum; Mbonda, Paul Chimi; Mbonda, Elie



Videourodynamics Identifies the Causes of Young Men with Lower Urinary Tract Symptoms and Low Uroflow  

Microsoft Academic Search

Objectives: Using videourodynamics (VUDS) we prospectively investigated the etiologies of lower urinary tract symptoms (LUTS) and low uroflow in young men and correlated the results with clinical symptoms and noninvasive exams.Methods: From 1999 to 2001, 90 men 18–50 years old with LUTS and low uroflow were enrolled. Patients with active urinary tract infection, congenital urogenital diseases, neurological diseases, diabetes mellitus

Chung Cheng Wang; Stephen Shei Dei Yang; Yung-Tai Chen; Jui-Hsiang Hsieh



Copper deficiency as cause of unexplained hematologic and neurologic deficits in patient with prior gastrointestinal surgery.  


Copper is a trace mineral essential to hematopoiesis and to the structure and function of the nervous system. Copper deficiency is a rare cause of anemia, leukopenia, and myeloneuropathy, but should be considered in the differential diagnosis in a patient with prior gastrointestinal surgery. We report the case of a 51-year-old woman admitted for nonspecific neurologic symptoms ultimately found to be due to copper malabsorption. PMID:16513908

Wu, Joanne; Ricker, Mari; Muench, John


Persistence of neurological damage induced by dietary vitamin B12 deficiency in infancy  

Microsoft Academic Search

A case is reported of a 14 month old boy with severe dietary vitamin B-12 deficiency caused by his mother’s vegan diet. Cinical, electroencephalography (EEG), and haematological findings are described. Cranial magnetic resonance imaging (MRI) showed severe frontal and frontoparietal cranial atrophy. Vitamin B-12 supplements led to a rapid improvement of haematological and neurological symptoms. Serum vitamin B-12 and urinary

Ursula von Schenck; Christine Bender-Götze; Berthold Koletzko



Treatment of fragile X-associated tremor ataxia syndrome (FXTAS) and related neurological problems  

Microsoft Academic Search

Fragile X-associated tremor\\/ataxia syndrome (FXTAS) is a progressive neurological disorder that affects older adult carriers, predominantly males, of premutation alleles (55 to 200 CGG repeats) of the fragile X (FMR1) gene. Principal features of FXTAS are intention tremor, ataxia, parkinsonism, cognitive decline, and peripheral neuropathy; ancillary features include, autonomic dysfunction, and psychiatric symptoms of anxiety, depression, and disinhibition. Although controlled

Randi J Hagerman; Deborah A Hall; Sarah Coffey; Maureen Leehey; James Bourgeois; John Gould; Lin Zhang; Andreea Seritan; Elizabeth Berry-Kravis; John Olichney; Joshua W Miller; Amy L Fong; Randall Carpenter; Cathy Bodine; Louise W Gane; Edgar Rainin; Hillary Hagerman; Paul J Hagerman



Diffusion and perfusion-weighted MRI in a patient with a prolonged reversible ischaemic neurological deficit  

Microsoft Academic Search

We report acute and follow-up diffusion- and perfusion-weighted MRI (DWI, PWI) findings in a patient with a prolonged reversible\\u000a ischaemic neurological deficit. PWI 12 h after the patient was last seen to be without symptoms revealed a large perfusion\\u000a deficit in the left posterior MCA territory with a relatively inconspicuous and much smaller abnormality on DWI. Follow-up\\u000a showed resolution of

T. Neumann-Haefelin; H. J. Wittsack; F. Wenserski; T. Q. Li; M. E. Moseley; M. Siebler; H. J. Freund



Neurological deficit due to cement extravasation following a vertebral augmentation procedure.  


The authors endeavor to highlight the surgical management of severe neurological deficit resulting from cement leakage after percutaneous vertebroplasty and to systematically review the literature on the management of this complication. A patient presented after a vertebroplasty procedure for traumatic injury. A CT scan showed polymethylmethacrylate leakage into the right foramina at T-11 and L-1 and associated central stenosis at L-1. He underwent decompression and fusion for removal of cement and stabilization of the fracture segment. In the authors' systematic review, they searched Medline, Scopus, and Cochrane databases to determine the overall number of reported cases of neurological deficit after cement leakage, and they collected data on symptom onset, clinical presentation, surgical management, and outcome. After surgery, despite neurological recovery postoperatively, the patient developed pneumonia and died 16 days after surgery. The literature review showed 21 cases of cement extravasation with neurological deficit. Ultimately, 15 patients had resolution of the postoperative deficit, 5 had limited change in neurological status, and 2 had no improvement. Cement augmentation procedures are relatively safe, but certain precautions should be taken to avoid such complications including high-resolution biplanar fluoroscopy, considering the use of a local anesthetic, and controlling the location of cement spread in relationship to the posterior vertebral body. Immediate surgical intervention with removal of cement provides good results with complete recovery in most cases. PMID:23641675

Sidhu, Gursukhman S; Kepler, Christopher K; Savage, Katherine E; Eachus, Benjamin; Albert, Todd J; Vaccaro, Alexander R



Acute sciatica and progressive neurological deficit secondary to facet synovial cysts: A report of two cases.  

PubMed Central

Objective: To describe two patients with lumbar facet synovial cysts causing sciatica and progressive neurological deficit. Clinical Features: A 52-year-old female with bilateral sciatica and a neurological deficit that progressed to a foot drop; and a 54-year-old female with worsening sciatica and progressive calf weakness were seen at a major tertiary care centre. Diagnostic imaging studies revealed the presence of spinal nerve root impingement by large facet synovial cysts. Interventions and Outcomes: Activity modification, gabapentinoid and non-steroidal anti-inflammatory medications were unsuccessful in ameliorating either patient’s symptoms. One patient had been receiving ongoing lumbar chiropractic spinal manipulative therapy despite the onset of a progressive neurological deficit. Both patients eventually required surgery to remove the cyst and decompress the affected spinal nerve roots. Conclusion: Patients with acute sciatica who develop a progressive neurological deficit while under care, require prompt referral for axial imaging and surgical consultation. Primary care spine clinicians need to be aware of lumbar facet synovial cysts as a possible cause of acute sciatica and the associated increased risk of the patient developing a progressive neurological deficit.

Arthur, Brian; Lewkonia, Peter; Quon, Jeffrey A.; Street, John; Bishop, Paul B.



Community-based study of neurological disorders in rural central Ethiopia.  


Between 1986 and 1988 a door-to-door survey was conducted on a stable rural population of 60,820 in central Ethiopia. Trained lay health workers made a complete census and identified cases with symptoms and signs of neurological disorders, using specially designed questionnaires which, in a previous pilot study, were found to have a sensitivity of 91% and specificity of 85%. Neurological disorders in the rural population were epilepsy, postpoliomyelitis paralysis, mental retardation, peripheral neuropathy (mainly due to leprosy), and deaf-mutism with prevalence rates (cases/100,000 population) of 520, 240, 170, 150 and 130, respectively. The prevalence rates of the other less common neurological disorders were 62 for hemiparesis (15 of which were for cerebrovascular accidents), 20 for cerebral palsy, 16 for optic atrophy, 12 for perceptive deafness, 10 for tropical spastic paraparesis, 7 for Parkinson's disease and 5 for motor neuron disease, ataxia and chorea/athetosis. Among related non-neurological conditions, blindness, locomotor disability and deafness were predominant. The significance and role of such a neuroepidemiological study in laying the strategies for the prevention of neurological disorders and rehabilitation of patients are discussed in the context of a developing country. PMID:2087251

Tekle-Haimanot, R; Abebe, M; Gebre-Mariam, A; Forsgren, L; Heijbel, J; Holmgren, G; Ekstedt, J



[Iberoamerican Academy of Pediatric Neurology: its history and importance in the development of Iberoamerican child neurology].  


The Iberoamerican Academy of Pediatric Neurology (AINP) started in 1992, in Avila (Spain) and was foundated by a group of pediatrics neurologists who organized three post graduate courses in pediatrics neurology, Miami, Margarita and Cancun, with excelents results, because these reason the AINP has growing, fasted its dramatic success has been mostly due to that group of people who love and build unconditionally with their only goal being the satisfaction of knowing that children with neurological disorders will eventually benefit from their work. In this article we wrote about the history of AINP since 1992, and the reason to foundated. The AINP has growing fasted, and we think that it will be very important in the development of pediatrics neurology in Iberoamerica in different ways like neurology education and the training of the young physician. PMID:12589603

Archila-Gruber, R


Perception of acoustic transients  

NASA Astrophysics Data System (ADS)

The research investigates the role of knowledge based or top-down processing in the perception of nonlinguistic, transient signals. The experiments address issues in transient pattern classification, target observation, attentional focusing, auditory induction, and computer based performance aids. The theoretical significance and naval relevance of the research is considered.

Howard, J. H., Jr.



Neurology in the United Kingdom. I: Historical development.  

