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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

[Neurological symptoms in poisoning].  

PubMed

Acute and chronic intoxications become manifest in primary neurological symptoms. After a definition of poisoning the autonomic, neurological and psychological disturbances are briefly discussed and the therapeutic measures presented in a table. Later, the neurological symptoms are described with reference to oberservations of cases of lead, thallium, E 605 (parathion), carbon monoxide, mercury, amphetamine and botulin poisoning. Four table and 9 figures supplement the text. PMID:6775212

Neu, I

1980-10-01

3

An uncommon cause of transient neurological dysfunction.  

PubMed

Transient neurological dysfunction may be associated with uncommon disorders and should prompt consideration of a broad differential diagnosis when assessing patients with episodic symptoms. The most common causes of transient neurological dysfunction include transient ischemic attack (TIA), seizure disorder, and migraine and its variants. However, underlying unusual pathophysiological processes such as brain tumors can also cause transient neurological dysfunction. Here we present a case of a 68-year-old male with oligodendroglial gliomatosis cerebri (OGC) who presented with TIA-like symptoms. Brain magnetic resonance imaging revealed multiple diffuse T2 hyperintensities within the white and gray matter. Magnetic resonance spectroscopy was suggestive of gliomatosis cerebri and was particularly helpful in this case. The diagnosis of OGC was confirmed by histopathology and molecular genetic studies on brain biopsy tissue. In this report, we discuss the clinical and radiological characteristics of OGC and highlight the unusual presentation of this case. PMID:24982718

Farooq, Muhammad U; Bhatt, Archit; Chang, Howard T

2014-07-01

4

An Uncommon Cause of Transient Neurological Dysfunction  

PubMed Central

Transient neurological dysfunction may be associated with uncommon disorders and should prompt consideration of a broad differential diagnosis when assessing patients with episodic symptoms. The most common causes of transient neurological dysfunction include transient ischemic attack (TIA), seizure disorder, and migraine and its variants. However, underlying unusual pathophysiological processes such as brain tumors can also cause transient neurological dysfunction. Here we present a case of a 68-year-old male with oligodendroglial gliomatosis cerebri (OGC) who presented with TIA-like symptoms. Brain magnetic resonance imaging revealed multiple diffuse T2 hyperintensities within the white and gray matter. Magnetic resonance spectroscopy was suggestive of gliomatosis cerebri and was particularly helpful in this case. The diagnosis of OGC was confirmed by histopathology and molecular genetic studies on brain biopsy tissue. In this report, we discuss the clinical and radiological characteristics of OGC and highlight the unusual presentation of this case.

Bhatt, Archit; Chang, Howard T.

2014-01-01

5

Conversion Disorder Presenting With Neurologic and Respiratory Symptoms  

Microsoft Academic Search

ave you ever been faced with medical or neurologic symptoms in a patient who, despite a thorough workup, does not appear to H have a medical or neurologic condition that explains those symptoms? Have you wondered how to address (and treat) these symptoms when you suspect that they may reflect a psychological or psychiatric etiology? If you have, then the

Joshuah L. Roffman; Theodore A. Stern

2005-01-01

6

A patient with acute visual loss and transient neurologic symptoms. Diagnosis: an acute central retinal artery occlusion (CRAO) in the left eye with severe retinal ischemia.  

PubMed

A 73-year-old man presented with acute visual loss in his left eye associated with transient left upper extremity numbness. Diagnosis was made in the emergency room, where treatment strategies were discussed. PMID:20944529

Kim, Johnstone M; Nahab, Fadi; Newman, Nancy J; Biousse, Valérie

2010-01-01

7

Neurological symptoms associated with sarcocystosis in adult sheep.  

PubMed Central

Four mature ewes developed mild neurological symptoms. Histological examination revealed a nonsuppurative encephalitis and myelitis associated with protozoan cysts identified as Sarcocystis spp. by immunoperoxidase. The mild clinical signs and apparent recovery of 1 ewe suggest that neurological disease caused by Sarcocystis spp. may be more common than indicated by the infrequency of reports. Images Figure 1.

