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1

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

1995-01-01

2

Functional neurological symptoms.  

PubMed

Functional neurological symptoms refer to neurological symptoms that are not explained by disease. They may also be called psychogenic, non-organic, somatoform, dissociative or conversion symptoms. The most common functional neurological symptoms are non-epileptic attacks and functional weakness. These are common in neurology and general medical practice, especially in emergency situations, where they can be mistaken for epilepsy or stroke. Many studies have shown that these symptoms often persist, are associated with distress and disability and, in the right hands, have a low rate of misdiagnosis. Physicians are often uncertain how to approach patients with these problems. Are patients making up the symptoms? How can the diagnosis be made confidently? What is the best way to explain the diagnosis to the patient? Does treatment ever help? This review takes readers through these questions with practical tips for avoiding common pitfalls, both in diagnosis and management. There is no good evidence that these symptoms are any more 'made up' than irritable bowel symptoms or chronic pain. The diagnosis should usually be made by a neurologist on the basis of positive signs of inconsistency such as Hoover's sign or the typical features of a non-epileptic attack. A 'functional' model of the symptoms is useful both in thinking about the problem and when explaining the symptoms to the patient. There are many useful steps in management that do not require a detailed understanding of aetiology in an individual patient. PMID:21365066

Stone, J

2011-03-01

3

Functional symptoms in neurology: mimics and chameleons.  

PubMed

The mimics and chameleons of functional symptoms in neurology could be a whole textbook of neurology. Nevertheless, there are some recurring themes when things go wrong, notably diagnostic bias introduced by the presence or absence of psychiatric comorbidity or life events, neurological diseases that look 'weird' and lack of appreciation of the more unusual features of functional symptoms themselves. PMID:23468561

Stone, Jon; Reuber, Markus; Carson, Alan

2013-04-01

4

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. PMID:19714636

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

2009-01-01

5

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

2010-01-01

6

Neurological symptoms in individuals with fibrodysplasia ossificans progressiva.  

PubMed

Fibrodysplasia ossificans progressiva (FOP), a rare, disabling condition caused by gain-of-function mutations of a bone morphogenetic protein (BMP) type I receptor, leads to episodes of heterotopic ossification and resultant immobility. Neurological problems have not been associated with FOP, but neurological symptoms are commonly reported by FOP patients. To determine the prevalence of neurological symptoms and their characteristics in individuals with FOP, we conducted a survey of the 470 patient members of the International FOP Association (IFOPA) using a questionnaire about neurological symptoms. There were 168 responses (105 females, 63 males; age 1.5-68 years) from 30 countries representing 36 % of IFOPA members. Chronic neurological symptoms were reported by 86 (51 %). Prevalence of neuropathic pain (NP) was significantly increased (P < 0.001) compared to the general population, and tenfold more common in females (15 %) than males (1.6 %). Of those with NP, 94 % reported other sensory abnormalities. Prevalence of recurrent severe headaches (HA) (26 %) was similar to that in the general population, but prevalence in females with FOP (36 %) was almost fourfold greater than in males. Prevalence of NP, HA, and other sensory abnormalities was substantially higher in post-pubertal females; 33 % reported symptoms worsened during menstrual periods. Worsening of neurological symptoms during FOP flare-ups was reported by 23 %. Three patients with FOP (1.8 %) reported myoclonus, a prevalence much greater than reported in the general population (P < 0.001). Our worldwide survey indicates that neurological symptoms are common in FOP. We speculate that these symptoms are related to effects of dysregulated BMP signaling on the central and/or peripheral nervous systems. PMID:22752062

Kitterman, Joseph A; Strober, Jonathan B; Kan, Lixin; Rocke, David M; Cali, Amanda; Peeper, Jeannie; Snow, Jennifer; Delai, Patricia L R; Morhart, Rolf; Pignolo, Robert J; Shore, Eileen M; Kaplan, Frederick S

2012-12-01

7

Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL).  

PubMed

A lady in her late 20s was admitted with a history of headaches and intermittent focal neurological symptoms which were greatly exacerbated by catheter angiography of the cerebral circulation. Cerebrospinal fluid analysis demonstrated a lymphocytic pleocytosis. She subsequently made a spontaneous recovery, without neurological sequelae. Her presentation fits the diagnostic criteria for the previously described syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL). HaNDL is a probably underdiagnosed nosological entity, characterised by often dramatic clinical manifestations but ultimately a good prognosis. PMID:22700346

Cifelli, A; Vaithianathar, L

2011-01-01

8

Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL)  

PubMed Central

A lady in her late 20s was admitted with a history of headaches and intermittent focal neurological symptoms which were greatly exacerbated by catheter angiography of the cerebral circulation. Cerebrospinal fluid analysis demonstrated a lymphocytic pleocytosis. She subsequently made a spontaneous recovery, without neurological sequelae. Her presentation fits the diagnostic criteria for the previously described syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL). HaNDL is a probably underdiagnosed nosological entity, characterised by often dramatic clinical manifestations but ultimately a good prognosis. PMID:22700346

Cifelli, A; Vaithianathar, L

2011-01-01

9

Fat embolism syndrome in a patient demonstrating only neurologic symptoms  

PubMed Central

Fat embolism syndrome (FES) is a recognized complication of both long bone fractures and intramedullary orthopedic procedures. The usual presenting features are respiratory failure, neurologic dysfunction and petechiae. In this report, a 25-year-old woman with FES presented with serious neurologic symptoms and signs in the absence of respiratory dysfunction. The diagnosis is essentially a clinical one, but nuclear magnetic resonance imaging of the brain revealed distinctive lesions that may help future diagnosis of FES. PMID:9793509

Bardana, David; Rudan, John; Cervenko, Frank; Smith, Roger

1998-01-01

10

Multidisciplinary treatment for functional neurological symptoms: a prospective study.  

PubMed

Although functional neurological symptoms are often very disabling there is limited information on outcome after treatment. Here we prospectively assessed the short- and long-term efficacy of an inpatient multidisciplinary programme for patients with FNS. We also sought to determine predictors of good outcome by assessing the responsiveness of different scales administered at admission, discharge and follow-up. Sixty-six consecutive patients were included. Assessments at admission, discharge and at 1 year follow-up (55 %) included: the Health of the Nation Outcome Scale, the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire-15, the Revised Illness Perception Questionnaire, the Common Neurological Symptom Questionnaire, the Fear Questionnaire and the Canadian Occupational Performance Measure. At discharge and at 1 year follow-up patients were also asked to complete five-point self-rated scales of improvement. There were significant improvements in clinician-rated mental health and functional ability. In addition, patients reported that their levels of mood and anxiety had improved and that they were less bothered by somatic symptoms in general and neurological symptoms in particular. Two-thirds of patients rated their general health such as "better" or "much better" at discharge and this improvement was maintained over the following year. Change in HoNOS score was the only measure that successfully predicted patient-rated improvement. Our data suggest that a specialized multidisciplinary inpatient programme for FNS can provide long-lasting benefits in the majority of patients. Good outcome at discharge was exclusively predicted by improvement in the HoNOS which continued to improve over the 1 year following discharge. PMID:25239392

Demartini, Benedetta; Batla, Amit; Petrochilos, Panayiota; Fisher, Linda; Edwards, Mark J; Joyce, Eileen

2014-12-01

11

Manganese exposure: neuropsychological and neurological symptoms and effects in welders.  

PubMed

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 B, Auditory Consonant Trigrams, Stroop, Rey-Osterreith, Animal Naming, Controlled Oral Word Association (COWAT), Test of Memory Malingering, Rey 15-item, Fingertapping, Grooved Pegboard, Dynamometer, Visual Attention Test, Lanthony d-15 Color Vision, Vistech Contrast Sensitivity, and Schirmer strips. The controls were administered a shorter battery of tests and the Rey-Osterreith, Animal Naming and some of the subtests of the WAIS-III, WMS-III were not administered. Mood tests, given to both groups, included the Symptom Checklist-40, Symptom Checklist-90-R, Profile of Mood Scale, Beck Depression Inventory II, and Beck Anxiety Inventory. Forty-seven welders and 42 controls were retained for statistical analysis after appropriate exclusions. Results showed a high rate of symptom prevalence and pronounced deficits in motor skills, visuomotor tracking speed and information processing, working memory, verbal skills (COWAT), delayed memory, and visuospatial skills. Neurological examinations compared to neuropsychological test results suggest that neuropsychologists obtain significantly more mood symptoms overall. Odds ratios indicate highly elevated risk for neuropsychological and neurological symptomatology of manganism. Mood disturbances including anxiety, depression, confusion, and impaired vision showed very high odds ratios. Neurological exams and neuropsychological tests exhibit complementarity and differences, though neuropsychological methods may be more sensitive in detecting early signs of manganism. The present study corroborates the findings of our previous study in another group of welders. PMID:16343629

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

2006-05-01

12

Atypical Craniosynostosis with Torticollis and Neurological Symptoms: A Rhombencephalosynapsis Sequence  

PubMed Central

Purpose. We describe a case of 3-year-old girl with rhombencephalosynapsis, a rare cerebellar anomaly. Patient. A 3-year-old girl was admitted to our hospital due to congenital torticollis and asymmetry of face, skull and trunk. Craniosynostosis was suspected due to abnormal head shape. 3D-CT revealed closure of the sagittal suture without scaphocephalic skull. Due to atypical craniosynostosis with neurological symptoms, brain-MRI was performed revealing rhombencephalosynapsis. Results. Our patient presented with atypical craniosynostosis and balance problems, not typical for scaphocephaly. Operative treatment for craniosynotosis was not carried out because the cause of the problems was the cerebellum instead of the brain. Conclusions. Therefore, we conclude that patients with atypical craniosynostosis should be examined with brain-MRI to exclude the intracranial malformations, which 3D-CT does not reveal. Without brain-MRI, decision (not) to perform surgery could have been different. PMID:20029674

Koljonen, Virve; Leikola, Junnu; Valanne, Leena; Hukki, Jyri

2009-01-01

13

Reliability of self-reported diagnoses in patients with neurologically unexplained symptoms  

Microsoft Academic Search

Background: Patients with neurologically unexplained symptoms (NUS) often have a previous history of other medically unexplained symptoms. A past history of such symptoms can help make a positive diagnosis of a somatoform or affective disorder, and enable appropriate management strategies. However, information on past medical diagnoses is primarily obtained from patient interviews and may be inaccurate, particularly in patients with

A Schrag; R J Brown; M R Trimble

2004-01-01

14

Early onset of neurological symptoms in fragile X premutation carriers exposed to neurotoxins  

PubMed Central

We present four cases of fragile X premutation carriers with early neurological symptoms, including symptoms consistent with multiple sclerosis (MS) and fragile X-associated tremor/ataxia syndrome (FXTAS). Each patient had significant exposure to one or more environmental neurotoxicants that have documented neurotoxicity (i.e. hexachlorocyclopentadiene or C56, Agent Orange, and 2,4- or 2,6-toluene diisocyanate and dichlormate). We hypothesize that premutation carriers are a vulnerable group to neurotoxins because elevated mRNA in the premutation can lead to early cell death and brain disease, leading to neuropsychiatric and neurological symptoms consistent with FXTAS. PMID:20466021

Paul, Ripon; Pessah, Isaac N.; Gane, Louise; Ono, Michele; Hagerman, Paul J.; Brunberg, James A.; Tassone, Flora; Bourgeois, James A.; Adams, Patrick E.; Nguyen, Danh V.; Hagerman, Randi

2014-01-01

15

Transient isolated brainstem symptoms preceding posterior circulation stroke: a population-based study  

PubMed Central

Summary Background Transient isolated brainstem symptoms (eg, isolated vertigo, dysarthria, diplopia) are not consistently classified as transient ischaemic attacks (TIAs) and data for prognosis are limited. If some of these transient neurological attacks (TNAs) are due to vertebrobasilar ischaemia, then they should be common during the days and weeks preceding posterior circulation strokes. We aimed to assess the frequency of TNAs before vertebrobasilar ischaemic stroke. Methods We studied all potential ischaemic events during the 90 days preceding an ischaemic stroke in patients ascertained within a prospective, population-based incidence study in Oxfordshire, UK (Oxford Vascular Study; 2002–2010) and compared rates of TNA preceding vertebrobasilar stroke versus carotid stroke. We classified the brainstem symptoms isolated vertigo, vertigo with non-focal symptoms, isolated double vision, transient generalised weakness, and binocular visual disturbance as TNAs in the vertebrobasilar territory; atypical amaurosis fugax and limb-shaking as TNAs in the carotid territory; and isolated slurred speech, migraine variants, transient confusion, and hemisensory tingling symptoms as TNAs in uncertain territory. Findings Of the 1141 patients with ischaemic stroke, vascular territory was categorisable in 1034 (91%) cases, with 275 vertebrobasilar strokes and 759 carotid strokes. Isolated brainstem TNAs were more frequent before a vertebrobasilar stroke (45 of 275 events) than before a carotid stroke (10 of 759; OR 14·7, 95% CI 7·3–29·5, p<0·0001), particularly during the preceding 2 days (22 of 252 before a vertebrobasilar stroke vs two of 751 before a carotid stroke, OR 35·8, 8·4–153·5, p<0·0001). Of all 59 TNAs preceding (median 4 days, IQR 1–30) vertebrobasilar stroke, only five (8%) fulfilled the National Institute of Neurological Disorders and Stroke (NINDS) criteria for TIA. The other 54 cases were isolated vertigo (n=23), non-NINDS binocular visual disturbance (n=9), vertigo with other non-focal symptoms (n=10), isolated slurred speech, hemisensory tingling, or diplopia (n=8), and non-focal events (n=4). Only 10 (22%) of the 45 patients with isolated brainstem TNAs sought medical attention before the stroke and a vascular cause was suspected by their physician in only one of these cases. Interpretation In patients with definite vertebrobasilar stroke, preceding transient isolated brainstem symptoms are common, but most symptoms do not satisfy traditional definitions of TIA. More studies of the prognosis of transient isolated brainstem symptoms are required. Funding Wellcome Trust, UK Medical Research Council, Dunhill Medical Trust, Stroke Association, National Institute for Health Research (NIHR), Thames Valley Primary Care Research Partnership, and the NIHR Biomedical Research Centre, Oxford. PMID:23206553

Paul, Nicola LM; Simoni, Michela; Rothwell, Peter M

2013-01-01

16

Diagnosis of the Encephalitozoon cuniculi infections in pet rabbits with neurological symptoms.  

PubMed

The purpose of the study was the in vivo diagnosing of E. cuniculi invasions in pet rabbits with neurological symptoms using the Real-Time PCR, and determination of the rate of invasion, in this group of animals. The study involved 103 pet rabbits with neurological symptoms. Parasitic invasions were diagnosed using Real-Time PCR. The DNA of the parasites for molecular tests was isolated from the urine of the diseased animals. Out of the 103 tested DNA samples, the presence of the E. cuniculi genetic material was detected in 27 samples (26.21%). The melting temperature (Tm) of all products was 77.5 degrees C. The presence of parasitic DNA in the urine of 26.21% of examined animals indicates that E. cuniculi infections occur widely in pet rabbits in Poland and are a significant cause of neurological disorders in those animals. PMID:24988865

Zietek, J; Adaszek, ?; Dziegiel, B; Kalinowski, M; Bartnicki, M; Kalinowska, A; Jarosz, ?; Winiarczyk, S

2014-01-01

17

Brain MR Imaging in the Evaluation of Chronic Headache in Patients without Other Neurologic Symptoms  

Microsoft Academic Search

Rationale and ObjectivesThe authors investigated the use of magnetic resonance (MR) imaging of the brain in adult patients with a primary complaint of chronic headache and no other neurologic symptoms or findings and determined the yield and MR predictors of major abnormalities in these patients.

Henry Z. Wang; Teresa M. Simonson; William R. Greco; William T. C. Yuh

2001-01-01

18

Neurologic Symptoms Associated With Cattle Farming in the Agricultural Health Study  

PubMed Central

Objective Infection with Campylobacter jejuni, a bacterium carried by poultry and livestock, is the most frequently identified antecedent to the autoimmune neurologic condition Guillain-Barré Syndrome. We used Agricultural Health Study data to assess whether cattle farming was associated with prevalence of neurologic symptoms. Methods Prevalence of self-reported symptoms in cattle farmers (n = 8878) was compared with farmers who did not work with animals (n = 7462), using multivariate regression. Results Prevalence of numbness and weakness were increased for beef and dairy farmers compared with the reference group (P < 0.0001). Of cattle farmers, 48% did not report raising other animal species, and prevalence of numbness and weakness were also increased in this subgroup compared with the reference group (P < 0.02). Conclusions Occupational exposure to cattle was associated with increased prevalence of self-reported symptoms associated with peripheral neuropathy. PMID:22975665

Vegosen, Leora; Davis, Meghan F.; Silbergeld, Ellen; Breysse, Patrick N.; Agnew, Jacqueline; Gray, Gregory; Freeman, Laura Beane; Kamel, Freya

2013-01-01

19

Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures: a case report and review of the literature  

PubMed Central

Introduction Only a high-energy force can cause thoracic spinal fracture-dislocation injuries, and such injuries should always be suspected in patients with polytrauma. The injury is usually accompanied by neurological symptoms. There are only a few cases of severe thoracic spinal fracture-dislocation without neurological symptoms in the literature, and until now, no case of severe thoracic spinal fracture-dislocation without neurological symptoms and without costal fractures has been reported. Case presentation A 30-year-old Han Chinese man had T6 to T7 vertebral fracture and anterolateral dislocation without neurological symptoms and costal fractures. The three-dimensional reconstruction by computed tomography and magnetic resonance imaging indicated the injuries in detail. A patient with thoracic spinal fracture-dislocation without neurological symptoms inclines to further dislocation of the spine and secondary neurological injury; therefore, laminectomy, reduction and internal fixations with rods and screws were done. The outcome was good. Severe spinal fracture-dislocation without neurological symptoms should be evaluated in detail, especially with three-dimensional reconstruction by computed tomography. Although treatment is individualized, reduction and internal fixation are advised for the patient if the condition is suitable for operation. Conclusions Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures is frighteningly rare; an operation should be done if the patient's condition permits. PMID:25316002

2014-01-01

20

Brain Magnetic Resonance Imaging Screening Is Not Useful for HIV-1-Infected Patients Without Neurological Symptoms.  

PubMed

Abstract We investigated the diagnostic usefulness of brain magnetic resonance imaging (MRI) screening in HIV-1-infected patients without neurological symptoms in detecting intracranial diseases at early stages. In this retrospective analysis, the study patients were HIV-1-infected patients who underwent brain MRI scan in clinical practice between 2001 and 2013. We excluded patients with MRI for (1) follow-up examination for prediagnosed intracranial diseases, (2) cancer staging, (3) screening mycobacterium/bacteria/fungi disease proliferation in the brain, and (4) evaluation for meningitis/encephalitis. The study patients (n=485) were classified into two groups: those who underwent brain MRI scan without any neurological symptoms/signs (asymptomatic patients, n=158) and those who underwent MRI due to such symptoms (symptomatic patients, n=327). Asymptomatic patients had lower CD4 counts than symptomatic patients (median 78 versus 241/?l). Intracranial diseases were detected in three (2%) of the asymptomatic patients [two toxoplasmosis and one progressive multifocal leukoencephalopathy (PML)] compared to 58 (19%) of the symptomatic patients (the ?(2) test, p<0.01). The latter included toxoplasmosis (n=10), PML (n=7), cytomegalovirus encephalitis (n=3), primary central nervous system lymphoma (n=3), cryptococcoma/meningitis (n=3), and HIV-associated dementia (n=17). Among symptomatic patients, intracranial diseases were common in those with slurred speech (3/6, 50%), seizure (4/10, 40%), eyesight/vision abnormality (5/16, 31%), altered mental status (8/31, 26%), and hemiplegia/numbness (13/50, 26%). For patients with CD4 count <200/?l, intracranial diseases were detected in only 3 (3%) of 144 asymptomatic patients, compared with 46 (32%) of 113 symptomatic patients (p<0.01). Brain MRI screening for HIV-1-infected patients without neurological symptoms is of little value. PMID:25084148

Nishijima, Takeshi; Gatanaga, Hiroyuki; Teruya, Katsuji; Tajima, Tsuyoshi; Kikuchi, Yoshimi; Hasuo, Kanehiro; Oka, Shinichi

2014-10-01

21

Relationships among postconcussional-type symptoms, depression, and anxiety in neurologically normal young adults and victims of mild brain injury  

Microsoft Academic Search

This study investigated the relationship between self-reports of postconcussional symptoms, depression, and anxiety in neurologically normal young adults and recovered victims of mild head injuries (MHI). The participants were 496 young adults with no history of MHI or depression, 56 neurologically normal individuals with clinical depression, and 40 people with history of MHI. All completed the Beaumont Postconcussional Index (BPCI),

Donald E Trahan; Christina E Ross; Shirley L Trahan

2001-01-01

22

MRI Findings May Predict Early Neurologic Deterioration in Acute Minor Stroke or Transient Ischemic Attack due to Intracranial Atherosclerosis  

Microsoft Academic Search

Background: Patients with intracranial atherosclerosis (ICAS) are at high risk of early recurrence or neurologic deterioration. Although minor stroke and transient ischemic attack (TIA) seem benign, their occurrence in patients with ICAS may lead to early neurological deterioration (END). We aimed to identify factors associated with END in ICAS patients presenting with acute minor stroke or TIA, with a focus

Joon-Tae Kim; Hye-Jin Kim; Sung-Hee Yoo; Man-Seok Park; Sun U. Kwon; Ki-Hyun Cho; Jong S. Kim; Dong-Wha Kang

2010-01-01

23

Organophosphate intermediate syndrome with neurological complications of extrapyramidal symptoms in clinical practice.  

PubMed

Organophosphates (OPs) are ubiquitous in the world as domestic and industrial agricultural insecticides. Intentional poisoning as suicides attempts are clinical phenomena seen in emergency departments and clinics in agricultural areas. Intermediate syndrome with the neurological complication of extra pyramidal symptoms following acute OP ingestion may occur in pediatric and adult cases. While death is the most serious consequence of toxic OP doses, low levels of exposure and nonfatal doses may disrupt the neurobehavioral development of fetuses and children in addition to bring linked to testicular cancer and male and female infertility. These are disturbing. Chronic and acute toxicity from OPs are barriers to the health of our present and future generations. Symptoms and treatment of acute and chronic OP exposure are briefly referenced with inclusion of the intermediate syndrome. Suggestions for local and systemic reduction of the acute and long term consequences of OP ingestion are opined. PMID:25002781

Detweiler, Mark B

2014-07-01

24

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

PubMed Central

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

2013-01-01

25

Onco-neural antibodies and tumour type determine survival and neurological symptoms in paraneoplastic neurological syndromes with Hu or CV2/CRMP5 antibodies  

PubMed Central

Objective Anti-Hu antibodies (Hu-Ab) and anti-CV2/CRMP5 antibodies (CV2/CRMP5-Ab) have been identified in association with paraneoplastic neurological disorders. However, it is not clear whether these antibodies are associated with specific neurological symptoms or are only markers of anti-cancer immune reaction. Methods To address this question, we compared 37 patients with CV2/CRMP5-Ab and 324 patients with Hu-Ab. Results Whereas the age and sex ratio were the same between the two groups, the distribution of neurological symptoms was not. Patients with CV2/CRMP5-Ab presented more frequently cerebellar ataxia, chorea, uveo/retinal symptoms and myasthenic syndrome (Lambert-Eaton myasthenic syndrome LEMS or myasthenia gravis). They also had better Rankin score. On the opposite, dysautonomia, brainstem encephalitis and peripheral neuropathy were more frequent in patients with Hu-Ab. Limbic encephalitis occurred similarly in both groups. Small cell lung cancer (SCLC) was the most frequently associated tumor in both groups of patients while malignant thymoma was observed only in patients with CV2/CRMP5-Ab. In particular, patients with CV2/CRMP5-Ab and thymoma developed more frequently myasthenic syndrome while patients with SCLC developed more frequently neuropathies. Chorea and myasthenic syndrome were only seen in patients with CV2/CRMP5-Ab. The median survival time was significantly longer in patients with CV2/CRMP5-Ab and this effect was not dependent on the type of tumor. Interpretation Our data demonstrate that in patients with paraneoplastic neurological syndromes, the neurological symptoms and survival vary with both the type of associated onco-neural antibody and the type of tumor. PMID:18931014

Honnorat, Jerome; Cartalat-Carel, Stephanie; Ricard, Damien; Camdessanche, Jean-Philippe; Carpentier, Antoine F.; Rogemond, Veronique; Chapuis, Francois; Aguera, Michele; Decullier, Evelyne; Duchemin, Anne-Marie; Graus, Francesc; Antoine, Jean-Christophe

2009-01-01

26

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

1999-01-01

27

Self-reported neurological symptoms in relation to CO emissions due to problem gas appliance installations in London: a cross-sectional survey  

Microsoft Academic Search

BACKGROUND: Previous research by the authors found evidence that up to 10% of particular household categories may be exposed to elevated carbon monoxide (CO) concentrations from poor quality gas appliance installations. The literature suggests certain neurological symptoms are linked to exposure to low levels of CO. This paper addresses the hypothesis that certain self-reported neurological symptoms experienced by a householder

Ben Croxford; Giovanni S Leonardi; Irene Kreis

2008-01-01

28

Ischemic Transient Neurological Events Identified by Immune Response to Cerebral Ischemia  

PubMed Central

Background and Purpose Deciphering whether a transient neurological event (TNE) is of ischemic or nonischemic etiology can be challenging. Ischemia of cerebral tissue elicits an immune response in stroke and transient ischemic attack (TIA). This response, as detected by RNA expressed in immune cells, could potentially distinguish ischemic from nonischemic TNE. Methods Analysis of 208 TIAs, ischemic strokes, controls and TNE was performed. RNA from blood was processed on microarrays. TIAs (n=26) and ischemic strokes (n=94) were compared to controls (n=44) to identify differentially expressed genes (FDR<0.05, fold change ??1.2?). Genes common to TIA and stroke were used predict ischemia in TIA-DWI positive / minor-stroke (n=17), nonischemic TNE (n=13) and TNE of unclear etiology (n=14). Results Seventy-four genes expressed in TIA were common to those in ischemic stroke. Functional pathways common to TIA and stroke related to activation of innate and adaptive immune systems, involving granulocytes and B-cells. A prediction model using 26 of the 74 ischemia genes distinguished TIA and stroke subjects from controls with 89% sensitivity and specificity. In the validation cohort, 17/17 TIA-DWI positive / minor-strokes were predicted to be ischemic, and 10/13 nonischemic TNE were predicted to be nonischemic. In TNE of unclear etiology, 71% were predicted to be ischemic. These subjects had higher ABCD2 scores. Conclusions A common molecular response to ischemia in TIA and stroke was identified, relating to activation of innate and adaptive immune systems. TNE of ischemic etiology were identified based upon gene profiles that may be of clinical utility once validated. PMID:22308247

Jickling, Glen C; Zhan, Xinhua; Stamova, Boryana; Ander, Bradley P; Tian, Yingfang; Liu, Dazhi; Sison, Shara-Mae; Verro, Piero; Johnston, S. Claiborne; Sharp, Frank R

2012-01-01

29

Screening for primary creatine deficiencies in French patients with unexplained neurological symptoms  

PubMed Central

A population of patients with unexplained neurological symptoms from six major French university hospitals was screened over a 28-month period for primary creatine disorder (PCD). Urine guanidinoacetate (GAA) and creatine:creatinine ratios were measured in a cohort of 6,353 subjects to identify PCD patients and compile their clinical, 1H-MRS, biochemical and molecular data. Six GAMT [N-guanidinoacetatemethyltransferase (EC 2.1.1.2)] and 10 X-linked creatine transporter (SLC6A8) but no AGAT (GATM) [L-arginine/glycine amidinotransferase (EC 2.1.4.1)] deficient patients were identified in this manner. Three additional affected sibs were further identified after familial inquiry (1 brother with GAMT deficiency and 2 brothers with SLC6A8 deficiency in two different families). The prevalence of PCD in this population was 0.25% (0.09% and 0.16% for GAMT and SLC6A8 deficiencies, respectively). Seven new PCD-causing mutations were discovered (2 nonsense [c.577C?>?T and c.289C?>?T] and 1 splicing [c.391?+?15G?>?T] mutations for the GAMT gene and, 2 missense [c.1208C?>?A and c.926C?>?A], 1 frameshift [c.930delG] and 1 splicing [c.1393-1G?>?A] mutations for the SLC6A8 gene). No hot spot mutations were observed in these genes, as all the mutations were distributed throughout the entire gene sequences and were essentially patient/family specific. Approximately one fifth of the mutations of SLC6A8, but not GAMT, were attributed to neo-mutation, germinal or somatic mosaicism events. The only SLC6A8-deficient female patient in our series presented with the severe phenotype usually characterizing affected male patients, an observation in agreement with recent evidence that is in support of the fact that this X-linked disorder might be more frequent than expected in the female population with intellectual disability. PMID:23234264

2012-01-01

30

Episodic neurologic dysfunction in patients with Hodgkin's disease.  

PubMed

Fourteen young patients, 12 women and two men, believed to be cured of Hodgkin's disease, suffered episodes of neurologic dysfunction. The mechanism responsible for these symptoms is unknown, but transient ischemia seems most likely. PMID:3778257

Feldmann, E; Posner, J B

1986-12-01

31

Neurological signs and late-life depressive symptoms in a community population: the ESPRIT Study  

E-print Network

;25(7):672-8" DOI : 10.1002/gps.2406 #12;2 Depressive symptomatology in late-life may therefore be a warning sign. Depressive symptomatology was ascertained using the CES-D and abnormal neurological signs / comorbidity from

Boyer, Edmond

32

A somatic cell defect is associated with the onset of neurological symptoms in a lysosomal storage disease  

PubMed Central

Mutations in individuals with the lysosomal storage disorder Niemann-Pick disease, type C1 (NPC1) are heterogeneous, not localized to specific protein domains, and not correlated to time of onset or disease severity. We demonstrate direct correlation of the time of neurological symptom onset with the severity of lysosomal defects in NPC1 patient-derived fibroblasts. This is a novel assay for NPC1 individuals that may be predictive of NPC1 disease progression and broadly applicable to other lysosomal disorders. PMID:23850077

Rodriguez-Gil, Jorge L.; Larson, Denise M.; Wassif, Christopher A.; Yanjanin, Nicole M.; Anderson, Stacie M.; Kirby, Martha R.; Trivedi, Niraj S.; Porter, Forbes D.; Pavan, William J.

2013-01-01

33

[Cerebral dysfunction, neurologic symptoms and recurrent delinquency--I. Review of the literature].  

PubMed

Men with polytropic and persistent delinquency constitute a core group of criminal offenders. Criminological research could establish a set of social characteristics for this group, but psychiatric, neurological and neuropsychological variables with importance to the formation of delinquent recidivism are rarely investigated. In this study we give a survey of the results concerning the relevance of genetic factors for delinquent behaviour. Then we review the development of the "minimal brain disorder" conception and its changes to "hyperkinetic syndrome", "attention deficit disorder" and to specific developmental disorders, which are all associated with a higher degree of conduct disorders and delinquent behaviour. We finally discuss the stability and relevance of nonfocal neurological ("soft") signs and depict a tentative model of the relations between the influential factors. Part II of this study (66) gives an account of the results of the "Heidelberg Delinquency Study" in this area. PMID:8050772

Kröber, H L; Scheurer, H; Sass, H

1994-05-01

34

Symptoms 'unexplained by organic disease' in 1144 new neurology out-patients: how often does the diagnosis change at follow-up?  

Microsoft Academic Search

It has been previously reported that a substantial proportion of newly referred neurology out-patients have symptoms that are considered by the assessing neurologist as unexplained by 'organic disease'. There has however been much controversy about how often such patients subsequently develop a disease diagnosis that, with hindsight, would have explained the symptoms. We aimed to determine in a large sample

Jon Stone; A. Carson; R. Duncan; R. Coleman; R. Roberts; C. Warlow; C. Hibberd; G. Murray; R. Cull; A. Pelosi; J. Cavanagh; K. Matthews; R. Goldbeck; R. Smyth; J. Walker; A. D. MacMahon; M. Sharpe

2009-01-01

35

Neurology Residency Department of Neurology &  

E-print Network

's symptoms and signs are the result of an organic or psychological disorder. Where they are due to an organic scientifically based, comprehensive and effective diagnosis and management for outpatients with neurological disorders. Clinical Skills For a patient with a neurological complaint or disorder, the physician

Shoubridge, Eric

36

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

PubMed Central

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 loss. A second goal was to determine if LOD, compared with EOD, would demonstrate more cognitive and neuroimaging changes. Method At regular intervals over a four year period non-demented, older, depressed adults were assessed on the Mini Mental Status Examination (MMSE) and the Montgomery-Asberg Depression Rating Scale (MADRS). They were also assessed on Magnetic Resonance Imaging (MRI). Results Compared with LOD, EOD had more depressive symptoms, more suicidal thoughts, and less social support. Growth curve analyses indicated that EOD demonstrated higher levels of residual depressive symptoms over time. The LOD group exhibited a greater decrement in cognitive scores. Contrary to the glucocorticoid cascade hypothesis, participants with EOD lost right hippocampal volume at a slower rate than did participants with LOD. Right cerebrum gray matter was initially smaller among participants with LOD. Conclusions EOD is associated with greater severity of depressive illness. LOD is associated with more severe cognitive and neurological changes. These differences are relevant to understanding cognitive impairment in geriatric depression. PMID:22934752

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

2012-01-01

37

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. PMID:16504144

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

2006-01-01

38

Transient Neurologic Deterioration after Total Removal of Parasagittal Meningioma Including Completely Occluding Superior Sagittal Sinus  

PubMed Central

In surgical planning of the parasagittal meningioma, invasion and occlusion of the superior sagittal sinus are important factors. When tumor is located within anterior 1/3, or when angiographic finding shows total occlusion of superior sagittal sinus, it is regarded that the ligation of superior sagittal sinus is safe. We report a case of parasagittal meningioma in 59-year-old male patient with complete occlusion of superior sagittal sinus which was confirmed by preoperative angiography, who developed temporary neurologic deterioration after superior sagittal sinus ligation and resection. PMID:19707499

Oh, In Ho; Choi, Seok Keun; Lim, Young Jin

2009-01-01

39

Transient Focal Neurological Deficits During Pregnancy in Carriers of Inherited Thrombophilia  

Microsoft Academic Search

Background and Purpose—The aim of our study was to investigate the association of transient ischemic cerebrovascular events during pregnancy and inherited thrombophilias. Methods—The study group comprised previously healthy pregnant women who had their first ischemic event during pregnancy (n512). The control group included 24 healthy women matched with the study women for age, ethnicity, and smoking status. All women were

Michael J. Kupferminc; Daniel Yair; Natan M. Bornstein; Joseph B. Lessing; Amiram Eldor

40

A Possible Effect of Concentrated Oolong Tea Causing Transient Ischemic Attack-Like Symptoms  

PubMed Central

Aims Tea (green, oolong, and black) is the second most widely consumed beverage worldwide, second only to water. Aside from a few reported adverse effects, tea, particularly green tea, appears to be beneficial for human health. In the case described herein, a male experienced several transient ischemic attack-like symptoms immediately following the consumption of a cup of high quality oolong tea. A thorough medical evaluation uncovered no evidence of such an attack and leads to the suggestion of a heretofore unreported response to oolong tea. Presentation of Case A 72-year old male with hypertension and atrial fibrillation, who takes valsartan/hydrochlorothiazide to control hypertension and warfarin to reduce the risk of thrombosis and thromboembolism, presented at the emergency room of a local hospital describing several transient ischemic attack-like symptoms immediately after consuming a cup of oolong tea. His symptoms included presyncope, disequilibrium, bilateral hand parathesias, mild dysphasia, and visual problems (but apparently not presbyopia or amaurosis fugax), all of which had disappeared in approximately two hours after drinking the tea. (Mild presyncope was previously noted by the patient when ingesting a strong green tea.) No unusual features emerged from his physical examination, and his blood work was unremarkable except for elevation of his partial thromboplastin time (39 sec) and prothrombin time (22.5 sec), giving an international reference of 2.0, all consistent with the effects of warfarin. A battery of tests by the emergency room physician, a cardiologist, and a neurologist, e.g. electrocardiogram, brain computerized tomography, 2-dimensional transthoracic echocardiogram, brain magnetic resonance imaging, with and without 20 ml Gadolinium, and a magnetic resonance angiogram, confirmed the earlier diagnosis of atrial fibrillation but disclosed no additional malfunction in his heart. His brain showed no evidence of a prior hemorrhage, and his carotid arteries were clear. Methodology and Results Analysis of the oolong tea by high performance liquid chromatography and mass spectrometry identified the major catechins and two methylxanthines, caffeine and theophylline, as well as other constituents, but there was no evidence of any extraneous chemicals that could lead to the symptoms. Conclusion In view of the rapid onset of symptoms after the consumption of oolong tea, bilateral as opposed to unilateral parathesis, and the absence of any evidence of a hemorrhage or the presence of impurities in the tea, we suggest that the transient ischemic attack-like symptoms could possibly be attributable to one or more components of the oolong tea and was not an atypical magnetic resonance imaging-negative transient ischemic attack. PMID:24900951

Layher, John W.; Poling, Jon S.; Ishihara, Mayumi; Azadi, Parastoo; Alvarez-Manilla, Gerardo; Puett, David

2014-01-01

41

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. PMID:20712750

Nadkarni, Radha B; Fristad, Mary A

2010-01-01

42

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. PMID:23637906

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

2013-01-01

43

Evolution of Substance use, Neurological and Psychiatric Symptoms in Schizophrenia and Substance use Disorder Patients: A 12-Week, Pilot, Case-Control Trial with Quetiapine  

PubMed Central

Neurological and psychiatric symptoms are consequences of substance abuse in schizophrenia and non-schizophrenia patients. The present case–control study examined changes in substance abuse/dependence, and neurological and psychiatric symptoms in substance abusers with [dual diagnosis (DD) group, n?=?26] and without schizophrenia [substance use disorder (SUD) group, n?=?24] and in non-abusing schizophrenia patients (SCZ group, n?=?23) undergoing 12-week treatment with the atypical antipsychotic, quetiapine. Neurological and psychiatric symptoms were evaluated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, the Extrapyramidal Symptoms Rating Scale, and the Barnes Akathisia Rating Scale. At endpoint, DD and SCZ patients were receiving significantly higher doses of quetiapine (mean?=?554 and 478?mg/day, respectively), relative to SUD patients (mean?=?150?mg/day). We found that SUD patients showed greater improvement in weekly dollars spent on alcohol and drugs and SUD severity, compared to DD patients. At endpoint, there was no significant difference in dollars spent, but DD patients still had a higher mean SUD severity. Interestingly, DD patients had significantly higher parkinsonism and depression than SCZ patients at baseline and endpoint. On the other hand, we found that SUD patients had significantly more akathisia at baseline, improved more than SCZ patients, and this was related to cannabis abuse/dependence. Finally, SUD patients improved more in Positive and Negative Syndrome Scale positive scores than DD and SCZ patients. Taken together, our results provide evidence for increased vulnerability to the adverse effects of alcohol and drugs in schizophrenia patients. They also suggest that substance abuse/withdrawal may mimic some symptoms of schizophrenia. Future studies will need to determine the role quetiapine played in these improvements. PMID:21629845

Zhornitsky, Simon; Stip, Emmanuel; Desfosses, Joelle; Pampoulova, Tania; Rizkallah, Elie; Rompre, Pierre-Paul; Bentaleb, Lahcen Ait; Lipp, Olivier; Chiasson, Jean-Pierre; Gendron, Alain; Potvin, Stephane

2011-01-01

44

Int J Geriatr Psychiatry . Author manuscript Neurological signs and late-life depressive symptoms in a community  

E-print Network

A cross-sectional analysis of 2102 older people without dementia from the ESPRIT project. Depressive symptomatology was ascertained using the CES-D and abnormal neurological signs/comorbidity from a full

Paris-Sud XI, Université de

45

Misdiagnosis of Transient Ischemic Attacks in the Emergency Room  

Microsoft Academic Search

Background: To determine a pattern of symptoms and\\/or risk factors that distinguishes transient ischemic attack (TIA) from nonischemic causes of transient neurologic attacks (NI-TNA). Methods: We reviewed demographic, clinical, and hospital data on 100 consecutive patients with transient focal neurologic episode(s) lasting less than 24 h and in whom the initial diagnosis was TIA. After inpatient evaluation and review, final

Shyam Prabhakaran; Adam J. Silver; Lakshmi Warrior; Bethany McClenathan; Vivien H. Lee

2008-01-01

46

A novel GJB1 frameshift mutation produces a transient CNS symptom of X-linked Charcot-Marie-Tooth disease.  

PubMed

X-linked Charcot-Marie-Tooth disease (CMT1X) is the second most common variant of CMT and is caused by mutations in the GJB1 gene encoding connexin 32. Some CMT1X patients with GJB1 missense mutations have shown transient central nervous system (CNS) symptoms with abnormal brain magnetic resonance imaging (MRI). Herein we report the first case with a novel GJB1 frameshift mutation that associates with a transient CNS symptom. The patient noticed high-arched feet and limited ankle dorsiflexion in early childhood; he transiently developed numbness and paresis of left face and arm, and dysphagia, with abnormal brain MRI. Although the CNS symptoms recovered within several hours without treatment, intravenous immunoglobulin (IVIg) therapy ameliorated progressing symptoms such as those of toe extensor muscles. His mother had been diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP), and repetitive IVIg treatments had relieved the symptoms. Therefore, inflammation might be involved in the pathophysiology of CMT1X with the GJB1 mutation, while molecular analysis revealed that the mutant GJB1 was more rapidly degraded by the proteasome pathway known as endoplasmic reticulum (ER)-associated degradation. PMID:20857133

Sakaguchi, Hideya; Yamashita, Satoshi; Miura, Akiko; Hirahara, Tomoo; Kimura, En; Maeda, Yasushi; Terasaki, Tadashi; Hirano, Teruyuki; Uchino, Makoto

2011-02-01

47

A novel GJB1 frameshift mutation produces a transient CNS symptom of X-linked Charcot–Marie–Tooth disease  

Microsoft Academic Search

X-linked Charcot–Marie–Tooth disease (CMT1X) is the second most common variant of CMT and is caused by mutations in the GJB1 gene encoding connexin 32. Some CMT1X patients with GJB1 missense mutations have shown transient central nervous system (CNS) symptoms with abnormal brain magnetic resonance imaging\\u000a (MRI). Herein we report the first case with a novel GJB1 frameshift mutation that associates with

Hideya SakaguchiSatoshi; Satoshi Yamashita; Akiko Miura; Tomoo Hirahara; En Kimura; Yasushi Maeda; Tadashi Terasaki; Teruyuki Hirano; Makoto Uchino

2011-01-01

48

An unusual cause of transient neurologic deficits: compression of the carotid artery by a thyroid cystic nodule.  