PubMed Central

International comparisons suggest that British neurological services are underdeveloped. Historical factors which have contributed to the current state of neurological services in the United Kingdom are described. Key issues include the dominance of London and the concept of specialised hospitals in the early history of neurology; the subsequent recognition of the needs of other parts of the United Kingdom, of district general hospitals, and of patients with chronic neurological disabilities not necessarily included within the traditional bounds of neurology; and the relationship between neurology and general medicine. The paper concludes with some suggestions as to how neurology services might develop in the future.

Langton Hewer, R; Wood, V A



Neurological complications of hepatitis C infection.  


Though well-known as a cause of liver disease, Hepatitis C virus infection is emerging as a cause of a variety of peripheral and central nervous system disorders. The virus causes chronic persistent infection with complex immune responses in the majority of individuals. Viral infection may have the potential to generate neurological illness through direct infection of neural cells or through immune-mediated mechanisms, including enhancement of autoimmune responses. Moreover, the mainstay of antiviral treatment of hepatitis C infection, interferon-alpha, is itself associated with neurological morbidity. Thus neurologists are increasingly faced with diagnosing or even predicting a wide spectrum of neurological complications of hepatitis C infection and/or its treatment. PMID:22991069

McCarthy, Micheline; Ortega, Melissa R



Cotard syndrome in neurological and psychiatric patients.  


The authors describe the frequency and characteristics of Cotard syndrome among neurological and psychiatric inpatients at a tertiary referral center. All inpatients from the National Institute of Neurology of Mexico (March 2007-May 2009) requiring neuropsychiatric consultation were reviewed. Among 1,321 inpatient consultations, 63.7% had neurological disease and one (0.11%) had viral encephalitis and Cotard syndrome. Of inpatients, 36.2% had pure psychiatric disorders and three (0.62%) had Cotard syndrome, associated with psychotic depression, depersonalization, and penile retraction (koro syndrome). This review discusses potential mechanisms for Cotard syndrome, including the role of a perceptual-emotional dissociation in self-misattribution in the deliré des negations. PMID:21037126

Ramirez-Bermudez, Jesus; Aguilar-Venegas, Luis C; Crail-Melendez, Daniel; Espinola-Nadurille, Mariana; Nente, Francisco; Mendez, Mario F



Mitochondria in Neuroplasticity and Neurological Disorders  

PubMed Central

Mitochondrial electron transport generates the ATP that is essential for the excitability and survival of neurons, and the protein phosphorylation reactions that mediate synaptic signaling and related long-term changes in neuronal structure and function. Mitochondria are highly dynamic organelles that divide, fuse and move purposefully within axons and dendrites. An Major functions of mitochondria in neurons include the regulation of Ca2+ and redox signaling, developmental and synaptic plasticity, and the arbitration of cell survival and death. The importance of mitochondria in neurons is evident in the neurological phenotypes in rare diseases caused by mutations in mitochondrial genes. Mitochondria-mediated oxidative stress, perturbed Ca2+ homeostasis and apoptosis may also contribute to the pathogenesis of prominent neurological diseases including Alzheimer’s, Parkinson’s and Huntington’s diseases, stroke, ALS and psychiatric disorders. Advances in understanding the molecular and cell biology of mitochondria are leading to novel approaches for the prevention and treatment of neurological disorders.

Mattson, Mark P.; Gleichmann, Marc; Cheng, Aiwu



A national neurological excellence centers network.  


The most relevant problems related to the management of neurological disorders are (i) the frequent hospitalization in nonspecialist departments, with the need for neurological consultation, and (ii) the frequent requests of GPs for highly specialized investigations that are very expensive and of little value in arriving at a correct diagnosis. In 1996, the Consorzio di Bioingegneria e Informatica Medica in Italy realized the CISNet project (in collaboration with the Consorzio Istituti Scientifici Neuroscienze e Tecnologie Biomediche and funded by the Centro Studi of the National Public Health Council) for the implementation of a national neurological excellence centers network (CISNet). In the CISNet project, neurologists will be able to give on-line interactive consultation and off-line consulting services identifying correct diagnostic/therapeutic procedures, evaluating the need for both examination in specialist centers and admission to specialized centers, and identifying the most appropriate ones. PMID:9533676

Pazzi, S; Cristiani, P; Cavallini, A



Prenatal Antecedents of Newborn Neurological Maturation  

PubMed Central

Fetal neurobehavioral development was modeled longitudinally using data collected at weekly intervals from 24- to -38 weeks gestation in a sample of 112 healthy pregnancies. Predictive associations between 3 measures of fetal neurobehavioral functioning and their developmental trajectories to neurological maturation in the 1st weeks after birth were examined. Prenatal measures included fetal heart rate variability, fetal movement, and coupling between fetal motor activity and heart rate patterning; neonatal outcomes include a standard neurologic examination (n = 97) and brainstem auditory evoked potential (BAEP; n = 47). Optimality in newborn motor activity and reflexes was predicted by fetal motor activity; fetal heart rate variability and somatic-cardiac coupling predicted BAEP parameters. Maternal pregnancy-specific psychological stress was associated with accelerated neurologic maturation.

DiPietro, Janet A.; Kivlighan, Katie T.; Costigan, Kathleen A.; Rubin, Suzanne E.; Shiffler, Dorothy E.; Henderson, Janice L.; Pillion, Joseph P.



[Personal genome research and neurological diseases: overview].  


Neurological diseases include those caused by a single defective gene,e.g., Huntington's disease, other polyglutamine diseases, and muscular dystrophies, and those that are mostly sporadic but rarely show Mendelian inheritance in some families, e.g., Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and epilepsy. The latter diseases are considered polygenic disorders. Both sporadic and Mendelian cases of these diseases are believed to share some common pathological mechanisms. Since the detection of causal genes for the Mendelian cases, studies have been initiated on disease pathology. SNPs and rare gene variants play important roles in common neurological diseases. From a technological perspective, next-generation sequencers have become widely available and have contributed to the advancement of research based on individual genome sequences (personal genome). This paper presents an overview, as well as a historical context, of the contribution of personal genome research to neurological disease studies. PMID:23475514

Toda, Tatsushi



[Neurologic and psychiatric manifestations of Lyme disease].  


The neurological and psychiatric manifestations of Borrelia burgdorferi sensu lato are so numerous that Borrelia is also called the "new great imitator". Thus knowing about the multiple clinical aspects of neuroborreliosis is necessary for the clinician. We reviewed literature for "classical" neuroborreliosis such as acute meningoradiculitis or chronicle encephalomyelitis, but also for encephalitis, myelitis, polyneuritis, radiculitis and more controversial disorders such as chronic neurological disorders, ischemic and hemorrhagic stroke, and motor neuron disease. We specified every time on which basis each disorder was attributed to Lyme disease, particularly if European or American criteria were met. Every part of the nervous system can be involved: from central to peripheral nervous system, and even muscles. In endemic areas, Lyme serology must be assessed in case of unexplained neurological or psychiatric disorder. In case of positive serology, CSF assessment with intrathecal anti-Borrelia antibody index will be more efficient to prove the diagnosis. PMID:17350199

Blanc, F



Neurologic disability: a hidden epidemic for India.  


India, the world's second most populous country, is facing the emergence of a hitherto "hidden" epidemic: neurologic disability. The rapid economic, demographic, and social transformation of India in recent decades has already resulted in the double burden of unresolved epidemics of infectious diseases (e.g., malaria, tuberculosis) coupled with rising rates of chronic diseases (e.g., cardiovascular diseases). Neurologic disability is likely to join these public health concerns as a third epidemic, largely due to 3 emerging health trends: 1) an increase in traumatic brain injuries (TBI) from road traffic accidents (RTA); 2) an increase in the incidence of age-related dementia; and 3) an increase in the stroke incidence. Without adequate preparation, the treatment and long-term care for an increasing population of neurologically disabled people will strain India's health care system and economy in the coming years in unprecedented ways. PMID:23170012

Das, Abhijit; Botticello, Amanda L; Wylie, Glenn R; Radhakrishnan, Kurupath



Redox neurology: visions of an emerging subspecialty.  


Recent years have witnessed a dramatic increase in publications implicating free radicals and oxidative stress in virtually every aspect of biology and medicine. Redox Neurology may be defined as the study of the roles of free radicals, transition metals, oxidative stress, and antioxidant defenses in diseases of the nervous system. In this position paper, an argument is presented for recognition of this field as an emerging subspecialty within medical neurology. A program for postresidency fellowship training in Redox Neurology that integrates laboratory experience with specialized clinical practice is proposed. Opportunities for research and teaching careers in the redox neurosciences are outlined. The paper concludes with a forecast of several research themes likely to preoccupy this nascent discipline in the days ahead. PMID:15105277

Schipper, Hyman M



Cognitive and Executive Function 12 Years after Childhood Bacterial Meningitis: Effect of Acute Neurologic Complications and Age of Onset  

Microsoft Academic Search

each of these domains. However, development was shown to keep pace with that exhibited by healthy controls, suggesting no deterioration in function with time since illness. While prediagnosis symptom duration and acute neurologic complications were not predictors of 12-year outcome, meningitis before 12 months of age was significantly related to poorer performance on tasks requiring language and executive skills. Conclusions

Vicki Anderson; Peter Anderson; Terry Nolan



Visualization, quantification and correlation of brain atrophy with clinical symptoms in spinocerebellar ataxia types 1, 3 and 6  

Microsoft Academic Search

Background and objectiveBiomarkers to monitor neurological dysfunction in autosomal dominant inherited spinocerebellar ataxias (SCA) are lacking. We therefore aimed to visualize, quantify and correlate localized brain atrophy with clinical symptoms in SCA1, SCA3, and SCA6.