Henderson, J M; Dies, K H; Haines, D M; Higgs, G W; Ayroud, M

1997-01-01

8

Functional (conversion) neurological symptoms: research since the millennium.  

PubMed

Functional neurological symptoms (FNS) are commonly encountered but have engendered remarkably little academic interest. 'UK-Functional Neurological Symptoms (UK-FNS)' was an informal inaugural meeting of UK based clinicians in March 2011 with a variety of research and clinical interests in the field. This narrative review reflects the content of the meeting, and our opinion of key findings in the field since the turn of the millennium. PMID:22661497

Carson, Alan J; Brown, Richard; David, Anthony S; Duncan, Roderick; Edwards, Mark J; Goldstein, Laura H; Grunewald, Richard; Howlett, Stephaine; Kanaan, Richard; Mellers, John; Nicholson, Timothy R; Reuber, M; Schrag, Anette-Eleonore; Stone, Jon; Voon, Valerie

2012-08-01

9

Neurological symptoms in individuals with fibrodysplasia ossificans progressiva  

PubMed Central

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.

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.

2012-01-01

10

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

11

Functional symptoms in neurology: questions and answers  

PubMed Central

Between 10 and 30% of patients seen by neurologists have symptoms for which there is no current pathophysiological explanation. The objective of this review is to answer questions many neurologists have about disorders characterised by unexplained symptoms (functional disorders) by conducting a multidisciplinary review based on published reports and clinical experience. Current concepts explain functional symptoms as resulting from auto-suggestion, innate coping styles, disorders of volition or attention. Predisposing, precipitating, and perpetuating aetiological factors can be identified and contribute to a therapeutic formulation. The sympathetic communication of the diagnosis by the neurologist is important and all patients should be screened for psychiatric or psychological symptoms because up to two thirds have symptomatic psychiatric comorbidity. Treatment programmes are likely to be most successful if there is close collaboration between neurologists, (liaison) psychiatrists, psychologists, and general practitioners. Long term, symptoms persist in over 50% of patients and many patients remain dependent on financial help from the government. Neurologists can acquire the skills needed to engage patients in psychological treatment but would benefit from closer working relationships with liaison psychiatry or psychology.

Reuber, M; Mitchell, A; Howlett, S; Crimlisk, H; Grunewald, R

2005-01-01

12

Neurological symptoms in patients with biopsy proven celiac disease.  

PubMed

In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet. PMID:19845007

Bürk, Katrin; Farecki, Marie-Louise; Lamprecht, Georg; Roth, Guenter; Decker, Patrice; Weller, Michael; Rammensee, Hans-Georg; Oertel, Wolfang

2009-12-15

13

Neurological and neuropsychological performance in HIV seropositive men without symptoms.  

PubMed

Ninety five HIV seropositive and 32 seronegative homosexual men were recruited to a prospective study of the early features and natural history of the neurological manifestations of HIV infection. There was no evidence from the initial neurological examination, a neuropsychological test battery, nerve conduction studies, somatosensory evoked potentials from the legs, P300 event related auditory evoked potentials, magnetic stimulation of the motor cortex, or MRI scans that HIV infected men without symptoms in CDC groups II/III differed significantly from a well matched seronegative comparison group. Only the subgroup in CDC IV showed evidence of impairment, and this was restricted to their performance on some of the cognitive tests. The results imply that, despite early invasion of the CNS by HIV, major disturbances of function manifest themselves only when the patient becomes immunosuppressed. The importance of an appropriate comparison group and awareness of the potentially confounding influences such as age, education, exposure to alcohol and drugs, and mood and anxiety in such studies is stressed. The essentially negative findings are important in the understanding of the pathogenesis of neurological effect in HIV infection and in the design and interpretation of therapeutic trials. PMID:1538222

McAllister, R H; Herns, M V; Harrison, M J; Newman, S P; Connolly, S; Fowler, C J; Fell, M; Durrance, P; Manji, H; Kendall, B E

1992-02-01

14

Neurological and neuropsychological performance in HIV seropositive men without symptoms.  