PubMed

We report a case of a 93-year-old man, who presented with limb-shaking transient ischemic attacks (TIAs) after orthostatic position change or turning his head to the left. The limb-shaking TIAs resulted from external compression of the carotid artery. Contrast-enhanced magnetic resonance angiography of the head and neck and Doppler ultrasound examination of the thyroid gland revealed a large cystic nodule in the right thyroid lobe, resulting in compression and posterior displacement of the right common carotid artery. Clinicians should be aware that limb-shaking TIAs can not only result from obstructive extracerebral or intracerebral artery disease, but also from external compression of the carotid artery. PMID:20123230

Braakman, Hilde M H; Knippenberg, Stephanie A M; de Bondt, Bert-Jan; Lodder, Jan

2010-01-01

49

The neurology clerkship core curriculum  

Microsoft Academic Search

Neurologic symptoms are common in all practice settings, and neurologic diseases comprise a large and increasing proportion of health care expenditures and global disease burden. Consequently, the training of all physicians should prepare them to recognize patients who may have neurologic disease, and to take the initial steps in evaluating and managing those patients. We present a core curriculum outlining

D. J. Gelb; C. H. Gunderson; K. A. Henry; H. S. Kirshner; R. F. Józefowicz

2008-01-01

50

Vitamin E dietary supplementation improves neurological symptoms and decreases c-Abl/p73 activation in Niemann-Pick C mice.  

PubMed

Niemann-Pick C (NPC) disease is a fatal neurodegenerative disorder characterized by the accumulation of free cholesterol in lysosomes. We have previously reported that oxidative stress is the main upstream stimulus activating the proapoptotic c-Abl/p73 pathway in NPC neurons. We have also observed accumulation of vitamin E in NPC lysosomes, which could lead to a potential decrease of its bioavailability. Our aim was to determine if dietary vitamin E supplementation could improve NPC disease in mice. NPC mice received an alpha-tocopherol (?-TOH) supplemented diet and neurological symptoms, survival, Purkinje cell loss, ?-TOH and nitrotyrosine levels, astrogliosis, and the c-Abl/p73 pathway functions were evaluated. In addition, the effect of ?-TOH on the c-Abl/p73 pathway was evaluated in an in vitro NPC neuron model. The ?-TOH rich diet delayed loss of weight, improved coordination and locomotor function and increased the survival of NPC mice. We found increased Purkinje neurons and ?-TOH levels and reduced astrogliosis, nitrotyrosine and phosphorylated p73 in cerebellum. A decrease of c-Abl/p73 activation was also observed in the in vitro NPC neurons treated with ?-TOH. In conclusion, our results show that vitamin E can delay neurodegeneration in NPC mice and suggest that its supplementation in the diet could be useful for the treatment of NPC patients. PMID:25079853

Marín, Tamara; Contreras, Pablo; Castro, Juan Francisco; Chamorro, David; Balboa, Elisa; Bosch-Morató, Mònica; Muñoz, Francisco J; Alvarez, Alejandra R; Zanlungo, Silvana

2014-08-01

51

Neurology Residency Department of Neurology &  

E-print Network

diseases necessary for the competent practice of neurology regardless of the specific subspecialty interestNeurology Residency Program Department of Neurology & Neurosurgery Postal address: Montreal Neurological Institute 3801 University Street Montreal, PQ, Canada H3A 2B4 Tel.: (514) 398-1904 Fax: (514) 398

Shoubridge, Eric

52

Emergency department CT screening of patients with nontraumatic neurological symptoms referred to the posterior fossa: comparison of thin versus thick slice images.  

PubMed

Evaluation of the posterior fossa (PF) on 5-mm-thick helical CT images (current default) has improved diagnostic accuracy compared to 5-mm sequential CT images; however, 5-mm-thick images may not be ideal for PF pathology due to volume averaging of rapid changes in anatomy in the Z-direction. Therefore, we sought to determine if routine review of 1.25-mm-thin helical CT images has superior accuracy in screening for nontraumatic PF pathology. MRI proof of diagnosis was obtained within 6 h of helical CT acquisition for 90 consecutive ED patients with, and 88 without, posterior fossa lesions. Helical CT images were post-processed at 1.25 and 5-mm-axial slice thickness. Two neuroradiologists blinded to the clinical/MRI findings reviewed both image sets. Interobserver agreement and accuracy were rated using Kappa statistics and ROC analysis, respectively. Of the 90/178 (51 %) who were MR positive, 60/90 (66 %) had stroke and 30/90 (33 %) had other etiologies. There was excellent interobserver agreement (? > 0.97) for both thick and thin slice assessments. The accuracy, sensitivity, and specificity for 1.25-mm images were 65, 44, and 84 %, respectively, and for 5-mm images were 67, 45, and 85 %, respectively. The diagnostic accuracy was not significantly different (p > 0.5). In this cohort of patients with nontraumatic neurological symptoms referred to the posterior fossa, 1.25-mm-thin slice CT reformatted images do not have superior accuracy compared to 5-mm-thick images. This information has implications on optimizing resource utilizations and efficiency in a busy emergency room. Review of 1.25-mm-thin images may help diagnostic accuracy only when review of 5-mm-thick images as current default is inconclusive. PMID:24469596

Kamalian, Shervin; Atkinson, Wendy L; Florin, Lauren A; Pomerantz, Stuart R; Lev, Michael H; Romero, Javier M

2014-06-01

53

The predictive significance of early caregiving experiences for symptoms of psychopathology through midadolescence: enduring or transient effects?  

PubMed

A fundamental question in the discipline of developmental psychopathology is whether early interpersonal experiences influence maladaptation in enduring or transient ways. We address this issue by applying a structural modeling approach developed by us to examine data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development on maternal sensitivity in the first 3 years of life and its association with symptoms of psychopathology through age 15. Results suggest that there may be enduring effects of early caregiving experiences on symptomatology as rated by teachers, although such effects were not found for maternal report. Additional analyses indicated that enduring associations found via teacher report could not be fully accounted for by continuity in caregiving experiences or by early contextual adversity. PMID:22800694

Haltigan, John D; Roisman, Glenn I; Fraley, R Chris

2013-02-01

54

Laryngospasm in neurological diseases  

Microsoft Academic Search

Laryngospasm is a clinical symptom characterized by involuntary spasms of the laryngeal muscles, which leads to paroxysms\\u000a of coughing, inspiratory stridor, and sometimes to episodes of complete upper-airway occlusion. Although laryngospasm is a\\u000a symptom mainly seen in otolaryngeal diseases and in the context of anesthesiological complications, it also occurs in neurological\\u000a disorders. In this review of the occurrence of laryngospasms

Hans-Jürgen Gdynia; Jan Kassubek; Anne-Dorte Sperfeld

2006-01-01

55

Prediction of Early Stroke Risk in Transient Symptoms with Infarction: Relevance to the New Tissue-Based Definition  

PubMed Central

Background and Purpose The risk of stroke shortly after TIA with infarction on DWI (also known as “transient symptoms with infarction” or “TSI”) is substantially higher than the risk after imaging-normal TIA. We sought to assess the utility of a web-based recurrence risk estimator (http://www.nmr.mgh.harvard.edu/RRE/) originally developed for use in patients with ischemic stroke for predicting 7-day risk of stroke in patients with TSI. Methods We calculated RRE and ABCD2 scores in a retrospective series of 257 consecutive patients with TSI diagnosed by DWI within 24 hours of symptom onset. We defined subsequent stroke as a clinical deterioration associated with new infarction spatially distinct from the index lesion. We assessed the predictive performance of each model by computing the area under receiver operating characteristics curve. Results Over 7-day follow-up, 16 patients developed a recurrent stroke (6.2%). The sensitivity and specificity of an RRE score of 2 or greater for predicting 7-day stroke risk were 87% and 73% respectively. The area under the ROC curve was 0.85 (95% CI, 0.78-0.92) for RRE and 0.57 (95% CI, 0.45-0.69) for the ABCD2 score (z-test, p<0.001). Conclusion The RRE score seems to predict the 7-day risk of stroke after a TSI. If further validated in larger datasets, the RRE score could be useful in identifying high-risk patients with TSI who may benefit from early intervention with targeted stroke prevention strategies. PMID:21680907

Arsava, E. Murat; Furie, Karen L.; Schwamm, Lee H.; Sorensen, A. Gregory; Ay, Hakan

2011-01-01

56

Iatrogenic neurology.  

PubMed

Iatrogenic disease is one of the most frequent causes of hospital admissions and constitutes a growing public health problem. The most common type of iatrogenic neurologic disease is pharmacologic, and the central and peripheral nervous systems are particularly vulnerable. Despite this, iatrogenic disease is generally overlooked as a differential diagnosis among neurologic patients. The clinical picture of pharmacologically mediated iatrogenic neurologic disease can range from mild to fatal. Common and uncommon forms of drug toxicity are comprehensively addressed in this chapter. While the majority of neurologic adverse effects are listed and referenced in the tables, the most relevant issues are further discussed in the text. PMID:24365439

Sposato, Luciano A; Fustinoni, Osvaldo

2014-01-01

57

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

2002-01-01

58

The Association of Transient Ischemic Attack Symptoms With Memory Impairment Among Elderly Participants of the Third US National Health and Nutrition Examination Survey  

Microsoft Academic Search

Background and Purpose: Stroke is a well-known risk factor for vascular dementia. However, the association of transient ischemic attacks with cognitive impairment is less well-established.Methods: Records from Third National Health and Nutrition Examination Survey were abstracted for demographic and medical information for participants with an age !60 years who reported being free of stroke. Five self-reported symptoms (weakness, numbness, loss

Paul Y. Takahashi; Liselotte N. Dyrbye; Kris G. Thomas; Onelis Quirindongo Cedeno; Frederick North; Robert J. Stroebel; Ramona S. DeJesus; Paul V. Targonski

2009-01-01

59

Impact of laparoscopic anterior 270° fundoplication on the quality of life and symptoms profile of neurodevelopmentally delayed versus neurologically unimpaired children and their parents  

Microsoft Academic Search

Background  This prospective study investigated the therapy-induced changes in the quality of life (QoL) experienced by neurologically\\u000a healthy and neurodevelopmentally delayed children and their parents after laparoscopic anterior 270° fundoplication (LAF).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  In this study, 40 patients (21 impaired) with a mean age of 7.8 years underwent LAF for gastroesophageal reflux disease (GERD)\\u000a and were evaluated before surgery and then 3 and 6 months

Carsten Engelmann; Stella Gritsa; Benno Manfred Ure

2010-01-01

60

Neurologic manifestations of malabsorption syndromes.  

PubMed

Although malabsorption is generally considered to be a gastrointestinal problem, the effects of malabsorption extend far beyond the gastrointestinal tract and can include neurologic dysfunction. Malabsorption may occur by a variety of mechanisms, both genetic and acquired, that interfere with the absorption of basic nutrients, vitamins, minerals, and trace elements. Disorders that interfere with fat absorption can lead to neurologic dysfunction as a consequence of associated impairment of fat-soluble vitamin absorption. Thus, individuals with genetic vitamin E deficiency and the familial hypocholesterolemias may develop symptoms of peripheral neuropathy, cerebellar ataxia, and other neurologic signs and symptoms. Disease processes that damage the enteric mucosa and produce malabsorption can trigger neurologic dysfunction both by immune-related processes, as in celiac disease, and by impairing absorption of essential vitamins and other nutrients, as in tropical sprue. Deficiencies of water-soluble vitamins, such as thiamine and niacin, can also develop in the setting of malabsorption and lead to neurologic dysfunction. Neurologists are aware of the neurologic damage that copper excess can cause in Wilson's disease, but copper deficiency due to malabsorption can also produce neurologic dysfunction in the form of myelopathy. It is vitally important for neurologists to be aware of the potential for malabsorptive processes to produce neurologic dysfunction, because effective treatment for such disorders is often available. PMID:24365342

Pfeiffer, Ronald F

2014-01-01

61

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. PMID:15640425

Graves, T; Hanna, M

2005-01-01

62

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

2012-01-01

63

[Neurological complications in cancer patients].  

PubMed

Neurological symptoms in cancer patients have a great impact on quality of life and need an interdisciplinary approach. They lead to significant impairment in activities of daily living (gait disorders, dizziness), a loss of patients independency (vegetative disturbances, wheel-chair dependency) and interfere with social activities (ban of driving in case of epilepsy). In this article we describe three main and serious neurological problems in the context of oncological patients. These are chemotherapy-induced polyneuropathy, malignant spinal cord compression and epileptic seizures. Our aim is to increase the awareness of neurological complications in cancer patients to improve patients care. PMID:25146945

Hundsberger, Thomas; Roth, Patrick; Roelcke, Ulrich

2014-08-20

64

Occupational Neurologic Disorders in Korea  

PubMed Central

This article presents a schematic review of the clinical manifestations of occupational neurologic disorders in Korea and discusses the toxicologic implications of these conditions. Vascular encephalopathy, parkinsonism, chronic toxic encephalopathy, cerebellar dysfunction, peripheral neuropathy, and neurodegenerative diseases are common presentations of occupational neurotoxic syndromes in Korea. Few neurotoxins cause patients to present with pathognomic neurologic syndrome. Detailed neurologic examinations and categorization of the clinical manifestations of neurologic disorders will improve the clinical management of occupational neurologic diseases. Physicians must be aware of the typical signs and symptoms of possible exposure to neurotoxins, and they should also pay attention to less-typical, rather-vague symptoms and signs in workers because the toxicologic characteristics of occupational neurologic diseases in Korea have changed from typical patterns to less-typical or equivocal patterns. This shift is likely to be due to several years of low-dose exposure, perhaps combined with the effects of aging, and new types of possibly toxicant-related neurodegenerative diseases. Close collaboration between neurologists and occupational physicians is needed to determine whether neurologic disorders are work-related. PMID:20607045

Jeong, Kyoung Sook; Yun, Yong-Hun; Oh, Myoung-Soon

2010-01-01

65

[Neurologic complications in inflammatory bowel diseases].  

PubMed

Some inflammatory diseases of the gastrointestinal system are associated with neurological symptoms which, in rare cases, may precede the onset of the gastrointestinal manifestation of the disease. Celiac sprue is characterized by an intolerance to the wheat protein gluten. The typical neurological manifestation of celiac sprue is cerebellar ataxia. The ataxia as well as the gastrointestinal symptoms can be treated with a strictly gluten-free diet. The neurological symptoms of Whipple's disease, a disorder caused by gram-positive bacilli, are variable. Typical symptoms of cerebral Whipple's disease include dementia, ophthalmoplegia, movement disorders, and signs of hypothalamic dysfunction. Nowadays, the diagnosis of cerebral Whipple's disease is made by PCR detection of the bacilli in the CSF. Crohn's disease and ulcerative colitis are associated with neurological symptoms to a similar proportion. Various forms of polyneuropathies have been observed. The CNS manifestations of inflammatory bowel diseases include thromboembolic stroke, cerebral venous thrombosis, and cerebral vasculitis. PMID:12242995

Töpper, R; Gartung, C; Block, F

2002-06-01

66

Individual Differences in Nicotine Dependence, Withdrawal Symptoms, and Sex Predict Transient fMRI-BOLD Responses to Smoking Cues  

Microsoft Academic Search

Exposure to smoking cues increases craving for cigarettes and can precipitate relapse. Whereas brain imaging studies have identified a distinct network of brain regions subserving the processing of smoking cues, little is known about the influence of individual difference factors and withdrawal symptoms on brain cue reactivity. Multiple regression analysis was used to evaluate relations between individual difference factors and

Francis J McClernon; Rachel V Kozink; Jed E Rose

2008-01-01

67

Paraneoplastic Neurological Syndrome in Fallopian Tube Cancer  

PubMed Central

We report on a rare case of paraneoplastic syndrome (PS) that was discovered on completion of diagnostic work-up to be an undifferentiated fallopian tube carcinoma. A 49-year-old Caucasian woman was admitted to neurology with vertigo, gait ataxia and dysarthria, transient ischaemic attack (TIA) and stroke were quickly excluded. Indicative for the further diagnosis of a paraneoplastic syndrome was the identification of onconeuronal antibodies the detection of which can be associated with certain tumour entities. The strongly positive anti-Yo antibody that is formed above all by breast and lung cancers as well as ovarian cancer led to a corresponding staging. The tumour markers CEA, CA 125 and CA 15-3 were in the normal ranges. Mammography and thorax CT were also unremarkable; on transvaginal sonography the internal genitals were inconspicuous except for a follicular cyst on the left. On abdominal CT the only conspicuous finding was a 1.5?cm ovarian cyst. After consensual agreement a bilateral laparoscopic adenexectomy was performed but with unremarkable abdominal findings. The histological examination confirmed a right-sided undifferentiated tubal carcinoma with the provisional classification FIGO IIA. After a stage-related staging operation, the final classification was found to be the FIGO-IIIC stage on account of positive retroperitoneal lymph nodes. Thus adjuvant chemotherapy with 6 cycles of carboplatin and paclitaxel was performed. By means of a timely, guideline-conform therapy for tubal carcinoma, the neurological symptoms and, above all, the dysarthria could be improved after 10 months.

Maas, E.; Skoberne, T.; Werner, A.; Braun, S.; Jackisch, C.

2014-01-01

68

Neurologic Sequelae of Brain Tumors in Children  

Microsoft Academic Search

Neurologic signs and symptoms are often the initial presenting features of a primary brain tumor and may also emerge during the course of therapy or as late effects of the tumor and its treatment. Variables that influence the development of such neurologic complications include the type, size, and location of the tumor, the patient’s age at diagnosis, and the treatment

Nicole J. Ullrich

2009-01-01

69

About Kennedy's Disease: Symptoms  

MedlinePLUS

Kennedy's Disease Association A Public Benefit, Non-Profit Organization Register GTranslate GTranslate Javascript is required to use ... KDA Newsletters Memorials Symptoms Print Email Medical Term: Definition: Neurological: Bulbar Signs The Bulbar muscles are those ...

70

When to consider thyroid dysfunction in the neurology clinic  

Microsoft Academic Search

There are many neurological manifestations of thyroid disease, and thyroid function has taken its place in the “routine bloods” of neurology practice. However, although conditions such as carpal tunnel syndrome prompt thyroid testing despite any clear evidence for this approach, other symptoms of potential significance in terms of thyroid disease may be overlooked in the busy general neurology clinic, or

N Mistry; J Wass; M R Turner

2009-01-01

71

Preliminary Hormonal Correlations in Female Patients as a Function of Somatic and Neurological Symptom Clusters: An Exploratory Development of a Multi-Hormonal Map for Bio-Identical Replacement Therapy (MHRT)  

PubMed Central

Females develop multiple hormonal alterations and certain genes may be involved in the intensity of subsequent symptoms including both mood and drug seeking. Seventy Four (74) females were included (mean age=60.23, SD=9.21, [43-87]). A medical evaluation was completed with hormone screening using a number of statistical analyses such as Pearson product moment; one way ANOVA and Regression analysis along with a Bonferroni significance correction p<.004. Of 120 correlations performed, significant hormone/domain correlations were as follows: DHEA/Genitourinary (r=.30, p<.05); FSH/Pulmonary (r=?.29, p<.05); Pregnenolone/Genitourinary (r=.40, p<.006) /Immunological (r=.38, p<.008); Testosterone/total endorsed symptoms (r=?0.34, p<.016); TSH/Pulmonary (r=?.33, p<.03) /Gynecological (r=.30, p<.05). Estrone/Musculoskeletal (r=?0.43, p<.012). After a Bonferroni correction (experiment-wise p<.00045) for statistical significance, no hormones remained significance. In the follow–up phase FSH/Neuropsychiatric (r=.56, p<.05) and Musculoskeletal (r=.67, p<.013); DHEA/Immunological (r=.64, p<.04); LH/ Musculoskeletal (r=.59, p<.34); Free Testosterone/Neuropsychiatric (r=.64, p<.019), Musculoskeletal (r=.68, p<.01), and Dermatologic (r=.57, p<.04); Total Testosterone/Immunological (r=.63, p<.028); TSH/Endocrinological (r=?.62, p<.031). Factor analysis of the MQ yielded two factors with eigenvalues > 1.0 (high loadings: first: Pulmonary, GI, Cardiovascular, and Immunological; second: Musculoskeletal, Gynecological, and the three Neurological domains). Both factors had significant correlations: first/pregnenolone (r=.37, p<.019); second/TSH (r=.33, p<.034). An additional factor analysis of hormone level clusters showed significant correlations with various domains. This study highlights the need to test the core biological endocrine hormones associated with females. Future research will focus on the relationship of for example Leptin and the electrophysiology of the brain. We are cautiously proposing a new paradigm shift whereby we replace the old nomenclature of HRT to MHRT. PMID:25309816

Braverman, Eric R; Oscar-Berman, Marlene; Kreuk, Florian; Kerner, Mallory; Dushaj, Kristina; Li, Mona; Stratton, Danielle; Trudesdell, Courtney; Blum, Kenneth

2014-01-01

72

Neurological manifestations of human babesiosis.  

PubMed

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

2013-01-01

73

Neurologic Complications of Lung Cancer  

Microsoft Academic Search

Lung cancer frequently causes neurological complications from direct and indirect effects. Brain metastases occur in 41% of\\u000a patients with non-small cell lung cancer and 35% with small cell lung cancer at autopsy. Presenting symptoms can be quite\\u000a protean. MRI continues to be the gold standard of detecting metastases. Biopsy or resection should be considered for patients\\u000a with a single lesion,

Suriya A. Jeyapalan; Anand Mahadevan

74

Paraneoplastic neurological syndromes  

PubMed Central

Purpose of review This review describes relevant advances in paraneoplastic neurological syndromes (PNS) with emphasis on particular syndromes and the impact of antibodies against surface antigens in their management. Recent findings PNS may present with symptoms that do not raise the suspicion of a paraneoplastic origin. The best example is anti-N-methyl-D-aspartate receptor encephalitis that in adult women frequently associates with ovarian teratoma. An electroencephalogram pattern described as ‘extreme delta brush’ was recently identified in 30% of patients with this disorder. Isolated myelopathy may have a paraneoplastic origin associated with amphiphysin or CV2 (CRMP5) antibodies. Jaw dystonia and laryngospasm can be the predominant symptom of the brainstem encephalitis associated with Ri antibodies. ?-Aminobutyric acid (GABA)B receptor antibodies are the most common antibodies found in patients with limbic encephalitis and small cell lung cancer, and contactin-associated protein 2 antibodies in patients with Morvan’s syndrome and thymoma. Lastly, a recent study identified delta/notch-like epidermal growth factor-related receptor (DNER) as the target antigen of Tr antibodies, a marker of cerebellar ataxia and Hodgkin’s lymphoma. Summary The number of antibodies relevant to PNS is now expanded to those against surface antigens. These antibodies do not confirm the paraneoplastic origin of the syndrome but predict a better response to immunotherapy. PMID:23041955

Graus, Francesc; Dalmau, Josep

2013-01-01

75

Neurology and neurologic practice in China  

PubMed Central

In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions. PMID:22123780

2011-01-01

76

Dengue: a new challenge for neurology  

PubMed Central

Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world's population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM) dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial. PMID:23355928

Puccioni-Sohler, Marzia; Orsini, Marco; Soares, Cristiane N.

2012-01-01

77

[Assessment and treatment of conversion disorder: the most fascinating borderline of psychiatry and neurology].  

PubMed

Conversion disorder or functional neurological disorder is a neurological symptom complex originating from psychological factors, which manifests in voluntary motor and sensory functions or as unexplained epilepsy-like seizures. Until the 1980's the disorder was called hysterical neurosis. Later on, various general terms, such as unexplained somatic symptoms, pseudoneurological, somatoformic, psychogenic, or psychosomatic symptoms, have been applied. The latest phrase, functional neurological symptoms, emphasizes the change in the functioning of the nervous system rather than in its structure. PMID:22506326

Vataja, Risto; Leppävuori, Antero

2012-01-01

78

Immunological markers in neurological disorders.  

PubMed

Neurological dysfunction results from vascular, inflammatory, degenerative, neoplastic, metabolic or genetic causes. Of particular interest is a group of neurological symptoms thought to be linked to an underlying tumour, the so-called paraneoplastic syndromes. It is considered to be due to an attempt by the immune system to subjugate the growth of the tumour by triggering an antibody response against the neuronal antigens expressed by the neoplasm. The unfortunate consequence of this is an assault by the immune components on the nervous tissue, thereby rapidly precipitating a variety of neurological deficits. Every level of the nervous system is potentially vulnerable, with the disability being considered as irreversible due to the lack of regenerative capacity of the neurons. This phenomenon is rare, occurring at an approximate frequency of less than 1% of all tumours and often accompanied by the presence of specific high-titre autoantibodies in both the cerebrospinal fluid and blood. This group of antibodies are non-pathogenic markers for paraneoplastic neurological syndromes, which have expanded to almost 20 since the discovery, in 1986, of the first clinically relevant syndrome. More recently, a new generation of antineuronal antibodies against cell surface antigens, having a direct pathogenic role in causing the disease, has emerged to complement the existing repertoire. Neuronal antibodies are useful diagnostic markers of the brain disease and also, in some cases, may reveal an underlying malignancy, thus facilitating faster diagnosis and earlier treatment with consequently better prognosis. PMID:22113957

Karim, A R; Jacob, S

2012-01-01

79

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. PMID:22888439

Pope, Jennifer V.; Edlow, Jonathan A.

2012-01-01

80

Transient ischaemic attacks: mimics and chameleons  

PubMed Central

Suspected transient ischaemic attack (TIA) is a common diagnostic challenge for physicians in neurology, stroke, general medicine and primary care. It is essential to identify TIAs promptly because of the very high early risk of ischaemic stroke, requiring urgent investigation and preventive treatment. On the other hand, it is also important to identify TIA ‘mimics’, to avoid unnecessary and expensive investigations, incorrect diagnostic labelling and inappropriate long-term prevention treatment. Although the pathophysiology of ischaemic stroke and TIA is identical, and both require rapid and accurate diagnosis, the differential diagnosis differs for TIA owing to the transience of symptoms. For TIA the diagnostic challenge is greater, and the ‘mimic’ rate higher (and more varied), because there is no definitive diagnostic test. TIA heralds a high risk of early ischaemic stroke, and in many cases the stroke can be prevented if the cause is identified, hence the widespread dissemination of guidelines including rapid assessment and risk tools like the ABCD2 score. However, these guidelines do not emphasise the substantial challenges in making the correct diagnosis in patients with transient neurological symptoms. In this article we will mainly consider the common TIA mimics, but also briefly mention the rather less common situations where TIAs can look like something else (‘chameleons’). PMID:24453269

Nadarajan, V; Perry, R J; Johnson, J; Werring, D J

2014-01-01

81

Hodgkin's Lymphoma: A Review of Neurologic Complications.  

PubMed

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

2011-01-01

82

Standardizing neurological assessments.  

PubMed

Evaluation of neurological status is imperative to patient assessment. Multiple assessment tools are readily available for clinicians to diagnose and report changes in neurological condition. Some of these tools include the Glasgow Coma Scale, the National Institutes of Health Stroke Scale, the Canadian Neurological Scale, and the Four Score. Although assessment tools are beneficial to help standardize the assessment and communication of findings, they are at times cumbersome, leaving bedside clinicians with questions concerning which tool is appropriate for a given patient population. This initiative began as a means to standardize assessments and communication for neuroscience patients. As success was met, the project was moved forward locally at our hospital campus and later extended to the entire health system. With the support of the chief of neurology, the neuroscience patient care services director, the stroke coordinator, and the neuroscience clinical educator, three different neurological examinations were developed. They were defined as the Basic Neurological Check, the Coma Neurological Check, and the National Institutes of Health Stroke Scale/Stroke Neurological Check. The neurological examinations would address the assessment needs of patients with acute stroke, general neurosurgery/neurology patients, and patients in coma. PMID:24556660

Iacono, Laura A; Wells, Celia; Mann-Finnerty, Kathy

2014-04-01

83

Chapter 38 American neurology  

Microsoft Academic Search

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

Frank R. Freemon

2009-01-01

84

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. PMID:2025592

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

1991-01-01

85

Neurological complications to vaccination against Japanese encephalitis.  

PubMed

Japanese encephalitis (JE) vaccine has been used for childhood immunization programmes in Asia since the 1960s. Also, travellers from other parts of the world have been vaccinated before travelling to Asian countries. Some JE vaccines are produced from infected mouse brains and contain small amounts of myelin basic protein. Neurological side effects in larger vaccine trials in Asia have been reported in 1-2.3 per million vaccinees. Statens Serum Institut is the only distributor of JE vaccine in Denmark, delivering 384 000 doses from 1983-96. In 1996, evaluation of initial symptoms and findings in 10 adult travellers from Denmark, who developed moderate-severe neurological symptoms within a few weeks of JE vaccination, was performed as well as follow-up magnetic resonance imaging (MRI) and clinical neurological examination. Three patients initially had symptoms varying from severe encephalitis-like illness to paraesthesia, double vision or parkinsonian gait disturbance. MRI showed severe atrophy of the corpus callosum with altered signal intensity indicating gliosis in one patient, another patient had several hyperintense spots located periventricularly in the white matter, while a third patient had spots with increased signals in the pons, the right substantia nigra and the occipital region. Acute disseminated encephalomyelitis (ADEM) is a possible explanation for these MRI changes, although multiple sclerosis is an alternative diagnosis in one or two of the patients. Another three patients had long-lasting headache, concentration difficulty or intellectual reduction. One man had afebrile convulsions, another gait instability and depression and one parkinsonism. A woman developed myelitis. If these findings are due to JE vaccination the frequency of neurological reactions to the vaccine is considerably higher than previously reported and in the future any minor neurological complaints occurring shortly after vaccination should lead to neurological examination and acute MRI scan should be considered. Copyright 1998 Lippincott Williams & Wilkins PMID:10210877

Plesner; Arlien-Soborg; Herning

1998-09-01

86

Migraine aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy  

PubMed Central

Background Migraine aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis. Methods During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years. Results Migraine with aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up. Conclusion The diagnosis of migraine aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-migraineous type. The aura features were more complex, with several aura symptoms and a higher prevalence of sensory and dysphasic aura than usual. Gradually developing aura symptoms, or different aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that migraine with aura in pregnancy usually has a good prognosis with regard to cerebrovascular events. PMID:17640340

Ertresvg, Janne Marit; Stovner, Lars Jacob; Kvavik, Lene Ekern; Johnsen, Hans-Jorgen; Zwart, John-Anker; Helde, Grethe; Bovim, Gunnar

2007-01-01

87

Amalgam exposure and neurological function.  

PubMed

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

2005-03-01

88

Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis: Multidisciplinary care, symptom management, and cognitive\\/behavioral impairment (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology  

Microsoft Academic Search

Objective: To systematically review evidence bearing on the management of patients with amyotro- phic lateral sclerosis (ALS). Methods: The authors analyzed studies from 1998 to 2007 to update the 1999 practice param- eter. Topics covered in this section include breaking the news, multidisciplinary clinics, symptom management, cognitive and behavioral impairment, communication, and palliative care for pa- tients with ALS. Results:

R. G. Miller; C. E. Jackson; E. J. Kasarskis; J. D. England; D. Forshew; W. Johnston; S. Kalra; J. S. Katz; H. Mitsumoto; J. Rosenfeld; C. Shoesmith; M. J. Strong; S. C. Woolley

2009-01-01

89

Neurologic complications of carcinoid.  

PubMed

We reviewed the records of all patients treated for carcinoid tumors at Memorial Sloan-Kettering Cancer Center from 1974 through 1984. Of 219 patients, 90 developed metastatic complications, and of these, 36 developed neurologic complications. Metastases, the most common neurologic complication, included epidural spinal cord compression (14 patients), intracranial metastases (13 patients), leptomeningeal metastases (1 patient), and peripheral nerve lesions (5 patients). Nonmetastatic complications were hepatic encephalopathy (six patients), herpes zoster infection (two patients), cerebral infarction due to septic emboli (one patient), superior sagittal sinus thrombosis (one patient), and carcinoid myopathy (one patient). The carcinoid syndrome was seen in eight patients (4%). Response of neurologic metastases to conventional radiation therapy was usually favorable. We conclude that (1) the frequency and type of neurologic complications associated with carcinoid tumors are similar to those seen with other systemic cancers; (2) CNS metastases are relatively common in patients with metastatic carcinoid (29%); and (3) the carcinoid syndrome is less common than CNS metastasis. PMID:3703281

Patchell, R A; Posner, J B

1986-06-01

90

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

91

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

92

Neurological disorders and inflammatory bowel diseases  

PubMed Central

Extraintestinal manifestations occur in about one-third of patients living with inflammatory bowel disease (IBD) and may precede the onset of gastrointestinal symptoms by many years. Neurologic disorders associated with IBD are not frequent, being reported in 3% of patients, but they often represent an important cause of morbidity and a relevant diagnostic issue. In addition, the increasing use of immunosuppressant and biological therapies for IBD may also play a pivotal role in the development of neurological disorders of different type and pathogenesis. Hence, we provide a complete and profound review of the main features of neurological complications associated with IBD, with particular reference to those related to drugs and with a specific focus on their clinical presentation and possible pathophysiological mechanisms. PMID:25083051

Casella, Giovanni; Tontini, Gian Eugenio; Bassotti, Gabrio; Pastorelli, Luca; Villanacci, Vincenzo; Spina, Luisa; Baldini, Vittorio; Vecchi, Maurizio

2014-01-01

93

Responding to CMV neurologic infections.  

PubMed

Cytomegalovirus (CMV) infections of the central nervous system (CNS) could be the most underrecognized neurologic complication of AIDS. CMV can cause a number of distinct neurologic syndromes in addition to retinitis. The actual rate of CMV CNS infection is unclear: studies show CMV encephalopathy exists in anywhere from 20 percent of the brains studied in autopsies to as high as 75 percent of cases involving more advanced cases of retinitis. Whatever the actual rate may be, unrecognized CMV encephalitis my cause both mild and severe neurocognitive impairment in patients with advanced HIV infection. CMV encephalitis symptoms are abrupt, progress rapidly, and occur late in the course of HIV disease, although signs of the most common alternate diagnosis, HIV encephalopathy, appear earlier and more gradually. There have been no prospectively controlled studies of the treatment of CMV CNS disease. Standard treatments for CMV retinitis may be inadequate as therapy for CMV infections in the brain. One explanation is that there is no treatment recovery for the extensive damage to the nerves that can be caused by the disease. ACTG 305, a 6-month, high dose, aggressive combination foscarnet/ganciclovir therapy has been developed to answer many of the nagging treatment issues surrounding CMV CNS disease as well as evaluate both quantitative CMV DNA PCR and CMV bDNA as assays for disease severity, progression, and response to therapy. PMID:11364010

Smart, T

1996-11-01

94

Assessment of child neurology outpatients with headache, dizziness, and fainting.  

PubMed

Neurologic symptoms such as headache, vertigo, dizziness, and fainting can create a diagnostic problem in pediatric neurology practice because they are also the most common presenting symptoms of psychiatric disorders. Children, especially adolescents, who are often admitted with such autonomic symptoms, are frequently misdiagnosed. In this study, we aimed to investigate the psychiatric morbidity and comorbidity rate in children and adolescents presenting with neurologic symptoms such as headache, vertigo, and syncope. We investigated 31 children who presented with these symptoms. All children were evaluated for their medical history and had a physical and neurologic examination. We attempted to rule out a possible organic etiology. All patients received a complete laboratory examination (blood count, electroencephalography), pediatric cardiology and otorhinolaryngology consultations, and a caloric test. All patients were assessed according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria. The majority of the patients (93.5%) received a psychiatric diagnosis according to the DSM-IV criteria. Most of these patients were adolescents and female. Psychosocial stressors such as academic problems, familial dysfunction, parental psychopathology, and child sexual abuse were associated with somatic symptoms. The results of this study demonstrated the importance of differential diagnosis and psychiatric comorbidity in a pediatric neurologic outpatient population. Treatment should be directed at biopsychosocial integrity, and a multidisciplinary treatment approach should be applied. PMID:15224706

Emiro?lu, Fatma Neslihan Inal; Kurul, Semra; Akay, Aynur; Miral, Süha; Dirik, Eray

2004-05-01

95

Neurologic manifestations of achondroplasia.  

PubMed

Achondroplasia is the best described and most common form of the congenital short-limbed dwarfing conditions. Achondroplasia is apparent at birth and has a birth prevalence of 1 in 20000-30000 live-born infants. Achondroplasia is inherited as an autosomal dominant condition, although 80% of cases occur sporadically as new events in their families. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3). Patients with achondroplasia should be evaluated by a multidisciplinary team of clinicians including geneticists, neurologists, and orthopedists, since there are numerous bony and neurological complications. The most severe complication results from craniocervical stenosis and medullary and upper spinal cord compression, which can have devastating and even lethal sequelae during early childhood. In subsequent decades, including adolescence, spinal cord and nerve compression are more prominent. The neurological complications of achondroplasia have been recognized in adults for more than a century and are attributed to bony defects, connective tissue structures, or both. Similar neurological complications are now appreciated in infants, young children, and teenagers with achondroplasia. Defective connective tissue elements in achondroplasia frequently lead to ligamentous laxity, which can aggravate the complications associated with bony stenosis. Bony abnormalities are known to cause neurological morbidity and lead to a shortened lifespan. Neurological complications associated with achondroplasia are reviewed, including recommendations for the evaluation and management of these clinical problems. PMID:24365319

Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J

2014-01-01

96

Neurological Complications of Transplantation  

PubMed Central

Hematopoietic cell transplantation (HCT) is the preferred treatment for an expanding range of neoplastic and nonmalignant conditions. Increasing numbers of solid organ transplantations (SOTs) add an additional population of immunosuppressed patients with multiple potential neurological problems. While the spectrum of neurological complications varies with conditioning procedure and hematopoietic cell or solid organ source, major neurological complications occur with all transplantation procedures. This 2 part review emphasizes a practical consultative approach to central and peripheral nervous system problems related to HCT or SOT with clinical and neuroimaging examples from the authors’ institutional experience with the following conditions: the diversity of manifestations of common infections such as varicella zoster virus, Aspergillus, and progressive multifocal leukoencephalopathy (PML), drug therapy-related complications, stroke mechanisms, the spectrum of graft versus host disease (GVHD), and neurologically important syndromes of immune reconstitution inflammatory syndrome (IRIS), posterior reversible encephalopathy syndrome (PRES), and posttransplantation lymphoproliferative disorder (PTLD). These complications preferentially occur at specific intervals after HCT and SOT, and neurological consultants must recognize an extensive spectrum of syndromes in order to effect timely diagnosis and expedite appropriate treatment. PMID:23983885

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

2013-01-01

97

Functional neurological disorders: The neurological assessment as treatment.  

PubMed

The neurologist's role in patients with functional disorders has traditionally been limited to making the diagnosis, excluding a 'disease' and pronouncing the symptoms to be 'non-organic' or 'psychogenic'. In this article, I argue that there are multiple opportunities during routine assessment of a patient with a functional disorder for the neurologist to take the lead with treatment. These opportunities occur throughout history taking, during the examination and, with greatest potential for treatment, at the end of the consultation. Elements of the neurologist's discussion that may be most useful include: (a) emphasis that symptoms are genuine, common and potentially reversible; (b) explanation of the positive nature of the diagnosis (i.e. not a diagnosis of exclusion); (c) simple advice about distraction techniques, self-help techniques and sources of information; (d) referral on to appropriate physiotherapy and/or psychological services; (e) offering outpatient review. I also discuss how new diagnostic criteria for DSM-5 and changes proposed for ICD-11 may facilitate changes that allow neurologists to bring their management of patients with functional disorders in line with other multidisciplinary neurological disorders in the outpatient clinic. PMID:25306077

Stone, J

2014-10-01

98

Current thinking: return to play and transient quadriplegia.  

PubMed

Athletes that participate in contact and collision sports assume risk of serious injury each time they take the field. For those athletes that have sustained an episode of transient quadriplegia, the decision of whether to return to competition can be a difficult one. Some athletes, realizing how close they may have come to permanent injury, may decide that further participation is not in their best interest. Others may be somewhat undecided, and some may want to return at all costs. As the treating physician, the goal is to identify those athletes who after a single episode of transient quadriplegia are at increased risk for further injury and consequently should discontinue participation in contact sports. Factors that may contribute to that determination include mechanism of injury, prior history of neurologic symptoms or injury, and anatomic features that may predispose to further injury such as disc herniation, fracture, or cervical stenosis. PMID:15659276

Cantu, Robert V; Cantu, Robert C

2005-02-01

99

Cancer Symptom Clusters: Old Concept But New Data  

Microsoft Academic Search

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

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

2010-01-01

100

[Neurological complications in uremia].  

PubMed

Neurological complications due to the uremic state or hemodialysis, contribute to the important cause of mortality in patients with uremia. Despite continuous advances in uremic treatment, many neurological complications of uremia, like uremic encephalopathy, peripheral neuropathy and myopathy fail to fully respond to hemodialysis. Moreover, hemodialysis or kidney transplantation may even induce neurological complications. Hemodialysis can directly or indirectly be associated with Wernicke's encephalopathy, dialytic dementia, dysequilibrium syndrome, cerebrovascular accidents, osmotic myelinolysis and mononeuropathy. Renal transplantation can give rise to rejection encephalopathy and acute femoral neuropathy. The use of immunosuppressive drugs after renal transplantation can cause reversible posterior leukoencephalopathy encephalopathy. The clinical, pathophysiological and therapeutical aspects of central nervous system, peripheral nervous system and myopathy complications in uremia are reviewed. PMID:18686653

Fong, Chin-Shih

2008-06-01

101

[Paraneoplastic neurological syndromes].  