Jörg B. Schulz; Johannes Borkert; Stefanie Wolf; Tanja Schmitz-Hübsch; Maryla Rakowicz; Caterina Mariotti; Ludger Schoels; Dagmar Timmann; Bart van de Warrenburg; Alexandra Dürr; Massimo Pandolfo; Jun-Suk Kang; Andrés González Mandly; Thomas Nägele; Marina Grisoli; Romana Boguslawska; Peter Bauer; Thomas Klockgether; Till-Karsten Hauser



Symptoms of Lung Cancer  


... and Giving Support For Health Professionals Get Involved Lung HelpLine Questions about your lung health? Ask an ... Lung Cancer Symptoms What are the Symptoms of Lung Cancer? Many people with lung cancer don’t ...


Signs and Symptoms  


... have milder symptoms. Rapid, forceful or irregular heartbeats (palpitations and arrhythmias) are common complications associated with hypertrophic ... in life. Common symptoms include shortness of breath, palpitations, fainting, swollen neck veins, abdominal discomfort and irregular ...


Symptoms, Diagnosis & Treatment  


... Home Current Issue Past Issues Cover Story: Leukemia/Lymphoma Symptoms, Diagnosis & Treatment Past Issues / Summer 2008 Table ... into (and restore) the body's blood cells. Hodgkin's Lymphoma Symptoms Painless, swollen lymph nodes in the neck, ...


Cervical Cancer Symptoms  


... Foundation for Women’s Cancer Home Types of Gynecologic Cancers Cervical Cancer Diagnosis and Treatment Symptoms Symptoms Cervical cancer ... Stay Connected About Gynecologic Cancers Types of Gynecologic Cancers Cervical Cancer Screening and Prevention Primary Prevention with Cervical ...


Vitiligo: Signs and Symptoms  


... Diseases and treatments U - W Vitiligo Signs, symptoms Vitiligo: Signs and symptoms Vitiligo causes loss of color. ... amount of color loss or type of vitiligo. Vitiligo has types and subtypes If you are diagnosed ...


Warts: Signs and Symptoms  


... Diseases and treatments U - W Warts Signs, symptoms Warts: Signs and symptoms There are a few different ... some of the different types of warts. Common warts (also called vurruca vulgaris) Wart under a child's ...


Shingles: Signs and Symptoms  


... Diseases and treatments Q - T Shingles Signs, symptoms Shingles: Signs and symptoms Shingles tends to cause more pain and less itching ... get a fever or headache with the rash. Shingles . The rash can be very painful and widespread. ...


Neurophysiological correlates of dissociative symptoms.  


OBJECTIVE: Dissociation is a mental process with psychological and somatoform manifestations, which is closely related to hypnotic suggestibility and essentially shows the ability to obtain distance from reality. An increased tendency to dissociate is a frequently reported characteristic of patients with functional neurological symptoms and syndromes (FNSS), which account for a substantial part of all neurological admissions. This review aims to investigate what heart rate variability (HRV), EEG and neuroimaging data (MRI) reveal about the nature of dissociation and related conditions. METHODS: Studies reporting HRV, EEG and neuroimaging data related to hypnosis, dissociation and FNSS were identified by searching the electronic databases Pubmed and ScienceDirect. RESULTS: The majority of the identified studies concerned the physiological characteristics of hypnosis; relatively few investigations on dissociation related FNSS were identified. General findings were increased parasympathetic functioning during hypnosis (as measured by HRV), and lower HRV in patients with FNSS. The large variety of EEG and functional MRI investigations with diverse results challenges definite conclusions, but evidence suggests that subcortical as well as (pre)frontal regions serve emotion regulation in dissociative conditions. Functional connectivity analyses suggest the presence of altered brain networks in patients with FNSS, in which limbic areas have an increased influence on motor preparatory regions. CONCLUSIONS: HRV, EEG and (functional) MRI are sensitive methods to detect physiological changes related to dissociation and dissociative disorders such as FNSS, and can possibly provide more information about their aetiology. The use of such measures could eventually provide biomarkers for earlier identification of patients at risk and appropriate treatment of dissociative conditions. PMID:23175855

van der Kruijs, Sylvie J M; Bodde, Nynke M G; Carrette, Evelien; Lazeron, Richard H C; Vonck, Kristl E J; Boon, Paul A J M; Langereis, Geert R; Cluitmans, Pierre J M; Feijs, Loe M G; Hofman, Paul A M; Backes, Walter H; Jansen, Jacobus F A; Aldenkamp, A P



IFN-? Signaling to Astrocytes Protects from Autoimmune Mediated Neurological Disability  

PubMed Central

Demyelination and axonal degeneration are determinants of progressive neurological disability in patients with multiple sclerosis (MS). Cells resident within the central nervous system (CNS) are active participants in development, progression and subsequent control of autoimmune disease; however, their individual contributions are not well understood. Astrocytes, the most abundant CNS cell type, are highly sensitive to environmental cues and are implicated in both detrimental and protective outcomes during autoimmune demyelination. Experimental autoimmune encephalomyelitis (EAE) was induced in transgenic mice expressing signaling defective dominant-negative interferon gamma (IFN-?) receptors on astrocytes to determine the influence of inflammation on astrocyte activity. Inhibition of IFN-? signaling to astrocytes did not influence disease incidence, onset, initial progression of symptoms, blood brain barrier (BBB) integrity or the composition of the acute CNS inflammatory response. Nevertheless, increased demyelination at peak acute disease in the absence of IFN-? signaling to astrocytes correlated with sustained clinical symptoms. Following peak disease, diminished clinical remission, increased mortality and sustained astrocyte activation within the gray matter demonstrate a critical role of IFN-? signaling to astrocytes in neuroprotection. Diminished disease remission was associated with escalating demyelination, axonal degeneration and sustained inflammation. The CNS infiltrating leukocyte composition was not altered; however, decreased IL-10 and IL-27 correlated with sustained disease. These data indicate that astrocytes play a critical role in limiting CNS autoimmune disease dependent upon a neuroprotective signaling pathway mediated by engagement of IFN-? receptors.

Hindinger, Claudia; Bergmann, Cornelia C.; Hinton, David R.; Phares, Timothy W.; Parra, Gabriel I.; Hussain, Shabbir; Savarin, Carine; Atkinson, Roscoe D.; Stohlman, Stephen A.



Post-vaccination symptoms following DTP and DT vaccination.  


Post-vaccination symptoms in 6,004 infants given adsorbed Diphtheria Tetanus and Pertussis (DTP) vaccine and 4,024 infants given adsorbed Diphtheria and Tetanus (DT) vaccine have been compared. Although crying, screaming and fever were slightly more frequent after adsorbed DTP than adsorbed DT, attacks of high-pitched screaming, episodes of pallor and hypotonia, convulsions, other neurological disorders and sudden infant death occurred with similar frequency in the two groups. No specific neurological effect attributable to the pertussis component was found. PMID:3879685

Pollock, T M; Miller, E; Mortimer, J Y; Smith, G



Familial hemiplegic migraine, neuropsychiatric symptoms, and Erdheim-Chester disease.  


We report the occurrence of unilateral cerebral hemisphere edema with subsequent cortical laminar necrosis in the setting of familial hemiplegic migraine (FHM) and permanent neurologic sequelae after resolution of an attack in 1 patient. Contemporaneous with this severe attack of FHM, the patient was found to exhibit multiple systemic and neurological symptoms referable to Erdheim-Chester disease (a rare non-Langerhans cell histiocytosis) that was confirmed by bone biopsy. This case demonstrates the severity possible with a migrainous infarction associated with FHM. The co-occurrence of two such rare entities in 1 patient suggests a possible relationship. PMID:15447701

Black, David F; Kung, Simon; Sola, Christopher L; Bostwick, Michael J; Swanson, Jerry W



Transient lower limb pain following accidental thoracic subarachnoid insertion of an epidural catheter  

Microsoft Academic Search

Transient sensory disturbances, including dysesthesia or neurologic deficits in the lower extremities or buttocks have been\\u000a described as complications of neuraxial anesthesia. We report a case of transient lower limb pain following the accidental\\u000a placement of an epidural catheter into the thoracic subarachnoid space. A 31-year-old woman was scheduled to undergo laparoscopic\\u000a myomectomy. An epidural catheter was accidentally inserted subarachnoid

Masaki Fuyuta; Yoshihiro Takasugi; Masahiro Morimoto; Toru Shirai; Mitsuo Morimoto; Yoshihisa Koga



Prenatal Antecedents of Newborn Neurological Maturation  

ERIC Educational Resources Information Center

|Fetal neurobehavioral development was modeled longitudinally using data collected at weekly intervals from 24 to 38 weeks gestation in a sample of 112 healthy pregnancies. Predictive associations between 3 measures of fetal neurobehavioral functioning and their developmental trajectories to neurological maturation in the first weeks after birth…

DiPietro, Janet A.; Kivlighan, Katie T.; Costigan, Kathleen A.; Rubin, Suzanne E.; Shiffler, Dorothy E.; Henderson, Janice L.; Pillion, Joseph P.