PubMed Central

Ninety five HIV seropositive and 32 seronegative homosexual men were recruited to a prospective study of the early features and natural history of the neurological manifestations of HIV infection. There was no evidence from the initial neurological examination, a neuropsychological test battery, nerve conduction studies, somatosensory evoked potentials from the legs, P300 event related auditory evoked potentials, magnetic stimulation of the motor cortex, or MRI scans that HIV infected men without symptoms in CDC groups II/III differed significantly from a well matched seronegative comparison group. Only the subgroup in CDC IV showed evidence of impairment, and this was restricted to their performance on some of the cognitive tests. The results imply that, despite early invasion of the CNS by HIV, major disturbances of function manifest themselves only when the patient becomes immunosuppressed. The importance of an appropriate comparison group and awareness of the potentially confounding influences such as age, education, exposure to alcohol and drugs, and mood and anxiety in such studies is stressed. The essentially negative findings are important in the understanding of the pathogenesis of neurological effect in HIV infection and in the design and interpretation of therapeutic trials.

McAllister, R H; Herns, M V; Harrison, M J; Newman, S P; Connolly, S; Fowler, C J; Fell, M; Durrance, P; Manji, H; Kendall, B E

1992-01-01

15

Neurological and neuropsychological performance in HIV seropositive men without symptoms  

Microsoft Academic Search

Ninety five HIV seropositive and 32 seronegative homosexual men were recruited to a prospective study of the early features and natural history of the neurological manifestations of HIV infection. There was no evidence from the initial neurological examination, a neuropsychological test battery, nerve conduction studies, somatosensory evoked potentials from the legs, P300 event related auditory evoked potentials, magnetic stimulation of

R H McAllister; M V Herns; M J Harrison; S P Newman; S Connolly; C J Fowler; M Fell; P Durrance; H Manji; B E Kendall

1992-01-01

16

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

PubMed

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

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

2013-02-01

17

Differentiating cerebral ischemia from functional neurological symptom disorder: a psychosomatic perspective  

PubMed Central

Background The differential diagnosis of pseudo-neurological symptoms often represents a clinical challenge. The Diagnostic and Statistical Manual of Mental Disorders, DSM-5, made an attempt to improve diagnostic criteria of conversion disorder (functional neurological symptom disorder). Incongruences of the neurological examination, i.e. positive neurological signs, indicate a new approach - whereas psychological factors are not necessary anymore. As the DSM-5 will influence the International Classification of Diseases, ICD-11, this is of importance. In the case presented, a history of psychological distress and adverse childhood experiences coexisted with a true neurological disorder. We discuss the relevance of an interdisciplinary assessment and of operationalized diagnostic criteria. Case presentation A 32-year-old man presented twice with neurological symptoms without obvious pathological organic findings. A conversion disorder was considered early on at the second admission by the neurology team. Sticking to ICD-10, this diagnosis was not supported by a specialist for psychosomatic medicine, due to missing hints of concurrent psychological distress in temporal association with neurological symptoms. Further investigations then revealed a deep vein thrombosis (though D-dimers had been negative), which had probably resulted in a crossed embolus. Conclusion The absence of a clear proof of biological dysfunction underlying neurological symptoms should not lead automatically to the diagnosis of a conversion disorder. In contrast, at least in more complex patients, the work-up should include repeated psychological and neurological assessments in close collaboration. According to ICD-10 positive signs of concurrent psychological distress are required, while DSM-5 emphasizes an incongruity between neurological symptoms and neurophysiological patterns of dysfunction. In the case presented, an extensive medical work-up was initially negative, and neither positive psychological nor positive neurological criteria could be identified. We conclude, that, even in times of more sophisticated operationalization of diagnostic criteria, the interdisciplinary assessment has to be based on an individual evaluation of all neurological and psychosocial findings. Prospective studies of inter-rater reliability and validity of psychological factors and positive neurological signs are needed, as evidence for both is limited. With respect to ICD-11, we suggest that positive neurological as well as psychological signs for functional neurological symptom disorder should be considered to increase diagnostic certainty.