PubMed

Paraneoplastic neurological syndromes (PNS) are uncommon and defined by an acute or subacute neurological syndrome associated with a cancer. These syndromes often antedate the diagnostis of the underlying neoplasia that is usually not clinically evident. An early diagnosis is the main condition for a better neurological and carcinologic outcome. Subacute cerebellar ataxia, subacute sensitive neuropathy, limbic encephalomyelitis, Lambert-Eaton myasthenic syndrome, opsoclonus myoclonus, dermatopolymyositis and intestinal pseudo-obstruction belong to the well-characterized PNS and their presence must lead to onconeuronal antibodies (ONA) detection. Treatment of the underlying neoplasia is the mainstay of treatment to obtain a better outcome. However, recent findings lead to consider immunological specific treatment according to the subtype of associated ONA. PNS associated with ONA targeting membrane antigens are thus usually responsive to immunomodulator therapies. Conversely, PNS associated with ONA targeting intracellular antigens are of poor outcome despite mild improvement under immunosuppressive therapies in some patients. PMID:21036427

Didelot, A; Honnorat, J

2011-10-01

102

Pain Therapy in German Neurology  

Microsoft Academic Search

In order to analyze aspects of pain patient care in neurology, we conducted a survey among German neurology departments that aimed to determine different structural aspects of neurological pain medicine. A 5-page questionnaire was sent to 391 neurological departments, and a return rate of 59.8% was achieved. Some 70% of university-based neurology departments have established their own outpatient clinic, and

Kathrin Gerbershagen; Volker Limmroth

2008-01-01

103

Neurologic effects of alcoholism.  

PubMed Central

Alcoholism, a worldwide disorder, is the cause of a variety of neurologic disorders. In this article we discuss the cellular pathophysiology of ethanol addition and abuse as well as evidence supporting and refuting the role of inheritance in alcoholism. A genetic marker for alcoholism has not been identified, but neurophysiologic studies may be promising. Some neurologic disorders related to longterm alcoholism are due predominantly to inadequate nutrition (the thiamine deficiency that causes Wernicke's encephalopathy), but others appear to involve the neurotoxicity of ethanol on brain (alcohol withdrawal syndrome and dementia) and peripheral nerves (alcoholic neuropathy and myopathy). Images PMID:7975567

Diamond, I; Messing, R O

1994-01-01

104

Creativity and neurological disease.  

PubMed

Although humans have long valued creativity, the generation of such innovation is still incompletely understood. Looking at the healthy brain, researchers have localized certain parts for a basic understanding of these mechanisms. By researching the brain affected by neurological disease, scientists have observed unique manifestations of creativity, such as in frontotemporal lobar degeneration, Alzheimer's disease, Parkinson's disease and parkinsonian spectrum disorders, and stroke, which help clarify these creative underpinnings. Incorporating both healthy and disease models of cerebral functioning, neurological and neuroscientific research from recent years has built on established theories and expanded current knowledge. PMID:24938215

Acosta, Lealani Mae Y

2014-08-01

105

ETHICAL PERSPECTIVES IN NEUROLOGY  

Microsoft Academic Search

The practice of neurology presents a series of ethical challenges for the clinician. These rarely have simple or straightforward solutions, but require careful consideration by the neurologist. This section of , written by colleagues with particular interest in the area of bioethics, provides a case vignette that raises one or more ethical questions related to the subject area of this

Nancy T. Rodgers-Neame; James P. Orlowski

2009-01-01

106

Neurology in ancient faces  

Microsoft Academic Search

BACKGROUNDClinical 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.METHODSAbout 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

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

2001-01-01

107

Neurology of developmental dyslexia  

Microsoft Academic Search

Developmental dyslexia was until recently considered to belong solely in the domain of educational psychology. With the advent of better theories on language and reading, and better methods for assessing the structure and function of living human brains and for determining genetic transmission, dyslexia is now poised to become a focal concern of cognitive neuroscience, neurology, and genetic research. Still

Albert M. Galaburda

1993-01-01

108

Neurologic manifestations in children with North American Lyme disease.  

PubMed

To delineate the spectrum of neurologic manifestations and the relative frequencies of different syndromes associated with North American Lyme disease, we describe 96 children referred for neurologic problems in the setting of Borrelia burgdorferi infection. The most frequent neurologic symptom was headache, and the most common sign was facial palsy. Less common manifestations were sleep disturbance, and papilledema associated with increased intracranial pressure. Signs and symptoms of peripheral nervous system involvement were infrequent. The most common clinical syndromes were mild encephalopathy, lymphocytic meningitis, and cranial neuropathy (facial nerve palsy). In contrast with adult patients with neurologic Lyme disease, meningoradiculitis (Bannwarth's syndrome) and peripheral neuropathy syndromes were rare. However, a "pseudotumor cerebri-like" syndrome seems to be unique to North American pediatric Lyme disease. PMID:8255465

Belman, A L; Iyer, M; Coyle, P K; Dattwyler, R

1993-12-01

109

Neurological outcome in adult patients with early-treated phenylketonuria  

Microsoft Academic Search

Due to the observation of severe neurological symptoms in single patients as well as brain imaging, neuropsychological and\\u000a neurophysiological abnormalities, the long-term prognosis of treated phenylketonuria is still under discussion. We investigated\\u000a the neurological outcome of 57 (24 male, 33 female) patients with phenylketonuria (diet onset <3 months) at a mean age of\\u000a 23.6 (17–33) years in comparison to control

J. Pietz; R. Dunckelmann; A. Rupp; D. Rating; H.-M. Meinck; H. Schmidt; H. J. Bremer

1998-01-01

110

The neurological disease ontology  

PubMed Central

Background We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. Description ND is implemented in OWL 2 and currently has more than 450 terms that refer to and describe various aspects of neurological diseases. ND directly imports the development version of OGMS, which uses BFO 2. Term development in ND has primarily extended the OGMS terms ‘disease’, ‘diagnosis’, ‘disease course’, and ‘disorder’. We have imported and utilize over 700 classes from related ontology efforts including the Foundational Model of Anatomy, Ontology for Biomedical Investigations, and Protein Ontology. ND terms are annotated with ontology metadata such as a label (term name), term editors, textual definition, definition source, curation status, and alternative terms (synonyms). Many terms have logical definitions in addition to these annotations. Current development has focused on the establishment of the upper-level structure of the ND hierarchy, as well as on the representation of Alzheimer’s disease, multiple sclerosis, and stroke. The ontology is available as a version-controlled file at http://code.google.com/p/neurological-disease-ontology along with a discussion list and an issue tracker. Conclusion ND seeks to provide a formal foundation for the representation of clinical and research data pertaining to neurological diseases. ND will enable its users to connect data in a robust way with related data that is annotated using other terminologies and ontologies in the biomedical domain. PMID:24314207

2013-01-01

111

After the fall: symptoms in bungee jumpers.  

PubMed

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

1998-05-01

112

[Vitamin D and neurology].  

PubMed

Vitamin D deficiency is associated with a higher risk of multiple sclerosis and also with a higher relapse rate as well as a higher number of MRI lesions. Elders with vitamin D deficiency have worse cognitive performance. Vitamin D deficiency is a risk factor for developing Alzheimer's disease. Ischemic stroke are more frequent and more severe in patients with low vitamin D levels. Carotid atherosclerosis is more frequent and more severe in patients with vitamin D deficiency. Vitamin D deficiency is associated with a higher risk and worse prognosis of Parkinson's disease. In the different neurological disorders discussed herein, gene polymorphisms that could alter vitamin D metabolism are also associated with a higher incidence or a worse disease prognosis. Despite the links between vitamin D deficiency and the risks of developing neurological disorders, there is, to date, no proof that supplementation could alter the course of these diseases. PMID:24054766

Thouvenot, Éric; Camu, William

2013-10-01

113

Neurology goes global  

PubMed Central

Summary In recent years, the need for additional neurologists and neurologic expertise in many low- and middle-income countries (LMIC) has become more apparent. Many organizations are committed to this unmet need, but the scope of the problem remains mostly underappreciated. Neurologists may be skeptical about their value in resource-limited settings, yet we are critically needed and can have a marked effect. International experiences, however, must be carried out in ethical, informed, and sustainable ways in tandem with local health care providers when possible. We present a brief overview of critical issues in global neurology, the importance of focusing on benefits to the LMIC, and options for volunteer opportunities in clinical service, education, research, and disaster relief. Finally, we offer practical pointers and resources for planning these experiences. PMID:25110621

Mateen, Farrah J.

2014-01-01

114

Neurologic manifestations of sarcoidosis.  

PubMed

Neurologic manifestations occur in more than 5% of sarcoidosis patients and may be the presenting feature. Neurosarcoidosis can manifest in a myriad of ways including: cranial neuropathy, aseptic meningitis, mass lesions, encephalopathy, vasculopathy, seizures, hypothalamic-pituitary disorders, hydrocephalus, myelopathy, peripheral neuropathy, and myopathy. Because its etiology is unknown, its neurological manifestations are so diverse, and its diagnosis cannot be readily confirmed by laboratory tests, neurosarcoidosis poses many clinical problems. The diagnosis of neurosarcoidosis is usually based on the identification of characteristic neurologic findings in an individual with proven systemic sarcoidosis as established by clinical, imaging, or histologic findings. Although corticosteroids are regarded as the foundation of treatment, they are not always successful and have serious side-effects. Moreover, some patients with neurosarcoidosis are refractory to conventional therapy, and approximately 5-10% die. Optimal management of patients with neurosarcoidosis benefits from an understanding of the broad clinical spectrum of neurosarcoidosis, appreciation of the ways to best confirm a diagnosis, and awareness of the full range of treatment options, including the use of alternative therapies such as immunotherapy. PMID:24365304

Krumholz, Allan; Stern, Barney J

2014-01-01

115

Symptom Management  

Cancer.gov

Symptom Management & Quality of Life Concept Design This video covers a variety of practical considerations for developing a symptom management concept for clinical research.. Co-sponsored by the National Cancer Institute Symptom Management and Health

116

Grand Rounds Department of Neurology  

E-print Network

medical education activities with patient care components to include curric- ulum in the subjectsGrand Rounds Department of Neurology Neurology Lecture Series Targeting neural plasticity to treat neurological disease Mike Kilgard, PhD Margaret Fonde Jonsson Professor School of Behavioral and Brain Sciences

Brody, James P.

117

Neurological Sequelae of Lupus  

MedlinePLUS

... of medication, rest, exercise, proper nutrition, and stress management, most individuals with lupus can often achieve remission or reduce their symptom levels. Medications used in the treatment of lupus may ...

118

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. PMID:20725577

Sanders, Catherine; Bechtel, Ann

2009-01-01

119

Neurological adverse events following regional anesthesia administration  

PubMed Central

Regional anesthesia and analgesia have been associated with improved analgesia, decreased postoperative nausea and vomiting, and increased patient satisfaction for many types of surgical procedures. In obstetric anesthesia care, it has also been associated with improved maternal mortality and major morbidity. The majority of neurological adverse events following regional anesthesia administration result in temporary sensory symptoms; long-term or permanent disabling motor and sensory problems are very rare. Infection and hemorrhagic complications, particularly with neuraxial blocks, can cause neurological adverse events. More commonly, however, there are no associated secondary factors and some combination of needle trauma, intraneural injection, and/or local anesthetic toxicity may be associated, but their individual contributions to any event are difficult to define. PMID:22915878

Kent, Christopher D; Bollag, Laurent

2010-01-01

120

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. PMID:5015052

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

1972-01-01

121

Neurology of inherited glycosylation disorders  

PubMed Central

Congenital disorders of glycosylation comprise most of the nearly 70 genetic disorders known to be caused by impaired synthesis of glycoconjugates. The effects are expressed in most organ systems, and most involve the nervous system. Typical manifestations include structural abnormalities, (eg, rapidly progressive cerebellar atrophy), myopathies (including congenital muscular dystrophies and limb-girdle dystrophies), strokes and stroke-like episodes, epileptic seizures, developmental delay, and demyelinating neuropathy. Patients can have neurological symptoms associated with coagulopathies, immune dysfunction with or without infections, and cardiac, renal, or hepatic failure, which are common features of glycosylation disorders. The diagnosis of congenital disorders of glycosylation should be considered for any patient with multisystem disease and in those with more specific phenotypic features. Measurement of concentrations of selected glycoconjugates can be used to screen for many of these disorders, and molecular diagnosis is becoming more widely available in clinical practice. Disease-modifying treatments are available for only a few disorders, but all affected individuals benefit from early diagnosis and aggressive management. PMID:22516080

Freeze, HH; Eklund, E A; Ng, BG; Patterson, M C

2013-01-01

122

Differentiation of true transient ischemic attack versus transient ischemic attack mimics  

PubMed Central

Background: Previous literatures have shown a transient ischemic attack (TIA) mimic rate of 9-31%. We aimed to ascertain the proportion of stroke mimics amongst suspected TIA patients. Methods: A prospective observational study was performed in Ghaem Hospital, Mashhad, Iran during 2012-2013. Consecutive TIA patients were identified in a stroke center. The initial diagnosis of TIA was made by the resident of neurology and final diagnosis of true TIA versus TIA mimics was made after 3 months follow-up by stroke subspecialist. Results: A total of 310 patients were assessed during a 3-month period of which 182 (58.7%) subjects were male and 128 (41.3%) were female. Ten percent of the patients was categorized as a TIA mimic. The presence of hypertension, aphasia, duration of symptoms, and increased age was the strongest predictor of a true TIA. Migraine was the most common etiology of stroke mimic in our study. Conclusion: It seems that many signs and symptoms have low diagnostic usefulness for discrimination of true TIA from non-cerebrovascular events and predictive usefulness of any sign or symptom should be interpreted by a stroke neurologist.

Noureddine, Ali; Ghandehari, Kavian; Taghi Shakeri, Mohammad

2014-01-01

123

Neurologic injury in snowmobiling  

PubMed Central

Background: Snowmobiles are increasingly popular recreational, all-terrain utility vehicles that require skill and physical strength to operate given their inherent maneuverability, acceleration, and top speed capabilities. These same characteristics increase the risk of injury with the operation of these vehicles, particularly neurological injury. We characterize our series of 107 patients involved in snowmobiling accidents. Methods: From January 2004 to January 2012, all snowmobiling-related injuries referred to our regional trauma center were reviewed. Information had been recorded in the hospital's trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries, with particular emphasis on neurological injuries and any associated details. Results: A total of 107 patients were identified. Ninety percent of injured riders were male. The mean age was 34.4 years (range 10-70), with 7% younger than age 16. The mean Injury Severity Score was 12.0 ± 0.69 (range 1-34). Although not documented in all patients, alcohol use was found in 7.5% of the patients and drug use found in one patient. Documentation of helmet use was available for only 31 of the patients; of which 13% were not helmeted. Causes included being thrown, flipped, or roll-over (33%), striking a stationary object (27%), being struck by a snowmobile (9%), striking another snowmobile (5.5%) or a car, train, or truck (5.5%), being injured by the machine itself (9%), other (2%) or unspecified (18%). Head injuries occurred in 35% patients, including concussion, subarachnoid hemorrhage, subdural hematoma, contusion, and facial/skull fracture. Spinal fractures occurred in 21% of the patients. Fractures to the thoracic spine were the most common (50%), followed by the cervical (41%) and lumbar (36%) spine. There were also three brachial plexus injuries, one tibial nerve injury, and one internal carotid artery dissection. Average length of stay was 4.98 ± 0.56 days. Disposition was home (78%), home with services (12%), rehabilitation placement (9%), and one death. Details regarding other systemic injuries will also be reviewed. Conclusions: Snowmobiles are a significant source of multi-trauma, particularly neurological injury. Neurosurgeons can play key roles in advocating for neurological safety in snowmobiling. PMID:25024887

Plog, Benjamin A.; Pierre, Clifford A.; Srinivasan, Vasisht; Srinivasan, Kaushik; Petraglia, Anthony L.; Huang, Jason H.

2014-01-01

124

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.?? PMID:9854955

Burn, D; Bates, D

1998-01-01

125

Basic Symptoms and Ultrahigh Risk Criteria: Symptom Development in the Initial Prodromal State  

Microsoft Academic Search

Symptom development during the prodromal phase of psy- chosis was explored retrospectively in first-episode psycho- sis patients with special emphasis on the assumed time- related syndromic sequence of ''unspecific symptoms (UN)-predictive basic symptoms (BS)-attenuated psy- chotic symptoms (APS)-(transient) psychotic symptoms (PS).'' Onset of syndromes was defined by first occurrence of any of their respective symptoms. Group means were inspected for

Frauke Schultze-Lutter; Stephan Ruhrmann; Julia Berning; Wolfgang Maier; Joachim Klosterkotter

2010-01-01

126

Methyl Bromide Poisoning--A Bizarre Neurological Disorder  

PubMed Central

Methyl bromide, a widely used fumigant, may cause burns of the skin, fatalities accompanied by coma and convulsions, or prolonged neurologic and psychiatric symptoms. Burns are more likely to occur where evaporation is prevented under protective clothing. Symptoms of serious illness may not develop for hours after exposure. Since action appears to be one of methylation, especially of SH groups, B.A.L. may be helpful if used promptly. PMID:14347974

Collins, Raymond P.

1965-01-01

127

Neurologic Parasitic Infections in Immigrants and Travelers  

PubMed Central

Infectious diseases are increasingly common in modern clinical practice and the contemporary neurologist must be aware of the clinical manifestations, potential complications, and management of common travel-related infections. The authors provide an approach to patients who present with neurologic symptoms, with a history of travel to or residence in tropical and developing countries. Although many other infections are important in this demographic, they focus on three parasitic infections that neurologists may encounter: cerebral malaria, neuroschistosomiasis, and neurocysticercosis. The epidemiology, pathophysiology, clinical manifestations, diagnostic evaluation, and treatment are discussed for each infection. PMID:21964842

Thakur, Kiran; Zunt, Joseph

2012-01-01

128

Medical marijuana in neurology.  

PubMed

Constituents of the Cannabis plant, cannabinoids, may be of therapeutic value in neurologic diseases. The most abundant cannabinoids are ?(9)-tetrahydrocannabinol, which possesses psychoactive properties, and cannabidiol, which has no intrinsic psychoactive effects, but exhibits neuroprotective properties in preclinical studies. A small number of high-quality clinical trials support the safety and efficacy of cannabinoids for treatment of spasticity of multiple sclerosis, pain refractory to opioids, glaucoma, nausea and vomiting. Lower level clinical evidence indicates that cannabinoids may be useful for dystonia, tics, tremors, epilepsy, migraine and weight loss. Data are also limited in regards to adverse events and safety. Common nonspecific adverse events are similar to those of other CNS 'depressants' and include weakness, mood changes and dizziness. Cannabinoids can have cardiovascular adverse events and, when smoked chronically, may affect pulmonary function. Fatalities are rare even with recreational use. There is a concern about psychological dependence, but physical dependence is less well documented. Cannabis preparations may presently offer an option for compassionate use in severe neurologic diseases, but at this point, only when standard-of-care therapy is ineffective. As more high-quality clinical data are gathered, the therapeutic application of cannabinoids will likely expand. PMID:25427150

Benbadis, Selim R; Sanchez-Ramos, Juan; Bozorg, Ali; Giarratano, Melissa; Kalidas, Kavita; Katzin, Lara; Robertson, Derrick; Vu, Tuan; Smith, Amanda; Zesiewicz, Theresa

2014-12-01

129

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

130

Happiness and neurological diseases.  

PubMed

Happiness is an emotional state reflecting positive feelings and satisfaction with life, which, as an outcome in disease states or as an end point in clinical trials, is a neglected concept in most therapeutic areas. In neurological disease, happiness is important as it can be diminished either as a direct result of damage to neuronal tissue or as a reaction to a poor prognosis. The monitoring and maintenance of happiness and wellbeing have historically been considered to be peripheral to medicine. However, as happiness interacts with the patient's physical health, it is an important parameter to assess alongside all aspects of any given disease. Happiness provides a reliable overview of the patient's general status over and above standard parameters for quality of life, and is more wide-ranging than the narrow measures of disease activity or treatment efficacy that are the focus of most clinical trials. In many studies, happiness has been associated with health and success in most areas of life, including performance at work, sporting achievement and social functioning. For approximately a decade, previously studied aspects of psychology have been grouped under the label of positive psychology (PoP). Principles of this discipline are now being used to guide some treatments in neurological and psychiatric diseases. PoP aims to define patient wellbeing in scientific terms and to increase understanding of happiness, meaning in life, resilience and character strengths, as well as to determine how this knowledge can be applied clinically to promote health. Some evidence has emerged recently suggesting that improvements in patient status can result from interventions to improve the patient's level of happiness in diseases, including epilepsy, Huntington's disease, multiple sclerosis, Parkinson's disease and stroke. Several effective approaches to increase happiness employ activities to engage and stimulate patients who might otherwise be unoccupied and isolated. In addition, specific interventions to increase happiness developed by PoP clinicians have demonstrated efficacy and validity. Several measurement scales now exist that reliably measure happiness as a long-term state, rather than as a fluctuating condition resulting from prevailing mood. These enable the use of happiness as an end point in clinical trials. As happiness becomes increasingly accepted as an important consideration in neurological disease, it is likely to be monitored more extensively, with measures to raise happiness levels being taken as an effective means of improving patient outcomes. PMID:19344298

Barak, Yoram; Achiron, Anat

2009-04-01

131

CASE REPORT Neurological abnormalities associated with mobile phone use  

Microsoft Academic Search

Dysaesthesiae of the scalp after mobile phone use have been previously reported but the pathological basis of these symptoms has been unclear. We report finding a neurological abnormality in a patient after prolonged use of a mobile phone. He had permanent unilateral dysaesthesiae of the scalp, slight loss of sensation, and abnormalities on current perception threshold testing of cervical and

B. Hocking; R. Westerman

132

Recent advance in immunological tests in paraneoplastic neurological syndrome.  

PubMed

Paraneoplastic neurological syndromes are uncommon, however; their diagnosis is of major practical importance. Any portion of the nervous system may be involved in paraneoplastic syndromes. There is increasing evidence that the pathogenesis of many paraneoplastic neurological syndromes appears to be an immune reaction against antigen shared by the cancer and the nervous system. The identification of antibodies in the serum or cerebrospinal fluid in the central nervous system of paraneoplastic syndrome patient confirms the clinical diagnosis of paraneoplastic syndrome, and allows early identification of an underlying tumor at a stage when it is localized and more amenable to treatment. Cancer therapy (surgery, radiotherapy, chemotherapy) seems to be the most efficient treatment for the paraneoplastic neurological symptoms. Immunomodulatory therapy (intravenous immunoglobulin, plasmapheresis, immunosuppression) can halt or even reverse the neurological syndrome. The recent advances in understanding of the autoimmune pathology of these disorders should lead to more effective treatment options. PMID:15835287

Fong, Chin-Shih

2005-03-01

133

Depression in older patients with neurologic illness: causes, recognition, management.  

PubMed

Depression is common in the elderly, particularly in older persons with neurologic illness. Its etiology in this population is incompletely understood and likely to be multifactorial. Identifying depression in elderly patients with neurologic illness can be a challenge, as many of its features resemble symptoms of the underlying neurologic disease or of the aging process itself. Nevertheless, recognition and effective management of depression in this population is vital, since depression is a major source of excess morbidity and since treatment often results in improved quality of life for patients and their caregivers. Assessing for suidicality is a key diagnostic consideration in this population. Antidepressant medications, psychotherapy, and electroconvulsive therapy all can be effective in treating depression in elderly neurologic patients. PMID:16265943

Carson, Alan; Margolin, Richard

2005-10-01

134

Multiple sclerosis: managing a complex neurological disease.  

PubMed

This article describes the complex neurological condition multiple sclerosis (MS) and its management. It outlines the pathophysiology and symptoms, the importance of timely access to specialist services for treatment of symptoms, and relapse and disease management. New and emerging therapies for the management of MS, the role of the multidisciplinary team, the importance of holistic assessment and the role of the MS specialist nurse are discussed. Self-management of MS is integral to managing this life-limiting long-term condition. While there is no cure for MS, new and oral disease-modifying therapies providing better efficacy in stabilising the disease have recently been introduced, reducing relapse frequency and disease activity, and delaying the progression of disability. PMID:25388738

Embrey, Nikki

2014-11-12

135

The Spectrum of Neurological Recovery  

PubMed Central

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.

2012-01-01

136

Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders.  

PubMed

Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way. PMID:23859280

Nowinski, W L; Chua, B C

2013-06-01

137

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. PMID:1564502

Warlow, C P

1992-01-01

138

Neurology of pregnancy.  

PubMed

Pregnancy creates alterations in maternal physiology which predispose to unique neurologic disorders. Pre-eclampsia, eclampsia, certain types of ischemic and hemorrhagic stroke, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome, and thunderclap headache all appear to share a common origin from vascular endothelial dysfunction, with overlapping clinical presentations. Multiple sclerosis often improves during pregnancy. Compression mononeuropathies may occur in the extremities. Myasthenia gravis may affect second stage labor. Various inflammatory peripheral neuropathies, dystrophies, myopathies may occur during pregnancy. The safety of specific immune suppressants is reviewed. Epilepsy does not have a significant effect upon the course of pregnancy, albeit there is a modest increase in the need for cesarean section. Certain antiepileptic drugs may produce fetal malformations, most notably valproic acid. Brain tumors are rare during pregnancy, but may increase in size due to activation of hormonal receptors on tumor cells surfaces, water retention, and engorged blood vessels. PMID:24365437

Block, H Steven; Biller, José

2014-01-01

139

Neurology and diving.  

PubMed

Diving exposes a person to the combined effects of increased ambient pressure and immersion. The reduction in pressure when surfacing can precipitate decompression sickness (DCS), caused by bubble formation within tissues due to inert gas supersaturation. Arterial gas embolism (AGE) can also occur due to pulmonary barotrauma as a result of breath holding during ascent or gas trapping due to disease, causing lung hyperexpansion, rupture and direct entry of alveolar gas into the blood. Bubble disease due to either DCS or AGE is collectively known as decompression illness. Tissue and intravascular bubbles can induce a cascade of events resulting in CNS injury. Manifestations of decompression illness can vary in severity, from mild (paresthesias, joint pains, fatigue) to severe (vertigo, hearing loss, paraplegia, quadriplegia). Particularly as these conditions are uncommon, early recognition is essential to provide appropriate management, consisting of first aid oxygen, targeted fluid resuscitation and hyperbaric oxygen, which is the definitive treatment. Less common neurologic conditions that do not require hyperbaric oxygen include rupture of a labyrinthine window due to inadequate equalization of middle ear pressure during descent, which can precipitate vertigo and hearing loss. Sinus and middle ear overpressurization during ascent can compress the trigeminal and facial nerves respectively, causing temporary facial hypesthesia and lower motor neuron facial weakness. Some conditions preclude safe diving, such as seizure disorders, since a convulsion underwater is likely to be fatal. Preventive measures to reduce neurologic complications of diving include exclusion of individuals with specific medical conditions and safe diving procedures, particularly related to descent and ascent. PMID:24365363

Massey, E Wayne; Moon, Richard E

2014-01-01

140

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

2011-01-01

141

Neurological complications of coeliac disease  

PubMed Central

A variety of neurological disorders have been reported in association with coeliac disease including epilepsy, ataxia, neuropathy, and myelopathy. The nature of this association is unclear and whether a specific neurological complication occurs in coeliac disease remains unproved. Malabsorption may lead to vitamin and trace element deficiencies. Therefore, patients who develop neurological dysfunction should be carefully screened for these. However, malabsorption does not satisfactorily explain the pathophysiology and clinical course of many of the associated neurological disorders. Other mechanisms proposed include altered autoimmunity, heredity, and gluten toxicity. This review attempts to summarise the literature and suggests directions for future research. PMID:12151653

Pengiran, T; Wills, A; Holmes, G

2002-01-01

142

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: cir-auz@mail.ru; 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)

2006-10-15

143

Rotavirus Symptoms  

MedlinePLUS

... copyright holder. Print page View page in Español (Spanish) Contact Us: Centers for Disease Control and Prevention ... CDC-INFO Rotavirus Home About Rotavirus Symptoms Symptoms - Spanish Transmission Transmission - Spanish Prevention Prevention - Spanish Treatment Treatment - ...

144

Stroke Awareness in Luxemburg: Deficit Concerning Symptoms and Risk Factors  

PubMed Central

BACKGROUND Awareness of stroke risk factors is important for stroke prevention. Knowledge of stroke symptoms and awareness regarding the necessity of seeking urgent stroke treatment are vital to provide rapid admission to a stroke unit. Data on this specific knowledge in Luxemburg are lacking. METHODS We investigated 420 patients from the Department of Neurology and their relatives using a questionnaire. There were 44% men and 56% women; 25% were immigrants and 75% Luxemburgish nationals; 13% already had had a stroke or transient ischemic attack (TIA); and the mean age was 55 years ranging from 18 to 87 years. RESULTS A total of 88% of participants knew that a stroke occurs in the head/brain. In all, 10% of participants did not know any symptom of a stroke. The most frequently quoted symptoms (>15%) were paralysis/weakness (36%), speech disorders (32%), cranial nerve deficit (16%), vertigo (15%), and visual disorders (15%). Sensory deficits were mentioned by only 4% of patients. Known risk factors (>15%) were smoking (40%), hypertension (32%), alcohol (32%), poor nutrition (28%), high cholesterol (26%), stress (23%), and lack of exercise (19%). Age (4%), diabetes (6%), carotid stenosis (2%), and heart disease (1%) were less frequently known. In all, 11% of participants did not know any risk factor of a stroke. A total of 89% of participants would correctly call the 112 (emergency phone number). The following groups were better informed: Luxemburgish nationals, younger people, and participants with higher education level. Stroke/TIA patients were better informed concerning stroke symptoms, but unfortunately not concerning how to react in the case of a stroke. There was no relevant gender difference. DISCUSSION Although most of the participants knew what to do in the case of a stroke, they did not know the relevant stroke symptoms and risk factors. Future campaigns should therefore focus on risk factors and symptoms, and should address immigrants, elderly persons, less-educated persons, and patients who had already suffered a stroke/TIA.

Droste, Dirk W; Safo, Jacqueline; Metz, René J; Osada, Nani

2014-01-01

145

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.

1984-12-01

146

TRAINING THE FUTURE NEUROLOGY WORKFORCE  

Microsoft Academic Search

2 and Gelb has emphasized that that the ideal focus of education in neurology has shifted to ambulatory settings3. Most neurologists support additional training in outpatient (72%), community (57%) and staff model health maintenance organizations (44%). Two thirds of the residents\\/fellows compared with about half of practicing neurologists indicated they would increase training in a community setting. Whereas neurology departments

Steven P. Ringel

147

Suicidal Behavior and Neurological Illnesses  

PubMed Central

Objective Suicidal ideation and behavior have been associated with a variety of neurological illnesses. Studies are ongoing in combat veterans and other groups to examine possible mechanisms and pathways that account for such associations. Method This article provides a review of the literature on suicide ideation and suicidal behavior in patients with neurological illnesses including publications on veteran’s health and military medicine. Studies of suicide attempts and deaths in people with neurological illnesses are also reviewed. Results The studies summarized in this review indicate that there are important linkages between suicidal ideation and behavior and neurological conditions, including epilepsy, multiple sclerosis, and amyotrophic lateral sclerosis. Conclusion Additional studies are needed to further clarify why suicide ideation and suicidal behavior are associated with neurological diseases, in order to improve quality of life, alleviate patient distress, and prevent nonfatal and fatal suicide attempts in veteran and non-veteran populations. PMID:24501694

Coughlin, Steven S; Sher, Leo

2013-01-01

148

[Contraception and neurology].  

PubMed

The purpose of this article is to clarify interactions between oral contraception (using low- and high-dose oral contraceptives) and the main neurological diseases occurring in genitally active women. Vascular disorders predominate, since contraception is in itself a well-recognized a risk factor, especially in case of other intercurrent risk factors (high blood pressure, smoking, diabetes, history of vascular event) contradicting contraception. Low-dose oral contraception can be proposed for women free of these risk factors. There is however a formal contraindication for oral contraception, even with mini-dose contraceptives, for women with a history of cerebral venous thrombosis. In case of migraine headache, which is also a risk factor of vascular disease (especially in case of aura), oral contraceptives should be discussed on an individual basis, depending on the presence of other risk factors. Contraception has no effect on epilepsy but oral contraceptives may be inhibited by inducing anti-seizure drugs. Non-inducing drugs are preferable. The course of certain brain tumors known to express estrogen or progesterone receptors (particularly meningiomas and hemangioblastomas) may worsen with oral contraception, which is formally contradicted except when search for hormone receptors is negative. Oral contraception has no influence in other disease such as multiple sclerosis PMID:12486383

Combes, Caroline; Redondo, Aimée; Rey, Alain

2002-10-01

149

Neurological Effects of Pesticide Use among Farmers in China  

PubMed Central

The intensive use of pesticides has attracted great attention from the Chinese government. However, current regulations have had limited influence on their safe use. Although the acute neurologic effects of pesticides have been well documented, little is known about their cumulative effects. Knowledge of the impact of pesticides on health may convince farmers to minimize their use. We conducted a cross-sectional study in three provinces of China to evaluate the relationship between pesticide exposure and neurological dysfunction. Crop farmers were divided into two groups depending on their level of pesticide exposure. A total of 236 participants were assessed by questionnaire and neurological examination for symptoms and signs of neuropathy. Characteristics of neurologic dysfunction following cumulative low-level exposure were assessed with logistic regression analysis. Farmers exposed to high-level pesticide use had greater risk of developing sensations of numbness or prickling (odds ratio (OR) 2.62, 95% confidence interval (CI): 1.08–6.36). After adjusting for recent exposure, the risk of numbness or prickling symptoms (OR 2.55, 95% CI: 1.04–6.25) remained statistically significant. Loss of muscle strength and decreased deep tendon reflexes had OR > 2, however, this did not reach statistical significance. These findings suggest that overuse of pesticides increased risk of neurologic dysfunction among farmers, with somatosensory small fibers most likely affected. Measures that are more efficient should be taken to curb excessive use of pesticides. PMID:24736684

Li, Yifan; Zhang, Chao; Yin, Yanhong; Cui, Fang; Cai, Jinyang; Chen, Zhaohui; Jin, Yanhong; Robson, Mark G.; Li, Mao; Ren, Yuting; Huang, Xusheng; Hu, Ruifa

2014-01-01

150

DEPARTMENT OF NEUROLOGY UNIVERSITY OF ROCHESTER  

E-print Network

Goals 9 Vascular Neurology Core Competencies Outline 12 Vascular Fellow Evaluation Instruments 20 FellowDEPARTMENT OF NEUROLOGY UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY VASCULAR NEUROLOGY FELLOWSHIP HANDBOOK 2009 - 2010 DEPARTMENT OF NEUROLOGY Copyright © 2009, by Department of Neurology

Goldman, Steven A.

151

Neurological aspects of osteopetrosis.  

PubMed

The osteopetroses are caused by reduced activity of osteoclasts which results in defective remodelling of bone and increased bone density. They range from a devastating neurometabolic disease, through severe malignant infantile osteopetrosis (OP) to two more benign conditions principally affecting adults [autosomal dominant OP (ADO I and II)]. In many patients the disease is caused by defects in either the proton pump [the a3 subunit of vacuolar-type H(+)-ATPase, encoded by the gene variously termed ATP6i or TCIRG1] or the ClC-7 chloride channel (ClCN7 gene). These pumps are responsible for acidifying the bone surface beneath the osteoclast. Although generally thought of as bone diseases, the most serious consequences of the osteopetroses are seen in the nervous system. Cranial nerves, blood vessels and the spinal cord are compressed by either gradual occlusion or lack of growth of skull foramina. Most patients with OP have some degree of optic atrophy and many children with severe forms of autosomal recessive OP are rendered blind; optic decompression is frequently attempted to prevent the latter. Auditory, facial and trigeminal nerves may also be affected, and hydrocephalus can develop. Stenosis of both arterial supply (internal carotid and vertebral arteries) and venous drainage may occur. The least understood form of the disease is neuronopathic OP [OP and infantile neuroaxonal dystrophy, MIM (Mendelian inheritance in man) 600329] which causes rapid neurodegeneration and death within the first year. Although characterized by the finding of widespread axonal spheroids and accumulation of ceroid lipofuscin, the biochemical basis of this disease remains unknown. The neurological complications of this disease and other variants are presented in the context of the latest classification of the disease. PMID:12662317

Steward, C G

2003-04-01

152

Neurologic complications associated with influenza vaccination: two adult cases.  

PubMed

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

2003-02-01

153

Neurological consequences of scuba diving with chronic sinusitis.  

PubMed

Sinus barotrauma from scuba diving is relatively common, usually self-limiting, and often the result of transient nasal pathology. We describe serious neurological sequelae occurring in two scuba divers who had chronic sinusitis We suggest guidelines for evaluating and treating divers who have chronic sinusitis. Divers with nasal or sinus pathology should be aware of the potentially serious consequences associated with scuba diving even after endoscopic sinus surgery to correct this condition. PMID:10942141

Parell, G J; Becker, G D

2000-08-01

154

Neurologic Complications in Infective Endocarditis  

PubMed Central

Neurologic complications of infective endocarditis (IE) are common and frequently life threatening. Neurologic events are not always obvious. The prediction and management of neurologic complications of IE are not easily approached algorithmically, and the impact they have on timing and ability to surgically repair or replace the affected valve often requires a painstaking evaluation and joint effort across multiple medical disciplines in order to achieve the best possible outcome. Although specific recommendations are always tailored to the individual patient, there are some guiding principles that can be used to help direct the decision-making process. Herein, we review the pathophysiology, epidemiology, manifestations, and diagnosis of neurological complications of IE and further consider the impact they have on clinical decision making. PMID:25360207

Morris, Nicholas A.; Matiello, Marcelo; Samuels, Martin A.

2014-01-01

155

Epigenetic treatment of neurological disease.  

PubMed

Neurological disease, and in particular neurodegenerative diseases, cause significant burdens on both patient and healthcare costs. Despite extensive research, treatment options for patients with these conditions remain limited, and generally, only provide modest symptomatic relief. Aberrant epigenetic post-translational modifications of proteins are emerging as important elements in the pathogenesis of neurological disease. Using Alzheimer's disease and Huntington's disease as examples in the following article, some of latest data linking both the histone code and the various proteins that regulate this code to the pathogenesis of neurological disease are discussed. The current evidence suggesting that pharmacologically targeting one such family, the histone deacetylases, may be of potential benefit in the treatment of such diseases is also discussed. Finally, some of the potential mechanisms to specifically target these proteins within the neurological setting are discussed. PMID:22126204

Gray, Steven G

2011-08-01

156

Historical perspective of Indian neurology  

PubMed Central

Objective: To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. Background: The history of neurology in India is divided into two periods: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C.) during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20th century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation's first allopathic medical colleges located in Madras (1835), Calcutta (1835) and Mumbai (1848). Prior to India's independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI). Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN). Design/Methods: Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Results: Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930's. Early pioneers and founders of the NSI (1951) include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991). The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in the amount of basic, clinical and epidemiological research being conducted across the country every day. Conclusions: The history of neurology in India roots back to its rich culture and tradition. Over time, there has been great structural and organizational evolution and the future of neurology in India appears to be bright. However, the number of neurologists and research in neurology needs to experience a significant growth in the future to ensure the best patient care. PMID:24339562

Mishra, Shrikant; Trikamji, Bhavesh; Singh, Sandeep; Singh, Parampreet; Nair, Rajasekharan

2013-01-01

157

Neuropsychiatric symptoms and celiac disease  

PubMed Central

Background Neuropsychiatric symptoms may represent an atypical manifestation of celiac disease that occur before a gastroenterological diagnosis is made. Some studies suggest that a gluten-free diet is effective in treating the depression, anxiety, and neurological complications associated with celiac disease. Method The article describes the case of a patient suffering from chronic, treatment-resistant symptoms of depression and anxiety. The diagnosis of celiac disease and introduction of an elimination diet caused a significant improvement in mental state and everyday functioning in the presenting patient. Conclusion The presence of persistent anxiety and depressive symptoms, with a poor reaction to pharmacological treatment, indicates a need to identify somatic reasons for the underlying condition. It is important to remember that celiac disease can occur at any age, not only in childhood. The presence of this somatic cause of persistent depressive and anxiety symptoms should be considered in the diagnostic process in adults. PMID:25342904

Urban-Kowalczyk, Malgorzata; OEmigielski, Janusz; Gmitrowicz, Agnieszka

2014-01-01

158

Association of sickle cell disease, priapism, exchange transfusion and neurological events: ASPEN syndrome.  

PubMed

Priapism and acute neurological events are believed to be unrelated complications of sickle cell hemoglobinopathy. We describe a syndrome based on our experience and a review of the literature of significant neurological events after partial exchange transfusion to treat priapism in sicklemic patients. Severe headache is often the initiating symptom of this complex. The ensuing neurological events range from seizure activity to obtundation requiring ventilatory support. The proposed pathophysiology of these neurological events is related to cerebral ischemia after an acute increase in per cent total hemoglobin, concomitant decrease in per cent hemoglobin S and subsequent release of vasoactive substances during penile detumescence. We have termed this constellation of events the ASPEN syndrome, an eponym for association of sickle cell disease, priapism, exchange transfusion and neurological events. Early recognition and aggressive medical management resulted in complete reversal of neurological sequela. PMID:8411432

Siegel, J F; Rich, M A; Brock, W A

1993-11-01

159

Meige's Syndrome: Rare Neurological Disorder Presenting as Conversion Disorder.  