Neurological Vision Rehabilitation: Description and Case Study  

ERIC Educational Resources Information Center

|The wars in Afghanistan and Iraq have been notable for the high rates of traumatic brain injury (TBI) that have been incurred by the troops. Visual impairments often occur following TBI and present new challenges for rehabilitation. We describe a neurological vision rehabilitation therapy that addresses the unique needs of patients with vision…

Kingston, John; Katsaros, Jennifer; Vu, Yurika; Goodrich, Gregory L.



Respiratory problems in children with neurological impairment  

Microsoft Academic Search

Children with severe neurological impairment have a high incidence of respiratory problems which are multifactorial and may be related to or dependent on the underlying disability. In addition, common respiratory conditions such as asthma will be represented in this group as in the general paediatric population. In order to maximise quality of life and reduce morbidity and mortality, each child

P C Seddon; Y Khan




ERIC Educational Resources Information Center




The Neurological Presentation of Ceruloplasmin Gene Mutations  

Microsoft Academic Search

Aceruloplasminemia is an autosomal recessive disorder of iron metabolism resulting from mutations of the ceruloplasmin gene. To better define the neurological phenotype of aceruloplasminemia we reviewed reports of published cases and sought details of unpublished ones. We identified 32 published reports and 1 unpublished case. The age at diagnosis ranged from 16 to 71 years with a mean of 51.

Alisdair McNeill; Massimo Pandolfo; Jens Kuhn; Huifang Shang; Hiroaki Miyajima



Classroom Correlates of Neurological "Soft Signs".  

ERIC Educational Resources Information Center

This study investigated the relationships between 19 neurological abnormalities in school children and measures of school performance in reading, math, and nonacademic classroom behaviors. The sample of 45 children was given a standardized achievement test and the Draw-a-Person instrument to obtain academic variables. Nonacademic behaviors…

Hartlage, Patricia L.; Hartlage, Lawrence C.


Anaerobic Infections in Children with Neurological Impairments.  

ERIC Educational Resources Information Center

Children with neurological impairments are prone to develop serious infection with anaerobic bacteria. The most common anaerobic infections are decubitus ulcers; gastrostomy site wound infections; pulmonary infections (aspiration pneumonia, lung abscesses, and tracheitis); and chronic suppurative otitis media. The unique microbiology of each of…

Brook, Itzhak



Preventing neurological complications from dysnatremias in children  

Microsoft Academic Search

Dysnatremias are among the most common electrolyte abnormalities encountered in hospitalized patients. In most cases, a dysnatremia results from improper fluid management. Dysnatremias can occasionally result in death or permanent neurological damage, a tragic complication that is usually preventable. In this manuscript, we discuss the epidemiology, pathogenesis and prevention and treatment of dysnatremias in children. We report on over 50

Michael L. Moritz; J. Carlos Ayus



Classroom Correlates of Neurological "Soft Signs".  

ERIC Educational Resources Information Center

|This study investigated the relationships between 19 neurological abnormalities in school children and measures of school performance in reading, math, and nonacademic classroom behaviors. The sample of 45 children was given a standardized achievement test and the Draw-a-Person instrument to obtain academic variables. Nonacademic behaviors…

Hartlage, Patricia L.; Hartlage, Lawrence C.


Positron emission tomography in neurological diseases  

Microsoft Academic Search

Positron emission tomography (PET) is the study of human physiology by electronic detection of positron-emitting radiopharmaceuticals. It is one of the noninvasive technolo- gies that can measure the metabolic and functional activity of living tissue. Positron emission tomography finds its clini- cal applications in broadly three specialties - oncology, car- diology, and neurology. The current review focuses on its indications

Sudhir Kumar; G Rajshekher; Subhashini Prabhakar



Anaerobic Infections in Children with Neurological Impairments.  

ERIC Educational Resources Information Center

|Children with neurological impairments are prone to develop serious infection with anaerobic bacteria. The most common anaerobic infections are decubitus ulcers; gastrostomy site wound infections; pulmonary infections (aspiration pneumonia, lung abscesses, and tracheitis); and chronic suppurative otitis media. The unique microbiology of each of…

Brook, Itzhak



Neurologic causes of hip pain in dancers.  


Hip pain in dancers is typically attributed to musculoskeletal etiologies due to local "wear-and-tear"; however, one must be aware of neurologic etiologies that may present with additional clinical findings and require specialized treatment. This article explores the presentation, potential causes, suggested work-up, and treatment options for femoral neuropathy, lateral femoral cutaneous syndrome, and piriformis syndrome. PMID:22687655

Martinez, Nina; Mandel, Steven; Peterson, Judith R



A computerized system for Neurologic Music Therapy  

Microsoft Academic Search

Description of a web-based system using Neurologic Music Therapy (NMT), targeted to children with autism. This paper will describe the requirements and therapy curriculum, document the system specifications, and review the current state of implementation. At present, the system is at the concept demo stage and virtually ready for user testing.

Billy Harris; Martha Summa-chadwick



Anosognosia: the neurology of beliefs and uncertainties  

Microsoft Academic Search

Anosognosia is a common, fascinating, and ill-understood disorder following brain damage, where patients who suffer severe deficits such as hemiplegia may remain unaware of and deny their handicap. Many studies including recent work published in this journal have attempted to determine the neurological, cognitive, and motivational bases of anosognosia. These studies have typically focused on descriptive correlations between anosognosia and

P. Vuilleumier


Sleep-related problems in neurologic diseases.  


There is a strong association between sleep-related problems and neurologic diseases. Neurologic diseases of the CNS can directly cause sleep problems when sleep-wake mechanisms associated with the ascending reticular activating system are involved. The major sleep disorders associated with neurologic problems are outlined in the International Classification of Sleep Disorders, 2nd edition, as hypersomnias of central origin, sleep-related breathing disorders, the insomnias, circadian rhythm sleep disorders, sleep-related movement disorders, parasomnias, and sleep-related epilepsy. In a patient with CNS disease and excessive sleepiness, sleep-related breathing disorders should be a first concern, given the known association between obstructive sleep apnea (OSA) and cerebrovascular disease and the potential confounding effects that OSA might have on an otherwise compromised ischemic CNS penumbra. A basic knowledge of the anatomy and physiology of the sleep-wake mechanisms provides a rationale for pharmacologic intervention. Nonpharmacologic treatments are also important, especially when sleep-related breathing disorders are a concern. In addition, as patients with neurologic diseases are often prone to the adverse effects of many medications, the specific treatment regimen for any given individual should always include good sleep hygiene practices that use cognitive behavioral therapy. PMID:22315121

Dyken, Mark Eric; Afifi, Adel K; Lin-Dyken, Deborah C



Neurological Vision Rehabilitation: Description and Case Study  

ERIC Educational Resources Information Center

The wars in Afghanistan and Iraq have been notable for the high rates of traumatic brain injury (TBI) that have been incurred by the troops. Visual impairments often occur following TBI and present new challenges for rehabilitation. We describe a neurological vision rehabilitation therapy that addresses the unique needs of patients with vision…

Kingston, John; Katsaros, Jennifer; Vu, Yurika; Goodrich, Gregory L.



Neurological complications of regional obstetric anesthesia  

Microsoft Academic Search

This article reviews common and rare neurological complications that can occur following obstetric regional anesthesia. Parturients are one of the largest patient groups to receive major regional anesthesia. They also are one of the healthiest and least willing to tolerate adverse outcomes. This article examines evidence-based information on the incidence, diagnosis, and recommended therapies for postdural puncture headache, postpartum back

Alison J MacArthur



Neurological bases for balance–anxiety links  

Microsoft Academic Search

This review paper examines neurologic bases of links between balance control and anxiety based upon neural circuits that are shared by pathways that mediate autonomic control, vestibulo-autonomic interactions, and anxiety. The core of this circuitry is a parabrachial nucleus network, consisting of the parabrachial nucleus and its reciprocal relationships with the extended central amygdaloid nucleus, infralimbic cortex, and hypothalamus. Specifically,

Carey D Balaban; Julian F Thayer



76 FR 61722 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings  

Federal Register 2010, 2011, 2012, 2013

...Institute of Neurological Disorders and Stroke; Notice of Closed Meetings Pursuant to...Institute of Neurological Disorders and Stroke Initial Review Group, Neurological Sciences...Institute of Neurological Disorders and Stroke Initial Review Group, Neurological...