2014-01-01

18

Longitudinal assessment of chlorpyrifos exposure and self-reported neurological symptoms in adolescent pesticide applicators  

PubMed Central

Objectives Occupational exposure of organophosphorus pesticides, such as chlorpyrifos (CPF), in adolescents is of particular concern because of the potential vulnerability of the developing neurological system. The objectives of this study were to examine how neurological symptoms reported over the application season vary across time, whether these effects are reversible postapplication and if there are associations between CPF biomarkers and neurological symptoms in an adolescent study population. Setting The longitudinal study was conducted in two agricultural districts of Menoufia Governorate, Egypt between April 2010 and January 2011. Participants Male adolescent participants, including CPF applicators (n=57) and non-applicators (n=38), were recruited. Primary and secondary outcome measures Self-reported data for 25 neurological symptoms were collected at 32 time points over the 8-month period before, during and after the application season. Additionally, urine and blood samples were collected to measure urine trichloro-2-pyridinol (TCPy), a CPF-specific biomarker and blood cholinesterase activity. Results Applicators and non-applicators report the highest numbers of symptoms during the application season, followed by a reduction in symptoms after the application ended. Applicators reported a greater percentage of neurological symptoms, relative to baseline, than non-applicators after accounting for potential covariates. Among the applicators, cumulative TCPy was positively and significantly associated with the average percentage of symptoms (B=4.56, 95% CI 3.29 to 5.84; p<0.001). Significant associations (p=0.03–0.07) between the change in butyrylcholinesterase activity from the preapplication to the postapplication season and several domains of neurological symptoms were also found, even after adjusting for potential covariates. Conclusions These observations demonstrate changes in the reporting of symptoms across the application season, showing an increase in symptom reporting during application and recovery following the end of pesticide application. These findings reinforce the growing concern regarding the neurotoxic health effects of CPF in adolescent applicators in developing countries and the need for developing and implementing intervention programmes.

Khan, Khalid; Ismail, Ahmed A; Abdel Rasoul, Gaafar; Bonner, Matthew R; Lasarev, Michael R; Hendy, Olfat; Al-Batanony, Manal; Crane, Alice L; Singleton, Steven T; Olson, James R; Rohlman, Diane S

2014-01-01

19

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

PubMed Central

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

2010-01-01

20

Covert Neurological Symptoms Associated with Silent Infarcts from Mid-Life to Older Age: The Atherosclerosis Risk in Communities Study  

PubMed Central

Background and Purpose Unrecognized or unreported stroke-like symptoms, called covert symptoms, occur in persons free of clinical stroke. Whether covert symptoms are associated with subclinical brain infarcts (SBI) is unknown. This study examined the association between covert stroke-like symptoms and SBI/stroke in persons with no history of stroke or TIA. Methods 1881 Atherosclerosis Risk in Communities (ARIC) participants free of clinical stroke or transient ischemic attack (TIA) (40% male, 50% African-American, 47–70y) were queried for covert symptoms and underwent cerebral MRI during baseline MRI visit. Symptoms were reassessed after 3 years at Visit 4 (n=1001; 39% male, 50% African-American), and approximately 10 years with a follow-up MRI (n=1006; 40% male, 50% African-American, 61–83y). Results Covert symptoms were associated with prevalent SBI (OR=1.94, [95% CI 1.21, 3.11], p=0.006). Baseline MRI visit symptoms were not associated with SBI at follow-up MRI visit. In participants without SBI at baseline, symptoms at Visit 4(OR=2.96, [1.23, 7.13], p=0.016) and symptoms at follow-up MRI visit (OR=4.29, [2.51, 7.33], p<0.001) were associated with a combined outcome of new SBI on follow-up MRI/clinical stroke. Covert symptoms at follow-up MRI visit were also associated with having new SBI (OR=2.26, (1.18, 4.32), p=0.014) on the follow-up MRI that were not seen on the baseline MRI. Conclusions Covert neurological symptoms were associated with prevalent SBI, and when ascertained at time of follow-up MRI, with new SBI. Covert symptoms may reflect heightened risk for future infarcts.