PubMed

Meige's syndrome is a rare neurological syndrome characterized by oromandibular dystonia and blepharospasm. Its pathophysiology is not clearly determined. A 35-year-old female presented to psychiatric department with blepharospasm and oromandibular dystonia with clinical provisional diagnosis of psychiatric disorder (Conversion Disorder). After thorough physical examination including detailed neurological exam and psychiatric evaluation no formal medical or psychiatric diagnosis could be made. The other differential diagnoses of extra pyramidal symptom, tardive dyskinesia, conversion disorder, anxiety disorder were ruled out by formal diagnostic criteria. Consequently with suspicion of Meige's syndrome she was referred to the department of Neurology and the diagnosis was confirmed. Hence, Meige's syndrome could be misdiagnosed as a psychiatric disorder such as conversion disorder or anxiety disorder because clinical features of Meige's syndrome are highly variable and affected by psychological factors and also can be inhibited voluntarily to some extent. PMID:24249940

Debadatta, Mohapatra; Mishra, Ajay K

2013-07-01

160

Neurological manifestations in patients with antiphospholipid syndrome  

PubMed Central

Background Anti-phospholipids syndrome (APS) is considered a non inflammatory auto-immune disease with a significant thrombophilic risk with varied clinical manifestations. The purpose of the current study was to investigate the frequency of thrombotic and non-thrombotic events in patients with APS. Methods In this retrospective study, 102 definite APS subjects were recruited (2007-2011) at Alzahra Hospital, Isfahan, Iran. The patients were referred to Multiple Sclerosis Clinic with the diagnosis of definite APS according to 2006 Sydney's criteria. Disorders associated with APS such as pregnancy complication, vascular thrombosis and livedo reticularis (LR) were assessed. Neurological signs and symptoms such as cognitive dysfunction were recorded. Data analyses were performed using SPSS software and P < 0.05 were considered to be statistically significant. Results Our findings showed that majority of female gender, higher rate of ischemic thrombotic stroke and high miscarriage lied in a large number of APS patients. Conclusion Overall recurrent miscarriage is a common complication among (antiphospholidpid antibody) aPL patients. Furthermore, ischemic stroke is the second common neurological manifestations of APS patients. PMID:24250929

Etemadifar, Masoud; Tahani, Soheil; Toghianifar, Nafiseh; Rahaimi, Marzieh; Eskandari, Nahid

2013-01-01

161

An Insidious Cardiac Sarcoma Presenting with Progressive Neurologic Dysfunction  

PubMed Central

Central nervous system metastases as the presentation of primary cardiac sarcoma are a very rare entity, with only a few previously reported cases. Sarcomas specifically make up 10 to 20% of all primary cardiac tumors. Patients with primary cardiac tumors typically present with cardiac symptomatology that may include arrhythmias, obstruction to blood flow and valve function, or symptoms of heart failure. We report a unique case of a patient with a primary cardiac sarcoma who presented with progressive neurologic dysfunction secondary to brain metastases without any preceding cardiac symptoms. We describe our novel management of these unique cases and discuss the current medical and surgical approaches to treating neurologic metastases from cardiac sarcoma. PMID:24416490

Pasalic, Dario; Hegerova, Livia T.; Gonsalves, Wilson I.; Robinson, Steven

2013-01-01

162

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

2010-01-01

163

Neurologic presentation of celiac disease.  

PubMed

Celiac disease (CD) long has been associated with neurologic and psychiatric disorders including cerebellar ataxia, peripheral neuropathy, epilepsy, dementia, and depression. Earlier reports mainly have documented the involvement of the nervous system as a complication of prediagnosed CD. However, more recent studies have emphasized that a wider spectrum of neurologic syndromes may be the presenting extraintestinal manifestation of gluten sensitivity with or without intestinal pathology. These include migraine, encephalopathy, chorea, brain stem dysfunction, myelopathy, mononeuritis multiplex, Guillain-Barre-like syndrome, and neuropathy with positive antiganglioside antibodies. The association between most neurologic syndromes described and gluten sensitivity remains to be confirmed by larger epidemiologic studies. It further has been suggested that gluten sensitivity (as evidenced by high antigliadin antibodies) is a common cause of neurologic syndromes (notably cerebellar ataxia) of otherwise unknown cause. Additional studies showed high prevalence of gluten sensitivity in genetic neurodegenerative disorders such as hereditary spinocerebellar ataxia and Huntington's disease. It remains unclear whether gluten sensitivity contributes to the pathogenesis of these disorders or whether it represents an epiphenomenon. Studies of gluten-free diet in patients with gluten sensitivity and neurologic syndromes have shown variable results. Diet trials also have been inconclusive in autism and schizophrenia, 2 diseases in which sensitivity to dietary gluten has been implicated. Further studies clearly are needed to assess the efficacy of gluten-free diet and to address the underlying mechanisms of nervous system pathology in gluten sensitivity. PMID:15825133

Bushara, Khalafalla O

2005-04-01

164

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. PMID:23526482

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

2013-01-01

165

Neurological Outcome after Surgical Treatment of Intramedullary Spinal Cord Tumors  

PubMed Central

Objective Recently, surgical outcomes of patients with intramedullary spinal cord tumors (IMSCT) have been improved due to advances of medicine. The purposes of our study were to evaluate the recent neurological outcomes after surgical treatment of IMSCTs. Methods We retrospectively reviewed 69 patients who underwent surgical treatment for IMSCT in our hospital between 1998 and 2013. Patient's age, sex, histological origin and grade, tumor location, tumor extension, preoperative neurological state, initial presenting symptom, and extend of tumor resection were analyzed to evaluate predictive factors that affect postoperative functional outcome. Results The neurological states at last follow-up were improved in 16 patients (23.2%), unchanged in 47 (68.1%), aggravated in 6 (8.7%). In all patients, the functional outcomes were good in 52 patients (75.4%), fair in 10 (14.5%), poor in 7 (10.1%). Preoperative good neurological state was the strongest positive predictor of good functional outcome (p<0.05). In tumor location, functional outcomes of thoracic tumors were poor than those in cervical and conus medullaris region (p=0.011). High-grade tumor shows poor outcome compare to low-grade tumor (p=0.03). Conclusion The most reliable predicting factor of surgical outcome was the preoperative neurological state. In addition, IMSCTs in thoracic region and high-grade tumor showed relatively bad outcome and had a risk of postoperative morbidity.

Lee, Sang-Min; Cho, Yong-Eun

2014-01-01

166

Gluten-related neurologic dysfunction.  

PubMed

The term gluten-related disorders (GRD) encompasses a spectrum of systemic autoimmune diseases with diverse manifestations. GRD are characterized by abnormal immunological responsiveness to ingested gluten in genetically susceptible individuals. Celiac disease (CD) or gluten-sensitive enteropathy is only one of a number of GRD. Extraintestinal manifestations include dermatitis herpetiformis (DH) and neurologic dysfunction. Furthermore it is only recently that the concept of extraintestinal manifestations without enteropathy has become accepted. In this chapter we review the spectrum of neurologic manifestations in GRD, discuss recent advances in their diagnosis, and look at their possible pathophysiologic mechanisms. PMID:24365341

Hadjivassiliou, Marios; Duker, Andrew P; Sanders, David S

2014-01-01

167

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

2004-01-01

168

College of Medicine NEU Neurology  

E-print Network

College of Medicine NEU Neurology KEY: # = new course * = course changed = course dropped-year curriculum. Pass-fail only. Prereq: Admission to first year, College of Medicine. NEU 825 SECOND approved electives offered by the various departments in the College of Medicine. The intent is to provide

MacAdam, Keith

169

Neurological complications of pertussis inoculation  

Microsoft Academic Search

Findings are presented in 36 children, seen in the past 11 years, who are believed to have suffered from neurological complications of pertussis inoculation (given as triple vaccine). The clustering of complications in the first 24 hours after inoculation suggests a causal rather than a coincidental relation. Possible contributory factors were present in one-third of patients studied and support the

M. Kulenkampff; J. S. Schwartzman; J. Wilson

1974-01-01

170

Bravo! Neurology at the Opera  

Microsoft Academic Search

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

Brandy R. Matthews

2010-01-01

171

Edgar Allan Poe and neurology.  

PubMed

Edgar Allan Poe was one of the most celebrated writers of all time. He published several masterpieces, some of which include references to neurological diseases. Poe suffered from recurrent depression, suggesting a bipolar disorder, as well as alcohol and drug abuse, which in fact led to his death from complications related to alcoholism. Various hypotheses were put forward, including Wernicke's encephalopathy. PMID:24964115

Teive, Hélio Afonso Ghizoni; de Paola, Luciano; Munhoz, Renato Puppi

2014-06-01

172

Gross cerebellar paraneoplastic neurological disorder in a patient with an occult breast cancer.  

PubMed

Paraneoplastic neurological disorders are relatively rare conditions posing both diagnostic as well as therapeutic challenges. A previously fit 66-year-old woman presented with subtle cerebellar symptoms which progressed rapidly over the course of days. Chest x-ray and routine blood tests were unremarkable. CT of the head with contrast showed no abnormality. Lumbar puncture showed no evidence of infection or oligoclonal bands. She was transferred to a neurological centre from a remote and rural setting. Subsequent MRI was reported to be normal as well. Tumour markers were negative but the paraneoplastic anti-Yo antibody was positive. A whole body CT scan revealed a spiculated left breast lesion which turned out to be malignant on fine needle aspiration. She underwent left mastectomy, had plasmapharesis and received high-dose intravenous Ig for her paraneoplastic neurological symptoms. She remained neurologically stable and underwent rehabilitation in her local hospital before getting discharged home. PMID:23595173

Poudel, Chandra K; Achar, K N

2013-01-01

173

Neurologic dysfunction in patients with rheumatoid arthritis of the cervical spine. Predictive value of clinical, radiographic and MR imaging parameters  

Microsoft Academic Search

The aim of this study was to evaluate if subjective symptoms, radiographic and especially MR parameters of cervical spine\\u000a involvement, can predict neurologic dysfunction in patients with severe rheumatoid arthritis (RA). Sequential radiographs,\\u000a MR imaging, and neurologic examination were performed yearly in 46 consecutive RA patients with symptoms indicative of cervical\\u000a spine involvement. Radiographic parameters were erosions of the dens

M. Reijnierse; B. A. C. Dijkmans; B. Hansen; T. L. Pope; H. M. Kroon; H. C. Holscher; F. C. Breedveld; J. L. Bloem

2001-01-01

174

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. PMID:22303049

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

2011-01-01

175

Menopausal symptoms  

PubMed Central

Introduction Menopause is a physiological event. In the UK, the median age for onset of menopausal symptoms is 45.5 to 47.5 years. Although endocrine changes are permanent, menopausal symptoms such as hot flushes, which are experienced by about 70% of women, usually resolve with time, although they can persist for decades in some women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments for menopausal symptoms? What are the effects of non-prescribed treatments for menopausal symptoms? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 79 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: agnus castus, antidepressants, black cohosh, clonidine, oestrogens, phyto-oestrogens, progestogens, testosterone, and tibolone. PMID:21696644

2011-01-01

176

Menopausal symptoms  

PubMed Central

Introduction Menopause is a physiological event. In the UK, the median age for onset of menopausal symptoms is 45.5 to 47.5 years. Although endocrine changes are permanent, menopausal symptoms such as hot flushes, which are experienced by about 70% of women, usually resolve with time, although they can persist for decades in some women. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical treatments for menopausal symptoms? What are the effects of non-prescribed treatments for menopausal symptoms? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 68 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: agnus castus, antidepressants, black cohosh, clonidine, oestrogens, phyto-oestrogens, progestogens, testosterone, and tibolone. PMID:21718582

2010-01-01

177

Diphtheria Symptoms  

MedlinePLUS

... by the bacteria. The pseudomembrane sticks to the tissue below and may get in the way of breathing. The toxin may be absorbed into the blood stream and may cause damage to the heart, kidneys and nerves. Related Pages Diphtheria for Parents: The Basics Describes symptoms ...

178

Transient performance  

NASA Astrophysics Data System (ADS)

Gas turbine engine transient behavior, that which is concerned with the changes in engine parameters during acceleration or decceleration of an engine from one steady state point to a different steady state point, is considered. An engine can also experience cyclic aerodynamic phenomena which occur at a nominally steady condition; examples are compressor rotator stall and intake or afterburner buzz. The following are discussed: certification requirements; mechanism of acceleration; compressor working lines and surge; and some important factors (pressure level, moment of inertia, heat soakage, clearances, measurement of transients, thrust reversal, and transient maneuvers which involve significant changes to the shaft speeds of the engine). A set of graphics illustrating transient performance is presented.

Curnock, Barry

179

[Inborn errors of metabolism in adult neurology].  

PubMed

Inborn errors of metabolism (IEM) are caused by mutations in genes coding for enzymes and other proteins involved in cell metabolism. Many IEM can be treated effectively. Although IEM have usually been considered pediatric diseases, they can present at any age, mostly with neurological and psychiatric symptoms, and therefore constitute an integral subspeciality of neurology. However, although they are increasingly being recognized, IEM remain rare, and the care for patients should be optimized in specialized reference centers. Since the number of different diseases is very large, the diagnostic approach needs to be rigorous, starting at the clinics and calling upon the additional help of neuroradiology, biochemistry and molecular biology. In practice, it is important for the neurologist to recognize: (1) when to start suspecting an IEM; and (2) how to correlate a given clinical presentation with one of the five major groups of diseases affecting the nervous system. These five groups may be classified as: (a) energy metabolism disorders such as respiratory chain disorders, pyruvate dehydrogenase deficiency, GLUT1 deficiency, fatty-acid ?-oxidation defects, and disorders involving key cofactors such as electron transfer flavoprotein, thiamine, biotin, riboflavin, vitamin E and coenzyme Q10; (b) intoxication syndromes such as porphyrias, urea-cycle defects, homocystinurias, organic acidurias and amino acidopathies; (c) lipid-storage disorders such as lysosomal storage disorders (Krabbe disease, metachromatic leukodystrophy, Niemann - Pick disease type C, Fabry disease and Gaucher's disease), peroxisomal disorders (adrenomyeloneuropathy, Refsum disease, disorders of pristanic acid metabolism, peroxisome biogenesis disorders), Tangier disease and cerebrotendinous xanthomatosis; (d) metal-storage diseases such as iron, copper and manganese metabolic disorders; and (e) neurotransmitter metabolism defects, including defects of serotonin, dopamine and glycine metabolism. PMID:23452774

Sedel, F

2013-02-01

180

HUNTINGTON'S DISEASE PRESENTING WITH SCHIZOPHRENIC SYMPTOMS : A CASE REPORT  

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. PMID:21776102

Gupta, Vinay; Deswal, R.S.

1992-01-01

181

Palliative care and neurology: time for a paradigm shift.  

PubMed

Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. PMID:24991027

Boersma, Isabel; Miyasaki, Janis; Kutner, Jean; Kluger, Benzi

2014-08-01

182

Airway management in neurological emergencies  

Microsoft Academic Search

Several neurological conditions may present to the emergency department (ED) with airway compromise or respiratory failure.\\u000a The severity of respiratory involvement in these patients may not always be obvious. Proper pulmonary management can significantly\\u000a reduce the respiratory complications associated with the morbidity and mortality of these patients. Rapid sequence intubation\\u000a (RSI) is the method of choice for definitive airway management

Lynn P. Roppolo; Karina Walters

2004-01-01

183

Emerging and Reemerging Neurologic Infections  

PubMed Central

The list of emerging and reemerging pathogens that cause neurologic disease is expanding. Various factors, including population growth and a rise in international travel, have contributed to the spread of pathogens to previously nonendemic regions. Recent advances in diagnostic methods have led to the identification of novel pathogens responsible for infections of the central nervous system. Furthermore, new issues have arisen surrounding established infections, particularly in an increasingly immunocompromised population due to advances in the treatment of rheumatologic disease and in transplant medicine.

Glaser, Carol A.

2014-01-01

184

Human Neurological Development: Past, Present and Future  

NASA Technical Reports Server (NTRS)

Neurological development is considered as the major human potential. Vision, vestibular function, intelligence, and nutrition are discussed as well as the treatment of neurological disfunctions, coma, and convulsive seizures.

Pelligra, R. (editor)

1978-01-01

185

Genomic medicine and neurological disease  

PubMed Central

“Genomic medicine” refers to the diagnosis, optimized management, and treatment of disease—as well as screening, counseling, and disease gene identification—in the context of information provided by an individual patient’s personal genome. Genomic medicine, to some extent synonymous with “personalized medicine,” has been made possible by recent advances in genome technologies. Genomic medicine represents a new approach to health care and disease management that attempts to optimize the care of a patient based upon information gleaned from his or her personal genome sequence. In this review, we describe recent progress in genomic medicine as it relates to neurological disease. Many neurological disorders either segregate as Mendelian phenotypes or occur sporadically in association with a new mutation in a single gene. Heritability also contributes to other neurological conditions that appear to exhibit more complex genetics. In addition to discussing current knowledge in this field, we offer suggestions for maximizing the utility of genomic information in clinical practice as the field of genomic medicine unfolds. PMID:21594611

Boone, Philip M.; Wiszniewski, Wojciech; Lupski, James R.

2011-01-01

186

Neurological manifestations of filarial infections.  

PubMed

Filarial infections cause a huge public health burden wherever they are endemic. These filaria may locate anywhere in the human body. Their manifestations and pathogenic mechanisms, except the most common ones, are rarely investigated systematically. Their neurological manifestations, however, are being increasingly recognized particularly with onchocerciasis or Loa loa infections, Wuchereria bancrofti, or Mansonella perstans. The risk of developing these manifestations may also increase in cases that harbor multiple filariasis or coinfections, for instance as with Plasmodium. The microfilaria of Onchocerca and Loa loa are seen in cerebrospinal fluid. The pathogenesis of neurological manifestations of these infections is complex; however, pathogenic reactions may be caused by mechanical disruption, e.g., degeneration often followed by granulomas, causing fibrosis or mass effects on other tissues, vascular lesions, e.g., vascular block of cerebral vessels, or disordered inflammatory responses resulting in meningitis, encephalitis or localized inflammatory responses. The chances of having neurological manifestations may also depend upon the frequency and"heaviness"of infection over a lifetime. Hence, this type of infection should no longer be considered a disease of the commonly affected areas but one that may produce systemic effects or other manifestations, and these should be considered in populations where they are endemic. PMID:23829914

Bhalla, Devender; Dumas, Michel; Preux, Pierre-Marie

2013-01-01

187

Premenstrual symptoms.  

PubMed

Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in many women may be precipitated by simple psychological events such as leaving home, while severely stressful events produce a higher incidence. Unless a physiological factor such as malnutrition is operating, menses usually recur spontaneously within a few months. Amenorrhea is a constant feature of anorexia nervosa and may precede related attitudes toward eating and body weight. This syndrome is best regarded as a chronic and often severe neurotic disorder requiring combined physiological and psychological treatment, although some evidence exists to indicate an endocrine disorder. Extensive basic research is needed on the complex relationship between the neuroendocrine system and emotion. PMID:4735136

1973-03-24

188

Italian neurology: past, present and future  

PubMed Central

Summary This short history of the Italian Society of Neurology focuses on its founders and leading personalities. The article also considers the present and the future of Italian neurology, emphasising in particular the scientific impact of Italian neurological research on the main international journals and the activities undertaken to increase the role of neurologists. PMID:21729588

Federico, Antonio

189

Neurology Clerkship MID-ROTATION EVALUATION  

E-print Network

evaluate the student's level of skill in the following competencies in Neurology. On the next page, pleaseNeurology Clerkship MID-ROTATION EVALUATION The University of Chicago Division of the Biological provide written comments to explain your scores. 0 1 2 3 4 5 Diagnosis and Management in Neurology 1

Issa, Naoum

190

Sleep Neurology - A Wakeup Call for Neurologists  

Microsoft Academic Search

Sleep medicine is an exploding field and yet the disorders of sleep, and the effects of sleep on many neurological disorders, have been largely ignored by the neurological community. This has both patient care and medico-political implications.Amongst those who first described sleep apnoea was the great French neurologist Henri Gastaut. Whilst several groups, including neurologists, have maintained interest in neurological

Samuel F. Berkovic; Philip King

2002-01-01

191

Neurologic Outcome Score for Infants and Children  

Microsoft Academic Search

Objectives: To develop and validate a practical outcome instrument applicable to a broad range of neurologic deficits in children. Methods: Reliability testing of a draft version of the Neurologic Outcome Scale for Infants and Children (NOSIC) in 100 children with a wide range of ages and levels of neurologic function was performed. After review of the reliability data by a

Pamela J. Okada; Kelly D. Young; Jill M. Baren; Soledad S. Raroque; Kenneth R. Huff; Jacqueline B. Wiebe; Peter L. Stavinoha; Roger J. Lewis

2003-01-01

192

The Neurological Manifestations of H1N1 Influenza Infection; Diagnostic Challenges and Recommendations  

PubMed Central

Background: World Health Organization declared pandemic phase of human infection with novel influenza A (H1N1) in April 2009. There are very few reports about the neurological complications of H1N1 virus infection in the literature. Occasionally, these complications are severe and even fatal in some individuals. The aims of this study were to report neurological complaints and/or complications associated with H1N1 virus infection. Methods: The medical files of all patients with H1N1 influenza infection admitted to a specified hospital in the city of , from October through November 2009 were reviewed. More information about the patients were obtained by phone calls to the patients or their care givers. All patients had confirmed H1N1 virus infection with real-time PCR assay. Results: Fifty-five patients with H1N1 infection were studied. Twenty-three patients had neurological signs and/or symptoms. Mild neurological complaints may be reported in up to 42% of patients infected by H1N1 virus. Severe neurological complications occurred in 9% of the patients. The most common neurological manifestations were headache, numbness and paresthesia, drowsiness and coma. One patient had a Guillain-Barre syndrome-like illness, and died in a few days. Another patient had focal status epilepticus and encephalopathy. Conclusions: The H1N1 infection seems to have been quite mild with a self-limited course in much of the world, yet there appears to be a subset, which is severely affected. We recommend performing diagnostic tests for H1N1influenza virus in all patients with respiratory illness and neurological signs/symptoms. We also recommend initiating treatment with appropriate antiviral drugs as soon as possible in those with any significant neurological presentation accompanied with respiratory illness and flu-like symptoms. PMID:23365476

Asadi-Pooya, Ali Akbar; Yaghoubi, Ehsan; Nikseresht, Alireza; Moghadami, Mohsen; Honarvar, Behnam

2011-01-01

193

Recurrent aortic dissection presenting with repeated transient ischemic attacks: a novel pathophysiology and successful endovascular treatment.  

PubMed

Aortic dissection is the most common and the most lethal event that can involve the aorta. Typically, aortic dissection presents with sharp, tearing, or ripping pain. Alternatively, the patients may suffer from possible extension of the dissecting aneurysm into the supra-aortic vessels resulting in syncope in 9.4 % of patients cerebrovascular accidents in 4.7 %. We present a case of recurrent aortic dissection, which presented with recurrent transient ischemic attacks (TIAs). The etiology of the neurological symptoms was attributed to a steal phenomenon. The right subclavian artery was supplied by retrograde flow from the right internal carotid artery through the false lumen of the dissection. To prevent further hemodynamic TIAs, we successfully occluded the proximal part of the false lumen of the dissection responsible for the steal phenomenon. PMID:23307261

Elshikh, S; Schumacher, M; Dohmen, A; Weber, J

2013-12-01

194

Clinical symptoms and symptom signatures of Alzheimer's disease subgroups.  

PubMed

Alzheimer's disease (AD) is a multifactorial disorder that involves several different mechanisms. Over 99% of AD patients suffer from the sporadic form of the disease. Based on cerebrospinal fluid (CSF) levels of amyloid-? (A?)(1-42), total tau, and ubiquitin--the markers associated with the histopathological hallmarks of the disease (A? plaques and abnormally hyperphosphorylated neurofibrillary tangles)--previous studies identified five subgroups of AD. Here we report the potential diagnostic predictive value of hallucination, hypokinesia, paranoia, rigidity, and tremors in aged individuals for AD and differences in the prevalence of these symptoms in the CSF marker-based subgroups of the disease. Analysis of 196 clinically diagnosed AD or Alzheimer with Lewy body, and 75 non-AD neurological and non-neurological control cases, all from a single center, showed that the presence of hallucination, hypokinesia, paranoia, rigidity, or tremors individually, or the presence of any of these, could diagnose AD with sensitivities and specificities of 14% and 99%; 30% and 99%; 15% and 99%; 16% and 100%; 16% and 96%; and 47% and 92%, respectively. The pattern of the prevalence of the above symptoms varied from AD subgroup to subgroup. Presence of any of these symptoms, as well as presence of each individual symptom except tremors, significantly differentiated AD subgroups from the predominantly control cluster. These findings encourage the exploration of hallucination, hypokinesia, paranoia, rigidity, and tremors in identifying various subgroups of AD for stratification of patients for clinical trials to develop therapeutic drugs. This study is for the special issue of the Journal of Alzheimer's Disease honoring Inge Grundke-Iqbal who made several seminal contributions in AD research. PMID:24002184

Iqbal, Khalid; Flory, Michael; Soininen, Hilkka

2013-01-01

195

Thal fundoplication in neurologically impaired children.  

PubMed

Children with neurological impairment (NI) frequently require feeding gastrostomy, and this often aggravates or produces gastroesophageal reflux (GER). From 1976 to 1994, 141 children with severe NI underwent Thal fundoplication and gastrostomy (GT). GER was evident in 80%; in the rest, fundoplication was an adjunct to GT. Ph results were positive in 38 cases, and 57 children had reflux according to the barium studies. There were no major intraoperative complications. Disruption of the repair and/or recurrent GER was noted in 14 cases (10%); 8 were redone as Thals, and 6 were converted to Nissen procedures. Pyloroplasty was done later in 9 children (6%). Bowel obstruction was seen in 4 patients (3%). Clinical follow-up (mean, 54 months) showed improvement in 96%; only 5 of the 141 (3.2%) have residual symptoms. Of the patients with an intact Thal, 67% could burp or vomit. The ability to vomit may protect the Thal fundoplication and avoid disruption of the repair. PMID:8783112

Ramachandran, V; Ashcraft, K W; Sharp, R J; Murphy, P J; Snyder, C L; Gittes, G K; Bickler, S W

1996-06-01

196

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

2010-01-01

197

Emerging and reemerging neurologic infections.  

PubMed

The list of emerging and reemerging pathogens that cause neurologic disease is expanding. Various factors, including population growth and a rise in international travel, have contributed to the spread of pathogens to previously nonendemic regions. Recent advances in diagnostic methods have led to the identification of novel pathogens responsible for infections of the central nervous system. Furthermore, new issues have arisen surrounding established infections, particularly in an increasingly immunocompromised population due to advances in the treatment of rheumatologic disease and in transplant medicine. PMID:25360203

Chow, Felicia C; Glaser, Carol A

2014-10-01

198

Nicotine and inflammatory neurological disorders  

PubMed Central

Cigarette smoke is a major health risk factor which significantly increases the incidence of diseases including lung cancer and respiratory infections. However, there is increasing evidence that smokers have a lower incidence of some inflammatory and neurodegenerative diseases. Nicotine is the main immunosuppressive constituent of cigarette smoke, which inhibits both the innate and adaptive immune responses. Unlike cigarette smoke, nicotine is not yet considered to be a carcinogen and may, in fact, have therapeutic potential as a neuroprotective and anti-inflammatory agent. This review provides a synopsis summarizing the effects of nicotine on the immune system and its (nicotine) influences on various neurological diseases. PMID:19448649

Piao, Wen-Hua; Campagnolo, Denise; Dayao, Carlos; Lukas, Ronald J; Wu, Jie; Shi, Fu-Dong

2009-01-01

199

Tuberculosis of spine: neurological deficit.  

PubMed

The most dreaded neurological complications in TB spine occur in active stage of disease by mechanical compression, instability and inflammation changes, while in healed disease, these occur due to intrinsic changes in spinal cord secondary to internal salient in long standing kyphotic deformity. A judicious combination of conservative therapy and operative decompression when needed should form a comprehensive integrated course of treatment for TB spine with neurological complications. The patients showing relatively preserved cord with evidence of edema/myelitis with predominantly fluid collection in extradural space on MRI resolve on non-operative treatment, while the patients with extradural compression of mixed or granulomatous nature showing entrapment of spinal cord should be undertaken for early surgical decompression. The disease focus should be debrided with removal of pus caseous tissue and sequestra. The viable bone should only be removed to decompress the spinal cord and resultant gap should be bridged by bone graft. The preserved volume of spinal cord with edema/myelitis and wet lesion on MRI usually would show good neural recovery. The spinal cord showing myelomalacia with reduced cord volume and dry lesion likely to show a poor neural recovery. The internal kyphectomy is indicated for paraplegia with healed disease. These cases are bad risk for surgery and neural recovery. The best form of treatment of late onset paraplegia is the prevention of development of severe kyphosis in initial active stage of disease. PMID:22565802

Jain, Anil K; Kumar, Jaswant

2013-06-01

200

Neurologic complications of craniovertebral dislocation.  

PubMed

Craniovertebral dislocation is uncommon, but its diagnosis is important taking into account the potential severity of the neurologic complications. A number of causes are known; the most common are Down syndrome, rheumatoid arthritis, Paget's disease, other metabolic bone diseases, and craniocervical trauma. Down's syndrome is a relatively common clinical condition but craniovertebral subluxation is only observed in a small percentage of patients. About half of all cervical spine injuries affect the atlanto-occipital region and C2 vertebra. In rheumatoid arthritis, craniocervical dislocation occurs in up to 40% of patients with severe disease. In Paget's disease, involvement of the craniovertebral region occurs in about 30% of all cases. The clinical neurologic syndrome is characterized by local pain, features of upper spinal cord and medullary compression, positive Lhermitte phenomenon, syncope associated with neck flexion, vertebral artery obstruction or dissection leading to stroke, and asymmetrical lower cranial nerve palsies. Neuroimaging is essential to confirm the clinical diagnosis and to categorize severity. The treatment of this disorder is usually surgical, but traction and external immobilization is relevant in some cases. Specific conditions may require additional treatments such as radiotherapy, antibiotics, or chemotherapy. PMID:24365311

de Carvalho, Mamede; Swash, Michael

2014-01-01

201

Neurologic events after partial exchange transfusion for priapism in sickle cell disease.  

PubMed

We describe six boys with homozygous sickle cell disease, aged 7 to 13 years, in whom acute, severe neurologic abnormalities developed 1 to 11 days after partial exchange transfusion was performed to treat priapism that was unresponsive to more conservative therapy. Hemoglobin levels were 10.5 to 13.4 gm/dl (mean 12.1 gm/dl), and hemoglobin S levels were 18% to 33% (mean 27%) before the onset of neurologic complications. Severe headache was the initial finding in five patients, four of whom had increased intracranial pressure and three of whom required tracheal intubation and hyperventilation. Four patients had seizures; three had focal neurologic deficits for more than 24 hours. Cerebral arteriography demonstrated vascular abnormalities, including irregularity, stenosis, and complete occlusion of vessels. Patients treated with regular erythrocyte transfusions had no recurrence of neurologic signs or symptoms when hemoglobin S levels were kept at 30% to 50%. The occurrence of serious neurologic complications after partial exchange transfusion in patients with homozygous sickle cell disease from three centers indicates the possibility of a causal relationship between the events. Early and thorough investigation of neurologic symptoms, especially severe headache, is warranted in this clinical setting. PMID:1593347

Rackoff, W R; Ohene-Frempong, K; Month, S; Scott, J P; Neahring, B; Cohen, A R

1992-06-01

202

Liposarcoma with unusual neurological manifestations.  

PubMed

Central nervous system involvement in liposarcoma is rare, the only symptom reported in the literature being local compression of the spinal cord. An exceptional case with peripheral nerve involvement due to local recurrence, in addition to spinal cord compression and cavernous sinus syndrome due to metastases is reported. PMID:7729079

Timmann, D; Faustmann, P M; Faiss, J H; Schmidt, U; Kryne-Kubat, B

1995-01-01

203

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

1989-01-01

204

Symptoms in smokers trying to quit  

E-print Network

ABSTRACT: Aims: To describe the prevalence and intensity of different symptoms in relation to tobacco abstinence. To explore latent dimensions between symptoms in smokers trying to quit. Design: A cross sectional study using a questionnaire to retrospectively assess symptoms over a period of 12 months. Setting: Swedish telephone quitline, a nationwide free of charge service. Participants: All 741 individuals who had called the quitline and signed up for smoking cessation treatment between February 2000 to November 2001 and reported to have been smoke free for at least 24 hours during the previous 12 month period from first contact. Measurements: Assessments were made by self-report, and abstinence was defined as “not a single puff of smoke during the last week”. A factor analysis approach where individual items aggregate into factors was used to explore the relationship between the different symptoms. Findings: High intensity of symptoms related to unsuccessful quitting attempts and included craving, irritability, apprehension/anxiety, difficulties concentrating, restlessness, depression / depressed mood, and insomnia. The factor loadings of all 17 symptoms resulted in three factors with factor 1, psychological being the most important. High scores on this factor relates to unsuccessful quitting attempts. Using Nicotine Replacement Therapy (NRT) for 5 weeks or longer, reduced symptoms included in factor 1. The other two factors were factor 2 physiological and factor 3 neurological. Conclusions: Symptoms that are psychological and/or neurological in nature are interrelated and appear to be the most significant obstacles for successful quitting attempts in a population-based setting. These symptoms may be successfully treated with NRT.

Tanja Tomson; Mats Toftgård; Hans Gilljam; Asgeir R. Helgason

205

Cranial irradiation in adults diagnosed with acute myelogenous leukemia presenting with hyperleukocytosis and neurologic dysfunction.  

PubMed

This study describes our institution's experience using whole brain radiation therapy (WBRT) to treat patients with acute myelogenous leukemia (AML) presenting with hyperleukocytosis. After approval by the institutional review board, we identified patients with AML and hyperleukocytosis using hospital records. The primary endpoints in the study included alleviation of neurological symptoms (or prevention if prophylactic RT was used), overall survival, development of intracranial hemorrhage (ICH) and ? grade 3 toxicities using the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0). Eighteen patients received WBRT for the treatment of AML hyperleukocytosis. Thirteen patients received treatment in order to control neurological symptoms. Clinical assessment showed that 12 of 13 patients (92%) achieved resolution of neurological symptoms either concurrent with RT or immediately after RT. The mean overall survival for all of the patients who received WBRT was 14.2 months (95% confidence interval, 5.4-23.0). No patient who received RT experienced ? grade 3 toxicity. Two (6%) patients developed ICH following therapy. Our institution's experience demonstrates that WBRT may be utilized as part of multimodality therapy in order to alleviate or prevent neurological symptoms in patients with AML presenting with leukostasis. PMID:23734620

Ferro, Adam; Jabbour, Salma K; Taunk, Neil K; Aisner, Joseph; Cohler, Alan; Somalya, Sanaa; Goyal, Sharad

2014-01-01

206

Pathophysiology of Parkinson's Disease: From Clinical Neurology to Basic Neuroscience and Back  

E-print Network

Pathophysiology of Parkinson's Disease: From Clinical Neurology to Basic Neuroscience and Back-Albrechts-Universita¨t, Kiel, Germany Abstract: Parkinson's disease (PD) is characterized by motor and nonmotor (cognitive symptoms of Parkinson's disease. © 2002 Movement Disorder Society Key words: Parkinsonism; MPTP; human

Friedman, Nir

207

Measles virus and subacute neurological disease: an unusual presentation of measles inclusion body encephalitis  

Microsoft Academic Search

A 20-year-old girl developed a subacute neurological illness characterized by seizures and epilepsia partialis continua, which resulted in her death within 10 weeks of her first symptom. Although she had a history of unusual reactions to viral infections, there was no evidence of any underlying disorder resulting in immunosuppression. Histopathology demonstrated the presence of dense infection with measles virus. The

D W Chadwick; S Martin; P H Buxton; A H Tomlinson

1982-01-01

208

[Neurological manifestations in riverine populations from areas exposed to mercury in the Brazilian Amazon].  

PubMed

This study evaluated current levels of mercury exposure and sensory symptoms in adults from three riverine communities in Pará State, Brazil, two of which located in the Tapajós River basin and one in the Tocantins basin. Participants in this study included 78 residents in Barreiras (Tapajós), 30 in São Luiz do Tapajós (Tapajós), and 49 in Furo do Maracujá (Tocantins). Total hair mercury concentrations were quantified by atomic absorption spectrophotometry, and neurological evaluation was conducted by routine examination. Mercury concentrations in the Tapajós communities were higher than those in the Tocantins (p < 0.01). Evaluation of neurological changes showed no significant difference between the communities in exposed areas and control areas for the changes observed by conventional neurological examination, except for gait deviation (p < 0.05). The study concludes that despite the mercury exposure levels, there was a low frequency of sensory alterations according to conventional neurological testing. PMID:24233045

Khoury, Eliana Dirce Torres; Souza, Givago da Silva; Silveira, Luiz Carlos de Lima; Costa, Carlos Araújo da; Araújo, Amélia A de; Pinheiro, Maria da Conceição Nascimento

2013-11-01

209

[Standardized neurologic study in senile dementia of Alzheimer's type].  

PubMed

Seventy five patients affected by senile dementia of the Alzheimer type (mean age 82) have been submitted to a standardized neurological examination of 88 items. Gait abnormalities were present in 57% of the cases. Extrapyramidal symptoms (akinesia or rigidity or tremor) were noticed in 64% of the cases but they were rarely associated with a typical parkinsonian syndrome. Myoclonus was observed in only 4 patients. The gait abnormalities were significantly associated with the presence of rigidity and grasp reflex but not with other primitive reflexes. The only symptoms to be correlated with dementia severity as assessed by the Mini Mental State were rigidity and optokinetic nystagmus abolition. Tremor and amyotrophy of the hands appeared to be negatively correlated to dementia severity. PMID:2680461

Davous, P; Lamour, Y; Roudier, M

1989-01-01

210

Liver cirrhosis in patients newly diagnosed with neurological phenotype of Wilson's disease  

PubMed Central

Summary Wilson’s disease (WD) can manifest itself in different clinical forms, the neurological and hepatic ones being the most common. It is suggested that neurological signs and psychiatric symptoms develop secondary to liver involvement. The aim of this study was to characterize the liver disease in patients newly diagnosed with the neurological form of WD. Treatment-naive patients diagnosed with WD were classified into three phenotypic groups: hepatic, neurological and pre-symptomatic. Liver involvement was ascertained through surrogate markers: abdominal ultrasound and laboratory parameters. In addition, study participants were screened for esophageal varices. Of 53 consecutively diagnosed WD patients, 23 individuals (43.4%) had a predominantly neurological presentation. In this group, cirrhosis was diagnosed in 11 (47.8%) subjects. Esophageal varices were present in all of them. In every patient with neurological WD, there was at least one sign of hepatic disease on ultrasound examination, indicating universal presence of liver involvement. The prevalence of surrogate signs of cirrhosis was similar in patients with the neurological and in those with the hepatic phenotype. PMID:25014046

Przybylkowski, Adam; Gromadzka, Grazyna; Chabik, Grzegorz; Wierzchowska, Agata; Litwin, Tomasz; Czlonkowska, Anna

2014-01-01

211

Neurological problems of jazz legends.  

PubMed

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 was a benign cystic glioma. Thelonious Monk had erratic moods, reflected in his pianism, and was ultimately mute and withdrawn, succumbing to cerebrovascular events. Charlie Parker dealt with mood lability and drug dependence, the latter emanating from analgesics following an accident, and ultimately lived as hard as he played his famous bebop saxophone lines and arpeggios. Charles Mingus hummed his last compositions into a tape recorder as he died with motor neuron disease. Bud Powell had severe posttraumatic headaches after being struck by a police stick defending Thelonious Monk during a Harlem club raid. PMID:19666887

Pearl, Phillip L

2009-08-01

212

Neurologic Complications of Plasma Cell Dyscrasias  

Microsoft Academic Search

Plasma cell dyscrasias are an uncommon but important cause of neurologic morbidity. The pathophysiology of these disorders\\u000a is quite varied and ranges from direct effects of cancer on neurologic tissues to remote effects caused by monoclonal antibodies.\\u000a This chapter discusses these hematologic disorders and their neurologic consequences including monoclonal gammopathy of undetermined\\u000a significance, multiple myeloma and its rare variants, osteosclerotic

John J. Kelly

213

Neurologic manifestations of the antiphospholipid syndrome  

Microsoft Academic Search

Antiphospholipid syndrome is an important cause of neurologic morbidity. The clinical criteria for antiphospholipid syndrome\\u000a include only cerebrovascular arterial and venous thrombosis, but many other neurologic manifestations have been associated\\u000a with antiphospholipid antibodies (aPL). This review discusses the role of aPL in cerebrovascular manifestations and in some\\u000a of the other neurologic manifestations commonly associated with these antibodies, as well as

Jose F. Roldan; Robin L. Brey

2007-01-01

214

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. PMID:20469138

Siemens, Peter

1974-01-01

215

Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity  

PubMed Central

Celiac Disease (CD) is an immune-mediated disease dependent on gluten (a protein present in wheat, rye or barley) that occurs in about 1% of the population and is generally characterized by gastrointestinal complaints. More recently the understanding and knowledge of gluten sensitivity (GS), has emerged as an illness distinct from celiac disease with an estimated prevalence 6 times that of CD. Gluten sensitive people do not have villous atrophy or antibodies that are present in celiac disease, but rather they can test positive for antibodies to gliadin. Both CD and GS may present with a variety of neurologic and psychiatric co-morbidities, however, extraintestinal symptoms may be the prime presentation in those with GS. However, gluten sensitivity remains undertreated and underrecognized as a contributing factor to psychiatric and neurologic manifestiations. This review focuses on neurologic and psychiatric manifestations implicated with gluten sensitivity, reviews the emergence of gluten sensitivity distinct from celiac disease, and summarizes the potential mechanisms related to this immune reaction. PMID:21877216

Jackson, Jessica R.; Eaton, William W.; Cascella, Nicola G.; Fasano, Alessio

2013-01-01

216

Neurologic Diseases - Multiple Languages: MedlinePlus  

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 ...