76 FR 9587 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings  

Federal Register 2010, 2011, 2012, 2013

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75 FR 5093 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings  

Federal Register 2010, 2011, 2012, 2013

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76 FR 64360 - National Institute of Neurological Disorders and Stroke Notice of Closed Meetings  

Federal Register 2010, 2011, 2012, 2013

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Federal Register 2010, 2011, 2012, 2013

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77 FR 24971 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings  

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75 FR 26268 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings  

Federal Register 2010, 2011, 2012, 2013

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78 FR 59041 - National Institute of Neurological Disorders and Stroke; Notice of Closed Meetings  

Federal Register 2010, 2011, 2012, 2013

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Propranolol in the Control of Schizophrenic Symptoms  

PubMed Central

All schizophrenic symptoms remitted completely in six out of 14 adults who had not responded to phenothiazine drugs and who were then given propranolol. Another patient improved markedly and four improved moderately. Two had minimal or transient improvement, and one left hospital unchanged after a short, severe, toxic reaction. The six with complete remissions all began to improve within a few days of starting propranolol and the florid symptoms remitted completely after three to 26 days. They were stabilized on a daily dose of 500-3,500 mg of propranolol and at the time of writing had remained well for up to six months. Two patients who stopped propranolol after their symptoms remitted relapsed severely within a few days. Toxic effects (ataxia, visual hallucinations, and confusional states) were related to the rate of increase rather than to the absolute dose of propranolol. After the procedure was modified unwanted effects were usually mild or absent.

Yorkston, N. J.; Zaki, Saniha A.; Malik, M. K. U.; Morrison, R. C.; Havard, C. W. H.



Base rate of post-concussion symptoms among normal people and its neuropsychological correlates  

Microsoft Academic Search

Objective: To explore the base rate of symptoms similar to those of post-concussion symptoms (PCS) among a group of participants without head injury. The effect of subjective complaints upon cognitive functioning was also examined.Design: A cross-sectional study.Participants: A total of 85 participants without head injury, other identifiable neurological diseases or psychiatric diseases were recruited.Outcome measures: These included Rivermead Post-concussion Symptoms

Raymond CK Chan



A neurological evaluation of workers exposed to mixtures of organic solvents.  

PubMed Central

Workers with long term exposure to mixtures of organic solvents below regulatory limits have been reported to experience mild, but clinically detectable, sensory or sensorimotor polyneuropathies. In conjuction with a cross sectional study of behavioural performance a clinical neurological evaluation was conducted among printers and spray painters to examine dose response relations. All 240 subjects completed an occupational history and symptom questionnaire and underwent a clinical neurological examination. On average, subjects had been employed on their current job for six years. Classification of solvent exposure for each subject was based on exposed versus non-exposed job titles and observations during an industrial hygiene walk-through or on the measured concentration of solvents in full shift personal air samples. The average full shift solvent concentration was 302 ppm for printing plant workers and 6-13 ppm for workers at other plants. Isopropanol and hexane were the major constituents. Neurological abnormalities consistent with mild polyneuropathy were found in 16% of subjects; none was clinically significant. Exposed/non-exposed comparisons showed slightly higher frequency of symptoms in the exposed subjects which was not related to solvent level. Subjects categorised as exposed during the walk- through survey also had poorer vibratory sensation measured at the foot and diminished ankle reflexes. In multiple linear regression models, however, controlling for age, sex, alcohol intake, and examiner, no significant (p less than 0.05) relation was found between solvent concentration and poor neurological function except for two point discrimination measured at the foot. This investigation has not provided evidence for dose related adverse neurological effects from exposure to moderately low levels of solvent mixtures for a relatively short duration, although this may be due to the shortness of exposure duration, the type of solvent exposure, or to selection factors.

Maizlish, N A; Fine, L J; Albers, J W; Whitehead, L; Langolf, G D



Abnormalities on neurological examination among sheep farmers exposed to organophosphorous pesticides.  

PubMed Central

OBJECTIVES: Organophosphates are effective pesticides which are frequently used in several agricultural settings. Although their acute effects are well characterised, it remains unclear whether long term exposure can damage the human nervous system. This study sought to investigate their long term effects by comparing abnormalities on neurological examination between groups of workers exposed to organophosphates and an unexposed group. METHODS: 146 exposed sheep farmers and 143 unexposed quarry workers were recruited into a cross sectional study of symptoms and neuropsychological effects of long term exposure to organophosphates in sheep dip. From a symptom questionnaire given immediately after dipping the 10 most symptomatic and 10 least symptomatic farmers were selected. Several months later each of these, along with 10 of the unexposed quarry workers, underwent a standardised neurological examination similar to that which might be used in clinical practice, at at time as remote as possible from recent exposure to organophosphates so as to exclude any acute effects. RESULTS: All 30 selected subjects agreed to participate. The components of the examination which showed a significant difference were two point discrimination on the dorsum of the hand (symptomatic farmers 22 mm; asymptomatic farmers 13 mm; quarry workers 8 mm) and the dorsum of the foot (symptomatic farmers 34 mm; asymptomatic farmers 10 mm; quarry workers 11 mm), and mean calf circumference (symptomatic farmers 35.0 cm; asymptomatic farmers 36.3 cm; quarry workers 38.6 cm). Overall the prevalence of neurological abnormalities was low. CONCLUSIONS: The differences in neurological examination detected between groups were subtle and their clinical significance was unclear. However, they do suggest evidence of an adverse neurological effect from exposure to organophosphates. Further, larger scale studies will be required before it is possible to confirm or refute the differences detected.

Beach, J R; Spurgeon, A; Stephens, R; Heafield, T; Calvert, I A; Levy, L S; Harrington, J M



Transient Global Amnesia  


... global amnesia is a sudden, temporary episode of memory loss that can't be attributed to a ... know well, but that doesn't make your memory loss less disturbing. Fortunately, transient global amnesia is ...


SPECT study of cerebral blood flow reactivity after acetazolamide in patients with transient ischemic attacks  

SciTech Connect

We investigated 15 patients with one or more transient ischemic attacks (TIAs) in the internal carotid artery territory within the month following the most recent TIA. Cerebral blood flow (CBF) was measured by single-photon emission computed tomography, using intravenous xenon-133 before and after injection of 1 g acetazolamide. Six patients had severe carotid stenosis or occlusion; the other nine patients had no significant carotid lesions. Twenty age-matched volunteers free of neurologic symptoms or history were used as controls. Mean CBF in the sylvian region was not significantly different between patients and controls. Seven patients exhibited a focal hypoperfusion at rest in the symptomatic hemisphere, and their hypoperfused areas were hyporeactive after administration of acetazolamide. Seven other patients exhibited hyporeactive areas after acetazolamide administration while their CBF tomograms at rest were normal. Thus, CBF abnormalities were detected in 14 of the 15 patients. Our findings suggest that CBF measured early after acetazolamide administration could be useful to confirm the clinical diagnosis of TIA. In the nine patients with no significant lesion of the internal carotid artery, the areas of hypoperfusion were small and were probably related to the focal ischemic event. In the six patients with severe lesions of the internal carotid artery, abnormalities were of variable size and intensity but were often large and pronounced. The discrepancy between these two subgroups of patients could be ascribed to the hemodynamic influence of the internal carotid artery lesions. Moreover, our findings may provide some insight into the pathophysiology of TIAs.

Chollet, F.; Celsis, P.; Clanet, M.; Guiraud-Chaumeil, B.; Rascol, A.; Marc-Vergnes, J.P.



Factors predicting distress among parents/caregivers of children with neurological disease and home enteral nutrition.  


BACKGROUND & AIMS: Caregivers of children with chronic diseases included in a home enteral nutrition (HEN) programme are at risk of experiencing a feeling of burden, high level of anxiety and psychological distress. The aims of this study were: first, to examine the prevalence of symptoms of anxiety-depression in caregivers of children with neurological diseases requiring HEN by gastrostomy tube (GT); second, to compare the characteristics of caregivers with high or low risk of exhibiting symptoms of anxiety-depression; and third, to investigate possible associations to child disease severity and nutrition support mode. METHODS: A cross-sectional observational study was performed in 58 caregivers of children (31 boys, aged 0.3-18 years) with neurological diseases and GT feeding. The characteristics of caregivers with high or low risk of presenting symptoms of anxiety-depression were compared regarding the following variables: socio-demographic characteristics, the primary caregiver's intrapsychic factors, anthropometric parameters of the child, length of HEN, type of nutrients delivered by GT and infusion regime. RESULTS: All primary caregivers were mothers. Fifty-three per cent of them showed high risk of exhibiting symptoms of anxiety-depression. Mothers with high or low risk of presenting symptoms of anxiety-depression were comparable in age and family socio-economic status. They were also similar in terms of age, anthropometric conditions and length of HEN in their children.No differences were found between the two groups of mothers according to the level of the child's motor function impairment, type of nutrients delivered by GT and infusion regime. Higher levels of psychological distress and perception of burden overload were found in mothers with high risk of exhibiting symptoms of anxiety-depression. CONCLUSIONS: This study found a high prevalence of symptoms of anxiety-depression, perception of burden overload and psychological distress in caregivers of children with HEN. Thus, greater practical and emotional support is required for these families. PMID:23461829

Pedrón-Giner, C; Calderón, C; Martínez-Costa, C; Borraz Gracia, S; Gómez-López, L



Intraoperative neurological event during cesarean section under spinal anesthesia with fentanyl and bupivacaine: Case report and review of literature  

PubMed Central

Neurological events similar to transient ischemic attack in a peripartum woman are uncommon. Cerebral complications of preeclampsia, thrombo-embolic phenomena, or high spinal can mimic such situations. Spinal anesthesia with local anesthetic and opioid is an established anesthetic technique for cesarean section. Although intrathecal opioids are safe for both the mother and fetus; some unusual complications such as dysphagia alone or associated with facial numbness, aphasia, have been reported. We report a case of transient aphonia and tingling sensation over the face without any dysphagia after intrathecal administration of bupivacaine and fentanyl for cesarean section.