Windham, Beverly G; Griswold, Michael E.; Shibata, Dean; Penman, Alan; Catellier, Diane J; Mosley, Thomas H.

2012-01-01

21

Severe neurological symptoms in a patient with advanced renal cell carcinoma treated with sunitinib.  

PubMed

Neurological symptoms are uncommon in patients administered sunitinib therapy; however, a few cases of dramatic neurotoxicity attributable to the development of reversible posterior leukoencephalopathy syndrome have been reported. Here, we report a case of a 71-year old woman with severe neurological symptoms occurring during sunitinib therapy for metastatic renal cell carcinoma. The clinical symptoms were typical for reversible posterior leukoencephalopathy syndrome, but there were no accompanying neuroimaging abnormalities. A Naranjo probability score of 3 indicates the adverse drug reaction was possible, but we discuss other potential causes of this event. PMID:23037634

Duchnowska, Renata; Miciuk, Beata; Bodnar, Lubomir; Wa?niewski, Leszek; Szczylik, Cezary

2013-06-01

22

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

Microsoft Academic Search

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

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

2001-01-01

23

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

PubMed Central

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

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

2013-01-01

24

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

PubMed Central

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

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

2013-01-01

25

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

PubMed

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

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

2010-01-01

26

PRISM: A Novel Research Tool to Assess the Prevalence of Pseudobulbar Affect Symptoms across Neurological Conditions  

PubMed Central

Background Pseudobulbar affect (PBA) is a neurological condition characterized by involuntary, sudden, and frequent episodes of laughing and/or crying, which can be socially disabling. Although PBA occurs secondary to many neurological conditions, with an estimated United States (US) prevalence of up to 2 million persons, it is thought to be under-recognized and undertreated. The PBA Registry Series (PRISM) was established to provide additional PBA symptom prevalence data in a large, representative US sample of patients with neurological conditions known to be associated with PBA. Methods Participating clinicians were asked to enroll ?20 consenting patients with any of 6 conditions: Alzheimer’s disease (AD), amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), Parkinson’s disease (PD), stroke, or traumatic brain injury (TBI). Patients (or their caregivers) completed the Center for Neurologic Study?Lability Scale (CNS-LS) and an 11-point scale measuring impact of the neurological condition on the patient’s quality of life (QOL). Presence of PBA symptoms was defined as a CNS?LS score ?13. Demographic data and current use of antidepressant or antipsychotic medications were also recorded. Results PRISM enrolled 5290 patients. More than one third of patients (n?=?1944; 36.7%) had a CNS-LS score ?13, suggesting PBA symptoms. The mean (SD) score measuring impact of neurological condition on QOL was significantly higher (worse) in patients with CNS-LS ?13 vs <13 (6.7 [2.5] vs. 4.7 [3.1], respectively; P<0.0001 two-sample t-test). A greater percentage of patients with CNS?LS ?13 versus <13 were using antidepressant/antipsychotic medications (53.0% vs 35.4%, respectively; P<0.0001, chi-square test). Conclusions Data from PRISM, the largest clinic-based study to assess PBA symptom prevalence, showed that PBA symptoms were common among patients with diverse neurological conditions. Higher CNS?LS scores were associated with impaired QOL and greater use of antipsychotic/antidepressant medications. These data underscore a need for greater awareness, recognition, and diagnosis of PBA.