217

Neurological abnormalities in young adults born preterm  

PubMed Central

Objective Individuals born before 33?weeks' gestation (very preterm, VPT) have an increased likelihood of neurological abnormality, impaired cognitive function, and reduced academic performance in childhood. It is currently not known whether neurological signs detected in VPT children persist into adulthood or become attenuated by maturation of the CNS. Method We assessed 153 VPT individuals and 71 term?born controls at 17–18?years old, using a comprehensive neurological examination. This examination divides neurological signs into primary and integrative domains, the former representing the localising signs of classical neurology, and the latter representing signs requiring integration between different neural networks or systems. Integrative signs are sub?divided into three groups: sensory integration, motor confusion, and sequencing. The VPT individuals have been followed up since birth, and neonatal information is available on them, along with the results of neurological assessment at 4 and 8?years of age and neuropsychological assessment at 18?years of age. Results The total neurology score and primary and integrative scores were significantly increased in VPT young adults compared to term?born controls. Within the integrative domain, sensory integration and motor confusion scores were significantly increased in the VPT group, but sequencing was not significantly different between the VPT and term groups. Integrative neurological abnormalities at 18 were strongly associated with reduced IQ but primary abnormalities were not. Conclusions Neurological signs are increased in VPT adults compared to term?born controls, and are strongly associated with reduced neuropsychological function. PMID:16543529

Allin, M; Rooney, M; Griffiths, T; Cuddy, M; Wyatt, J; Rifkin, L; Murray, R

2006-01-01

218

Challenges in neurological practice in developing countries.  

PubMed

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

2012-01-01

219

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. PMID:23861594

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

2013-01-01

220

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

2010-01-01

221

SCHOOL OF MEDICINE DEPARTMENT OF NEUROLOGICAL SURGERY  

E-print Network

SCHOOL OF MEDICINE DEPARTMENT OF NEUROLOGICAL SURGERY The University of California, Davis, Department of Neurological Surgery is seeking applicants for three open positions in our faculty://recruit.ucdavis.edu/apply/jpf00122 Peripheral Nerve - Neurosurgery: Requires expertise in spinal surgery and Fellowship training

Leistikow, Bruce N.

222

Evolution of Neurologic Features in Williams Syndrome  

Microsoft Academic Search

As a part of a large multidisciplinary clinical and research follow-up study, 47 Williams syndrome pa- tients underwent detailed neurologic testing. Because previous studies have documented the absence of ma- jor neurologic signs in Williams syndrome, the neuro- logic testing focused on soft signs. Previous findings of impairment of both gross and fine motor coordination were confirmed, and the presence

Chiara Gagliardi; Sara Martelli; Michael D. Burt; Renato Borgatti

2007-01-01

223

Neurologic decompression sickness following cabin pressure fluctuations at high altitude.  

PubMed

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

2010-04-01

224

Unusual cause of acute neurologic deficit in childhood: primary central nervous system vasculitis presenting with basilar arterial occlusion  

Microsoft Academic Search

Introduction  Primary central nervous system (CNS) vasculitis of childhood is a rare disorder. The most common signs and symptoms are acute\\u000a severe headache and focal neurologic deficit. It should be suspected in children who have an acquired neurologic deficit that\\u000a remains unexplained after an initial basic evaluation. Diagnosis usually depends on brain magnetic resonance imaging and conventional\\u000a angiography of cerebral vasculature.

Eren Kale Çekinmez; Nurcan Cengiz; ?lknur Erol; Osman K?z?lk?l?ç; Yasemin Uslu

2009-01-01

225

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. PMID:24167649

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

2013-01-01

226

Toward a neurology of loneliness.  

PubMed

Social isolation has been recognized as a major risk factor for morbidity and mortality in humans for more than a quarter century. The brain is the key organ of social connections and processes, however, and the same objective social relationship can be experienced as caring and protective or as exploitive and isolating. We review evidence that the perception of social isolation (i.e., loneliness) impacts brain and behavior and is a risk factor for broad-based morbidity and mortality. However, the causal role of loneliness on neural mechanisms and mortality is difficult to test conclusively in humans. Mechanistic animal studies provide a lens through which to evaluate the neurological effects of a member of a social species living chronically on the social perimeter. Experimental studies show that social isolation produces significant changes in brain structures and processes in adult social animals. These effects are not uniform across the brain or across species but instead are most evident in brain regions that reflect differences in the functional demands of solitary versus social living for a particular species. The human and animal literatures have developed independently, however, and significant gaps also exist. The current review underscores the importance of integrating human and animal research to delineate the mechanisms through which social relationships impact the brain, health, and well-being. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:25222636

Cacioppo, Stephanie; Capitanio, John P; Cacioppo, John T

2014-11-01

227

Agenesis of the corpus callosum: symptoms consistent with developmental disability in two siblings.  

PubMed

Agenesis of the corpus callosum (AgCC) is a congenital disorder that disrupts the development of neurological structures connecting the right and left hemispheres of the brain. In addition to neurological symptoms, many individuals with AgCC demonstrate marked deficits in social, communication, and adaptive skills. This paper presents two case studies of congenital AgCC in siblings with socioemotional and behavioral symptoms consistent with developmental disability, but with notably different symptom presentations and clinical needs. Conclusions from these cases suggest that unique symptom profiles of individuals with AgCC warrant careful consideration for referral to appropriate academic and habilitative services. PMID:24417213

Cavalari, Rachel N S; Donovick, Peter J

2015-02-01

228

The neurological manifestations of trauma: lessons from World War I.  

PubMed

Changes in the clinical presentation of functional disorders and the influence of social and cultural factors can be investigated through the historical case notes from mental hospitals. World War I (WWI) was a potent trigger of functional disorders with neurological or psychiatric symptoms. We analysed 100 randomly selected case files of German servicemen admitted to the Department of Psychiatry of the Charité Medical School of Berlin University during WWI and classified them according to contemporaneous and retrospective modern diagnoses. We compared the clinical presentations with accounts in the German and British medical literature of the time. Most patients obtained the contemporaneous diagnosis of 'psychopathic constitution' or hysteria reflecting the general view of German psychiatrists that not the war but an individual predisposition was the basis for the development of symptoms. The clinical picture was dominated by pseudoneurological motor or sensory symptoms as well as pseudoseizures. Some soldiers relived combat experiences in dream-like dissociative states that partly resemble modern-day post-traumatic stress disorder. Most servicemen were classified as unfit for military service but very few of them were granted compensation. Severe functional disorders of a neurological character could develop even without traumatic exposure in combat, which is of interest for the current debate on triggers of stress disorders. The high incidence of pseudoseizures accords with the psychiatric literature of the time and contrasts with accounts of war-related disorders in Britain. The tendency of German psychiatrists not to send traumatised servicemen back to active duty also distinguished between German and British practice. Our data contribute to the debate on the changing patterns of human responses to traumatic experience and their historical and social context. PMID:22065177

Linden, Stefanie C; Hess, Volker; Jones, Edgar

2012-04-01

229

Transient detector apparatus  

Microsoft Academic Search

A transient detector apparatus utilizing peak and slope detectors to determine the presence of transient signal in a logic signal. Individual slope measurements of the input signal are compared with a logic criteria to establish the occurrence of a transient. The peak voltage and pulse width of a transient are digitized in order to time tag or isolate a transient

Lapeyrolerie

1985-01-01

230

The Hyponatremic Hypertensive Syndrome in a Preterm Infant: A Case of Severe Hyponatremia with Neurological Sequels  

PubMed Central

Objective. To report the irreversible severe neurological symptoms following the hyponatremic hypertensive syndrome (HHS) in an infant after umbilical arterial catheterization. Design. Case report with review of the literature. Setting. Neonatal intensive care unit at a tertiary care children's hospital. Patient. A three-week-old preterm infant. Conclusions. In evaluating a neonate with hyponatremia and hypertension, HHS should be considered, especially in case of umbilical arterial catheterization. In case of diagnostic delay, there is a risk of severe irreversible neurological damage. PMID:21876801

van Tellingen, Vera; R. Lilien, Marc; F. M. Bruinenberg, Jos; B. de Vries, Willem

2011-01-01

231

Sleep-disordered breathing in neurologic conditions.  

PubMed

Sleep-related breathing disorder or sleep-disordered breathing (SDB) encompasses central sleep apnea (CSA), obstructive sleep apnea (OSA), and sleep-related hypoventilation or hypoxemic syndromes. SDB is common in neurologic conditions that affect the central and/or peripheral nervous systems. Patients with neurologic conditions are at risk for SDB due to a combination of factors such as muscular weakness, damage to areas of the brain that control respiration, use of sedating medications, and weight gain from limited physical activity. This article discusses recognition and treatment of SDB as important aspects of treating patients with neurologic disease. PMID:25156770

Deak, Maryann C; Kirsch, Douglas B

2014-09-01

232

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. PMID:21808478

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

2011-01-01

233

Conference report: 9th international summer school of neurology.  

PubMed

The International Summer School of Neurology provides a forum for a selected group of medical students and postgraduates specializing in neurology to interact with an internationally recognized faculty in the neurological sciences. Credit for having the vision to create the School goes to its founders and program coordinators, Dafin F. Mure?anu (Professor of Neurology and Chairman of the Department of Clinical Neurosciences, University of Medicine and Pharmacy "IuIiu Ha?ieganu", Cluj-Napoca, Romania) and Natan M. Bornstein (Professor of Neurology, Tel-Aviv University Sackler School of Medicine, Israel). This year's edition of the School, its ninth, continued the tradition of integrating classes covering the latest developments in the neurological sciences with a tranquil setting on the shores of the Black Sea. Long-term support from academic organizations such as The Society for the Study of Neuroprotection and Neuroplasticity, Tel Aviv University, Uppsala Universitet, the Romanian Society of Neurology and World Federation for NeuroRehabilitation (among others) has been an important factor in sustaining the School over the years. This year's program began on Sunday afternoon (July 6) with a series of basic research talks on advances in brain protection and recovery, including nanowired drug delivery for the treatment of traumatic and concussive brain injuries, the peripheral nerve microenvironment in chronic pain, and practical pharmacology in neurorehabilitation. It is of paramount important that physicians have a grasp of the basic science underlying clinical medicine. The first full day of the course, Monday July 7, was divided into morning and afternoon sessions covering the topics of neurorehabilitation and peripheral neuropathies, repectively. The high prevalence of back pain and its bearing on an individual's quality of life, together with associated health care costs is a matter of common knowledge. The two principal factors in treatment of lower back pain are: to operate or not and how to alleviate pain. An interdisciplinary approach is recommended, which encompasses both morphological and functional findings. A clear diagnosis is of paramount importance in protecting the patient from unnecessary surgery and the fear of failed back surgery. Symptoms of peripheral neuropathy are common neurologic complaints. Peripheral neuropathy has an overall prevalence of 2 - 3% in the general population, which can reach 8% or more in those over 55 years of age. Understanding the cause(s) of peripheral neuropathy is important, as it may inform on treatment to prevent progression to disability and poor quality of life. Diabetic neuropathy is perhaps the most common peripheral neuropathy. A key clinical issue in the management of diabetic neuropathy is pain. Treatment options available for diabetic neuropathy should target both metabolic and vascular disturbances along with the clinical manifestations such as neuropathic pain and dysautonomic manifestations, and the role of advanced glycation end-products (AGEs), whose accumulation may be exacerbated by hyperglycemia. Non-steroidal anti-inflammatory drugs remain in the frontline of analgesic drugs prescribed for nociceptive pain, which is surprising given that clinical and experimental evidence shows that neuropathic pain syndromes in general respond poorly to the former or opioid analgesics. Thiamine (vitamin B1) is efficacious as an adjuvant medicine to treat neuropathic disorders, with its lipid-soluble form (benfotiamine) having much higher bioavailability compared to thiamine. At the preclinical level benfotiamine demonstrated lower toxicity in comparison to water-soluble vitamin B1. In clinical studies, benfotiamine restored nerve function in diabetic neuropathy, improved nerve conduction velocity, prevented diabetic retinal damage and halted the development of diabetic nephropathy without affecting blood glucose levels. It is believed that benfotiamine prevents progression of diabetic complications by increasing tissue levels of thiamine diphosphate. The resul

Skaper, Stephen D

2014-01-01

234

MONTREAL NEUROLOGICAL INSTITUTE AND HOSPITAL RESEARCH ETHICS BOARD (REB) REQUIREMENTS  

E-print Network

. Categorize subject as: psychiatric ; neurological ; juvenile ; mentally challenged ; competent ; incompetentspecsubj 2002-06-18 MONTREAL NEUROLOGICAL INSTITUTE AND HOSPITAL RESEARCH ETHICS BOARD (REB medically as indicated: 1 Definition: Patients diagnosed with psychiatric, neurologic or other medical

Shoubridge, Eric

235

Thalamocortical dysrhythmia: A neurological and neuropsychiatric syndrome characterized  

E-print Network

with major depression. Patients were carefully selected by using standard neurologi- cal psychiatric-resistant neurological or neuropsychiatric disorders. Control subjects ranged between 24 and 45 years old; patientsThalamocortical dysrhythmia: A neurological and neuropsychiatric syndrome characterized

236

21 CFR 882.1480 - Neurological endoscope.  

Code of Federal Regulations, 2010 CFR

...Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES...light source used to view the inside of the ventricles of the brain. (b) Classification. Class II (performance...

2010-04-01

237

Medical Marijuana in Certain Neurological Disorders  

MedlinePLUS

... of Systematic Review for PATIENTS and their FAMILIES MEDICAL MARIJUANA IN CERTAIN NEUROLOGICAL DISORDERS ©2014 American Academy of ... systematic review, visit AAN.com/guidelines. What is medical marijuana? Marijuana is an herb that grows naturally in ...

238

Clinical neurologic indices of toxicity in animals.  

PubMed Central

The fundamental structures and functions of the nervous systems of animals and humans are conserved in many ways across species. These similarities provide a basis for developing common neurologic examinations for a number of species of animals and also provide a basis for developing risk assessments across species for neurologic end points. The neurologic examination requires no expensive equipment and can be conducted in the field or wherever impaired animals are identified. The proper conduct of neurologic examinations in animals assumes that the examiner has a fundamental understanding of the normal structure and function of the nervous system as well as knowledge about the spontaneous disease background of the species being studied. PMID:9182039

O'Donoghue, J L

1996-01-01

239

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...

2013-01-01

240

14 CFR 67.109 - Neurologic.  

Code of Federal Regulations, 2011 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...

2011-01-01

241

14 CFR 67.109 - Neurologic.  

Code of Federal Regulations, 2012 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...

2012-01-01

242

14 CFR 67.309 - Neurologic.  

Code of Federal Regulations, 2012 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...

2012-01-01

243

14 CFR 67.309 - Neurologic.  

Code of Federal Regulations, 2010 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...

2010-01-01

244

14 CFR 67.209 - Neurologic.  

Code of Federal Regulations, 2012 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...

2012-01-01

245

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...

2013-01-01

246

14 CFR 67.309 - Neurologic.  

Code of Federal Regulations, 2011 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...

2011-01-01

247

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...

2013-01-01

248

14 CFR 67.209 - Neurologic.  

Code of Federal Regulations, 2011 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...

2011-01-01

249

Neurologic Education in Emergency Medicine Training Programs  

Microsoft Academic Search

Abstract Objectives: Neurologic,complaints,are a frequent,cause of emergency,department,visits. The morbidity,and,mortality of neurologic,complaints,such,as headache,and,stroke can be extensive. Thus, emergency medicine residency pro- grams,should,ensure,adequate,training in such,neurologic emergencies.,The,authors,sought,to determine,what methods,are being used,to educate,residents on neurologic emergencies.,Methods: A two-page,survey,was,mailed,to directors,of all 126 accredited,emergency,medicine,resi- dency,programs,in the United States. The number,and,types of lectures to residents, required rotations, and electives offered were assessed. Means, standard deviations (SDs), and,proportions,are

Brian A. Stettler; Edward C. Jauch; Brett Kissela; Christopher J. Lindsell

2005-01-01

250

[Minor neurological signs and pediatric psychiatric vulnerability].  

PubMed

In the present study we investigate the quantity of Neurologic Soft Signs in connection with the type of Psychiatric Disorders in a sample of thirty boys and thirty girls of age between four and fifteen years. The results shaw that the Neurologic Soft Signs mentioned are present in a significant quantity with regard to the gravity of the psychiatric disorders. Likewise, their evaluation can be very useful to determine the child's neuro-maturational condition and psychiatry vulnerability. PMID:1699394

Díaz Atienza, J; Blánquez Rodríguez, M P

1990-01-01

251

Hors d'oeuvres for neurology.  

PubMed

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

1999-01-01

252

Neurologic Complications of Pediatric Systemic Cancer  

Microsoft Academic Search

Each year in the United States, an average of one to two children per 10,000 develop cancer. Survival rates for children with\\u000a cancer have continued to increase quite dramatically over the last several decades. Many cancer patients have symptomatic\\u000a neurologic complications during the course of their illness, and neurologic problems are a common reason for hospitalization\\u000a of both adult and

Nicole J. Ullrich; Scott L. Pomeroy

253

EducationatURMCProgramFeatures Program: Neurology Residency Program  

E-print Network

centers of excellence in geriatric medicine, women's health, obstetrics, bariatric surgery, and joint replacement surgery. The URMC Department of Neurology began providing full consultative neurological services

Goldman, Steven A.

254

Neurological disorders in Gulf War veterans  

PubMed Central

We present a review of neurological function in Gulf War veterans (GWV). Twenty-two studies were reviewed, including large hospitalization and registry studies, large population-based epidemiological studies, investigations of a single military unit, small uncontrolled studies of ill veterans and small controlled studies of veterans. In nearly all studies, neurological function was normal in most GWVs, except for a small proportion who were diagnosed with compression neuropathies (carpal tunnel syndrome or ulnar neuropathy). In the great majority of controlled studies, there were no differences in the rates of neurological abnormalities in GWVs and controls. In a national US study, the incidence of amyotrophic lateral sclerosis (ALS) seems to be significantly increased in GWVs, compared to the rate in controls. However, it is possible that military service, in general, might be associated with an increased risk of ALS, rather than Gulf War service in particular. Taken together, the conclusion is that if a neurological examination in a GWV is within normal limits, then extensive neurological testing is unlikely to diagnose occult neurological disorders. PMID:16687265

Rose, Michael R; Brix, Kelley Ann

2006-01-01

255

Chapter 50: history of tropical neurology.  

PubMed

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

2010-01-01

256

Anesthetic management for parturients with neurological disorders  

PubMed Central

Anesthesia care for the pregnant and the parturient presenting with a neurological disease requires (1) expertise with neuroanesthesia and obstetric anesthesia care, (2) accurate physical examination of the neurological system preoperatively, (3) safe choice and conductance of the anesthesia technique (mostly regional anesthesia), (4) avoidance of unfavorable drug effects for the fetus and the nervous system of the mother, and (5) intraoperative neuromonitoring together with the control of the fetal heart rate. The most important message is that in the ideal case, any woman with a known, preexisting neurological disorder should discuss her plans to become pregnant with her physician before she becomes pregnant. Neurological diseases in pregnancy can be classified into three categories: (a) Pre-existent chronic neurological diseases such as epilepsy and multiple sclerosis (MS). (b) Diseases with onset predominantly in pregnancy such as some brain tumors or cerebrovascular events. (c) Pregnancy-induced conditions such as eclampsia and Hemolysis elevated liver enzymes and low platelets syndrome. This article addresses specific issues surrounding neurologic disease in pregnant women including MS parturient, spinal cord injury, parturient with increased intracranial pressure and shunts, parturient with brain tumors, Guillain-Barré syndrome and epilepsy.

El-Refai, Nesrine Abd El-Rahman

2013-01-01

257

Hodgkin’s lymphoma presenting as a complex paraneoplastic neurological syndrome: a case report  

PubMed Central

Introduction Paraneoplastic neuropathies are rare. They are often difficult to diagnose, especially when they precede the diagnosis of cancer. Hodgkin's lymphoma is associated with multiple paraneoplastic neurological syndromes, of which demyelinating polyneuropathies are very unusual. Association with chronic inflammatory demyelinating polyneuropathy is even more uncommon. Case presentation We report the rare case of a 74-year-old Caucasian man who presented with a complex neurological syndrome and was eventually diagnosed with the nodular sclerosing variant of Hodgkin's lymphoma. With timely diagnosis and early institution of treatment of the underlying malignancy, our patient began to show gradual improvement of his symptoms. Conclusion Hodgkin's lymphoma is associated with several paraneoplastic neurological syndromes. Sometimes it can be the only presenting feature of an underlying Hodgkin's lymphoma, posing a diagnostic challenge. Prompt oncologic treatment and immunotherapy can be beneficial if instituted early in the course of the disease. PMID:23566362

2013-01-01

258

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. PMID:22949910

Rison, Richard Alan; Rosenheck, Rachel Ellen

2012-01-01

259

Neurotology symptoms at referral to vestibular evaluation  

PubMed Central

Background Dizziness-vertigo is common in adults, but clinical providers may rarely diagnose vestibular impairment and referral could be delayed. To assess neurotology symptoms (including triggers) reported by patients with peripheral vestibular disease, during the year just before their referral to vestibular evaluation. Methods 282 patients with peripheral vestibular disease and 282 control subjects accepted to participate. They had no middle ear, retinal, neurological, psychiatric, autoimmune or autonomic disorders. They reported their symptoms by a standardized questionnaire along with their anxiety/depression symptoms. Results Patients were referred after months or years from the onset of their symptoms, 24% of them reported frequent falls with a long clinical evolution; 10% of them reported no vertigo but instability related to specific triggers; 86% patients and 12% control subjects reported instability when moving the head rapidly and 79% patients and 6% control subjects reported instability when changing posture. Seven out of the 9 symptoms explored by the questionnaire allowed the correct classification of circa 95% of the participants (Discriminant function analysis, p?symptoms showed a mild correlation with the total score of symptoms (multiple R2 =0.18, p?symptoms may have a mild influence on the report of symptoms of vestibular disease in both, patients and control subjects. PMID:24279682

2013-01-01

260

A systematic review of the influence of occupational organophosphate pesticides exposure on neurological impairment  

PubMed Central

Objective The aim of this study was to conduct a systematic review of the published literature and to estimate whether or not there is a causal relationship between occupational exposure to organophosphate pesticides (OPs) and either neurological impairment or depressive symptoms. Data sources EMBASE, MEDLINE, Global Health and PsycINFO (1980 to April 2014). Setting Observational studies (cross-sectional, cohort and case–control studies) with exposed and unexposed groups. Participants People who occupationally use OPs for more than 1?month and their family. Primary outcome Results of neurological core test batteries or depressive symptoms such as headaches, anxiety and dizziness. Study appraisal and synthesis methods After an extensive search of various literature databases, one author screened titles and abstracts, searched the relevant publications manually and conducted data extraction. All extracted data from the selected articles were synthesised for analysis. Quality appraisal was conducted using the Newcastle Ottawa Scale. Results Of the 1024 articles retrieved by database search, 24 studies that met the inclusion and exclusion criteria were selected for analysis. Of the selected studies, 17 were cross-sectional and the remaining 7 were cohort and nested case–control studies. The geographical areas included in the studies were the USA (10 studies), the UK (4 studies), Africa (4 studies), Asia (3 studies), Europe (2 studies) and South America (1 study). Each of the included studies used different exposure and outcome assessments such as neurological scores and depressive symptoms, making it difficult to compare the results exactly. Most studies showed that exposed groups had poorer results than unexposed groups; however, owing to the inconsistent neurological test batteries, there was not enough pooling evidence to conduct a meta-analysis. Conclusions The findings of this literature review indicate that it is necessary to standardise the neurological or neuropsychological test battery and methods of measuring exposure to OPs. PMID:24961715

Takahashi, Noriko; Hashizume, Masahiro

2014-01-01

261

Neurological damage in MSUD: the role of oxidative stress.  

PubMed

Maple syrup urine disease (MSUD) is a metabolic disease caused by a deficiency in the branched-chain ?-keto acid dehydrogenase complex, leading to the accumulation of branched-chain keto acids and their corresponding branched-chain amino acids (BCAA) in patients. Treatment involves protein-restricted diet and the supplementation with a specific formula containing essential amino acids (except BCAA) and micronutrients, in order to avoid the appearance of neurological symptoms. Although the accumulation of toxic metabolites is associated to appearance of symptoms, the mechanisms underlying the brain damage in MSUD remain unclear, and new evidence has emerged indicating that oxidative stress contributes to this damage. In this context, this review addresses some of the recent findings obtained from cells lines, animal studies, and from patients indicating that oxidative stress is an important determinant of the pathophysiology of MSUD. Recent works have shown that the metabolites accumulated in the disease induce morphological alterations in C6 glioma cells through nitrogen reactive species generation. In addition, several works demonstrated that the levels of important antioxidants decrease in animal models and also in MSUD patients (what have been attributed to protein-restricted diets). Also, markers of lipid, protein, and DNA oxidative damage have been reported in MSUD, probably secondary to the high production of free radicals. Considering these findings, it is well-established that oxidative stress contributes to brain damage in MSUD, and this review offers new perspectives for the prevention of the neurological damage in MSUD, which may include the use of appropriate antioxidants as a novel adjuvant therapy for patients. PMID:24220995

Sitta, Angela; Ribas, Graziela S; Mescka, Caroline P; Barschak, Alethéa G; Wajner, Moacir; Vargas, Carmen R

2014-03-01

262

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

PubMed

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

2010-01-01

263

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. PMID:21397102

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

2010-01-01

264

Treatment-Emergent CNS Symptoms Following Triptan Therapy are Part of The Attack  

Microsoft Academic Search

If treatment-emergent central nervous system (CNS) symptoms following triptan therapy represent direct pharmacological effects of the drug, they should occur independent of response to active drug. However, if they represent unmasking of neurological symptoms of the migraine attack after pain is relieved, they should be more common in responders both to active drug and to placebo. To explore this issue,

PJ Goadsby; DW Dodick; M Almas; H-C Diener; P Tfelt-Hansen; RB Lipton; B Parsons

2007-01-01

265

Symptom masquerade: understanding the meaning of symptoms  

Microsoft Academic Search

Goals Somatization refers to patients who transform distress and global suffering into pain and symptom expression. We have observed the opposite phenomenon in some outpatients seen for palliative care: patients who transform pain nociception into global suffering or other symptoms. The goal of this study is to describe the meaning of these patients’ experiences that are not expressed as pain

Marlene Z. Cohen; Lori Williams; Patti Knight; Julie Snider; Kavin Hanzik; Michael J. Fisch

2004-01-01

266

Early neurologic complications of pulmonary arteriovenous malformation in a newborn: an indication for surgical resection  

Microsoft Academic Search

A case report of a neonate with pulmonary arteriovenous malformation is described. The anomaly was prenatally diagnosed, and family history was positive for Rendu-Osler-Weber syndrome.Because neurologic symptoms developed during the second week of life, surgical resection was deemed the best curative option to avoid further embolic events and reoccurrence of the lesion. Previous reports detailing coil embolization therapy for pulmonary

Alessandro Borsellino; Claudio Giorlandino; Saverio Malena; Alessandro Trucchi; Roberta Cilio; Piero Bagolan

2006-01-01

267

Case report Open Access Neurological manifestations in speech after snake bite: a rare case  

E-print Network

The patient was admitted after reporting a snake bite from which he later developed neurological signs and symptoms among which a flaccid dysarthria. The patient underwent speech therapy and showed significant improvement over a short period of time. The favorable outcome of the present study highlights the role of speech therapy in such a case, where it often remains un-emphasized. Pan African Medical Journal, 2010 4:13 This article is available online at:

Dharam Vir; Dipti Gupta; Munish Modi; Naresh P

268

Factors affecting outcome of depressive symptoms in alcoholics.  

PubMed

Eighty-eight patients consecutively admitted to an alcohol treatment program were studied to determine the amount of depressive symptoms on entry to the program and after 4 weeks of treatment. The degree of symptoms was in turn related to various aspects of their drinking behavior. Twenty-two of the patients were classified as having moderate to marked depressive symptoms, 40 had mild symptoms, and 26 had no significant symptoms at the time of entry into the program. Factors in drinking behavior that best characterized those with moderate to marked symptoms were addiction, sleep disturbance, hangover incapacitation, loss of control, neurological signs, and organicity/toxicity. At the end of treatment, only four patients could actually be diagnosed as depressed, while 12 had mild residual symptoms and 72 no longer had significant symptoms. The one factor that clearly distinguished those patients with residual depressive symptoms was the use of drinking for social facilitation. For such individuals, bars and drinking were the focus of social life. The favorable course of depressive symptoms in alcoholics soon after they stop drinking suggests that they are more likely the consequence of drinking than the cause of it. The fact that patients who drink primarily to facilitate social aspects of their lives were the most likely to have residual symptoms suggests that treatment of such individuals should involve development of alternative mechanisms of social interaction. PMID:6346922

Nakamura, M M; Overall, J E; Hollister, L E; Radcliffe, E

1983-01-01

269

Spinal Epidural Abscess: Common Symptoms of an Emergency Condition  

PubMed Central

Summary Spinal epidural abscess (SEA) is a severe pyogenic infection of the epidural space that leads to devastating neurological deficits and may be fatal. SEA is usually located in the thoracic and lumbar parts of the vertebral column and injures the spine by direct compression or local ischemia. Spinal injury may be prevented if surgical and medical interventions are implemented early. The diagnosis is difficult, because clinical symptoms are not specific and can mimic many benign conditions. The classical triad of symptoms includes back pain, fever and neurological deterioration. The gold standard in the diagnostic evaluation is magnetic resonance imaging with gadolinium enhancement, which determines the location and extent of the abscess. Increased awareness of the disease is essential for rapid recognition and immediate implementation of treatment. Here we describe the case of a 26-year-old woman with SEA with fever, back pain in the thoracic region and delayed symptoms of a transverse spinal cord injury. PMID:24007734

Rosc-Bereza, K.; Arkuszewski, M.; Ciach-Wysocka, E.; Boczarska-Jedynak, M.

2013-01-01

270

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

PubMed

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

2013-07-01

271

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. PMID:22997467

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

2012-01-01

272

Abstract --Cerebral palsy is a non-progressive neurological disorder caused by disturbances to the developing brain.  

E-print Network

Abstract -- Cerebral palsy is a non-progressive neurological disorder caused by disturbances forms of therapy for children with cerebral palsy are effective in minimizing symptoms, many children Cerebral palsy describes a group of permanent physical disorders caused by disturbances to the fetal

273

Prediction of Neurologic Deterioration in Patients with Lacunar Infarction in the Territory of the Lenticulostriate Artery Using Perfusion CT  

Microsoft Academic Search

BACKGROUND AND PURPOSE: A significant proportion of patients with lacunar infarctions experience neurologic deterioration after onset. However, no clinical examination has been established for prediction of the progress of symptoms. To determine the hemodynamic predictors of such progression, we performed perfusion CT to quantitatively assess cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) of patients

Mikito Yamada; Shinichi Yoshimura; Yasuhiko Kaku; Toru Iwama; Hirotaka Watarai; Takashi Andoh; Noboru Sakai

2004-01-01

274

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

2004-01-01

275

Preimplantation genetic diagnosis for inherited neurological disorders.  

PubMed

Preimplantation genetic diagnosis (PGD) is an option for couples at risk of having offspring with an inherited debilitating or fatal neurological disorder who wish to conceive a healthy child. PGD has been carried out for conditions with various modes of inheritance, including spinal muscular atrophy, Huntington disease, fragile X syndrome, and chromosomal or mitochondrial disorders, and for susceptibility genes for cancers with nervous system involvement. Most couples at risk of transmitting a genetic mutation would opt for PGD over prenatal testing and possible termination of a pregnancy. The aim of this Perspectives article is to assist neurologists in counselling and treating patients who wish to explore the option of PGD to enable conception of an unaffected child. PGD can be accomplished for most disorders in which the genetic basis is known, and we argue that it is time for clinicians and neurological societies to consider the evidence and to formulate guidelines for the responsible integration of PGD into modern preventative neurology. PMID:24866878

Tur-Kaspa, Ilan; Jeelani, Roohi; Doraiswamy, P Murali

2014-07-01

276

The History of Reimbursements in Neurology  

PubMed Central

The Patient Protection and Affordable Care Act (PPACA) addresses consumer protection, employer-provided insurance coverage, as well as the government’s role in providing health care access to the most vulnerable populations. Within the practice of neurology, the PPACA has the challenging goal of reconciling the needs of the growing elderly population with the financial barriers to costly yet available health care services. To bridge that gap, all health care professionals working in the field of neurology must reflect on the effect previous Medicare reimbursement policies have had on the current practice of neurology, and utilize lessons learned in recent years. The test of time will tell whether the PPACA will achieve the goal of decreasing in health care spending while ensuring quality universal healthcare services. PMID:24223566

Lakhan, Shaheen E.; Ebied, Amr M.; Tepper, Deborah; Nguyen, Truc

2013-01-01

277

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. PMID:19081372

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

2009-01-01

278

The history of reimbursements in neurology.  

PubMed

The Patient Protection and Affordable Care Act (PPACA) addresses consumer protection, employer-provided insurance coverage, as well as the government's role in providing health care access to the most vulnerable populations. Within the practice of neurology, the PPACA has the challenging goal of reconciling the needs of the growing elderly population with the financial barriers to costly yet available health care services. To bridge that gap, all health care professionals working in the field of neurology must reflect on the effect previous Medicare reimbursement policies have had on the current practice of neurology, and utilize lessons learned in recent years. The test of time will tell whether the PPACA will achieve the goal of decreasing in health care spending while ensuring quality universal healthcare services. PMID:24223566

Lakhan, Shaheen E; Ebied, Amr M; Tepper, Deborah; Nguyen, Truc

2013-01-01

279

Eleven years of experience with the neurologic complications in Korean patients with acute aortic dissection: a retrospective study  

PubMed Central

Background This study attempts to explore the clinical features, possible mechanisms and prognosis of the neurologic complications in patients with acute aortic dissection (AD). Methods Medical records of 278 consecutive patients with AD (165 with type A and 113 with type B dissection) over 11.5 years were retrospectively analyzed for clinical history, CT findings, neurologic complications and outcome. Neurologic complications were classified into early-onset or delayed-onset complications. Independent t-test or Chi-square test (or Fisher exact test) was used for comparing the different groups. Multivariable logistic regression analysis was performed to determine the independent association between variables. Results The mean age of the included patients (145 male and 133 female) was 59.4 years (range 19–91 years). 41 patients (14.7%) had a neurologic complication, which included 21 with early-onset complication and 23 with delayed-onset complication, including 3 with both. Advanced age and classic type of dissection were independently associated with the neurologic complication in patients with type A dissection. The most frequent manifestation was ischemic stroke (26 patients, 9.4%), followed by hypoxic encephalopathy (9, 3.2%), ischemic neuropathy (5, 1.8%), spinal cord ischemia (5, 1.8%), seizure (2, 0.7%), hoarseness (1, 0.4%) and septic encephalopathy (1, 0.4%). Overall in-hospital mortality was 10.1%, whereas the complicated group had a mortality rate of 43.9%. Renal impairment, pulse deficit, neurologic complication and nonsurgical treatment were independent variables for determining in-hospital mortality in patients with type A dissection. Conclusions The dominance of neurologic symptom in the early stage of AD may make its early diagnosis difficult. Besides chest pain and widened mediastinum in chest x-ray, variable neurologic symptoms including left hemiparesis with asymmetric pulse and hypotension may suggest underlying AD. PMID:23692963

2013-01-01

280

Vitiligo: Signs and Symptoms  

MedlinePLUS

... 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 ...

281

Shingles: Signs and Symptoms  

MedlinePLUS

... Diseases and treatments Q - T Shingles Signs, symptoms Shingles: Signs and symptoms Shingles tends to cause more ... painful before the shingles appeared. Learn more about shingles: Shingles Shingles: Who gets, causes Shingles: Diagnosis, treatment, ...

282

Heart attack symptoms (image)  

MedlinePLUS

... Some people (the elderly, people with diabetes, and women) may have little or no chest pain. Or, they may experience unusual symptoms (shortness of breath, fatigue, weakness). Women are more likely than men to have symptoms ...

283

Symptoms of Acoustic Neuroma  

MedlinePLUS

... Neuroma Legacy Society Search ANAUSA.org Symptoms of Acoustic Neuroma Early symptoms are easily overlooked, thus making diagnosis ... Resources Patient Survey Links Additional Resources © 2014 Acoustic Neuroma Association Acoustic Neuroma Association • 600 Peachtree Parkway • Suite 108 • Cumming, ...

284

Neurological Soft Signs in Schizophrenia: A Meta-analysis  

PubMed Central

Background: Neurological soft signs (NSS) are hypothesized as candidate endophenotypes for schizophrenia, but their prevalence and relations with clinical and demographic data are unknown. The authors undertook a quantification (meta-analysis) of the published literature on NSS in patients with schizophrenia and healthy controls. A systematic search was conducted for published articles reporting NSS and related data using standard measures in schizophrenia and healthy comparison groups. Method: A systematic search was conducted for published articles reporting data on the prevalence of NSS in schizophrenia using standard clinical rating scales and healthy comparison groups. Meta-analyses were performed using the Comprehensive Meta-analysis software package. Effect sizes (Cohen d) indexing the difference between schizophrenic patients and the healthy controls were calculated on the basis of reported statistics. Potential moderator variables evaluated included age of patient samples, level of education, sample sex proportions, medication doses, and negative and positive symptoms. Results: A total of 33 articles met inclusion criteria for the meta-analysis. A large and reliable group difference (Cohen d) indicated that, on average, a majority of patients (73%) perform outside the range of healthy subjects on aggregate NSS measures. Cognitive performance and positive and negative symptoms share 2%–10% of their variance with NSS. Conclusions: NSS occur in a majority of the schizophrenia patient population and are largely distinct from symptomatic and cognitive features of the illness. PMID:19377058

Chan, Raymond C. K.; Xu, Ting; Heinrichs, R. Walter; Yu, Yue; Wang, Ya

2010-01-01

285

Neurological adverse events in patients receiving anti-TNF therapy: a prospective imaging and electrophysiological study  

PubMed Central

Introduction The aim was to investigate the frequency of neurological adverse events in patients with rheumatoid arthritis (RA) and spondylarthropathies (SpA) treated with tumor necrosis factor (TNF) ? antagonists. Methods Seventy-seven patients eligible for anti-TNF? therapy were evaluated. There were 36 patients with RA, 41 with SpA [24 psoriatic arthritis (PsA) and 17 with ankylosing spondylitis (AS)]. All patients had a complete physical and neurological examination. Brain and cervical spine magnetic resonance imaging (MRI) and neurophysiological tests were performed in all patients before the initiation of anti-TNF? therapy and after a mean of 18 months or when clinical symptoms and signs indicated a neurological disease. Exclusion criteria included hypertension, diabetes mellitus, dyslipidemia, heart arrhythmias, atherothrombotic events, vitamin B12 and iron deficiency, head and neck trauma and neurological surgeries. Results Two patients did not receive anti-TNF? therapy because brain MRIs at baseline revealed lesions compatible with demyelinating diseases. Thus, 75 patients received anti-TNF? (38 infliximab, 19 adalimumab and 18 etanercept). Three patients developed neurological adverse events. A 35-year-old man with PsA after 8 months of infliximab therapy presented with paresis of the left facial nerve and brain MRI showed demyelinating lesions. Infliximab was discontinued and he was treated with pulses of corticosteroids recovering completely after two months. The second patient was a 45-year-old woman with RA who after 6 months of adalimumab therapy presented with optic neuritis. The third patient was a 50-year-old woman with AS, whom after 25 months of infliximab therapy, presented with tingling and numbness of the lower extremities and neurophysiological tests revealed peripheral neuropathy. In both patients anti-TNF were discontinued and they improved without treatment after 2 months. The rest of our patients showed no symptoms and MRIs showed no abnormalities. The estimated rate of neurological adverse events in patients treated with anti-TNF therapy is 4% (3/75). Conclusions Neurological adverse events after anti-TNF? therapy were observed in our patient. Brain MRI and neurophysiological tests are essential tools to discriminate neurological diseases. PMID:24938855

2014-01-01

286

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

2001-01-01

287

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

1995-01-01

288

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

289

The Neurology Quality of Life Measurement Initiative  

PubMed Central

Objective The National Institute of Neurological Disorders and Stroke (NINDS) commissioned the Neurology Quality of Life (Neuro-QOL) project to develop a bilingual (English/Spanish), clinically relevant and psychometrically robust HRQL assessment tool. This paper describes the development and calibration of these banks and scales. Design Classical and modern test construction methodologies were used, including input from essential stakeholder groups. Setting An online patient panel testing service and eleven academic medical centers and clinics from across the United States and Puerto Rico that treat major neurological disorders. Participants Adult and pediatric patients representing different neurological disorders specified in this study, proxy respondents for select conditions (stroke and pediatric conditions), and English and Spanish speaking participants from the general population. Main Outcome Measures Multiple generic and condition specific measures used to provide construct validity evidence to new Neuro-QOL tool. Results Neuro-QOL has developed 14 generic item banks and 8 targeted scales to assess HRQL in five adult (stroke, multiple sclerosis, Parkinson’s disease, epilepsy, and amyotrophic lateral sclerosis) and two pediatric conditions (epilepsy and muscular dystrophies). Conclusions The Neuro-QOL system will continue to evolve, with validation efforts in clinical populations, and new bank development in health domains not currently included. The potential for Neuro-QOL measures in rehabilitation research and clinical settings is discussed. PMID:21958920

Cella, David; Nowinski, Cindy; Peterman, Amy; Victorson, David; Miller, Deborah; Lai, Jin-Shei; Moy, Claudia

2011-01-01

290

Teaching Undergraduate Medical Students the Neurological Examination.  

ERIC Educational Resources Information Center

The University of Arizona College of Medicine program described extends the role of practical instructor or programmed patient to that of evaluator and teacher of neurological examinations skills for preclinical medical students. The process may help improve the quality of medical education without increasing the size of clinical faculty. (LBH)

Laguna, Jose F.; Stillman, Paula L.