Ray, Bikash Ranjan; Baidya, Dalim Kumar; Gregory, Deepak Mathew; Sunder, Rani



Contemporary Teaching of Neurology. Teaching Neurological Behavior to General Practitioners: A Fresh Approach  

ERIC Educational Resources Information Center

Ways in which teaching neurology can be simplified for the nonspecialist practitioner are addressed in this assessment of the state-of-the-art in France. The hypothesis implies simplifying both the diagnoses and symptomatology. (LBH)

Derouesne, C.; Salamon, R.



Mutations of Glucocerebrosidase: Discrimination of Neurologic and Non-Neurologic Phenotypes of Gaucher Disease  

Microsoft Academic Search

Multiple molecular forms of beta -glucocerebrosidase that permit discrimination between neurologic and non-neurologic phenotypes of Gaucher disease have been identified radioimmunologically in fibroblasts and human brain tissue. In normal human fibroblasts these forms have been shown by NaDodSO4\\/polyacrylamide gel electrophoresis to have apparent Mr of 63,000 (form A1), 61,000 (form A2), and 56,000 (form B). The Mr 63,000 form may

Edward I. Ginns; Roscoe O. Brady; Samuel Pirruccello; Carol Moore; Susan Sorrell; F. Scott Furbish; Gary J. Murray; Joseph Tager; John A. Barranger



Posterior Direct Decompression and Fusion of the Lower Thoracic and Lumbar Fractures with Neurological Deficit  

PubMed Central

Study Design A retrospective study. Purpose To analyze the treatment outcome of patients with lower thoracic and lumbar fractures combined with neurological deficits. Overview of Literature Although various methods of the surgical treatment for lower thoracic and lumbar fractures are used, there has been no surgical treatment established as a superior option than others. Methods Between March 2001 and August 2009, this study enrolled 13 patients with lower thoracic and lumbar fractures who underwent spinal canal decompression by removing posteriorly displaced bony fragments via the posterior approach and who followed up for more than a year. We analyzed the difference between the preoperative and postoperative extents of canal encroachment, degrees of neurologic deficits and changes in the local kyphotic angle. Results The average age of the patients was 37 years. There were 10 patients with unstable burst factures and 3 patients with translational injuries. Canal encroachment improved from preoperative average of 84% to 9% postoperatively. Local kyphosis also improved from 20.5° to 1.5°. In 92% (12/13) of the patients, neurologic deficit improved more than Frankel grade 1 and an average improvement of 1.7 grade was observed. Deterioration of neurologic symptoms was not observed. Although some loss of reduction of kyphotic deformity was observed at the final follow-up, serious complications were not observed. Conclusions When posteriorly displaced bony fragments were removed by the posterior approach, neurological recovery could be facilitated by adequate decompression without serious complications. The posterior direct decompression could be used as one of treatments for lower thoracic and lumbar fractures combined with neurologic injuries.

Jun, Deuk Soo; Ahn, Byoung Geun



Clinical manifestations of neurological involvement in primary Sjögren’s syndrome.  


The aim of this study was to evaluate neurological manifestations of primary Sjögren’s syndrome (pSS) and investigate the etiology and pathogenesis of peripheral and central nervous complications in pSS. Thirty-two patients with pSS were enrolled in the present study, 20 of whom had neurological involvement plus sicca symptoms. The clinical features were evaluated by neurological examinations including nerve conduction study, magnetic resonance imaging, cerebrospinal fluid, and electroencephalogram. The frequency of fever was significantly higher (P?=?0.006) in pSS with neurological involvement than in pSS without neurological involvement. There was no statistical significance in other factors between the two groups. Peripheral nervous system (PNS), central nervous system (CNS), and both PNS and CNS involvements were revealed in 14, 3, and 3 patients, respectively. Optic neuritis and trigeminal neuralgia were revealed frequently in cranial neuropathy. Anti-aquaporin 4 antibody was detected in one patient with optic neuritis. Of the nine patients with polyneuropathy, eight patients presented pure sensory neuropathy including small fiber neuropathy (SFN). pSS with SFN appeared to have no clinically abnormal features, including muscle weakness and decreasing deep tendon reflex. Skin biopsy revealed epidermal nerve fiber degenerated in one pSS patient with pure sensory neuropathy who was diagnosed as having SFN. Our observations suggest that a number of mechanisms can be attributed to neurological involvements in pSS rather than just the mechanisms previously described (i.e., vasculitis and ganglioneuronitis). Presumably, specific autoantibodies may directly induce injury of the nervous system. PMID:20393864

Gono, Takahisa; Kawaguchi, Yasushi; Katsumata, Yasuhiro; Takagi, Kae; Tochimoto, Akiko; Baba, Sayumi; Okamoto, Yuko; Ota, Yuko; Yamanaka, Hisashi



Musculoskeletal symptoms among electricians.  


This study ascertained the presence of musculoskeletal symptoms among electricians, in order to evaluate the prevalence of cumulative trauma disorders (CTD) in this population. We adapted the CTD surveillance questionnaire used by National Institute for Occupational Safety and Health (NIOSH) to assess the prevalence of neck, shoulder, elbow, hand/wrist, back, and knee symptoms in the year prior to the survey. Questionnaires were completed by 308 apprentices and journeymen enrolled in training classes at the local union hall. The participants were relatively young individuals, and 86% of the participants were currently working as electricians. Participants reported a high prevalence of symptoms which occurred more than three times during the past year or which lasted more than 1 week. Back symptoms and hand/wrist symptoms were experienced most frequently, by about half the population, while elbow symptoms were reported by only 15% of participants. Symptom prevalence was lower, but still notable, when defined as symptoms which had occurred at least once a month or lasted more than a week in the past year. Eighty-two percent of participants reported at least one musculoskeletal symptom using the most inclusive definition, while 57% reported two or more symptoms. This survey highlights that: 1) low back discomfort is common in young construction workers, and resulted in medical care, missed work, or light duty for almost 35% of the participants; 2) neck discomfort is also very common and required doctor visits or work modification for almost one quarter of the participants; 3) these construction workers continued to work with symptoms that are classifiable as a CTD; and 4) history of injury is correlated with the subsequent prevalence of musculoskeletal symptoms. PMID:8147388

Hunting, K L; Welch, L S; Cuccherini, B A; Seiger, L A



Influence of Neurological Medication on Nutritional Status  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Define the potential nutritional risks associated with chronic antiepileptic drug therapy.\\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Understand the possible nutrition interactions in critically ill patients requiring aggressive pharmacologic therapy in the\\u000a acute management of neurologic insults, including traumatic brain injury, stroke, and intracranial hemorrhage.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Recognize the potential treatment strategies to prevent negative health outcomes related to specific drug–nutrient interactions\\u000a in neurologically impaired

Marianne S. Aloupis; Ame L. Golaszewski


Neurological abnormalities associated with CDMA exposure.  


Dysaesthesiae of the scalp and neurological abnormality after mobile phone use have been reported previously, but the roles of the phone per se or the radiations in causing these findings have been questioned. We report finding a neurological abnormality in a patient after accidental exposure of the left side of the face to mobile phone radiation [code division multiple access (CDMA)] from a down-powered mobile phone base station antenna. He had headaches, unilateral left blurred vision and pupil constriction, unilateral altered sensation on the forehead, and abnormalities of current perception thresholds on testing the left trigeminal ophthalmic nerve. His nerve function recovered during 6 months follow-up. His exposure was 0.015-0.06 mW/cm(2) over 1-2 h. The implications regarding health effects of radiofrequency radiation are discussed. PMID:11584121

Hocking, B; Westerman, R



Recognition and treatment of neurologic Wilson's disease.  


As Wilson's disease is both preventable and treatable, the diagnosis must not be missed. Despite this, it is usually misdiagnosed. Misdiagnosis and delay in treatment are clinically relevant because if left untreated, Wilson's disease progresses to hepatic failure or severe neurologic disability, and death. Those adequately treated have a normal life span. Wilson's disease is an autosomal recessive disease caused by mutations in the ATP7B gene. Mutations in ATP7B result in abnormal copper metabolism and subsequent toxic accumulation of copper. The clinical manifestations of neurologic Wilson's disease include variable combinations of dysarthria, dystonia, tremor, parkinsonism, ataxia, and choreoathetosis. Once the possibility of Wilson's disease is considered, diagnosis is straight forward. Currently available treatments, including zinc acetate and trientine, are generally well tolerated and effective. PMID:23677665

Lorincz, Matthew T



Sleep problems in children with neurological disorders.  