Brooks, Benjamin Rix; Crumpacker, David; Fellus, Jonathan; Kantor, Daniel; Kaye, Randall E.

2013-01-01

27

[Neurology].  

PubMed

Neurology is a polymorphic discipline, with several subspecialties. In 2006, as in the previous years, a huge amount of scientific work focusing on treatment has been published. However, there has not been a true revolution in any of the current therapeutic strategies; rather, we experienced an improvement in the knowledge about several specific "details". This allows to consider more and more variables when administering a specific treatment, therefore, in each subspecialty a move towards a better patient's care has been made. In this contribution, several specialists analyse and interpret new facts about their respective neurological domain. PMID:17354660

Botez, S; Carota, A; Dunand, M; Du Pasquier, R; Kuntzer, T; Michel, P; Morier, J; Schluep, M; Rossetti, A O

2007-01-10

28

A rare case of complete C2–C3 dislocation with mild neurological symptoms  

Microsoft Academic Search

The authors report a rare case of complete C2–C3 dislocation with unexpectedly mild neurological symptoms in a 57 year old\\u000a man involved in a motor vehicle accident, who had previously undergone posterior laminectomy from C3 through C7. A retrospective\\u000a chart analysis and a thorough radiographic review were performed. X-rays and CT of the cervical spine demonstrated a complete\\u000a dislocation at the

Theofilos G. Machinis; Kostas N. Fountas; E. Z. Kapsalaki; I. Kapsalakis; A. A. Grigorian

2006-01-01

29

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

PubMed Central

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

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

2011-01-01

30

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

PubMed Central

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

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

2013-01-01

31

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

PubMed

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

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

2007-01-26

32

Extremely elevated cerebrospinal fluid protein levels in a child with neurologic symptoms: beware of haemophagocytic lymphohistiocytosis.  

PubMed

Neurologic symptoms can be the initial manifestation of haemophagocytic lymphohistiocytosis (HLH). In this case study, we present a 3-year old boy with a clinical picture of encephalitis, a cerebrospinal fluid (CSF) protein level up to 1165 mg/dl and diffuse cerebral MRI abnormalities. The diagnosis of HLH was established only 6 weeks after initial presentation. The boy recovered after HLH therapy with persisting mild cognitive defects. Genetic investigation demonstrated X-linked lymphoproliferative disease (XLP) as the underlying cause of HLH. The extremely elevated protein level in CSF in this case has not yet been reported in patients with HLH. PMID:24433830

Voeten, Michiel; Maes, Philip; Wojciechowski, Marek; Vandenbossche, Luc; Meyts, Isabelle; Ceulemans, Berten

2014-05-01

33

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

34

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

PubMed Central

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.

Detweiler, Mark B.

2014-01-01

35

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

Microsoft Academic Search

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

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

2000-01-01

36

Dexmedetomidine improves the histological and neurological outcomes 48h after transient spinal ischemia in rats.  

PubMed

Dexmedetomidine, an ?2 adrenoceptor agonist, provides neuroprotection against various cerebral ischemia models through its anti-apoptotic effects. Dexmedetomidine also improves paraplegia induced by intrathecal morphine after short-term spinal ischemia. However, there are no reports regarding dexmedetomidine?s ability to provide neuroprotection solely against transient spinal ischemia. We investigated whether dexmedetomidine would provide spinal protection following transient spinal ischemia in rats. Adult male Sprague Dawley rats were randomly assigned to one of the following five groups: (1) intravenous infusion of 0.9% NaCl at the rate of 0.5mL/h (control), (2) dexmedetomidine 0.1µg/kg/h, (3) dexmedetomidine 1µg/kg/h, (4) dexmedetomidine 10µg/kg/h, or (5) intravenous infusion of 0.9% NaCl without spinal ischemia (sham). The rats received saline solution or dexmedetomidine from 30min before spinal cord ischemia to 48h after ischemia. Spinal cord ischemia was induced by intraaortic balloon occlusion combined with proximal arterial hypotension for 10min. Ischemic injury was assessed by neurological deficit scores and the number of viable motor nerve cells in the anterior spinal cord at 48h after reperfusion. Neurological deficit scores in the dexmedetomidine-treated rats were significantly lower than the scores in the control group at 24 and 48h after ischemia (P<0.05). The number of viable motor nerve cells was significantly larger in the dexmedetomidine-treated rats than in the control rats (P<0.05), but the number of motor nerve cells in the dexmedetomidine group was significantly smaller than the sham group. Our results indicate that the continuous administration of dexmedetomidine improves neurological and histological outcomes 48h after transient spinal ischemia in rats. PMID:24755109