1978-01-01

291

BRAINA JOURNAL OF NEUROLOGY BOOK REVIEW  

E-print Network

BRAINA JOURNAL OF NEUROLOGY BOOK REVIEW Ingredients for a brain In thinking about components of the brain that are important for mental function, there are several obvious things to consider. The brain.g. lattice). Studies of the brain's wiring diagram also suggest the presence of regions that act as hubs

Rolls, Edmund T.

292

Integrating cognitive psychology, neurology and neuroimaging  

Microsoft Academic Search

In the last decade, there has been a dramatic increase in research effectively integrating cognitive psychology, functional neuroimaging, and behavioral neurology. This new work is typically conducting basic research into aspects of the human mind and brain. The present review features as examples of such integrations two series of studies by the author and his colleagues. One series, employing object

Lawrence M. Parsons

2001-01-01

293

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

Patrik Vuilleumier

2004-01-01

294

DNA repair deficiency and neurological disease  

Microsoft Academic Search

The ability to respond to genotoxic stress is a prerequisite for the successful development of the nervous system. Mutations in various DNA repair factors can lead to human diseases that are characterized by pronounced neuropathology. In many of these syndromes the neurological component is among the most deleterious aspects of the disease. The nervous system poses a particular challenge in

Peter J. McKinnon

2009-01-01

295

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

2005-01-01

296

DNA repair abnormalities leading to ataxia: shared neurological phenotypes and risk factors.  

PubMed

Since identification of mutations in the ATM gene leading to ataxia-telangiectasia, enormous efforts have been devoted to discovering the roles this protein plays in DNA repair as well as other cellular functions. Even before the identification of ATM mutations, it was clear that other diseases with different genomic loci had very similar neurological symptoms. There has been significant progress in understanding why cancer and immunodeficiency occur in ataxia-telangiectasia even though many details remain to be determined, but the field is no closer to determining why the nervous system requires ATM and other DNA repair genes. Even though rodent disease models have similar DNA repair abnormalities as the human diseases, they have no consistent, robust neuropathological phenotype making it difficult to understand the neurological underpinnings of disease. Therefore, it may be useful to reassess the neurological and neuropathological characteristics of ataxia-telangiectasia in human patients to look for potential commonalities in DNA repair diseases that result in ataxia. In doing so, it is clear that ataxia-telangiectasia and similar diseases share neurological features other than merely ataxia, such as length-dependent motor and sensory neuropathies, and that the neuroanatomical localization for these symptoms is understood. Cells affected in ataxia-telangiectasia and similar diseases are some of the largest single nucleated cells in the body. In addition, a subset of these diseases also has extrapyramidal movements and oculomotor apraxia. These neurological and neuropathological similarities may indicate a common DNA repair related pathogenesis with very large cell size as a critical risk factor. PMID:25038946

Gilmore, Edward C

2014-10-01

297

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. PMID:3814530

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

1987-01-01

298

TIA (Transient Ischemic Attack)  

MedlinePLUS

TIA (Transient Ischemic Attack) Updated:Oct 2,2014 Excerpted from “ Why Rush? ”, Stroke Connection January/February 2009 (Science update October 2012) While transient ischemic attack (TIA) is often labeled “mini-stroke,” ...

299

Psychiatric signs and symptoms in treatable inborn errors of metabolism.  

PubMed

Possible underlying organic causes of psychiatric symptoms can be overlooked in the clinical setting. It is important to increase awareness amongst psychiatric and neurological professionals with regard to certain inborn errors of metabolism as, in some cases, disease-specific therapies are available that can, for instance, treat underlying metabolic causes. The following article describes the basic pathophysiology, clinical and neurological features, and available diagnostic procedures of six treatable metabolic diseases that are associated with neuropsychiatric symptoms: Wilson's disease, cerebrotendinous xanthomatosis, porphyrias, homocysteinemia, urea cycle disorders, and Niemann-Pick disease type C (NP-C). NP-C is taken as a particularly relevant example because, while it is traditionally considered to be a condition that presents with severe neurological and systemic manifestations in children, an increasing number of patients are being detected who have the adolescent- or adult-onset form, which is frequently associated with neuropsychiatric signs. A notable proportion of adult-onset cases have been reported where NP-C has mistakenly been diagnosed and treated as a psychiatric condition, usually based on patients' initial presentation with psychotic or schizophrenia-like symptoms. Underlying organic causes of psychiatric disorders such as psychosis should be considered among patients with atypical symptoms and/or resistance to standard therapy. Alongside improved frameworks for additional multidisciplinary diagnostic work in patients with suspected organic disease, the development of convenient and affordable biochemical screening and/or diagnostic methods has enabled new ways to narrow down differential diagnoses. PMID:25145892

Nia, S

2014-09-01

300

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.

NONE

1996-09-01

301

Neurologic impairment following closed head injury predicts post-traumatic neurogenesis.  

PubMed

In the mammalian hippocampus, neurogenesis persists into adulthood, and increased generation of newborn neurons could be of clinical benefit following concussive head injuries. Post-traumatic neurogenesis has been well documented using "open" traumatic brain injury (TBI) models in rodents; however, human TBI most commonly involves closed head injury. Here we used a closed head injury (CHI) model to examine post-traumatic hippocampal neurogenesis in mice. All mice were subjected to the same CHI protocol, and a gross-motor based injury severity score was used to characterize neurologic impairment 1h after the injury. When analyzed 2weeks later, post-traumatic neurogenesis was significantly increased only in mice with a high degree of transient neurologic impairment immediately after injury. This increase was associated with an early increase in c-fos activity, and subsequent reactive astrocytosis and microglial activation in the dentate gyrus. Our results demonstrate that the initial degree of neurologic impairment after closed head injury predicts the induction of secondary physiologic and pathophysiologic processes, and that animals with severe neurologic impairment early after injury manifest an increase in post-traumatic neurogenesis in the absence of gross anatomic pathology. PMID:24861442

Villasana, L E; Westbrook, G L; Schnell, E

2014-11-01

302

Complex transient epileptic amnesia  

Microsoft Academic Search

Transient epileptic amnesia is a rare but probably underrecognized form of temporal lobe epilepsy, which typically manifests as episodic isolated memory loss. Consequently, transient epileptic amnesia may be readily misdiagnosed as a nonepileptic memory dysfunction in older individuals. When appropriately recognized, it has been described as a treatment-responsive syndrome amenable to antiepileptic drugs. We describe a patient with drug-resistant transient

Ryan D. Walsh; Robert E. Wharen; William O. Tatum

2011-01-01

303

Recognition of error symptoms in large systems  

NASA Technical Reports Server (NTRS)

A methodology for automatically detecting symptoms of frequently occurring errors in large computer systems is developed. The proposed symptom recognition methodology and its validation are based on probabilistic techniques. The technique is shown to work on real failure data from two CYBER systems at the University of Illinois. The methodology allows for the resolution between independent and dependent causes and, also quantifies a measure of the strength of relationship among errors. Comparison made with failure/repair information obtained from field maintenance engineers shows that in 85% of the cases, the error symptoms recognized by our approach correspond to real system problems. Further, the remaining 15% although not directly supported by field data, were confirmed as valid problems. Some of these were shown to be persistent problems which otherwise would have been considered as minor transients and hence ignored.

Iyer, Ravishankar K.; Sridhar, V.

1987-01-01

304

14 CFR 67.109 - Neurologic.  

Code of Federal Regulations, 2010 CFR

...airman medical certificate are: (a) No established medical history or clinical diagnosis of any of the following: (1) Epilepsy; (2) A disturbance of consciousness without satisfactory medical explanation of the cause; or (3) A transient...

2010-01-01

305

14 CFR 67.209 - Neurologic.  

Code of Federal Regulations, 2010 CFR

...airman medical certificate are: (a) No established medical history or clinical diagnosis of any of the following: (1) Epilepsy; (2) A disturbance of consciousness without satisfactory medical explanation of the cause; or (3) A transient...

2010-01-01

306

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

1982-01-01

307

Predictors of Late Neurological Deterioration After Spontaneous Intracerebral Hemorrhage  

PubMed Central

Background Although intracerebral hemorrhage (ICH) is a common form of cerebrovascular disease, little is known about factors leading to neurological deterioration occurring beyond 48 h after hematoma formation. The purpose of this study was to characterize the incidence, consequences, and associative factors of late neurological deterioration (LND) in patients with spontaneous ICH. Methods Using the Duke University Hospital Neuroscience Intensive Care Unit database from July 2007 to June 2012, a cohort of 149 consecutive patients with spontaneous supratentorial ICH met criteria for analysis. LND was defined as a decrease of two or more points in Glasgow Coma Scale score or death during the period from 48 h to 1 week after ICH symptom onset. Unfavorable outcome was defined as a modified Rankin Scale score of >2 at discharge. Results Forty-three subjects (28.9 %) developed LND. Logistic regression models revealed hematoma volume (OR = 1.017, 95 % CI 1.003–1.032, p = 0.019), intraventricular hemorrhage (OR = 2.519, 95 % CI 1.142–5.554, p = 0.022) and serum glucose on admission (OR = 2.614, 95 % CI 1.146–5.965, p = 0.022) as independent predictors of LND. After adjusting for ICH score, LND was independently associated with unfavorable outcome (OR = 4.000, 95 % CI 1.280–12.500, p = 0.017). In 65 subjects with follow-up computed tomography images, an increase in midline shift, as a surrogate for cerebral edema, was independently associated with LND (OR = 3.822, 95 % CI 1.157–12.622, p = 0.028). Conclusions LND is a common phenomenon in patients with ICH; further, LND appears to affect outcome. Independent predictors of LND include hematoma volume, intraventricular hemorrhage, and blood glucose on admission. Progression of perihematomal edema may be one mechanism for LND. PMID:23979796

Sun, Weiping; Pan, Wenqin; Kranz, Peter G.; Hailey, Claire E.; Williamson, Rachel A.; Sun, Wei; Laskowitz, Daniel T.

2014-01-01

308

Chorea as a symptom of neuroborreliosis: a case study.  

PubMed

Borrelia burgdorferi (Bb) can cause a large number of neurological symptoms. Although extrapyramidal disturbances are rare (representing less than 2% of all neurological complications), diffuse choreic dyskinesias have been described during the course of mild encephalitis. The data published in the literature suggest that there are clinical and neurological analogies between neuroborreliosis and multiple sclerosis (MS). The presence of specific anti-Bb antibodies in cerebrospinal fluid is a discriminating factor that allows a diagnosis of neuroborreliosis to be made. We describe the case of a patient with Lyme disease, characterised by widespread chorea and behavioural disturbances. Emphasis is placed on the atypical onset and evolution, the difficulties encountered in formulating a diagnosis, and the uncertainties concerning the pathophysiology and clinical/neuroradiological correlations of the disease. PMID:10933464

Piccolo, I; Thiella, G; Sterzi, R; Colombo, N; Defanti, C A

1998-08-01

309

Transient cortical blindness after coronary artery angiography  

PubMed Central

Coronary angiography is the current gold standard for the diagnosis of ischemic heart disease and therefore the prevalence of percutaneous coronary procedures such as angiography and angioplasty is high. The occurrence of cerebral complications after coronary angiography and coronary angioplasty is low and it mainly includes transient ischemic attack and stroke. The prevalence of transient cortical blindness after X-ray contrast media is low and it is usually seen after cerebral angiography. Until now only a few cases of transient cortical blindness have been described after coronary artery angiography. Regarding the spread of coronary angiography worldwide and in Poland this complication is uniquely rare. A 32-year-old man with multiple extrasystolic ventricular arrhythmia suggesting Brugada syndrome diagnosis according to morphology of the left bundle branch block and with decreased left ventricular ejection fraction was admitted to the First Department of Cardiology and Hypertension, Medical College of the Jagiellonian University in Krakow. Coronary angiography was performed in order to exclude ischemic etiology of the observed abnormalities. No arteriosclerotic lesions were found in coronary arteries. Transient cortical blindness was observed directly after angiography which may have been caused by the neurotoxic effect of the used X-ray contrast medium. In ophthalmologic and neurologic examination as well as in the cerebral computed tomography scan no pathologies were found. Visual impairment disappeared totally within several hours. PMID:24570699

Wojciechowska, Wiktoria; Rajzer, Marek; Jurczyszyn, Artur; Bazan-Socha, Stanislawa; Bryniarski, Leszek; Czarnecka, Danuta

2013-01-01

310

The intracranial B-waves' amplitude as prognostication criterion of neurological complications in neuroendovascular interventions.  

PubMed

The purpose of this study was to evaluate dynamics of B-waves' amplitudes (BWA) of blood flow velocity (BFV) in patients with cerebrovascular diseases during endovascular operations. We examined 12 patients with neurovascular pathology during neuroendovascular interventions. Patients were divided into two groups: 1st group (6 cases)--without intraoperative neurological complications, 2nd group (6 cases)--with complications. Bilateral monitoring of BFV in middle cerebral arteries was carried out applying Multi Dop X. To estimate BWA Fourier analysis was used. In the 1st group preoperative BWA on the affected side was 3.9 +/- 0.6 cm/s. Intraoperative (during an access to pathologic formation and its embolisation) BWA increased up to 7.7 +/- 1.1 cm/s (p < 0.05). Postoperative BWA decreased to 4.2 +/- 0.8 cm/s. In the 2nd group the preoperative BWA on the affected side was 9.6 +/- 1.1 cm/s (p < 0.05), thus higher than in the 1st group. Intraoperatively we observed further increase of BWA up to 12.1 +/- 2.6 cm/s, accompanied by occurrence or increase of neurological symptoms. Postoperative BWA decreased to 10.4 +/- 2.9 cm/s, whereas we didn't observe regression of neurological symptoms. PMID:16060241

Semenyutin, V B; Aliev, V A; Nikitin, P I; Kozlov, A V

2005-01-01

311

Neurology Journal Club: a new subsection.  

PubMed

The term "journal club" traditionally refers to a gathering of physicians for the critical review of current medical literature and discussion regarding the clinical application of the results. Since the formation of the first documented journal club over 130 years ago, the organization and purpose of this academic tool has gone through many changes. Despite the advent of "virtual" online journal clubs, most academic departments still employ a physical meeting between trainees and the faculty. The Neurology® Journal Club is a new subsection of the Resident & Fellow Section with the goal of enhancing the traditional journal club experience by publishing examples of structured critical appraisals of medical literature. The Journal Club critiques, written by neurology residents and fellows with faculty supervision, will examine each article for key features of hypothesis and design, methods, results, and interpretation. PMID:21876198

Millichap, John J; Goldstein, Joshua L

2011-08-30

312

Davunetide: Peptide therapeutic in neurological disorders.  

PubMed

This review focuses on the therapeutic effects and mechanisms of action of NAP (davunetide), an eight amino acid snippet derived from activity-dependent neuroprotective protein (ADNP) which was discovered in the laboratory of Prof. Illana Gozes. The effects of NAP and its related peptides in models of neurodegenerative diseases and other neurological disorders will be described here in details. Possible mechanisms of NAP actions include anti-inflammatory effect, antioxidant activity, inhibition of protein aggregation and interaction with microtubules. In line with the fact that all of these features are characteristic to most neurological/neurodegenerative disorders, NAP was found to have beneficial effects on the behavioral manifestations associated with these disorders. PMID:24533805

Magen, Iddo; Gozes, Illana

2014-01-01

313

Catastrophic neurologic syndrome with dramatic ECG changes?  

PubMed Central

Cerebrogenic ECG abnormalities, especially prominent T wave inversions and prolongation of the QT(U) interval, are well-described. Brady- and tachyarrhythmias, including polymorphic VT, have been also described in the setting of neurologic injury. We report an unusual case of a 22-year-old man who presented with idiopathic acute encephalopathy. His hospital course was complicated by persistent fevers, along with refractory seizures treated with propofol. Serial ECG findings included marked ventricular repolarization prolongation with bursts of torsade de pointes, diffuse ST elevations simulating extensive myocardial ischemia or infarction, as well as a Brugada-like pattern. To our knowledge, this case is the first reported with the combination of such findings in a patient with a catastrophic neurologic syndrome. PMID:23973089

Goldberger, Zachary D.; Creutzfeldt, Claire J.; Goldberger, Ary L.

2014-01-01

314

The neurology of aretaeus: radix pedis neurologia.  

PubMed

Aretaeus (Aretaios) was a physician born in Cappadocia in about the 2nd century AD, a student of medicine and physician in Alexandria. His works are found in eight books which espoused the physiological and pathological views of the Hippocratic principles derived from the pneumatists and the eclectic schools. Though he has been called the forgotten physician, it has been said that: 'after Hippocrates no single Greek author has equalled Aretaios'. In order to give an indication of his neurological legacy, this paper offers a summary of and quotations from his principal neurological contributions: migraine, vertigo, tetanus, epilepsy, melancholia, strokes and paralysis. One of his most important discoveries was the notion that the pyramidal tract decussates. PMID:23969486

Pearce, J M S

2013-01-01

315

Severe neurologic manifestations in acute intermittent porphyria developed after spine surgery under general anesthesia: a case report  

PubMed Central

Porphyrias are inherited metabolic disorders resulting from a specific enzyme defect in the heme biosynthetic pathway. Porphyrias are induced by various precipitants. Clinical features include abdominal pain, neurologic manifestations, autonomic neuropathy, and mental disturbance. Diagnosis may be delayed because of variable symptoms that mimic other diseases and because of the rarity of of porphyrias. Although most patients with known porphyria can complete anesthesia and surgery safely, undiagnosed porphyric patients are in danger of porphyric crisis due to inadvertent exposure to precipitating drugs and environment. We report a case of a patient who experienced delayed emergence with neurological disturbance after general anesthesia, ultimately diagnosed as acute intermittent porphyria.

Park, Eun Young; Kim, Yi Seul; Lim, Kyung-Jee; Lee, Hye Kyoung; Lee, Soo Kyung; Choi, Hyun

2014-01-01

316

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. PMID:23275848

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

2012-01-01

317

Transient loss of consciousness and syncope.  

PubMed

Syncope describes a sudden and brief transient loss of consciousness (TLOC) with postural failure due to cerebral global hypoperfusion. The term TLOC is used when the cause is either unrelated to cerebral hypoperfusion or is unknown. The most common causes of syncopal TLOC include: (1) cardiogenic syncope (cardiac arrhythmias, structural cardiac diseases, others); (2) orthostatic hypotension (due to drugs, hypovolemia, primary or secondary autonomic failure, others); (3) neurally mediated syncope (cardioinhibitory, vasodepressor, and mixed forms). Rarely neurologic disorders (such as epilepsy, transient ischemic attacks, and the subclavian steal syndrome) can lead to cerebal hypoperfusion and syncope. Nonsyncopal TLOC may be due to neurologic (epilepsy, sleep attacks, and other states with fluctuating vigilance), medical (hypoglycemia, drugs), psychiatric, or post-traumatic disorders. Basic diagnostic workup of TLOC includes a thorough history and physical examination, and a 12-lead electrocardiogram (ECG). Blood testing, electroencephalogram (EEG), magnetic resonance imaging (MRI) of the brain, echocardiography, head-up tilt test, carotid sinus massage, Holter monitoring, and loop recorders should be obtained only in specific contexts. Management strategies involve pharmacologic and nonpharmacologic interventions, and cardiac pacing. PMID:24365296

Bassetti, Claudio L

2014-01-01

318

Acute neurologic illness of unknown etiology in children - colorado, august-september 2014.  

PubMed

On September 12, 2014, CDC was notified by the Colorado Department of Public Health and Environment of a cluster of nine children evaluated at Children's Hospital Colorado with acute neurologic illness characterized by extremity weakness, cranial nerve dysfunction (e.g., diplopia, facial droop, dysphagia, or dysarthria), or both. Neurologic illness onsets occurred during August 8-September 15, 2014. The median age of the children was 8 years (range = 1-18 years). Other than neck, back, or extremity pain in some patients, all had normal sensation. All had a preceding febrile illness, most with upper respiratory symptoms, occurring 3-16 days (median = 7 days) before onset of neurologic illness. Seven of eight patients with magnetic resonance imaging of the spinal cord had nonenhancing lesions of the gray matter of the spinal cord spanning multiple levels, and seven of nine with magnetic resonance imaging of the brain had nonenhancing brainstem lesions (most commonly the dorsal pons). Two of five with magnetic resonance imaging of the lumbosacral region had gadolinium enhancement of the ventral nerve roots of the cauda equina. Eight children were up to date on polio vaccination. Eight have not yet fully recovered neurologically. PMID:25299607

Pastula, Daniel M; Aliabadi, Negar; Haynes, Amber K; Messacar, Kevin; Schreiner, Teri; Maloney, John; Dominguez, Samuel R; Davizon, Emily Spence; Leshem, Eyal; Fischer, Marc; Nix, W Allan; Oberste, M Steven; Seward, Jane; Feikin, Daniel; Miller, Lisa

2014-10-10

319

Application of Array-Based Comparative Genomic Hybridization to Pediatric Neurologic Diseases  

PubMed Central

Purpose Array comparative genomic hybridization (array-CGH) is a technique used to analyze quantitative increase or decrease of chromosomes by competitive DNA hybridization of patients and controls. This study aimed to evaluate the benefits and yield of array-CGH in comparison with conventional karyotyping in pediatric neurology patients. Materials and Methods We included 87 patients from the pediatric neurology clinic with at least one of the following features: developmental delay, mental retardation, dysmorphic face, or epilepsy. DNA extracted from patients and controls was hybridized on the Roche NimbleGen 135K oligonucleotide array and compared with G-band karyotyping. The results were analyzed with findings reported in recent publications and internet databases. Results Chromosome imbalances, including 9 cases detected also by G-band karyotyping, were found in 28 patients (32.2%), and at least 19 of them seemed to be causally related to the abnormal phenotypes. Regarding each clinical symptom, 26.2% of 42 developmental delay patients, 44.4% of 18 mental retardation patients, 42.9% of 28 dysmorphic face patients, and 34.6% of 26 epilepsy patients showed abnormal array results. Conclusion Although there were relatively small number of tests in patients with pediatric neurologic disease, this study demonstrated that array-CGH is a very useful tool for clinical diagnosis of unknown genome abnormalities performed in pediatric neurology clinics. PMID:24339284

Byeon, Jung Hye; Shin, Eunsim; Kim, Gun-Ha; Lee, Kyungok; Hong, Young Sook; Lee, Joo Won

2014-01-01

320

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. PMID:19300614

Ney, John P; Joseph, Kevin R

2007-01-01

321

Peripheral Biomarkers of Excitotoxicity in Neurological Diseases  

Microsoft Academic Search

Since the proposal that excessive glutamater-gic stimulation, also known as excitotoxicity, could be responsible for neuronal\\u000a suffering and death, several studies have repeatedly confirmed the key role of this mechanism in the pathogenesis of different\\u000a neurological diseases. Therefore, it is conceivable that assessing the glutamatergic function directly in patients could be\\u000a extremely useful for early diagnosis, prognostic evaluation, and optimization

Lucio Tremolizzo; Gessica Sala; Carlo Ferrarese

322

Music and child neurology: a developmental perspective  

Microsoft Academic Search

When I was first contacted by the Mariani Foundation to become part of their project on Music, I thought it was a great occasion\\u000a to convey all my interests together. The Foundation had always been involved in Child Neurology and Rehabilitation and was\\u000a at that time very carefully watching the developments of a young discipline, soon to become so popular,

Luisa Lopez; Tor Vergata

323

MR angiography in pediatric neurological disorders  

Microsoft Academic Search

MR angiography using 3D and 2D time-of-flight techniques were used to evaluate pediatric neurological disorders. MRA (arteriography) and MRV (venography) were abnormal in 63 and 45 cases, respectively. Conventional cerebral angiography was performed in 30 cases. These techniques were compared with MRI and conventional angiography. In addition, the value of MR angiography for surgical planning was subjectively evaluated. Our results

B. C. P. Lee; T. S. Park; B. A. Kaufman

1995-01-01

324

Imaging of Common Adult Neurologic Disorders  

PubMed Central

The family physician is often called upon to diagnose a range of adult neurologic disorders. Clinical history, physical examination, laboratory tests, and imaging studies are required to discover their cause. Various imaging modalities can be used to evaluate common adult disorders of the central nervous system. ImagesFigures 1-2Figure 3Figure 4Figures 5-6Figures 7-8Figures 9-11 PMID:21229013

McLennan, Michael K.; Marotta, Thomas R.; TerBrugge, Karel G.; Marotta, Joseph T.

1991-01-01

325

Neurological disorders presenting mainly in adolescence  

PubMed Central

The aim of this review is to discuss some of the neurological diseases that present mainly in the adolescent period. The article focuses on the usual presentation and course of the more common, and some uncommon, epilepsies, neuromuscular disorders, neurodegenerative disorders, inflammatory disorders of the central nervous system and some other, miscellaneous conditions. The article ends with a very brief and general discussion about management issues in this age group. PMID:17264287

Macleod, S; Appleton, R E

2007-01-01

326

Caval variations in neurologically diseased patients  

PubMed Central

Background The import of the cavum variation and its prevalence rate in healthy individuals is still not clear, likewise in neurologically diseased patients. Purpose To evaluate the frequency and pattern of caval variations in neurologically diseased patients. Material and Methods The presence or absence of the cavum septum pellucidum (CSP), cavum vergae (CV), or cavum velum interpositum (CVI) was reviewed from successive cranial computerized tomography (CT) images of patients who were aged 6 months and above. Two hundred and seventeen cranial CT images were reviewed. Results At least a cavum variation was noted in 130 (59.9%) of the CT scan images reviewed. The CV, CVI, and CSP were noted in 86 (39.6%), 53 (24.4%), and 50 images (23%), respectively. Caval multiplicity was noted in 102 patients (47%). There was no significant difference in the rate of occurrence of cavum variations in patients with congenital brain diseases and acquired brain conditions (P?=?0.484), neither was there a significant difference in the frequency of cavum variation in children aged older than 6 months compared to adults (P?=?0.101). Conclusion Cava variations are relatively common in neurological brain diseases. Patients with congenital brain diseases did not have a higher frequency of cava variation when compared with those that had acquired lesions. The most common type of cavum variation noted in this study was the vergae variety, while the CSP is the rarest. PMID:25298867

Akinola, Rachael A; Nelson-Paseda, Adedolapo O

2014-01-01

327

Neurologic complications of cardiac tests and procedures.  

PubMed

Arterial or central venous vascular access is the cornerstone of invasive cardiac diagnosis, monitoring, and therapeutics. Although procedural safety has significantly improved with protocols perfected over decades of use, their prevalence renders even the uncommon neurologic complication clinically relevant. Serious peripheral nerve complications result from direct or indirect nerve injuries in the setting of a hematoma or compartment syndrome. Functional outcome is dependent upon prompt diagnosis and early treatment, so proceduralists should be aware of the relevant anatomy and early signs of nerve injury. Ischemic stroke is the most common central nervous system complication of diagnostic and therapeutic cardiac catheterization, and is presumed to be due to embolization of atherosclerotic plaque or thrombus dislodged during guiding catheter manipulation, platelet-fibrin thrombus that forms on the catheters, or air that appears during catheter flushing. Acute neurologic deterioration after thrombolysis for acute myocardial infarction should be presumed to be an intracranial hemorrhage until proven otherwise. The ideal angiography suite of the future is patientcentric and multipurpose, coordinating diagnostic and therapeutic strategies for multivascular disease, allowing for multispecialty collaboration, and, in the event of a neurologic complication of a cardiac procedure, facilitating the various treating physicians to converge efficiently upon the patient. PMID:24365287

Sila, Cathy

2014-01-01

328

Neurological findings in incontinentia pigmenti; a review.  

PubMed

Incontinentia Pigmenti is a rare X-linked multisystem disorder with well described and pathognomonic skin manifestations. Neurological manifestations are found in 30% of IP patients, forming one of the major causes of morbidity and mortality of the condition. In this review, clinical and brain imaging data of 45 IP patients with a neurological phenotype are reviewed. Several clinical presentations could be identified, comprising seizures, infantile encephalopathy, acute disseminated encephalomyelitis and ischemic stroke. Most neurological features presented during the neonatal period. No patients presented during adolescence or at adult age. Seizures of different type are reported in about 20% of the patients at young age and seem to correlate with the degree of cerebrovascular damage. Brain MRI findings include periventricular and subcortical white matter disease, haemorrhagic changes, corpus callosum hypoplasia, cerebral atrophy and cerebellar hypoplasia. Ocular findings comprise a range of retinal vascular changes and optic atrophy, but also developmental defects like microphthalmia and cataract. Most findings may reflect changes following brain injury. Both (ischemic) vascular and inflammatory components may play a role in the cerebral and ocular phenotype. However, a role of disturbed apoptosis during development may also be a contributing factor. PMID:22564885

Meuwissen, Marije E C; Mancini, Grazia M S

2012-05-01

329

Sparring and Neurological Function in Professional Boxers  

PubMed Central

Despite increased interest regarding the potentially long-term negative impact of chronic traumatic brain injury, limited research has been conducted regarding such injuries and neurological outcomes in real world settings. To increase understanding regarding the relationship between sparring (e.g., training under the tutelage of an experienced boxing coach for the purpose of improving skills and/or fitness) and neurological functioning, professional boxers (n?=?237) who competed in Maryland between 2003 and 2008 completed measures regarding sparring exposure (Cumulative Sparring Index, CSI) and performance on tests of cognition (Symbol Digit Modalities Test, SDMT) and balance (Sharpened Romberg Test, SRT). Measures were completed prior to boxing matches. Higher scores on the CSI (increased sparring exposure) were associated with poorer performance on both tests of cognition (SDMT) and balance (SRT). A threshold effect was noted regarding performance on the SDMT, with those reporting CSI values greater than about 150 experiencing a decline in cognition. A history of frequent and/or intense sparring may pose a significant risk for developing boxing associated neurological sequelae. Implementing administration of clinically meaningful tests before bouts, such as the CSI, SDMT, and/or the SRT, as well as documentation of results into the boxer’s physicals or medical profiles may be an important step for improving boxing safety. PMID:25101253

Stiller, John W.; Yu, Steven S.; Brenner, Lisa A.; Langenberg, Patricia; Scrofani, Phillip; Pannella, Patrick; Hsu, Edbert B.; Roberts, Darryl W.; Monsell, Ray M. T.; Binks, Sidney W.; Guzman, Alvaro; Postolache, Teodor T.

2014-01-01

330

[Medically unexplained symptoms].  

PubMed

Patients with physical symptoms for which no medical explanation can be found are relatively common in general practice. Patients with medically unexplained symptoms are frequently frustrating to physicians both in primary and secondary care and utilize health sources disproportionately. They frequently attend both primary care units and hospitals and are usually not satisfied with the care they receive. Medically unexplained symptoms in patient populations are strongly associated with psychiatric pathology and with anxiety and depression in particular. They are also linked to personality pathology, childhood adversity, adult trauma or medically unexplained symptoms in childhood. The predictive value of alexithymia in determining these symptoms is controversial. Patients who have high negative affectivity or neuroticism tend to score high on measures of physical symptoms. These symptoms have a high degree of co-occurrence. The same person may meet the diagnostic criteria for several functional somatic syndromes simultaneously. The clinician should be aware of the cultural and social shaping of the bodily experience of these patients and hence acknowledge the somatic nature and reality of the symptoms. The clinician should make the person feel understood and establish a positive collaborative relationship. This would enable him/her to correct misconceptions about the disease and give a positive explanation of symptoms. Antidepressant therapy and cognitive-behavioural psychotherapy have been proved to be moderately effective in this group of patients. Because of the high disability that might be caused by these symptoms, psychiatrists and primary and secondary care physicians should pay careful attention to this clinical condition. These symptoms may also aid us in challenging the long-held idea of mind-body dualism which is inherent in Western biomedicine. PMID:12794657

Sayar, Kemal

2002-01-01

331

Neurology Manpower--A Survey. NINCDS Monograph No. 16.  

ERIC Educational Resources Information Center

The three-year neurology manpower study reported here was directed toward (1) identifying the presently available neurological manpower and the demographic and professional characteristics of neurologists and neurologists-in-training in the United States as of 1971; (2) determining the current and emerging patterns for utilizing neurological

American Neurological Association, Miami, FL.

332

STANFORD HOSPITAL & CLINICS PRESENTS Annual Breakthroughs in Neurologic  

E-print Network

-based information on the treatment of patients with Neurologic disorders. These clinical updates will be providedSTANFORD HOSPITAL & CLINICS PRESENTS 2nd Annual Breakthroughs in Neurologic Therapies: Restoring in Neurologic Therapies: Restoring Function to the Nervous System OCTOBER 7-8, 2011 Tell a colleague

Li, Fei-Fei

333

Director, Neuro Palliative Medicine Program Montreal Neurological Institute and Hospital  

E-print Network

the quality of life from diagnosis to the end of life for patients with life- limiting neurological diseasesDirector, Neuro Palliative Medicine Program Montreal Neurological Institute and Hospital Mc, 2011 Position Start Date Available immediately The Montreal Neurological Institute and Hospital (The

Shoubridge, Eric

334

Neurological Eponyms Derived from Literature and Visual Art  

Microsoft Academic Search

Eponyms are common in medicine, and neurology is not an exception. Most neurological eponyms originate from the names of those who first described a disease or pathological condition, as well as from the names of characters from the literature and mythical or biblical heroes. The article describes en block both widespread and nowadays seldom used or even forgotten neurological eponyms

Valmantas Budrys

2005-01-01

335

Swallowing in neurological outpatients: Use of a timed test  

Microsoft Academic Search

Swallowing was studied prospectively in a consecutive group of 90 neurology outpatients under 70 years of age. No patient had been referred primarily because of dysphagia. Patients were classified into four groups: those with (1) neurological or (2) non-neurological diagnoses possibly relevant to disordered swallowing, (3) functional disorders, and (4) definite diagnoses not likely to be relevant. They were defined

Kalyanee M. Nathadwarawala; Anna McGroary; Charles M. Wiles

1994-01-01

336

Early neurological complications of coronary artery bypass surgery  

Microsoft Academic Search

A prospective study of 312 patients undergoing elective coronary artery bypass surgery was undertaken to determine the incidence, severity, and functional impact of postoperative neurological complications. Detailed evaluation of the patients showed that neurological complications after surgery were common, occurring in 191 of the 312 patients (61%). Although such a high proportion of the total developed detectable changes, serious neurological

P J Shaw; D Bates; N E Cartlidge; D Heaviside; D G Julian; D A Shaw

1985-01-01

337

INSOMNIA: SYMPTOM OR DIAGNOSIS?  

Microsoft Academic Search

Is insomnia a clinical entity in its own right or is it simply a symptom of an underlying medical or psychological disorder? The widely held view among many clinicians and researchers is that insomnia is secondary to or an epiphenomenon of a ‘primary’ medical or psychological disorder. Consequently, insomnia ‘symptoms’ have tended to be trivialized or ignored. This paper aims

Allison G Harvey

2001-01-01

338

CHILDHOOD PSYCHOSIS OR MENTAL RETARDATION: A DIAGNOSTIC DILEMMA. II. PEDIATRIC AND NEUROLOGICAL ASPECTS.  

PubMed

A pediatric and neurological study of 62 retarded psychotic children revealed more family psychopathology, complications of pregnancy, and serious postnatal illness than in a control group. Motor development and speech development were slow in psychotic children, but obstetrical complications at the time of birth were not significantly more frequent than in controls. Abnormal physical findings in psychotic children were mainly congenital anomalies. Neurological deficits included mental retardation, speech defects, strabismus, and other non-localizing signs. EEG tracings were abnormal in 27 of 51 psychotic patients. At least 46 of the 62 psychotic children studied had evidence of organic brain disease.Although an inadequate family background may be associated with the development of psychosis, a severe disturbance of temporal and frontal lobe function may produce psychotic symptoms with or without familial predisposition. PMID:14081786

HINTON, G G

1963-11-16

339

Transient Voltage Recorder  

NASA Technical Reports Server (NTRS)

A voltage transient recorder can detect lightning induced transient voltages. The recorder detects a lightning induced transient voltage and adjusts input amplifiers to accurately record transient voltage magnitudes. The recorder stores voltage data from numerous monitored channels, or devices. The data is time stamped and can be output in real time, or stored for later retrieval. The transient recorder, in one embodiment, includes an analog-to-digital converter and a voltage threshold detector. When an input voltage exceeds a pre-determined voltage threshold, the recorder stores the incoming voltage magnitude and time of arrival. The recorder also determines if its input amplifier circuits clip the incoming signal or if the incoming signal is too low. If the input data is clipped or too low, the recorder adjusts the gain of the amplifier circuits to accurately acquire subsequent components of the lightning induced transients.

Medelius, Pedro J. (Inventor); Simpson, Howard J. (Inventor)

2002-01-01

340

Electromagnetic Transients from Supernovae  

NASA Astrophysics Data System (ADS)

A core-collapse supernova (SN) would produce an expanding shell of charged particles which interact with the surrounding magnetic field of the progenitor star producing a transient radio pulse. Approximately one supernova event per century is expected in a galaxy. Such a pulse may be detected by a transient radio array. We present details of an ongoing such for such events by the Eight-meter-wavelength Transient Array (ETA). )

Kothari, Manthan

2010-02-01

341

Clinical Symptoms and Risk Factors in Cerebral Microangiopathy Patients  

PubMed Central

Objective Although the clinical manifestation and risk factors of cerebral microangiopathy (CM) remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated retrospectively in a cohort of CM patients. Methods Patients treated at the Department of Neurology, University of Bonn for CM (n?=?223; 98m, 125f; aged 77.32±9.09) from 2005 to 2010 were retrospectively enrolled. Clinical symptoms, blood chemistry, potential risk factors, demographic data and ratings of vascular pathology in the brain based on the Wahlund scale were analyzed using Pearson's chi square test and one-way ANOVA. Results Progressive cognitive decline (38.1%), gait apraxia (27.8%), stroke-related symptoms and seizures (24.2%), TIA-symptoms (22%) and vertigo (17%) were frequent symptoms within the study population. Frontal lobe WMLs/lacunar infarcts led to more frequent presentation of progressive cognitive decline, seizures, gait apraxia, stroke-related symptoms, TIA, vertigo and incontinence. Parietooccipital WMLs/lacunar infarcts were related to higher frequencies of TIA, seizures and incontinence. Basal ganglia WMLs/lacunar infarcts were seen in patients with more complaints of gait apraxia, vertigo and incontinence. Age (p?=?.012), arterial hypertension (p<.000), obesity (p<.000) and cerebral macroangiopathy (p?=?.018) were positively related to cerebral lesion load. For increased glucose level, homocysteine, CRP and D-Dimers there was no association. Conclusion This underlines the association of CM with neurological symptoms upon admission in a topographical manner. Seizures and vertigo are symptoms of CM which may have been missed in previous studies. In addition to confirming known risk factors such as aging and arterial hypertension, obesity appears to increase the risk as well. Since the incidence of CM is increasing, future studies should focus on the importance of prevention of vascular risk factors on its pathogenesis. PMID:23393549

Okroglic, Sandra; Widmann, Catherine N.; Urbach, Horst; Scheltens, Philip; Heneka, Michael T.

2013-01-01

342

Base rates of postconcussion syndrome by method of symptom report.  

PubMed

This study compared the base rate of postconcussion syndrome (PCS) symptoms using three different assessment methods in a nonclinical sample. Seventy-three university students with no history of brain injury or neurological disease reported symptoms experienced during the previous 2 weeks in response to an open-ended question, a structured interview (simulated), and the British Columbia Postconcussion Symptom Inventory (BC-PSI). Statistically significant differences (all p < .001, d = 1.80-3.93, large effect sizes) were found between the number of symptoms reported on all assessment methods, such that participants reported the most PCS symptoms on the BC-PSI (M = 9.45, SD = 2.52), followed by the structured interview (M = 5.58, SD = 2.02), and the open-ended question (M = 1.86, SD = 1.00). Further, 100%, 92.1%, and 25.4% of the sample reported three or more ICD-10 Category C PCS symptoms on the BC-PSI, structured interview, and open-ended question, respectively. Findings suggest that method of assessment influences PCS base rates, such that symptom elicitation decreases relative to the reduction in prompting associated with each assessment method. Therefore, different diagnostic conclusions may be drawn depending on method of assessment used. Clinicians need to consider how their chosen assessment method may be influencing the symptoms reported by their patients. PMID:23373602

Edmed, Shannon L; Sullivan, Karen A

2012-01-01

343

mapcourtesyNINDs 36 NeurologyNow apr i l / m ay 2014 www.NeurologyNow.com  

E-print Network

mapcourtesyNINDs 36 NeurologyNow · apr i l / m ay 2014 www.NeurologyNow.com A world's fair amounts to stroke research, that's precisely what the National Insti- tute of Neurological Disorders and Stroke and results can be shared quickly to have the greatest im- pact on patient health. NINDS believes that NIH

O'Toole, Alice J.

344

Setting the agenda for neurological nursing: strategic directions.  

PubMed

This paper explores a range of issues related to neurological care. The scope and scale of neurological conditions is described in order to illustrate disparities in research funding and care delivery as compared with cancer and cardiovascular disease. Financial implications, ethical issues and health service development are outlined as a context for the state of the art of neurological nursing. Areas for potential neurological nursing research are identified. Finally, it is argued that policy and research must be linked if neurological care, research and education are to receive greater resource allocation. PMID:16386254

Smith, Lorraine N

2006-11-01

345

Dysregulation of gene expression as a cause of Cockayne syndrome neurological disease.  