This review describes the complex and often reciprocal relationship between sleep problems, neurological disorders and/or intellectual disability in children. The causes of Intellectual disability (ID) discussed in this review include those conditions present from or around the time of birth, although it also considers traumatic brain injuries occurring later in development. This review discusses the patterns of sleep difficulty associated with specific disorders and summarizes the assessment and interventions, both behavioural and pharmacological, applicable to children. Many neurological disorders such as epilepsy, narcolepsy and neurorespiratory disorders vary considerably in terms of the degree of co-morbid problems and can present with a spectrum of effects on underlying cognitive or behavioural substrates including sleep function. These conditions are discussed as they provide useful insights into how disordered sleep can impact on cognitive development and behaviour. The review draws both on the literature in these areas and the extensive clinical experience of the authors. PMID:18415818

Dorris, Liam; Scott, Nicola; Zuberi, Sameer; Gibson, Neil; Espie, Colin


Positive clinical neuroscience: explorations in positive neurology.  


Disorders of the brain and its sensory organs have traditionally been associated with deficits in movement, perception, cognition, emotion, and behavior. It is increasingly evident, however, that positive phenomena may also occur in such conditions, with implications for the individual, science, medicine, and for society. This article provides a selective review of such positive phenomena--enhanced function after brain lesions, better-than-normal performance in people with sensory loss, creativity associated with neurological disease, and enhanced performance associated with aging. We propose that, akin to the well-established field of positive psychology and the emerging field of positive clinical psychology, the nascent fields of positive neurology and positive neuropsychology offer new avenues to understand brain-behavior relationships, with both theoretical and therapeutic implications. PMID:23286954

Kapur, Narinder; Cole, Jonathan; Manly, Tom; Viskontas, Indre; Ninteman, Aafke; Hasher, Lynn; Pascual-Leone, Alvaro



Therapeutic plasma exchange in neurology: 2012.  


In treating neuroimmunological diseases, neurologists have a number of different drugs to choose from ranging from corticosteroids to IVIg to more specific cell based therapies, the latter most frequently from the world of oncology. In some diseases, therapeutic plasma exchange, a procedure rather than a drug, is used. The most obvious advantage of therapeutic plasma exchange is the usually rapid onset of action presumably due to removal of pathogenic auto-antibodies. In some diseases, a single course of therapeutic plasma exchange is used while in others prolonged treatment with therapeutic plasma exchange is used. This article will review the use of therapeutic plasma exchange in neurology and will draw heavily upon recent consensus statements from the American Society for Apheresis and the American Academy of Neurology and by Cochrane reviews. PMID:23420591

Cortese, Irene; Cornblath, David R



Cognitive impairment in patients with carotid artery occlusion and ipsilateral transient ischemic attacks  

Microsoft Academic Search

Although transient ischemic attacks (TIAs) by definition do not cause lasting neurological deficits, cognitive impairment has been suggested in patients with carotid artery disease who have suffered from a TIA. The purpose of our study was to assess whether patients with carotid artery disease and TIAs are cognitively impaired, to describe the frequency, nature and severity of this impairment, and

Floor C. Bakker; Catharina J. M. Klijn; Aagje Jennekens-Schinkel; Ingeborg van der Tweel; Cornelis A. F. Tulleken; L. Jaap Kappelle



Neurological Management of Fulminant Hepatic Failure  

Microsoft Academic Search

Acute liver failure (ALF) is uncommon in the United States, but presents acutely and catastrophically, often with deadly consequences.\\u000a Hepatic encephalopathy, cerebral edema, elevated intracranial pressure, and intracranial hemorrhage due to coagulopathy are\\u000a common occurrences in patients with ALF. Appropriate management of multi-system organ failure and neurological complications\\u000a are essential in bridging patients to transplant and ensuring satisfactory outcomes.

Jennifer A. Frontera; Thomas Kalb



Neurological complications of ankylosing spondylitis: neurophysiological assessment  

Microsoft Academic Search

Studies examined the neurological involvement of ankylosing spondylitis (AS) are limited. This study aimed to assess the frequency\\u000a of myelopathy, radiculopathy and myopathy in AS correlating them to the clinical, radiological and laboratory parameters.\\u000a Included were 24 patients with AS. Axial status was assessed using bath ankylosing spondylitis metrology index (BASMI). Patients\\u000a underwent (a) standard cervical and lumbar spine and

Eman M. Khedr; Sonia M. Rashad; Sherifa A. Hamed; Fatma El-Zharaa; Abdel Karim H. Abdalla



Neurological complications of Grönblad-Strandberg syndrome  

Microsoft Academic Search

Neurological complications resulting from pronounced cerebrovascular changes were observed in a 59-year-old female suffering from Grönblad-Strandberg syndrome. In addition to typical skin changes of the pseudoxanthoma elasticum and ocular alterations (exudative macular degeneration and angioid streaks) there were an unusual number of disturbed endocrinological functions. The ophthalmological findings revealed characteristic breaks in Bruch's membrane, proliferation of chorioidal vessels into the

K. Fasshauer; C. D. Reimers; H.-J. Gnau; I. Strempel; C. Rossberg



Neurological complications of ankylosing spondylitis: neurophysiological assessment.  


Studies examined the neurological involvement of ankylosing spondylitis (AS) are limited. This study aimed to assess the frequency of myelopathy, radiculopathy and myopathy in AS correlating them to the clinical, radiological and laboratory parameters. Included were 24 patients with AS. Axial status was assessed using bath ankylosing spondylitis metrology index (BASMI). Patients underwent (a) standard cervical and lumbar spine and sacroiliac joint radiography, (b) somatosensory (SSEP) and magnetic motor (MEP) evoked potentials of upper and lower limbs, (c) electromyography (EMG) of trapezius and supraspinatus muscles. Patients' mean age and duration of illness were 36 and 5.99 years. Bath ankylosing spondylitis metrology index mean score was 4.6. Twenty-five percent (n = 6) of patients had neurological manifestations, 8.3% of them had myelopathy and 16.7% had radiculopathy. Ossification of the posterior (OPLL) and anterior (OALL) longitudinal ligaments were found in 8.3% (n = 2) and 4.2% (n = 1). About 70.8% (n = 17) had >or=1 neurophysiological test abnormalities. Twelve patients (50%) had SSEP abnormalities, seven had prolonged central conduction time (CCT) of median and/or ulnar nerves suggesting cervical myelopathy. Six had delayed peripheral or root latencies at Erb's or interpeak latency (Erb's-C5) suggesting radiculopathy. Motor evoked potentials was abnormal in 54% (n = 13). Twelve (50%) and five (20.8%) patients had abnormal MEP of upper limbs and lower limbs, respectively. About 50% (n = 12) had myopathic features of trapezius and supraspinatus muscles. Only 8.3% (n = 2) had neuropathic features. We concluded that subclinical neurological complications are frequent in AS compared to clinically manifest complications. Somatosensory evoked potential and MEP are useful to identify AS patients prone to develop neurological complications. PMID:19153738

Khedr, Eman M; Rashad, Sonia M; Hamed, Sherifa A; El-Zharaa, Fatma; Abdalla, Abdel Karim H



Vinken and Bruyn's Handbook of Clinical Neurology  

Microsoft Academic Search

Vinken and Bruyn's Handbook of Clinical Neurology (HCN) is best characterized as an encyclopedia. In this paper we describe the origin, production, and reception of HCN. Data were gathered from a literature search, by screening of HCN-volumes, interviewing key-role persons and a study of an HCN-archive. The initiative for HCN was taken by two Excerpta Medica staff members, the one

P. J. Koehler; F. G. I. Jennekens



Minor Neurological Dysfunction in Children with Dyslexia  

ERIC Educational Resources Information Center

|Aim: To improve understanding of brain function in children with severe dyslexia in terms of minor neurological dysfunctions (MNDs). Method: One hundred and four children (81 males, 23 females; age range 7-12y; mean age 9y 7mo, SD 1y 2mo;) with severe dyslexia (the presence of a Full-scale IQ score of greater than or equal to 85, retardation in…

Punt, Marja; de Jong, Marianne; de Groot, Erik; Hadders-Algra, Mijna



Neurologic uses of botulinum neurotoxin type A  

PubMed Central

This article reviews the current and most neurologic uses of botulinum neurotoxin type A (BoNT-A), beginning with relevant historical data, neurochemical mechanism at the neuromuscular junction. Current commercial preparations of BoNT-A are reviewed, as are immunologic issues relating to secondary failure of BoNT-A therapy. Clinical uses are summarized with an emphasis on controlled clinical trials (as appropriate), including facial movement disorders, focal neck and limb dystonias, spasticity, hypersecretory syndromes, and pain.

Ney, John P; Joseph, Kevin R



Symptoms of Learning Disabilities  


... trust For Parents Home | LD Basics | Assessment & Evaluation | Early Childhood | Attention Deficit Disorder | Help with Your Child | Special Education | Mental Health For Parents > LD Basics > Symptoms of ...


The role of neurosciences intensive care in neurological conditions.  