PubMed

Cockayne syndrome (CS) is a multisystem disorder with severe neurological symptoms. The majority of CS patients carry mutations in Cockayne syndrome group B (CSB), best known for its role in transcription-coupled nucleotide excision repair. Indeed, because various repair pathways are compromised in patient cells, CS is widely considered a genome instability syndrome. Here, we investigate the connection between the neuropathology of CS and dysregulation of gene expression. Transcriptome analysis of human fibroblasts revealed that even in the absence of DNA damage, CSB affects the expression of thousands of genes, many of which are neuronal genes. CSB is present in a significant subset of these genes, suggesting that regulation is direct, at the level of transcription. Importantly, reprogramming of CS fibroblasts to neuron-like cells is defective unless an exogenous CSB gene is introduced. Moreover, neuroblastoma cells from which CSB is depleted show defects in gene expression programs required for neuronal differentiation, and fail to differentiate and extend neurites. Likewise, neuron-like cells cannot be maintained without CSB. Finally, a number of disease symptoms may be explained by marked gene expression changes in the brain of patients with CS. Together, these data point to dysregulation of gene regulatory networks as a cause of the neurological symptoms in CS. PMID:25249633

Wang, Yuming; Chakravarty, Probir; Ranes, Michael; Kelly, Gavin; Brooks, Philip J; Neilan, Edward; Stewart, Aengus; Schiavo, Giampietro; Svejstrup, Jesper Q

2014-10-01

346

Dysregulation of gene expression as a cause of Cockayne syndrome neurological disease  

PubMed Central

Cockayne syndrome (CS) is a multisystem disorder with severe neurological symptoms. The majority of CS patients carry mutations in Cockayne syndrome group B (CSB), best known for its role in transcription-coupled nucleotide excision repair. Indeed, because various repair pathways are compromised in patient cells, CS is widely considered a genome instability syndrome. Here, we investigate the connection between the neuropathology of CS and dysregulation of gene expression. Transcriptome analysis of human fibroblasts revealed that even in the absence of DNA damage, CSB affects the expression of thousands of genes, many of which are neuronal genes. CSB is present in a significant subset of these genes, suggesting that regulation is direct, at the level of transcription. Importantly, reprogramming of CS fibroblasts to neuron-like cells is defective unless an exogenous CSB gene is introduced. Moreover, neuroblastoma cells from which CSB is depleted show defects in gene expression programs required for neuronal differentiation, and fail to differentiate and extend neurites. Likewise, neuron-like cells cannot be maintained without CSB. Finally, a number of disease symptoms may be explained by marked gene expression changes in the brain of patients with CS. Together, these data point to dysregulation of gene regulatory networks as a cause of the neurological symptoms in CS. PMID:25249633

Wang, Yuming; Chakravarty, Probir; Ranes, Michael; Kelly, Gavin; Brooks, Philip J.; Neilan, Edward; Stewart, Aengus; Schiavo, Giampietro; Svejstrup, Jesper Q.

2014-01-01

347

Psychiatric manifestations of neurologic disease: where are we headed?  

PubMed Central

Neuropsychiatry represents a field of medicine situated at the crossroads of neurology and psychiatry, and deals with the interface of behavioral phenomena driven by brain dysfunction. Psychiatric symptoms are highly prevalent in these conditions, are a major source of disability and diminished quality of life, and potentially represent the target of treatment interventions that stand to significantly decrease the suffering they generate. In this article, the disease paradigm is explained, with particular attention to its role as an organizing principle for the field. Specific diseases including traumatic brain injury, stroke, Parkinson's disease, Alzheimer's disease, multiple sclerosis, and epilepsy are explored in relation to the presentation of multiple psychiatric phenotypes in each, associations with underlying brain pathology, and existing treatment approaches. Finally, the afticle explores the inherent complexities in this area of research and proposes a framework for future work based on the understanding of phenomenology and associated risk factors, the involvement of the rapidly advancing field of neuroscience, and targeted treatment development to serve as a road map for advancement in the field. PMID:17726911

Lyketsos, Constantin G.; Kozauer, Nicholas; Rabins, Peter V.

2007-01-01

348

Peripherin-IgG Association with Neurologic and Endocrine Autoimmunity  

PubMed Central

Peripherin-IgG has been reported a pertinent autoantibody in non-obese type 1 diabetic (NOD) mice. However, it has not previously been recognized in any human disease. In blinded evaluation of serum for markers of neurological autoimmunity in a high-volume diagnostic laboratory, we incidentally identified 26 patients (61% female) with an IgG that bound selectively to neural elements in enteric ganglia, sympathetic nerve trunks and discrete nerve tracts in mid-brain and hind-brain. The target antigen was identified as peripherin, a 55 kDa-type III intermediate filament protein. Review of clinical histories revealed that 54% of seropositive patients had dysautonomia (predominantly gastrointestinal dysmotility), 30% had neuropathies with varied sensory symptoms and 35% had clinical or serological evidence of endocrinopathy (type 1 diabetes, thyroiditis or premature ovarian failure). Collectively, 73% had autonomic dysfunction or endocrinopathy. None of 173 healthy subjects was seropositive. Subsequent western blot evaluation of archival sera from patients with small fiber/autonomic neuropathies (with or without endocrinopathy) revealed a 33% seropositivity rate for peripherin IgG. Our further demonstration that peripherin-immunoreactive autonomic fibers in pancreas, thyroid and ovary are juxtaposed to endocrine epithelium, complement our clinical observations in suggesting that neuronal elements may be a pertinent initial target for immune attack in multiple forms of endocrine autoimmunity (intermolecular epitope spreading). It remains to be determined whether or not peripherin-IgG is predictive for development of small fiber neuropathy (autonomic or somatic). PMID:20061119

Chamberlain, Jayne L.; Pittock, Sean J.; Oprescu, Anna-Maria; Dege, Carissa; Apiwattanakul, Metha; Kryzer, Thomas J.; Lennon, Vanda A.

2010-01-01

349

The neurology of folic acid deficiency.  

PubMed

The metabolism of folic acid and the metabolism of vitamin B12 are intimately linked such that deficiency of either vitamin leads to an identical megaloblastic anemia. The neurologic manifestations of folate deficiency overlap with those of vitamin B12 deficiency and include cognitive impairment, dementia, depression, and, less commonly, peripheral neuropathy and subacute combined degeneration of the spinal cord. In both deficiency states there is often dissociation between the neuropsychiatric and the hematologic complications. There is a similar overlap and dissociation between neurologic and hematologic manifestations of inborn errors of folate and vitamin B12 metabolism. Low folate and raised homocysteine levels are risk factors for dementia, including Alzheimer's disease, and depression. Even when folate deficiency is secondary to psychiatric illness due to apathy or poor diet it may eventually aggravate the underlying disorder in a vicious circle effect. Clinical responses to treatment with folates are usually slow over weeks and months, probably due to the efficient blood-brain barrier mechanism for the vitamin, perhaps in turn related to the experimentally demonstrated excitatory properties of folate derivatives. The inappropriate administration of folic acid in the presence of vitamin B12 deficiency may lead to both neurologic and, later, hematologic relapse. Impaired maternal folate intake and status increases the risk of neural tube defects. Periconceptual prophylactic administration of the vitamin reduces, but does not eliminate the risk of neural tube defects even in the absence of folate deficiency. Folates and vitamin B12 have fundamental roles in central nervous system function at all ages, especially in purine, thymidine, neucleotide, and DNA synthesis, genomic and nongenomic methylation and, therefore, in tissue growth, differentiation and repair. There is interest in the potential role of both vitamins in the prevention of disorders of central nervous system development, mood, dementia, including Alzheimer's disease, and aging. PMID:24365361

Reynolds, E H

2014-01-01

350

Metabolic disturbances in diseases with neurological involvement.  

PubMed

Degeneration of specific neuronal populations and progressive nervous system dysfunction characterize neurodegenerative diseases, including Alzheimer's disease and Parkinson's disease. These findings are also reported in inherited diseases such as phenylketonuria and glutaric aciduria type I. The involvement of mitochondrial dysfunction in these diseases was reported, elicited by genetic alterations, exogenous toxins or buildup of toxic metabolites. In this review we shall discuss some metabolic alterations related to the pathophysiology of diseases with neurological involvement and aging process. These findings may help identifying early disease biomarkers and lead to more effective therapies to improve the quality of life of the patients affected by these devastating illnesses. PMID:25110608

Duarte, João M N; Schuck, Patrícia F; Wenk, Gary L; Ferreira, Gustavo C

2014-08-01

351

Bilateral common carotid occlusion without neurological deficit.  

PubMed

A 40-year-old man presented with pain and numbness in his right arm. On his clinical examination, no neurological deficit was found. Bilateral common carotid artery duplex sonography scan demonstrated no flow in either lumen. No abnormality was recognized on brain CT. On cerebral digital substraction angiogram, total occlusion of the brachiocephalic trunk and left carotid artery were shown. There was a modest stenosis in the left vertebral artery. Collateral circulation feeding the intracranial carotid system mainly originated from the left vertebrobasilar system. Previous cases of bilateral carotid occlusion are reviewed and discussed. PMID:12452914

Karaköse, Serdar; Karabacakoglu, Aydin; Solak, Hasan

2002-12-01

352

The ketogenic diet as a treatment paradigm for diverse neurological disorders.  

PubMed

Dietary and metabolic therapies have been attempted in a wide variety of neurological diseases, including epilepsy, headache, neurotrauma, Alzheimer disease, Parkinson disease, sleep disorders, brain cancer, autism, pain, and multiple sclerosis. The impetus for using various diets to treat - or at least ameliorate symptoms of - these disorders stems from both a lack of effectiveness of pharmacological therapies, and also the intrinsic appeal of implementing a more "natural" treatment. The enormous spectrum of pathophysiological mechanisms underlying the aforementioned diseases would suggest a degree of complexity that cannot be impacted universally by any single dietary treatment. Yet, it is conceivable that alterations in certain dietary constituents could affect the course and impact the outcome of these brain disorders. Further, it is possible that a final common neurometabolic pathway might be influenced by a variety of dietary interventions. The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD) used in patients with medically intractable epilepsy. While the mechanisms through which the KD works remain unclear, there is now compelling evidence that its efficacy is likely related to the normalization of aberrant energy metabolism. The concept that many neurological conditions are linked pathophysiologically to energy dysregulation could well provide a common research and experimental therapeutics platform, from which the course of several neurological diseases could be favorably influenced by dietary means. Here we provide an overview of studies using the KD in a wide panoply of neurologic disorders in which neuroprotection is an essential component. PMID:22509165

Stafstrom, Carl E; Rho, Jong M

2012-01-01

353

Headache as presenting symptom of neurosarcoidosis.  

PubMed

Headache may occur in neurosarcoidosis and diagnostic criteria are given in the International Classification of Headache Disorders (ICHD-II). We present a case series of patients suffering from neurosarcoidosis in whom headache was the presenting symptom. The aim of the present study was to analyze the possible clinical presentations and the corresponding cerebral lesions in a retrospective chart review of patients suffering from neurosarcoidosis in whom headache was the presenting symptom. Medical records and data of six patients were analyzed. The possible diagnoses of headache forms included in ICDH-II, and in particular the correspondence with the criteria for "headache attributed to neurosarcoidosis", as well as neuroimaging findings were evaluated in each patient. The ICHD-II criteria were fulfilled in all the six patients. As for as clinical presentation, in three patients (50 %), headache had the clinical characteristics of Tolosa-Hunt syndrome, with evidence of a lesion into the cavernous sinus. In the remaining three cases headache was the only neurological symptom found in association with systemic features of sarcoidosis, and had the clinical features of tension-type headache. Our findings confirm that the clinical features of headache in patients with this disorder may have different presentations, which depend on neuropathologic involvement. Thus, a detailed neuroimaging study and CSF evaluation are needed to confirm diagnosis, particularly in patients with no sign of systemic sarcoidosis or in those in whom head pain may mimic a primary headache syndrome. PMID:23695076

Curone, M; Tullo, V; Peccarisi, C; Bussone, G; D'Amico, D

2013-05-01

354

Cold stress induces lower urinary tract symptoms.  

PubMed

Cold stress as a result of whole-body cooling at low environmental temperatures exacerbates lower urinary tract symptoms, such as urinary urgency, nocturia and residual urine. We established a model system using healthy conscious rats to explore the mechanisms of cold stress-induced detrusor overactivity. In this review, we summarize the basic findings shown by this model. Rats that were quickly transferred from room temperature (27 ± 2°C) to low temperature (4 ± 2°C) showed detrusor overactivity including increased basal pressure and decreased voiding interval, micturition volume, and bladder capacity. The cold stress-induced detrusor overactivity is mediated through a resiniferatoxin-sensitve C-fiber sensory nerve pathway involving ?1-adrenergic receptors. Transient receptor potential melastatin 8 channels, which are sensitive to thermal changes below 25-28°C, also play an important role in mediating the cold stress responses. Additionally, the sympathetic nervous system is associated with transient hypertension and decreases of skin surface temperature that are closely correlated with the detrusor overactivity. With this cold stress model, we showed that ?1-adrenergic receptor antagonists have the potential to treat cold stress-exacerbated lower urinary tract symptoms. In addition, we showed that traditional Japanese herbal mixtures composed of Hachimijiogan act, in part, by increasing skin temperature and reducing the number of cold sensitive transient receptor potential melastatin channels in the skin. The effects of herbal mixtures have the potential to treat and/or prevent the exacerbation of lower urinary tract symptoms by providing resistance to the cold stress responses. Our model provides new opportunities for utilizing animal disease models with altered lower urinary tract functions to explore the effects of novel therapeutic drugs. PMID:23441811

Imamura, Tetsuya; Ishizuka, Osamu; Nishizawa, Osamu

2013-07-01

355

Listeriosis: Definition and Symptoms  

MedlinePLUS

... page: About CDC.gov . Listeria (Listeriosis) Share Compartir Definition Listeria : Food Poisoning's Rare but Deadly Germ February ... 888) 232-6348 Contact CDC–INFO Listeria (Listeriosis) Definition & Symptoms Outbreaks Oasis Brands Inc., Cheese Recall & Advice ...

356

Medically unexplained physical symptoms  

Microsoft Academic Search

ObjectiveThe aim of this study was to estimate the number of patients with medically unexplained physical symptoms (MUPS) that could be eligible for group cognitive–behavioural treatment (CBT) and to assess the acceptability of this treatment.

I. A. Arnold; A. E. M. Speckens; A. M. van Hemert

2004-01-01

357

Tetanus: Symptoms and Complications  

MedlinePLUS

... of the muscles of the jaw, or "lockjaw". Tetanus symptoms include: Headache Jaw cramping Sudden, involuntary muscle ... sweating High blood pressure and fast heart rate Tetanus complications include: Uncontrolled/involuntary muscular contraction of the ...

358

Module 3 – Symptoms  

Cancer.gov

Module three of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study Original Version presents approaches to and management of commonly encountered symptoms and syndromes of cancer patients.

359

Dyslexia: Causes, Symptoms, Definition.  

ERIC Educational Resources Information Center

The article reviews proposed causes and observable symptoms that characterize dyslexia, concluding that individualized analysis and specialized treatments are required and that, until an operational definition can be agreed upon, use of the label "dyslexia" is counterproductive. (DB)

Shannon, Albert J.

1986-01-01

360

Smallpox and smallpox vaccination: neurological implications.  

PubMed

Compulsory vaccination was discontinued in the U.S. in 1972; the world was declared free of smallpox infection in 1980. Since that time, no new smallpox infections have been recognized, and only limited numbers of military and laboratory personnel have been vaccinated. As a result, the majority of the U.S. and the world population have no or diminished immunity to smallpox. Widespread vaccination, beginning with the military and health care workers, is now being undertaken. Public health strategies for immunizing the general population include preexposure voluntary vaccination, case surveillance with ring vaccination, and mass vaccination at the time of attack. Cutaneous complications of vaccination occur in immunosuppressed subjects and in those with atopic dermatitis. Among the most serious complications is postvaccinal encephalomyelitis (PVEM). A related condition, postvaccinial encephalopathy (PVE), may be seen in children less than two years of age. There are no markers to predict who will develop PVEM. In the past, mortality was high, ranging from 10 to 50%. The neuropathology of PVEM suggested an immune-mediated attack on the CNS, but the target of the immune response is unknown. Comprehensive programs are needed for surveillance and confirming case definitions for neurologic complications. Multi-institutional controlled trials of antiviral and immune modulating therapy of PVEM should be considered. Neurologists should be actively involved in the planning process for vaccination programs and in the treatment of neurologic complications. PMID:12707424

Booss, John; Davis, Larry E

2003-04-22

361

Neurological caricatures since the 15th century.  

PubMed

During the Renaissance, different artists began to draw medical illustrations from various viewpoints. Leonardo da Vinci was among those who sought to portray the emotional as well as the physical qualities of man. Other European artists described caricatural aspects of medical activities. In Northern Europe, Albrecht Durer, Hieronymus Bosch, and Pieter Brueghel were also famous for drawing caricatures. Later English artists, notably William Hogarth, Thomas Rowlandson, James Gillray, and the Cruikshanks, satirized life in general and the medical profession in particular. In Spain, Francisco Goya's works became increasingly macabre and satirical following his own mysterious illness and, in France, Honore Daumier used satire and humor to expose medical quackery. Also physicians such as Charles Bell and Jean-Martin Charcot were talented caricaturists. Their own personal artistic styles reflected their approach and gave a different "image" of neurology. Caricatures were popular portraits of developments in science and medicine and were frequently used whenever scientific language was too difficult to disseminate, in particular in the field of neurology. PMID:18629699

Lorusso, Lorenzo

2008-01-01

362

Premature ovarian insufficiency and neurological function.  

PubMed

Premature ovarian insufficiency (POI) involves loss of ovarian function before age 40. POI has been associated with neurological dysfunction and an increased risk of dementia, perhaps due to depletion in estrogen levels. The present review discusses the effects of POI caused by genetic disorder, natural premature menopause, surgical menopause, breast cancer treatment and gonadotropin-releasing hormone (GnRH) agonist treatment. Overall, data suggest an increased risk of neurological disorder where POI is due to premature menopause or induced from surgery. This increased risk appears to be most apparent on domains of global cognitive and verbal memory tests. Where POI is caused by genetic disorder, observed cognitive deficiencies may be more likely to have a genetic basis rather than being due to the effects of sex steroids on the brain. Findings related to loss of cognitive function after chemotherapy or GnRH treatments are mixed. There are also discrepant data related to use of hormone therapy after POI (particularly after surgical menopause). After surgery, hormone treatment appears to be most beneficial if initiated close to the average natural age of menopause. PMID:24942013

Soni, M; Hogervorst, E

2014-09-01

363

Vinken and Bruyn's Handbook of Clinical Neurology. A witness of late-twentieth century neurological progress.  

PubMed

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 a strategist with expertise in information systems, the other a gifted neurologist with an expert knowledge of who is who in the world of neurological literature. Within a period of 38 years, 2799 authors, 28 volume editors, the two initiators, and a third chief editor for the American continent described the whole of neurology in 1909 chapters on all together 46,025 pages (excluding index volumes). HCN was sold mainly to medical institutes in affluent countries. A digital version of the revised edition was proposed by the editors but refused by the publisher for commercial reasons. HCN was in general well received by book reviewers. The main criticisms concerned the price of the volumes, lack of editorial control, inadequacy of indexes, and lack of cross references. HCN offers unrivalled information on the state of the art of the clinical neurosciences in the second half of the twentieth century. In addition, it contains extensive reviews of the history of neurological diseases in the volumes of the original edition. PMID:18161596

Koehler, P J; Jennekens, F G I

2008-01-01

364

Chapter 8 The development of neurology and the neurological sciences in the 17th century  

Microsoft Academic Search

Circa 1660 several favorable factors, instrumental to the invention of neurology, converged at the University of Oxford. Animals and men were believed to have a material soul whose functions throughout the nervous system were accessible to research. In 1659 inductive methods were introduced in clinical medicine by Thomas Willis, the founder of English epidemiology and biochemistry. The Vertuosi,who later founded

Hansruedi Isler

2009-01-01

365

[Hyperammonemia and transient blindness after transurethral resection of the prostate. Review of a case].  

PubMed

We report a case of hyperammonemia and transient blindness following transurethral prostatic resectin. Glicine and ammonia metabolism are reviewed. Water intoxication may not account for these symptoms. PMID:1927654

Isa Kroon, W A; Aguera Fernández, L G; Rosell Costa, D; de Castro Barbosa, F; Sánchez de la Muela, P L; Robles García, J E; Zudaire Bergera, J J; Berián Polo, J M

1991-01-01

366

Symptom Management Concept Design Webinar  

Cancer.gov

Objectives Describe the review process for a symptom management concept Identify the required elements included in a symptom management concept Identify key statistical considerations for a symptom management concept Describe issues to consider

367

Contact Dermatitis: Signs and Symptoms  

MedlinePLUS

... treatments A - D Contact dermatitis Signs and symptoms Contact dermatitis: Signs and symptoms Allergic contact dermatitis : Testing ... these symptoms, you need immediate medical care. Allergic contact dermatitis This skin condition occurs when you have ...

368

The early struggles of the fledgling American Academy of Neurology: resistance from the old guard of American neurology.  

PubMed

The American Neurological Association, established in 1874, was a small exclusive society comprising senior neurologists at a select number of north-eastern academic institutions. In 1948, an attempt was made to establish a second neurological society in the USA. The American Academy of Neurology was formed around a group of young neurologists who represented the country's Midwest and other regions. The American Academy of Neurology is now the larger of the two organizations, even though the American Academy of Neurology began as a small and politically vulnerable organization, arising in the shadow of the powerful and established American Neurological Association. How did the 75-year-old association react when a second, seemingly redundant, neurological association attempted to organize? This question has not been the focus of historical work, and the purpose of this study was to address this. To do so, the author studied the primary source materials in the American Academy of Neurology Historical Collection and the papers of Dr Henry Alsop Riley, an American neurologist, who was influential in both the American Neurological Association and American Academy of Neurology. On its formation, the American Academy of Neurology did not enter a vacuum. Indeed, the long-existing American Neurological Association actively resisted the new organization. There was reluctance to accept the new idea on a conceptual level, a formal attempt to hijack the new organization and discussions about punitive actions against its founder, while at the same time an attempt to bring him into the American Neurological Association leadership. Although the American Neurological Association attempted to frame itself as the patrician 'upper chamber' of American neurology, the American Academy of Neurology leadership was ultimately savvier at political manoeuvring and use of government agencies and funding organizations. The struggle of the American Academy of Neurology with the American Neurological Association was in many ways one manifestation of a larger societal struggle in a post-bellum (post-World War II) America with a changing demographic. The struggle involved the rise of democratic medical populism in the country's Midwest versus establishment medicine (mainly situated in the Northeast), and perhaps, the rise of the middle class versus the aristocrats. PMID:23288329

Louis, Elan D

2013-01-01

369

Table 3.10 Medical Examination Participation Rates Among Vietnam and Non-Vletnll n Veterans Who Had Telephone Interviews, by Selected Neurological and I~uscular  

E-print Network

Table 3.10 Medical Examination Participation Rates Among Vietnam and Non-Vletnll n Veterans Who of eligible veterans interviewed by telephone who underwent examination. d Number of veterans-Reported Neurological and Muscular SymptomsB Ani )ng Vietnam and Non-Vietnam Veterans Selected for Medical Examination

370

55710.2217/FNL.12.47 2012 Future Medicine Ltd ISSN 1479-6708Future Neurol. (2012) 7(5), 557571 FutureNeurology  

E-print Network

­571 FutureNeurology part of Alzheimer's disease causes a progressive deteriora- tion of cognitive function of the root cause of Alzheimer's disease typically focus on specific molecular pathways and do not address express symptoms analogous to those observed in Alzheimer's disease patients. Malignant synaptic growth

Hasselmo, Michael

371

[40 years of neurological intensive care in Croatia].  

PubMed

On the 40 year anniversary of the foundation of the first Neurological intensive therapy unit (ICU) in Zagreb, Croatia and in the region, the author recalls circumstances which stipulated its realization. The process lasted several years, from the proposal in 1968, starting working in provisional conditions in 1971--acquiring experience, and normal functioning in the newly adapted rooms in 1974. Paying tribute to personalities who supported and participated in the advances of this process, the author informs that at the First Congress of Intensive Care (London, 1974) his report on Zagreb Neurological intensive therapy unit was the only one in neurology. The basic principles of therapy are nowadays the standard in the neurological departments, enabling better recovery from stroke, neurological ailment with high mortality. Positive development brought to the realization of the concept of comprehensive care for cerebrovascular patients, including prevention, early intensive therapy and neurological restoration measures after stroke. PMID:24490335

Barac, Bosko

2013-01-01

372

Pediatric neurological disorder and present nuclear detonation: a hot issue.  

PubMed

It is no doubt for the health effect of the radiation from the nuclear detonation from the destroyed nuclear power plant. Due to the present crisis in Japan, the public health concern on this issue should be raised. In pediatric neurology, there are some interesting reports on pediatric neurological disorder and its relationship to leaked radiation. In this specific brief article, the author hereby discusses on the nuclear detonation and pediatric neurological disorder. Although there are some reports on the increased incidence of some pediatric neurological malignancies and congenital neurological anomalies there is no confirmed evidence. Effect on cognitive function is still controversial. The induction of abnormal electroencephalography is also mentioned. The observation on the effect of present crisis in pediatric neurology can provide more information and help better understand this topic. PMID:22670268

Wiwanitkit, Viroj

2011-12-01

373

Transient nucleation in glasses  

NASA Technical Reports Server (NTRS)

Nucleation rates in condensed systems are frequently not at their steady state values. Such time dependent (or transient) nucleation is most clearly observed in devitrification studies of metallic and silicate glasses. The origin of transient nucleation and its role in the formation and stability of desired phases and microstructures are discussed. Numerical models of nucleation in isothermal and nonisothermal situations, based on the coupled differential equations describing cluster evolution within the classical theory, are presented. The importance of transient nucleation in glass formation and crystallization is discussed.

Kelton, K. F.

1991-01-01

374

Translational Research in Neurology and Neuroscience 2010  

PubMed Central

Over the past 2 decades, enormous progress has been made with regard to pharmacotherapies for patients with multiple sclerosis. There is perhaps no other subspecialty in neurology in which more agents have been approved that substantially alter the clinical course of a disabling disorder. Many of the pharmaceuticals that are currently approved, in clinical trials, or in preclinical development were initially evaluated in an animal model of multiple sclerosis, experimental autoimmune encephalomyelitis. Two Food and Drug Administration–approved agents (glatiramer acetate and natalizumab) were developed using the experimental autoimmune encephalomyelitis model. This model has served clinician-scientists for many decades to enable understanding the inflammatory cascade that underlies clinical disease activity and disease surrogate markers detected in patients. PMID:20625066

Stüve, Olaf; Kieseier, Bernd C.; Hemmer, Bernhard; Hartung, Hans-Peter; Awad, Amer; Frohman, Elliot M.; Greenberg, Benjamin M.; Racke, Michael K.; Zamvil, Scott S.; Phillips, J. Theodore; Gold, Ralf; Chan, Andrew; Zettl, Uwe; Milo, Ron; Marder, Ellen; Khan, Omar; Eagar, Todd N.

2013-01-01

375

Neurology of microgravity and space travel  

NASA Technical Reports Server (NTRS)

Exposure to microgravity and space travel produce several neurologic changes, including SAS, ataxia, postural disturbances, perceptual illusions, neuromuscular weakness, and fatigue. Inflight SAS, perceptual illusions, and ocular changes are of more importance. After landing, however, ataxia, perceptual illusions, neuromuscular weakness, and fatigue play greater roles in astronaut health and readaptation to a terrestrial environment. Cardiovascular adjustments to microgravity, bone demineralization, and possible decompression sickness and excessive radiation exposure contribute further to medical problems of astronauts in space. A better understanding of the mechanisms by which microgravity adversely affects the nervous system and more effective treatments will provide healthier, happier, and longer stays in space on the space station Freedom and during the mission to Mars.

Fujii, M. D.; Patten, B. M.

1992-01-01

376

Neurologic manifestations of gastrointestinal and liver diseases.  

PubMed

Hepatic and gastrointestinal disorders can produce a wide spectrum of neurologic complications both affecting the central nervous system (CNS) and the peripheral nervous system. These manifestations range in severity from coma in acute liver failure and acute pancreatitis, to minor cognitive changes in chronic portosystemic encephalopathy and hepatitis C. Cerebrovascular diseases can complicate hepatitis C infection and inflammatory bowel disease. Demyelinating disorders may co-exist with inflammatory bowel disease. Anti-tumor necrosis factor alpha drugs may induce demyelination. Ataxia may occur in malabsorption syndromes and in gluten related disorders. Characteristic movement disorders are key features of acquired hepatocerebral degeneration and of Whipple disease. Multiple types of neuropathy can be found in association with hepatitis, inflammatory bowel disease and gluten related disorders. PMID:25171900

Ferro, José M; Oliveira, Sofia

2014-10-01

377

Neurologic manifestations of chronic methamphetamine abuse  

PubMed Central

Summary Chronic methamphetamine abuse has devastating effects on the central nervous system. The degree to which addicts will tolerate the dysfunction in the way they think, feel, move, and even look, is a powerful testimony to the addictive properties of this drug. While the mechanisms behind these disorders are complex, at their heart they involve the recurring increase in the concentrations of central monoamines with subsequent dysfunction in dopaminergic neurotransmission. The mainstay of treatment for the problems associated with chronic methamphetamine abuse is abstinence. However, by recognizing the manifestations of chronic abuse, clinicians will be better able to help their patients get treatment for their addiction and to deal with the neurologic complications related to chronic abuse. PMID:21803215

Rusyniak, Daniel E.

2011-01-01

378

Neuroprotective and neurological properties of Melissa officinalis.  

PubMed

Melissa officinalis has traditionally been used due to its effects on nervous system. Both methanolic and aqueous extracts were tested for protective effects on the PC12 cell line, free radical scavenging properties and neurological activities (inhibition of MAO-A and acetylcholinesterase enzymes and affinity to the GABA(A)-benzodiazepine receptor). The results suggest that the plant has a significant (P < 0.05) protective effect on hydrogen peroxide induced toxicity in PC12 cells. The radical scavenging properties were also investigated in cells and in cell free systems, where this plant was shown to be a good free radical scavenger. The MAO-A bioassay was also performed to detect possible antidepressant activities demonstrating that both extracts inhibited this enzyme, which has a key role in neurotransmitters metabolism. However, no activity was detected in the acetylcholinesterase and GABA assays. In general, the methanolic extract was more effective than the aqueous. PMID:19760174

López, Víctor; Martín, Sara; Gómez-Serranillos, Maria Pilar; Carretero, Maria Emilia; Jäger, Anna K; Calvo, Maria Isabel

2009-11-01

379

PET/MRI for Neurological Applications  

PubMed Central

PET and MRI provide complementary information in the study of the human brain. Simultaneous PET/MR data acquisition allows the spatial and temporal correlation of the measured signals, opening up opportunities impossible to realize using stand-alone instruments. This paper reviews the methodological improvements and potential neurological and psychiatric applications of this novel technology. We first present methods for improving the performance and information content of each modality by using the information provided by the other technique. On the PET side, we discuss methods that use the simultaneously acquired MR data to improve the PET data quantification. On the MR side, we present how improved PET quantification could be used to validate a number of MR techniques. Finally, we describe promising research, translational and clinical applications that could benefit from these advanced tools. PMID:23143086

Catana, Ciprian; Drzezga, Alexander; Heiss, Wolf-Dieter; Rosen, Bruce R.

2013-01-01

380

Neurologic Aspects of Infections in International Travelers  

PubMed Central

Background As international travel for business and pleasure becomes part of contemporary lifestyle, the clinician today is confronted with an increasing number of travelers returning ill with unfamiliar syndromes. The physician will encounter a myriad of patients with exotic infections, emerging infectious diseases, or resurgent Old-World infections. Review Summary This review article will discuss salient points of important infectious diseases associated with overseas travel, provide a syndromic approach to the traveler who returns with neurologic manifestations, and list resources for additional diagnostic, therapeutic, and preventive information. Conclusions As many of infections acquired in other countries can directly or indirectly affect the nervous system, the care of the ill traveler often falls into the hands of neurologists. The contemporary neurologist should therefore be knowledgeable of the clinical manifestations, potential complications, and appropriate management of region-specific infections. PMID:15631642

Han, May H.; Zunt, Joseph R.

2009-01-01

381

The Prevalence and Impact of Neurologic Disease in Cancer  

Microsoft Academic Search

Up to 45% of patients with cancer require evaluation of a neurologic problem. The most common reasons for referral to a neurology\\u000a service are pain, altered mental status, motor weakness and headache. After consultation, the most frequent diagnoses made\\u000a are metabolic and toxic encephalopathy, polyneuropathy, cerebrovascular diseases, vertebral metastasis, and brain metastasis.\\u000a Early recognition of a neurologic problem and institution

Evert C. A. Kaal; Charles J. Vecht

382

Neurologic events in neonates treated surgically for congenital heart disease  

Microsoft Academic Search

Objective:The incidence of acute neurologic events prior to discharge in neonates with congenital heart disease (CHD) was determined and peri-operative characteristics predictive of a neurologic event were identified.Study design:A retrospective chart review over 1 year was conducted of infants <1 month of age with a diagnosis of CHD. Outcomes were measured by the occurrence of an acute neurologic event defined

V Y Chock; V M Reddy; D Bernstein; A Madan

2006-01-01

383

The presentation of a transient hyperintense lesion with Legionnaires disease in a patient--is it a coincidence or an incidental finding?  

PubMed

Up to date the presentation of transient splenial lesions in corpus callosum were reported in diffusion weighted magnetic resonance imaging (MRI) only in epileptic patients and patients under antiepileptic therapy. A 41 year old male with no previous medical history was admitted to our clinic with symptoms of pneumonia. The neurological exam revealed stupor, but when awake his speech and orientation were normal. There were no meningeal irritation signs, cranial nerves, piramidal and cerebellar functions were normal. He had moderate respiratory distress and had bilateral rales in lower lobes while on auscultation. Laboratory tests revealed high liver function levels and high acute phase reactants. Arterial blood levels showed hypoxemia. A brain MRI showed a hypointensity in the splenium of corpus callosum on T1 weighted images. There was markedly increased signal in this region on diffusion weighted imaging and hypointense on ADC. The lesion was slightly hyperintense on T2 and FLAIR weighted images. A repeat brain MRI was done 30 days after the initial study and showed a complete resolution of the splenial lesion. Transient splenial lesions can be seen due to different mechanisms in different clinical settings. It should be noted that these lesions are mostly reversible. Unnecessary therapies and procedures should be avoided in these lesions. PMID:23607232

Kiliç, Eda Coban; Aksoy, Selma; Sahin, Ahmet Riza; Uzun, Nuray; Gökyigit, Münevver

2013-01-30

384

Patient heal thyself: modeling and treating neurological disorders using patient-derived stem cells  

PubMed Central

Disorders of the brain and spinal cord are common worldwide problems but have remained very difficult to treat. As a group they have diverse etiologies and can be due to trauma, infection, tumors, genetic mutations and environmental insults. Though distinct in etiology, neurological disorders share an overall intractability as current therapies are largely limited to treatment of symptoms. Improved outcomes are further constrained by the minimal endogenous capacity of the brain and spinal cord for repair. Spectacular recent scientific advances, however, suggest that new stem cell-based approaches may change this undesirable situation. In this review, I will broadly outline the challenges of studying and treating disorders of the brain and spinal cord. I will review ongoing attempts to use stem cell-based therapies to both model and treat neurological disorders. While this field is in its infancy, expected advances and needed breakthroughs point to a future where patient-derived stem cells will be the basis for the emerging discipline of regenerative neurology. PMID:23598977

Ess, Kevin C

2013-01-01

385

Stem cell transplantation in neurological diseases: improving effectiveness in animal models  

PubMed Central

Neurological diseases afflict a growing proportion of the human population. There are two reasons for this: first, the average age of the population (especially in the industrialized world) is increasing, and second, the diagnostic tools to detect these pathologies are now more sophisticated and can be used on a higher percentage of the population. In many cases, neurological disease has a pharmacological treatment which, as in the case of Alzheimer's disease, Parkinson's disease, Epilepsy, and Multiple Sclerosis can reduce the symptoms and slow down the course of the disease but cannot reverse its effects or heal the patient. In the last two decades the transplantation approach, by means of stem cells of different origin, has been suggested for the treatment of neurological diseases. The choice of slightly different animal models and the differences in methods of stem cell preparation make it difficult to compare the results of transplantation experiments. Moreover, the translation of these results into clinical trials with human subjects is difficult and has so far met with little success. This review seeks to discuss the reasons for these difficulties by considering the differences between human and animal cells (including isolation, handling and transplantation) and between the human disease model and the animal disease model. PMID:25364724

Adami, Raffaella; Scesa, Giuseppe; Bottai, Daniele

2014-01-01

386

Fate of manganese associated with the inhalation of welding fumes: potential neurological effects.  

PubMed

Welding fumes are a complex mixture composed of different metals. Most welding fumes contain a small percentage of manganese. There is an emerging concern among occupational health officials about the potential neurological effects associated with the exposure to manganese in welding fumes. Little is known about the fate of manganese that is complexed with other metals in the welding particles after inhalation. Depending on the welding process and the composition of the welding electrode, manganese may be present in different oxidation states and have different solubility properties. These differences may affect the biological responses to manganese after the inhalation of welding fumes. Manganese intoxication and the associated neurological symptoms have been reported in individual cases of welders who have been exposed to high concentrations of manganese-containing welding fumes due to work in poorly ventilated areas. However, the question remains as to whether welders who are exposed to low levels of welding fumes over long periods of time are at risk for the development of neurological diseases. For the most part, questions remain unanswered. There is still paucity of adequate scientific reports on welders who suffered significant neurotoxicity, hence there is a need for well-designed epidemiology studies that combine complete information on the occupational exposure of welders with both behavioral and biochemical endpoints of neurotoxicity. PMID:16219356

Antonini, James M; Santamaria, Annette B; Jenkins, Neil T; Albini, Elisa; Lucchini, Roberto

2006-05-01

387

Executive dysfunctions and depression in Behçet's disease without explicit neurological involvement.  

PubMed

This study aims to assess the executive functions and depression status in patients with Behçet's disease without explicit neurological involvement and to evaluate cognitive functions in this group of patients independent of accompanying depression. In the present study, 30 patients with Behçet's disease in the non-active phase of their illness and 30 healthy volunteers were included. In the evaluation of depression levels, Beck Depression Inventory was employed. The executive functions of the patients were evaluated by Wisconsin Card Sorting Test (WCST) and Stroop Test (ST). Beck Depression Inventory scores measured in the Behçet's disease group, in which no clinically serious depression was observed, were higher than the control group. Then, it was observed that the scores of neuropsychological tests of the Behçet's disease group were found to be significantly lower, especially in WCST, while significant relations were revealed between Beck Depression Inventory scores and WCST, ST scores. The authors' findings suggest that there may be factors other than depression causing executive impairment in patients with Behçet's disease without explicit neurological symptoms. Executive dysfunctions may occur in association with mild depressive states due to chronic disease stress or silent and/or future neurological involvement of Behçet's disease, especially in the frontal lobes. PMID:16884449

Erberk-Ozen, Nurper; Birol, Ahu; Boratav, Cumhur; Kocak, Mukadder

2006-08-01

388

Perforation of the gastrointestinal tract in patients receiving steroids for neurologic disease.  

PubMed

Between 1980 and 1984, of 107 patients receiving 16 mg/d of dexamethasone for spinal cord compression, three (2.8%) developed gastrointestinal (GI) perforation and two (1.9%) GI bleeding; of 226 being tapered from 100 mg/d of dexamethasone, perforation occurred in six (2.7%) and GI bleeding in eight (3.5%). Of 125 patients with GI perforations treated between 1979 and 1986, 41 (33%) were on steroids, 24 for neurologic disease. Median duration of steroid therapy was 24 days; 20 (91%) of the neurologic patients perforated within 30 days. The steroid group had more free peritoneal involvement (p less than 0.00001), but fewer signs and symptoms of peritonitis (p less than 0.000001) than the nonsteroid group. Seventeen patients were receiving steroids for cord compression; they had significantly more rectosigmoid perforations (p less than 0.014) and associated constipation (p less than 0.000001) than the 108 remaining patients. GI perforation is a less well-recognized complication of steroid therapy in neurologic patients than is GI bleeding though it occurs as frequently, is more difficult to diagnose, and far more serious. In steroid-treated patients, prevention of constipation might avert this serious complication, while early diagnosis will improve the outcome. PMID:3258062

Fadul, C E; Lemann, W; Thaler, H T; Posner, J B

1988-03-01

389

Neuropsychological symptoms and occupational exposure to anaesthetics.  

PubMed Central

OBJECTIVE--To analyse the relation between symptoms regularly reported by hospital personnel and exposure to anaesthetics. SETTING--Personnel of 18 hospitals in Paris from 1987 to 1989. DESIGN--An exposed group that included all operating theatre members except for doctors, and which was divided into three subgroups depending on the degree of exposure--exposure was measured by the frequency of the use of the scavenging system--and a control group that included other hospital personnel matched by hospital, sex, occupation, age, and duration of service. SUBJECTS--557 exposed workers and 566 unexposed workers. MAIN OUTCOME MEASURES--The groups were compared according to the crude rates of regular symptoms. Adjusted odds ratios were calculated to estimate the risks associated with exposure to anaesthetic gas. Liver transaminase activities (alanine aminotransferase, aspartate aminotransferase (s-ASAT, and gamma-glutamyl transpeptidase) were measured and compared between groups of exposure. RESULTS--After controlling for working conditions and matching factors, neuropsychological symptoms and tiredness were reported more by workers in less often scavenged theatres than by controls. No difference was found between workers of the well scavenged theatres and controls. Among the exposed workers, the members of paediatric surgical staffs reported a higher rate of neurological complaints (tingling, numbness, cramps) and tiredness than the members of the other surgical staffs. They had a high value of s-ASAT more frequently than the other exposed workers. CONCLUSION--These results strengthen the hypothesis of a causal relation between exposure to anaesthetics and neuropsychological symptoms, and show a dose-response effect. They suggest that the use of ventilating systems in operating rooms is an effective means of prevention. PMID:1571297

Saurel-Cubizolles, M J; Estryn-Behar, M; Maillard, M F; Mugnier, N; Masson, A; Monod, G

1992-01-01

390

Will neurology residents with large student loan debts become academicians?  

PubMed

Medical education in the United States is expensive, with 4-year tuition at some institutions totaling more than 150,000 US dollars. Most US graduates have student debt burdens. Using an internet survey, we tested the hypothesis that high student debt adversely affects neurology residents' desire to pursue careers in academic neurology. The results indicate median year 2000 US graduate neurology resident student debt is in the 50,000 to 75,000 US dollars range and that this debt burden may deter US graduates from pursuing careers in academic neurology. PMID:11839863

Doherty, Michael J; Schneider, A T; Tirschwell, D L

2002-02-12

391

Presenting symptoms of children with cancer: a primary-care population-based study  

PubMed Central

Background Knowledge of how children with cancer present in general practice is sparse. Timely referral from general practice is important to ensure early diagnosis. Aim To investigate the presenting symptoms and GPs’ interpretations of symptoms of children with cancer. Design and setting A Danish nationwide population-based study including children (<15 years) with an incident cancer diagnosis (January 2007 to December 2010). Method A questionnaire on symptoms and their interpretation was mailed to GPs (n?=?363). Symptoms were classified according to the International Classification of Primary Care (ICPC)-2 classification. Results GPs’ response rate was 87% (315/363) and GPs were involved in the diagnostic process of 253 (80.3%) children. Symptoms were few (2.4 per child) and most fell into the category ‘general and unspecified’ (71.9%), apart from patients with tumours of the central nervous system (CNS), whose symptoms fell mostly in the category ‘neurological’ (for example, headache). Symptoms like pain, swelling/lump, or fatigue were reported in 25% of the patients and they were the most commonly reported symptoms. GPs interpreted children’s symptoms as alarm symptoms in 20.2%, as serious (that is, not alarm) symptoms in 52.9%, and as vague symptoms in 26.9%. GPs’ interpretation varied significantly by diagnosis (P<0.001). Conclusion Children with cancer presented with few symptoms in general practice, of which most were ‘general and unspecified’ symptoms. Only 20% presented alarm symptoms, while 27% presented vague and non-specific symptoms. This low level of alarm symptoms may influence the time from symptom presentation in general practice to final diagnosis. PMID:22781993

Ahrensberg, Jette M?ller; Hansen, Rikke Pilegaard; Olesen, Frede; Schr?der, Henrik; Vedsted, Peter

2012-01-01

392

Paroxysmal sneezing at the onset of syncopes and transient ischemic attack revealing a papillary cardiac fibroelastoma.  

PubMed

Sneezing can at times be associated with neurological disorders. The "sneeze center" is localized in the lateral medulla. We report the case of a 50-year-old man who presented three episodes of sneezing, two of them followed by an episode of transient gait instability and dizziness and the third one followed by an episode of transient left hemiparesis due to fibroelastoma of the aortic cardiac valve. To the best of our knowledge, this is the first description of a transient ischemic attack due to cardiac papillary fibroelastoma and revealed by violent episodes of sneezing. PMID:25045556

Mathis, Stéphane; Lamy, Matthias; Ciron, Jonathan; Iljicsov, Anna; Arjmand, Roxana; Agius, Pierre; Neau, Jean-Philippe

2014-01-01

393

Paroxysmal Sneezing at the Onset of Syncopes and Transient Ischemic Attack Revealing a Papillary Cardiac Fibroelastoma  

PubMed Central

Sneezing can at times be associated with neurological disorders. The “sneeze center” is localized in the lateral medulla. We report the case of a 50-year-old man who presented three episodes of sneezing, two of them followed by an episode of transient gait instability and dizziness and the third one followed by an episode of transient left hemiparesis due to fibroelastoma of the aortic cardiac valve. To the best of our knowledge, this is the first description of a transient ischemic attack due to cardiac papillary fibroelastoma and revealed by violent episodes of sneezing. PMID:25045556

Mathis, Stephane; Lamy, Matthias; Ciron, Jonathan; Iljicsov, Anna; Arjmand, Roxana; Agius, Pierre; Neau, Jean-Philippe

2014-01-01

394

Femtosecond Transient Imaging  

E-print Network

This thesis proposes a novel framework called transient imaging for image formation and scene understanding through impulse illumination and time images. Using time-of-flight cameras and multi-path analysis of global light ...

Kirmani, Ahmed (Ghulam Ahmed)

2010-01-01

395

Transient Response Analysis  

NASA Technical Reports Server (NTRS)

Transient Response Analysis Program, TRAP aids in analysis of frequency response of force-transmission and shock-damping devices. Devices analyzed with TRAP include hydraulic actuators, automotive shock absorbers and electromechanical actuators.

Blackman, L. D.

1985-01-01

396

Transient monocular visual loss.  

PubMed

Transient monocular visual loss may be caused by a variety of ophthalmic and systemic conditions. Management depends on identifying the cause. Embolic occlusions of arteries supplying the eye are a most important cause. Such emboli often arise from the heart, aorta, and internal carotid arteries. The most common embolic substances are white platelet-fibrin and red erythrocyte-fibrin thrombi, cholesterol crystals, and calcific particles. Retinal vasoconstriction is another important cause of transient monocular visual loss. The conditions that cause anterior ischemic optic neuropathy may occasionally cause transient visual loss. Transient monocular visual loss may also be related to conditions that cause papilledema and some conditions intrinsic to the eye, such as optic disk drusen and colobomas. PMID:17540127

Amick, Amy; Caplan, Louis R

2007-01-01

397

Complex transient epileptic amnesia.  

PubMed

Transient epileptic amnesia is a rare but probably underrecognized form of temporal lobe epilepsy, which typically manifests as episodic isolated memory loss. Consequently, transient epileptic amnesia may be readily misdiagnosed as a nonepileptic memory dysfunction in older individuals. When appropriately recognized, it has been described as a treatment-responsive syndrome amenable to antiepileptic drugs. We describe a patient with drug-resistant transient epileptic amnesia treated with unilateral temporal lobectomy. Prolonged postictal slowing in the mesial temporal structures was evident on invasive electroencephalography 5 hours after the occurrence of a brief focal seizure. These findings support the theory of a Todd phenomenon as the underlying pathophysiological mechanism in transient epileptic amnesia. PMID:21262589

Walsh, Ryan D; Wharen, Robert E; Tatum, William O

2011-02-01

398

Transient renal dysfunction with reversible splenial lesion.  

PubMed

We report the case of a 6-month-old boy with transient renal dysfunction who had an intensified signal in the splenium of the corpus callosum on magnetic resonance imaging. He presented to hospital with fever and sudden disturbance of consciousness. Cerebrospinal fluid analysis did not show pleocytosis. The mild consciousness disturbance disappeared after 30?min, but the splenial signal persisted even after 8 days. Further, renal glucosuria, increased excretion of select amino acids, and abnormal fractional excretion of electrolytes were observed, indicating renal tubular dysfunction. The abnormal urinary findings spontaneously resolved by day 9 of hospitalization. The splenial lesion took 21 days to normalize. There were no signs of neurological complications 2 months later. This case suggests the possibility of renal involvement in splenial lesions. PMID:25336014

Watanabe, Toru; Matsuda, Tomoka; Kitagata, Ryoichi; Tajima, Iwao; Ono, Hiroyuki; Hirano, Keiko; Shirai, Masami; Endoh, Akira; Hongo, Teruaki

2014-10-01

399

Gamma ray transients  

NASA Technical Reports Server (NTRS)

The discovery of cosmic gamma ray bursts was made with systems designed at Los Alamos Laboratory for the detection of nuclear explosions beyond the atmosphere. HELIOS-2 was the first gamma ray burst instrument launched; its initial results in 1976, seemed to deepen the mystery around gamma ray transients. Interplanetary spacecraft data were reviewed in terms of explaining the behavior and source of the transients.

Cline, Thomas L.

1987-01-01

400

Multiresolution transient detection  

Microsoft Academic Search

Designs and studies the performance of a multiresolution-based transient detector. The transients the authors are interested in consist of wide-band, pulse-like, coherent structures in a turbulent flow. To take advantage of the fast pyramidal wavelet algorithm, an important point when processing large amounts of experimental data, the detector makes use of the discrete wavelet transform. The authors show how the

Patrice Abry; Patrick Flandrin

1994-01-01

401

Associations between marine phytoplankton and symptoms of illness among recreational beachgoers in Puerto Rico, 2009  

EPA Science Inventory

While phytoplankton generally have crucial roles in marine ecosystems, a small subset can release toxins and produce harmful algal blooms (HABs). HABs can be a threat to human health as symptoms from exposure range from neurological impairment to gastrointestinal (GI), dermal, a...

402

Alzheimer's Disease Patients' Cognitive Status and Course Years Prior to Symptom Recognition  

Microsoft Academic Search

This is a prospective examination of the cognitive performance and cognitive course of persons in an asymptomatic “preclinical” phase who eventually developed Alzheimer's disease (AD). We compared performances on the Mayo Cognitive Factor Scales (MCFS) of 20 persons in a neurologically normal cohort who subsequently developed AD to the performances of 60 persons who remained free of dementia symptoms. For

Jane H. Cerhan; Robert J. Ivnik; Glenn E. Smith; Mary M. Machulda; Bradley F. Boeve; David S. Knopman; Ronald C. Petersen; Eric G. Tangalos

2007-01-01

403

Children in chronic pain: Promoting pediatric patients' symptom accounts in tertiary care  

Microsoft Academic Search

This paper examines how clinicians promote pediatric patients' symptom accounts at the beginning of visits in three pediatric tertiary care clinics at a university hospital in the United States: pain, gastroenterology and neurology. Quantitative and qualitative data were collected for 69 patient–parent pairs, including videotaped intake visits. Two forms of child account promotion, together with their corresponding distribution across clinics,

Ignasi Clemente; Seung-Hee Lee; John Heritage

2008-01-01

404

A cross-sectional study of the relation between symptoms and physical findings in computer operators  

Microsoft Academic Search

BACKGROUND: The character of upper limb disorder in computer operators is subject to debate. A peripheral nerve-involvement is suggested from the common presence of a triad of symptoms consisting of pain, paraestesiae and subjective weakness, and from physical findings suggesting neuropathy. This study aimed to examine the outcome of a detailed neurological examination in computer operators and to compare findings

Jørgen R Jepsen; Gert Thomsen

2006-01-01

405

The Tullio phenomenon: a neurologically neglected presentation.  

PubMed

The Tullio phenomenon refers to sound-induced disequilibrium or oscillopsia. Patients with this condition frequently present to neurologists, many of whom are unfamiliar with the condition and its diagnostic criteria. Indeed, due to the unusual nature of the symptoms patients are often misdiagnosed as having psychiatric disturbances. Tullio patients describe disequilibrium, auditory and visual symptoms, which are recurrent, brief, and often triggered by loud noises or middle ear pressure changes, e.g. the Valsalva manoeuvre. Many cases are associated with superior semicircular canal dehiscence (SCCD). Early work suggested that the presence of sound-induced torsional eye movements and visual field tilts were consequent upon a utricular-mediated ocular tilt reaction. However, more recent evidence from imaging and oculographic research, as well as data from our patient series indicates that these ocular abnormalities are usually the result of superior semicircular canal stimulation. The clinical history and a focussed examination are often sufficient to make the diagnosis, which can be confirmed with high resolution CT imaging of the temporal bones. In some patients, surgical occlusion or resurfacing of the affected canal can ameliorate symptoms and signs. The aim of this paper is two-fold: Firstly, to review the clinical features of the Tullio phenomenon, and secondly, to highlight our own observations in three cases with a new clinical syndrome consisting of Tullio's phenomenon with bilateral vestibular failure, a pure horizontal nystagmus in response to sound, and no evidence of canal dehiscence. PMID:21743992

Kaski, Diego; Davies, R; Luxon, L; Bronstein, A M; Rudge, P

2012-01-01

406

Sequelae of fume exposure in confined space welding: a neurological and neuropsychological case series.  

PubMed

Welding fume contains manganese (Mn) which is known to be bio-available to and neurotoxic for the central nervous system. Although an essential metal, Mn overexposure may cause manganism, a parkinsonian syndrome. The present welder study sought to improve the clinical portrait of manganism and to determine dose-effect relationships. The welders were employed in the construction of the new Bay Bridge (San Francisco) and welded in confined spaces for up to 2 years with minimal protection and poor ventilation. Neurological, neuropsychological, neurophysiological, and pulmonary examinations were given to 49 welders. Clinical cases were selected on the basis of apriori defined criteria pertaining to welding history and neurological/neuropsychological features. Among the 43 eligible welders, 11 cases of manganism were identified presenting with the following symptoms: sleep disturbance, mood changes, bradykinesia, headaches, sexual dysfunction, olfaction loss, muscular rigidity, tremors, hallucinations, slurred speech, postural instability, monotonous voice, and facial masking. Significant associations between outcome variables and cumulative exposure index (CEI) or blood Mn (MnB) were obtained with CEI for variables implicating attention and concentration, working and immediate memory, cognitive flexibility, and verbal learning; and with MnB for executive function, cognitive flexibility, visuo-spatial construction ability, and visual contrast sensitivity. This study strongly suggests that neuropsychological features contribute in a dose-effect related way to the portrait of manganism usually characterized by tremor, loss in balance, diminished cognitive performance, and signs and symptoms of parkinsonism. PMID:17169432

Bowler, Rosemarie M; Nakagawa, Sanae; Drezgic, Marija; Roels, Harry A; Park, Robert M; Diamond, Emily; Mergler, Donna; Bouchard, Maryse; Bowler, Russell P; Koller, William

2007-03-01

407

Neurologic effects of solvents in older adults. (UW retired worker study). Final performance report  

SciTech Connect

The possibility that previous occupational exposure to solvents might be associated with clinically significant neurological dysfunction in older adults was investigated in a cross-sectional study. Subjects included 67 painters, 22 aerospace painters and fuel cell sealers, and a comparison group of 126 carpenters. All subjects had retired from regular employment at least 1 year prior to the study. As measured by semiquantitative exposure index, the cumulative histories of lifetime occupational solvent exposure were on the average comparable in the two exposed study groups, painters and aerospace workers. The carpenters differed from the other groups in solvent exposure by several orders of magnitude. The painters had a significantly higher history of consuming alcoholic beverages than did the other two study groups. The painters had a significantly higher score on the Beck Depression Inventory, a measure of current depressive symptoms. The painters reported significantly more general neurologic symptoms than did the other two groups. The aerospace workers showed much greater evidence of possible adverse effects from former solvent exposure on current neuropsychological function than did the painters when determined by reasoning and memory tests, memory visual motor speed and motor tests. No evidence of persistent effects on liver or renal excretory function was seen in solvent exposed subjects.

Daniell, W.E.

1993-11-12

408

Symptoms and Quality of Life in Cancer Patients With Brain Metastases Following Palliative Radiotherapy  

SciTech Connect

Purpose: To examine prospectively patient self-rated symptoms and quality of life (QOL) indicators in patients with brain metastases following whole brain radiotherapy (WBRT). Methods and Materials: Consecutive patients with brain metastases referred for WBRT were approached for this study. Patients were asked to rate their symptoms and QOL using the Spitzer Quality of Life Index questionnaire. Follow-up was at 1, 2, and 3 months following WBRT. Linear regression analysis was used to determine the change in symptom severity over time. Results: Between August 2005 to October 2007, 129 patients with brain metastases were enrolled. The majority of patients (88%) received 20 Gy in five fractions. Median age was 64 years, and median Karnofsky Performance Status at baseline was 70. The most commonly experienced symptoms at baseline were headaches, weakness, balance problems, and fatigue. Thirty-five percent of patients rated neurological functional (NF) status as 1, indicating moderate neurological symptoms and need for assistance. Forty-three percent of patients had stable or decreased fatigue, and 47% had a stable or improved NF status over time (p = 0.0040). Although certain QOL domains improved over time, all other QOL domains and symptom items did not change significantly following WBRT. Conclusion: WBRT may have contributed to symptom stabilization in our study. An alternative goal of WBRT may be the prevention of symptom progression and QOL deterioration. Further research is required to select the most appropriate group of patients with brain metastases who would benefit most from WBRT.

Wong, Jennifer; Hird, Amanda; Zhang Liying; Tsao, May; Sinclair, Emily; Barnes, Elizabeth; Danjoux, Cyril [Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.c [Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto (Canada)

2009-11-15

409

Common Symptoms and Distress Experienced Among Patients with Colorectal Cancer: A Qualitative part of Mixed Method Design  

PubMed Central

Background : Colorectal cancer is one of the most common types of tumour in the world. Treatment side effects, together with the tumour symptoms, can result in a ‘symptom burden’. To understand the patient’s burden during chemotherapy treatment and plan effective symptom relief there is a need for more knowledge about the experience of symptoms from the patients’ perspective. Objectives : The study was designed to qualitatively identify and describe the most common symptoms among patients treated for colorectal cancer, and discover whether there are barriers to reporting symptoms. Methods : Thirteen Swedish patients diagnosed with colorectal cancer and treated with chemotherapy were interviewed face-to-face. The interviews were audio-taped and transcribed verbatim. The transcripts were analysed by following the principles of qualitative content analysis. Results : Nine symptoms/forms of distress were identified. Those most frequently expressed were fatigue, changed bowel habits, and affected mental well-being, closely followed by nausea, loss of appetite and neurological problems. Of particular note were the affected mental well-being, the magnitude of the neurological problems described, the symptoms related to skin and mucous membrane problems, and the reports of distressing pain. Barriers to symptom control were only expressed by the patients in passing and very vaguely. Conclusion : This study confirms other reports on most common symptoms in colorectal cancer. It also highlights the early onset of symptoms and provides data on less well-studied issues that warrant further study, namely affected mental well-being, the magnitude of the neurological problems and symptoms related to the skin and mucous membranes. Nurses need to be sensitive to the patients’ need presented and not only noting symptoms/distresses they have guidelines for. PMID:22977653

Borjeson, Sussanne; Starkhammar, Hans; Unosson, Mitra; Bertero, Carina

2012-01-01

410

Neurological manifestations of oculodentodigital dysplasia: a Cx43 channelopathy of the central nervous system?  

PubMed Central

The coordination of tissue function is mediated by gap junctions (GJs) that enable direct cell–cell transfer of metabolic and electric signals. GJs are formed by connexins of which Cx43 is most widespread in the human body. In the brain, Cx43 GJs are mostly found in astroglia where they coordinate the propagation of Ca2+ waves, spatial K+ buffering, and distribution of glucose. Beyond its role in direct intercellular communication, Cx43 also forms unapposed, non-junctional hemichannels in the plasma membrane of glial cells. These allow the passage of several neuro- and gliotransmitters that may, combined with downstream paracrine signaling, complement direct GJ communication among glial cells and sustain glial-neuronal signaling. Mutations in the GJA1 gene encoding Cx43 have been identified in a rare, mostly autosomal dominant syndrome called oculodentodigital dysplasia (ODDD). ODDD patients display a pleiotropic phenotype reflected by eye, hand, teeth, and foot abnormalities, as well as craniofacial and bone malformations. Remarkably, neurological symptoms such as dysarthria, neurogenic bladder (manifested as urinary incontinence), spasticity or muscle weakness, ataxia, and epilepsy are other prominent features observed in ODDD patients. Over 10 mutations detected in patients diagnosed with neurological disorders are associated with altered functionality of Cx43 GJs/hemichannels, but the link between ODDD-related abnormal channel activities and neurologic phenotype is still elusive. Here, we present an overview on the nature of the mutants conveying structural and functional changes of Cx43 channels and discuss available evidence for aberrant Cx43 GJ and hemichannel function. In a final step, we examine the possibilities of how channel dysfunction may lead to some of the neurological manifestations of ODDD. PMID:24133447

De Bock, Marijke; Kerrebrouck, Marianne; Wang, Nan; Leybaert, Luc

2013-01-01

411

Neurological disease rises from ocean to bring model for human epilepsy to life.  

PubMed

Domoic acid of macroalgal origin was used for traditional and medicinal purposes in Japan and largely forgotten until its rediscovery in diatoms that poisoned 107 people after consumption of contaminated mussels. The more severely poisoned victims had seizures and/or amnesia and four died; however, one survivor unexpectedly developed temporal lobe epilepsy (TLE) a year after the event. Nearly a decade later, several thousand sea lions have stranded on California beaches with neurological symptoms. Analysis of the animals stranded over an eight year period indicated five clusters of acute neurological poisoning; however, nearly a quarter have stranded individually outside these events with clinical signs of a chronic neurological syndrome similar to TLE. These poisonings are not limited to sea lions, which serve as readily observed sentinels for other marine animals that strand during domoic acid poisoning events, including several species of dolphin and whales. Acute domoic acid poisoning is five-times more prominent in adult female sea lions as a result of the proximity of their year-round breeding grounds to major domoic acid bloom events. The chronic neurological syndrome, on the other hand, is more prevalent in young animals, with many potentially poisoned in utero. The sea lion rookeries of the Channel Islands are at the crossroads of domoic acid producing harmful algal blooms and a huge industrial discharge site for dichlorodiphenyltrichloroethane (DDTs). Studies in experimental animals suggest that chronic poisoning observed in immature sea lions may result from a spatial and temporal coincidence of DDTs and domoic acid during early life stages. Emergence of an epilepsy syndrome from the ocean brings a human epilepsy model to life and provides unexpected insights into interaction with legacy contaminants and expression of disease at different life stages. PMID:22069654

Ramsdell, John S

2010-07-01

412

Granins as disease-biomarkers: translational potential for psychiatric and neurological disorders.  

PubMed

The identification of biomarkers represents a fundamental medical advance that can lead to an improved understanding of disease pathogenesis, and holds the potential to define surrogate diagnostic and prognostic endpoints. Because of the inherent difficulties in assessing brain function in patients and objectively identifying neurological and cognitive/emotional symptoms, future application of biomarkers to neurological and psychiatric disorders is extremely desirable. This article discusses the biomarker potential of the granin family, a group of acidic proteins present in the secretory granules of a wide variety of endocrine, neuronal and neuroendocrine cells: chromogranin A (CgA), CgB, Secretogranin II (SgII), SgIII, HISL-19 antigen, 7B2, NESP55, VGF and ProSAAS. Their relative abundance, functional significance, and secretion into the cerebrospinal fluid (CSF), saliva, and the general circulation have made granins tractable targets as biomarkers for many diseases of neuronal and endocrine origin, recently impacting diagnosis of a number of neurological and psychiatric disorders including amyotrophic lateral sclerosis (ALS), Alzheimer's disease, frontotemporal dementia, and schizophrenia. Although research has not yet validated the clinical utility of granins as surrogate endpoints for the progression or treatment of neurological or psychiatric disease, a growing body of experimental evidence indicates that the use of granins as biomarkers might be of great potential clinical interest. Advances that further elucidate the mechanism(s) of action of granins, coupled with improvements in biomarker technology and direct clinical application, should increase the translational effectiveness of this family of proteins in disease diagnosis and drug discovery. PMID:20600637

Bartolomucci, A; Pasinetti, G M; Salton, S R J

2010-09-29

413

Neurological Disease Rises from Ocean to Bring Model for Human Epilepsy to Life  

PubMed Central

Domoic acid of macroalgal origin was used for traditional and medicinal purposes in Japan and largely forgotten until its rediscovery in diatoms that poisoned 107 people after consumption of contaminated mussels. The more severely poisoned victims had seizures and/or amnesia and four died; however, one survivor unexpectedly developed temporal lobe epilepsy (TLE) a year after the event. Nearly a decade later, several thousand sea lions have stranded on California beaches with neurological symptoms. Analysis of the animals stranded over an eight year period indicated five clusters of acute neurological poisoning; however, nearly a quarter have stranded individually outside these events with clinical signs of a chronic neurological syndrome similar to TLE. These poisonings are not limited to sea lions, which serve as readily observed sentinels for other marine animals that strand during domoic acid poisoning events, including several species of dolphin and whales. Acute domoic acid poisoning is five-times more prominent in adult female sea lions as a result of the proximity of their year-round breeding grounds to major domoic acid bloom events. The chronic neurological syndrome, on the other hand, is more prevalent in young animals, with many potentially poisoned in utero. The sea lion rookeries of the Channel Islands are at the crossroads of domoic acid producing harmful algal blooms and a huge industrial discharge site for dichlorodiphenyltrichloroethane (DDTs). Studies in experimental animals suggest that chronic poisoning observed in immature sea lions may result from a spatial and temporal coincidence of DDTs and domoic acid during early life stages. Emergence of an epilepsy syndrome from the ocean brings a human epilepsy model to life and provides unexpected insights into interaction with legacy contaminants and expression of disease at different life stages. PMID:22069654

Ramsdell, John S.

2010-01-01

414

Bullying and PTSD Symptoms  

ERIC Educational Resources Information Center

PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

2012-01-01

415

Flu Symptoms & Severity  

MedlinePLUS

... PCR and Other Molecular Assays for Diagnosis of Influenza Virus Infection Clinical Signs and Symptoms of Influenza International ... Assessment and Biosafety Level Recommendations Highly Pathogenic Avian Influenza A (H5N1) Virus H5N1 In Birds and Other Animals H5N1 In ...

416

The specificity of neurological signs in schizophrenia: a review  

Microsoft Academic Search

This review examines the extent to which neurological signs are more prevalent in schizophrenia patients, compared to mood-disorder patients and healthy subjects, and whether there is a pattern in any of the differences that may be found. We included 17 studies and calculated the weighted mean prevalence of 30 neurological signs. The prevalence of most signs appears to be significantly

Marco P. M. Boks; Sascha Russo; Rikus Knegtering; Robert J. van den Bosch

2000-01-01

417

The splice of life: Alternative splicing and neurological disease  

Microsoft Academic Search

Splicing of pre-messenger RNA is regulated differently in the brain compared with other tissues. Recognition of aberrations in splicing events that are associated with neurological disease has contributed to our understanding of disease pathogenesis in some cases. Neuron-specific proteins involved in RNA splicing and metabolism are also affected in several neurological disorders. These findings have begun to bridge what we

B. Kate Dredge; Alexandros D. Polydorides; Robert B. Darnell

2001-01-01

418

Attitudes of US medical trainees towards neurology education: \\  

Microsoft Academic Search

BACKGROUND: Several studies in the United Kingdom and Asia have suggested that medical students and residents have particular difficulty in diagnosing and managing patients with neurological problems. Little recent information is available for US trainees. We examined whether students and residents at a US university have difficulty in dealing with patients with neurological problems, identified the perceived sources of these

Andrey V Zinchuk; Eoin P Flanagan; Niall J Tubridy; Wendy A Miller; Louise D McCullough

2010-01-01

419

FIRST EINSTEIN RESIDENT IN NEUROLOGY ELECTROPHYSIOLOGIST, COGNITIVE NEUROSCIENTIST  

E-print Network

-on patient evaluation with an unshakeable belief in the potential of neurological therapies to combat even the most profound neurological damage due to stroke. He was an early advocate of anticoagulant therapy proposals. One of Saul's creative enterprises as Chairman was his support of six-month research sabbaticals

Brown, Lucy L.

420

Education Research: Neurology residency training in the new millennium  

Microsoft Academic Search

Objective: To survey adult neurology program directors (ANPD) to identify their most pressing needs at a time of dramatic change in neurology resident education. Methods: All US ANPD were surveyed in 2007 using an instrument adjusted from a 1999 survey instrument. The goal was to characterize current program content, the institution and evaluation of the core competencies, program director characteristics,

L. A. Schuh; J. C. Adair; O. Drogan; B. M. Kissela; J. C. Morgenlander; J. R. Corboy

2009-01-01

421

1the department of neurological surgery at ucsf  

E-print Network

Patient Safety & Quality Improvement Program 26 UCSF Neurological Surgery Community Extension Program 28 Parsa (page 4). A new program to streamline multidisciplinary care for patients with sports concussions1the department of neurological surgery at ucsf 2012 year in review University of California San

Klein, Ophir

422

The Examination of Peer Review and Publication in Neurology  

Microsoft Academic Search

Despite remarkable growth in the clinical neurology literature, there is little research on peer review and biomedical publication in neurology. Biomedical publication research encompasses every step of the research process, from the methodology to the publication of research findings. Some general medical journals have served as leaders in improving scientific publication. Many medical fields have taken it upon themselves to

Victoria S. S. Wong

2010-01-01

423

Emerging Subspecialties in Neurology: Translational research in movement disorders  

Microsoft Academic Search

Movement disorders constitute a unique field and several characteristics distinguish it from other sub- specialties of neurology. Movement disorders special- ists rely on clinical phenomenology to generate differential diagnoses and based on a detailed history and neurologic examination, an accurate clinical di- agnosis is usually made. Although the pathogenesis of many disorders in the field is not well-understood, therapeutic measures

Sheng-Han Kuo; George R. Jackson

2009-01-01

424

Neurologic Complications of 405 Consecutive Continuous Axillary Catheters  

Microsoft Academic Search

Continuous axillary brachial plexus block may theoret- ically increase the risk of neurologic complications be- cause of catheter-induced mechanical trauma or local anesthetic toxicity. In this study, we retrospectively re- viewed the frequency of complications using current techniques and applications. There were 405 continu- ous axillary catheters in 368 patients. A preexisting neurologic condition was present in 41 (10.1%) patients,

Bradley D. Bergman; James R. Hebl; Jay Kent; Terese T. Horlocker

2003-01-01

425

Neurology in Federico Fellini?s work and life.  

PubMed

The authors present a historical review of the neurological diseases related to the famous moviemaker Federico Fellini. There is an account of diseases depicted on his movies as well as his ischemic stroke and consequent neurological deficit - left spatial neglect. PMID:25252239

Teive, Hélio Afonso Ghizoni; Caramelli, Paulo; Cardoso, Francisco Eduardo Costa

2014-09-01

426

Epilepsy as a Rare Neurologic Manifestation of Oculodentodigitalis Dysplasia  

PubMed Central

Oculodentodigitalis dysplasia (ODDD) is an extremely rare inherited disorder involving the development of the face, eyes, teeth and limbs. In addition, some patients develop neurological problems mostly a spastic paraparesis associated with white matter abnormalities on magnetic resonance imaging. This report describes a patient with epilepsy, a rare neurologic manifestation of this syndrome. PMID:24665271

BARZEGAR, Mohammad; SAYADNASIRI, Mohammad; TABRIZI, Aidin

2012-01-01

427

Behavioural Neurology 17 (2006) 105108 105 Clinical Note  

E-print Network

have been described in stroke, migraine, epilepsy, autism, Alzheimer's disease and fronto with Parkinson's disease Anjan Chatterjee, Roy H. Hamilton and Prin X. Amorapanth Department of Neurology with neurological diseases sometimes produce remarkably appealing art. Here we present the art of a patient

Chatterjee, Anjan

428

Pattern of Paediatric Neurological Disorders in Port Harcourt, Nigeria  

PubMed Central

Background: Paediatric Neurological disorders in developing countries are very challenging. This is due to its chronicity, late presentation and unavailability of modern diagnostic facilities in developing countries like Nigeria. Lack of these modern technology and manpower contribute significantly to increased morbidity and mortality. This study demonstrates the pattern of neurological disorders and the challenges in management in a developing country. Materials and Method: This was a retrospective hospital based analysis of neurological disorders seen in the Paediatric neurology unit of the University of Port Harcourt Teaching hospital, Nigeria from January 2004 to December 2009. Descriptive statistics was used to present the result. Result: A total of 35,473 patients were seen in the Paediatric unit. Of these 2,379 had neurological disorders. This gave a prevalence of 6.7% of Paediatric neurological disorders. There were 1,431 males and 948 females (male: female ratio of 1.51:1.0). The age ranged from 3 months to 15 years. The age group 1->5 years accounted for the most affected age group constituting 87.7%. The most frequent Paediatric neurological disorders were epilepsy (24.6%), cerebral palsy (15.4%), and central nervous system infections (9.5%). Conclusions/Recommendation: Wide spectrum of neurological disorders occur in our environment. The high incidence of epilepsy and cerebral palsy suggests that effort should be geared towards educating the populace about early diagnosis and prompt management. PMID:23675231

Frank-Briggs, A. I.; D Alikor, E. A.

2011-01-01

429

Establishing a Neurological-Psychiatric Biobank: Banking, informatics, ethics  

Microsoft Academic Search

The recent development of genetic databases and biobanks in a number of countries reflects scientist’s beliefs in the future health benefits to be derived from genetic research. The NEPSYBANK is a national program of the Hungarian Clinical Neurogenetic Society with comprehensive participation of the Neurology and Psychiatry Departments of Medical Universities and the National Institute of Psychiatry and Neurology. The

Maria J. Molnar; Peter Bencsik

2006-01-01

430

Genetics or Neurological Compromise in People Who Stutter  

E-print Network

Genetics or Neurological Compromise in People Who Stutter Edited from Per Alm, 2007 By Glyndon suggest that genetic factors and early neurological incidents may have an additive effect ... one would expect to find a continuum between two hypothetically extreme groups with `pure' genetic stuttering

de Lijser, Peter

431

Mapping the literature: palliative care within adult and child neurology.  

PubMed

Objectives of this review were to examine definitions and background of palliative care, as well as address whether there is an increased need for palliative care education among neurologists. The review also explores what literature exists regarding palliative care within general neurology and child neurology. A literature review was conducted examining use of palliative care within child neurology. More than 100 articles and textbooks were retrieved and reviewed. Expert guidelines stress the importance of expertise in palliative care among neurologists. Subspecialties written about in child neurology include that of peripheral nervous system disorders, neurodegenerative diseases, and metabolic disorders. Adult and child neurology patients have a great need for improved palliative care services, as they frequently develop cumulative physical and cognitive disabilities over time and cope with decreasing quality of life before reaching the terminal stage of their illness. PMID:24717986

Dallara, Alexis; Meret, Anca; Saroyan, John

2014-12-01

432

A Rare Neurological Complication of Ranolazine  

PubMed Central

Myoclonus is not a known side effect of ranolazine. We report a case of myoclonus in a 72-year-old female who underwent cardiac catheterization for angina and was started on ranolazine after the procedure. Two days after ranolazine therapy on 1000?mg per day in divided doses, myoclonus developed, which severely impaired her normal activity. Her symptoms resolved 2 days after discontinuation of ranolazine. Ranolazine was resumed after discharge from hospital with recurrent myoclonus after two days of therapy. The causal relationship between ranolazine and myoclonus was suggested by cessation of myoclonus after ranolazine was discontinued. PMID:23936696

Porhomayon, Jahan; Zadeii, Gino; Yarahmadi, Alireza

2013-01-01

433

Neurologic Manifestations of Chronic Methamphetamine Abuse  

PubMed Central

COMMENTARY ON METHAMPHETAMINE ABUSE FOR PSYCHIATRIC PRACTICE Every decade seems to have its own unique drug problem. The 1970s had hallucinogens, the 1980s had crack cocaine, the 1990s had designer drugs, the 2000s had methamphetamine (Meth), and in the 2010s we are dealing with the scourge of prescription drug abuse. While each of these drug epidemics has distinctive problems and history, the one with perhaps the greatest impact on the practice of Psychiatry is Meth. By increasing the extracellular concentrations of dopamine while slowly damaging the dopaminergic neurotransmission, Meth is a powerfully addictive drug whose chronic use preferentially causes psychiatric complications. Chronic Meth users have deficits in memory and executive functioning as well as higher rates of anxiety, depression, and most notably psychosis. It is because of addiction and chronic psychosis from Meth abuse that the Meth user is most likely to come to the attention of the practicing Psychiatrist/Psychologist. Understanding the chronic neurologic manifestations of Meth abuse will better arm practitioners with the diagnostic and therapeutic tools needed to make the Meth epidemic one of historical interest only. PMID:23688691

Rusyniak, Daniel E.

2013-01-01

434

The clinical maze of mitochondrial neurology  

PubMed Central

Mitochondrial diseases involve the respiratory chain, which is under the dual control of nuclear and mitochondrial DNA (mtDNA). The complexity of mitochondrial genetics provides one explanation for the clinical heterogeneity of mitochondrial diseases, but our understanding of disease pathogenesis remains limited. Classification of Mendelian mitochondrial encephalomyopathies has been laborious, but whole-exome sequencing studies have revealed unexpected molecular aetiologies for both typical and atypical mitochondrial disease phenotypes. Mendelian mitochondrial defects can affect five components of mitochondrial biology: subunits of respiratory chain complexes (direct hits); mitochondrial assembly proteins; mtDNA translation; phospholipid composition of the inner mitochondrial membrane; or mitochondrial dynamics. A sixth category—defects of mtDNA maintenance—combines features of Mendelian and mitochondrial genetics. Genetic defects in mitochondrial dynamics are especially important in neurology as they cause optic atrophy, hereditary spastic paraplegia, and Charcot–Marie–Tooth disease. Therapy is inadequate and mostly palliative, but promising new avenues are being identified. Here, we review current knowledge on the genetics and pathogenesis of the six categories of mitochondrial disorders outlined above, focusing on their salient clinical manifestations and highlighting novel clinical entities. An outline of diagnostic clues for the various forms of mitochondrial disease, as well as potential therapeutic strategies, is also discussed. PMID:23835535

DiMauro, Salvatore; Schon, Eric A.; Carelli, Valerio; Hirano, Michio

2014-01-01

435

Facial palsy: interpretation of neurologic findings.  

PubMed

A review of the otoneurologic findings in 500 patients with facial paralysis revealed their importance for diagnosis, prognosis, and understanding the pathophysiology of Bell's palsy. Diagnosis. The presence of simultaneous bilateral palsy, facial paralysis associated with lateral rectus palsy, slowly progressive facial weakness with or without hyperkinesis, and facial paralysis that showed no recovery after six months excluded Bell's palsy from the diagnosis. Ipsilateral recurrent palsies were another indication to suspect an underlying cause, since a tumor of the facial nerve caused the paralysis in 30% of the patients with this finding. Signs such as intact forehead movement, alterations in facial sensation, and corneal hypesthesia--although often associated with lesions in the cerebral cortex, cerebellopontine angle, or internal auditory canal--were also found in patients with Bell's palsy. Prognosis. A spontaneous complete recovery following Bell's palsy occurs in about 70% of the patients; but in the presence of a dry eye or dysacousis, the prognosis for a complete recovery drops 10 and 25%, respectively. Pathophysiology. It is proposed that the wide range of neurologic findings associated with Bell's palsy is due to a viral polyneuropathy. This is a disorder that primarily involves sensory nerves, and the facial motor deficit results from involvement of the sensory fibers carried with the facial nerve within the fallopian canal. PMID:672368

May, M; Hardin, W B

1978-08-01

436

Hyperhomocysteinemia and Neurologic Disorders: a Review  

PubMed Central

Homocysteine (Hcy) is a sulfur-containing amino acid that is generated during methionine metabolism. It has a physiologic role in DNA metabolism via methylation, a process governed by the presentation of folate, and vitamins B6 and B12. Physiologic Hcy levels are determined primarily by dietary intake and vitamin status. Elevated plasma levels of Hcy (eHcy) can be caused by deficiency of either vitamin B12 or folate, or a combination thereof. Certain genetic factors also cause eHcy, such as C667T substitution of the gene encoding methylenetetrahydrofolate reductase. eHcy has been observed in several medical conditions, such as cardiovascular disorders, atherosclerosis, myocardial infarction, stroke, minimal cognitive impairment, dementia, Parkinson's disease, multiple sclerosis, epilepsy, and eclampsia. There is evidence from laboratory and clinical studies that Hcy, and especially eHcy, exerts direct toxic effects on both the vascular and nervous systems. This article provides a review of the current literature on the possible roles of eHcy relevant to various neurologic disorders.

Ansari, Ramin; Mallack, Eric; Luo, Jin Jun

2014-01-01

437

Ketogenic diets, mitochondria, and neurological diseases.  

PubMed

The ketogenic diet (KD) is a broad-spectrum therapy for medically intractable epilepsy and is receiving growing attention as a potential treatment for neurological disorders arising in part from bioenergetic dysregulation. The high-fat/low-carbohydrate "classic KD", as well as dietary variations such as the medium-chain triglyceride diet, the modified Atkins diet, the low-glycemic index treatment, and caloric restriction, enhance cellular metabolic and mitochondrial function. Hence, the broad neuroprotective properties of such therapies may stem from improved cellular metabolism. Data from clinical and preclinical studies indicate that these diets restrict glycolysis and increase fatty acid oxidation, actions which result in ketosis, replenishment of the TCA cycle (i.e., anaplerosis), restoration of neurotransmitter and ion channel function, and enhanced mitochondrial respiration. Further, there is mounting evidence that the KD and its variants can impact key signaling pathways that evolved to sense the energetic state of the cell, and that help maintain cellular homeostasis. These pathways, which include PPARs, AMP-activated kinase, mammalian target of rapamycin, and the sirtuins, have all been recently implicated in the neuroprotective effects of the KD. Further research in this area may lead to future therapeutic strategies aimed at mimicking the pleiotropic neuroprotective effects of the KD. PMID:24847102

Gano, Lindsey B; Patel, Manisha; Rho, Jong M

2014-11-01

438

The clinical maze of mitochondrial neurology.  

PubMed

Mitochondrial diseases involve the respiratory chain, which is under the dual control of nuclear and mitochondrial DNA (mtDNA). The complexity of mitochondrial genetics provides one explanation for the clinical heterogeneity of mitochondrial diseases, but our understanding of disease pathogenesis remains limited. Classification of Mendelian mitochondrial encephalomyopathies has been laborious, but whole-exome sequencing studies have revealed unexpected molecular aetiologies for both typical and atypical mitochondrial disease phenotypes. Mendelian mitochondrial defects can affect five components of mitochondrial biology: subunits of respiratory chain complexes (direct hits); mitochondrial assembly proteins; mtDNA translation; phospholipid composition of the inner mitochondrial membrane; or mitochondrial dynamics. A sixth category-defects of mtDNA maintenance-combines features of Mendelian and mitochondrial genetics. Genetic defects in mitochondrial dynamics are especially important in neurology as they cause optic atrophy, hereditary spastic paraplegia, and Charcot-Marie-Tooth disease. Therapy is inadequate and mostly palliative, but promising new avenues are being identified. Here, we review current knowledge on the genetics and pathogenesis of the six categories of mitochondrial disorders outlined above, focusing on their salient clinical manifestations and highlighting novel clin