The neurosciences intensive care unit provides specialized medical and nursing care to both the neurosurgical and neurological patient. This second of two articles describes the role it plays in the management of patients with neurological conditions. PMID:24105308

Sadek, Ahmed-Ramadan; Damian, Maxwell; Eynon, C Andy



Applicability of yeast genetics to neurologic disease.  


As advances in gene mapping technology reveal genes associated with neurologic diseases, the need to identify a gene's normal function arises often. Experimental genetics is very useful in identifying a gene's function. It relies on model organisms both because it is not appropriate in humans, and because many processes are remarkably similar among eukaryotes. Many cellular processes have evolved once, and species differences are variations on a theme. Molecular genetic tools available in the yeast Saccharomyces cerevisiae provide a means to more rapidly reach an understanding of gene function, yielding substantial insight into the same process in humans. Yeast will never complain of headache or "spells," but do have expansions of trinucleotide repeats, prions, and other processes very much analogous to those underlying many neurologic diseases. In spite of the absence of a nervous system in yeast, yeast genetics has contributed substantial insight into neurologic diseases mechanisms. The real strength of yeast in studying human disease is in genetic analysis of gene function and in providing genetically powerful functional assays. Arch Neurol. 2000;57:1129-1134 PMID:10927792

Walberg, M W



Chronic neurological sequelae to organophosphate pesticide poisoning.  

PubMed Central

OBJECTIVES. This work was undertaken to determine whether there are any chronic neurological sequelae to acute organophosphate pesticide poisoning. METHODS. California surveillance data were used in a study of neurological function among 128 men poisoned by organophosphate pesticides in California from 1982 to 1990 and 90 referents. Tests included a neurological physical examination, 5 nerve conduction tests, 2 vibrotactile sensitivity tests, 10 neurobehavioral tests, and 1 postural sway test. RESULTS. After correcting for confounding, the poisoned group performed significantly worse than the referent group on two neurobehavioral tests (sustained visual attention and mood scales). When the data were restricted to men with documented cholinesterase inhibition (n = 83) or to men who had been hospitalized (n = 36), the poisoned subjects also showed significantly worse vibrotactile sensitivity of finger and toe. Significant trends of increased impairment were found with increased days of disability on a wide spectrum of tests of both central and peripheral nerve function. CONCLUSIONS. While these findings are limited by low response rates and by small sample sizes for specific pesticides, this study was based on a large surveillance database and is the largest study to date of the chronic effects of organophosphate pesticide poisoning. The evidence of some long-term effects of poisoning is consistent with two prior studies.

Steenland, K; Jenkins, B; Ames, R G; O'Malley, M; Chrislip, D; Russo, J



Mild hypothermia in neurologic emergency: an update.  


Induced hypothermia to treat various neurologic emergencies, which had initially been introduced into clinical practice in the 1940s and 1950s, had become obsolete by the 1980s. In the early 1990s, however, it made a comeback in the treatment of severe traumatic brain injury. The success of mild hypothermia led to the broadening of its application to many other neurologic emergencies. We sought to summarize recent developments in mild hypothermia, as well as its therapeutic potential and limitations. Mild hypothermia has been applied with varying degrees of success in many neurologic emergencies, including traumatic brain injury, spinal cord injury, ischemic stroke, subarachnoid hemorrhage, out-of-hospital cardiopulmonary arrest, hepatic encephalopathy, perinatal asphyxia (hypoxic-anoxic encephalopathy), and infantile viral encephalopathy. At present, the efficacy and safety of mild hypothermia remain unproved. Although the preliminary clinical studies have shown that mild hypothermia can be a feasible and relatively safe treatment, multicenter randomized, controlled trials are warranted to define the indications for induced hypothermia in an evidence-based fashion. PMID:12140503

Inamasu, Joji; Ichikizaki, Kiyoshi



Neurologic Complications Following Pediatric Renal Transplantation.  


We reviewed neurologic complications after renal transplantation in children over a 20-year period. Neurologic complications were classified as early (within 3 months) and delayed (beyond 3 months). Of 115 children, 10 (8.7%) had complications. Early complications were found in 4.35% of patients: seizures in 4 (posterior reversible leukoencephalopathy syndrome due to immunosuppressant toxicity [2], sepsis/presumed meningitis [1], and indeterminate [1]) and headaches in 1. One patient with seizures received levetiracetam for 6 months and 1 with headaches received amitriptyline prophylaxis. Late complications were noted in 4.35% of patients: seizures in 3 (posterior reversible leukoencephalopathy syndrome due to hypertension [2], hypertensive encephalopathy [1]), headaches in 2, and tremors in 1. Two patients with seizures were treated with anti-epilepsy medications; 1 with migraine received cyproheptadine prophylaxis. Neurologic complications develop in children after renal transplantation. Seizures due to posterior reversible leukoencephalopathy syndrome were the commonest complication. Early detection and appropriate management of these complications is important. PMID:23752071

Ghosh, Partha S; Kwon, Charles; Klein, Melanie; Corder, Julie; Ghosh, Debabrata



tDCS-enhanced motor and cognitive function in neurological diseases.  


Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation tool that is now being widely used in neuroscientific and clinical research in humans. While initial studies focused on modulation of cortical excitability, the technique quickly progressed to studies on motor and cognitive functions in healthy humans and in patients with neurological diseases. In the present review we will first provide the reader with a brief background on the basic principles of tDCS. In the main part, we will outline recent studies with tDCS that aimed at enhancing behavioral outcome or disease-specific symptoms in patients suffering from mild cognitive impairment, Alzheimer's disease, movement disorders, and epilepsy, or persistent deficits after stroke. The review will close with a summary statement on the present use of tDCS in the treatment of neurological disorders, and an outlook to further developments in this realm. tDCS may be an ideal tool to be administered in parallel to intensive cognitive or motor training in neurological disease, but efficacy for the areas of activities and participation still needs to be established in controlled randomized trials. Its use in reducing disease-specific symptoms like dystonia or epileptic seizures is still unclear. PMID:23727025

Flöel, Agnes



Neurological soft signs in schizophrenia - The past, the present and the future  

PubMed Central

Clinical neurological abnormalities in patients with schizophrenia have been generally called “Neurological Soft Signs” (NSS). Studies have consistently shown increased NSS in patients with schizophrenia as compared to healthy persons. Early studies were limited by possible confounds of prior neuroleptic medications and illness chronicity. Studies in first episode never treated schizophrenia patients have addressed these confounds. The clinical significance of these findings and the correlation with cognitive dysmetria is the focus of the current review. Relevant literature was obtained using PUBMED and MEDLINE search (1980–2008) and a direct search of reference list of pertinent journal articles. In a 2003 study, neuroleptic-naive schizophrenia patients had significantly more NSS than controls. Patients who were more neurologically impaired had more negative symptoms. Higher NSS scores in treatment-naive schizophrenia patients and the absence of correlation between NSS and illness duration lends support to a neurodevelopmental pathogenesis for schizophrenia. The finding of incoordination and cerebellar signs in most studies also supports the “cognitive dysmetria” explanatory model for schizophrenia. A significant subgroup of patients with schizophrenia may have more neuropathological abnormalities, which predisposes them for a more severe and chronic course of illness. These patients may potentially be identified by clinical neurological examination, which might be very important for prognostication and evolving better methods of treatment for these patients. NSS, by themselves or as a composite index with other neurobiological parameters, hold potential as a candidate endophenotype for schizophrenia.

Varambally, Shivarama; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N.



Neurological manifestations of gastrointestinal disorders, with particular reference to the differential diagnosis of multiple sclerosis.  


Neurological manifestations of gastrointestinal disorders are described, with particular reference to those resembling multiple sclerosis (MS) on clinical or MRI grounds. Patients with celiac disease can present cerebellar ataxia, progressive myoclonic ataxia, myelopathy, or cerebral, brainstem and peripheral nerve involvement. Antigliadin antibodies can be found in subjects with neurological dysfunction of unknown cause, particularly in sporadic cerebellar ataxia ("gluten ataxia"). Patients with Whipple's disease can develop mental and psychiatric changes, supranuclear gaze palsy, upper motoneuron signs, hypothalamic dysfunction, cranial nerve abnormalities, seizures, ataxia, myorhythmia and sensory deficits. Neurological manifestations can complicate inflammatory bowel disease (e.g. ulcerative colitis and Crohn's disease) due to vascular or vasculitic mechanisms. Cases with both Crohn's disease and MS or cerebral vasculitis are described. Epilepsy, chronic inflammatory polyneuropathy, muscle involvement and myasthenia gravis are also reported. The central nervous system can be affected in patients with hepatitis C virus (HCV) infection because of vasculitis associated with HCV-related cryoglobulinemia. Mitochondrial neurogastrointestinal encephalopathy (MNGIE) is a disease caused by multiple deletions of mitochondrial DNA. It is characterized by peripheral neuropathy, ophthalmoplegia, deafness, leukoencephalopathy, and gastrointestinal symptoms due to visceral neuropathy. Neurological manifestations can be the consequence of vitamin B1, nicotinamide, vitamin B12, vitamin D, or vitamin E deficiency and from nutritional deficiency states following gastric surgery. PMID:11794474

Ghezzi, A; Zaffaroni, M