Goyagi, Toru; Tobe, Yoshitsugu

2014-05-30

37

Neurological soft signs in schizophrenia: Are they related to negative or positive symptoms, neuropsychological performance, and violence?  

Microsoft Academic Search

This investigation was carried out on 31 unemployed schizophrenic outpatient men. The general purpose was to explore new aspects of neurological soft signs in schizophrenia. A 108-item version of the Nathan Kline Institute scale of soft signs, the Schedule for Affective Disorders and Schizophrenia psychiatric interview, the negative and positive symptom scale (PANSS), a comprehensive scale of life-time history of

Suzanne Léveillé; Céline Constantineau; S HODGINS; J TOUPIN

1995-01-01

38

Neurological symptoms in tricolor sharkminnow Balantiocheilos melanopterus associated with Myxobolus balantiocheili n. sp. infecting the central nervous system  

Microsoft Academic Search

A new species, Myxobolus balantiocheili, is described from the central nervous system of wild and cultured tricolor sharkminnow Balantiocheilos melanopterus from Thailand. The infec- tion was associated with emaciation and severe neurological symptoms, including sudden uncoordi- nated darting, rolling and pitching. Whitish cysts of varying shape, measuring 70 to 500 µm, were located in the brain, spinal cord and in

Arne Levsen; Tor Alvik; Sindre Grotmol

2004-01-01

39

Symptom Progression or Fluctuation in Transient Ischemic Attack Patients Predicts Subsequent Stroke  

Microsoft Academic Search

Background: The aim of this study was to investigate whether progression or fluctuation of transient ischemic attack (TIA) symptoms is a predictor of subsequent stroke. Methods: We prospectively analyzed 113 consecutive patients admitted with a diagnosis of classical TIA with symptom duration of less than 24 h. We assessed the background characteristics, TIA symptoms, attack characteristics, results of in-hospital examinations,

Makoto Nakajima; Teruyuki Hirano; Hiroaki Naritomi; Kazuo Minematsu

2010-01-01

40

Na +,K +ATPase activity is selectively increased in thalamus in thiamine deficiency prior to the appearance of neurological symptoms  

Microsoft Academic Search

The relationship between progression of neurological status and the activities of both Na+,K+- and Mg2+-dependent-ATPase (adenosine 5?-triphosphate phosphohydrolase) was investigated in brain regions of pyrithiamine-induced thiamine deficient rats. Thalamic Na+,K+-ATPase activity was selectively increased by 200% (P < 0.01) prior to the appearance of symptoms of thiamine deficiency and normalized in symptomatic rats. This selective transitory activation precludes a mediation

Darrell D. Mousseau; Vemuganti L. Raghavendra Rao; Roger F. Butterworth

1996-01-01

41

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.

2012-01-01

42

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

PubMed

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

Cheillan, David; Joncquel-Chevalier Curt, Marie; Briand, Gilbert; Salomons, Gajja S; Mention-Mulliez, Karine; Dobbelaere, Dries; Cuisset, Jean-Marie; Lion-François, Laurence; Portes, Vincent Des; Chabli, Allel; Valayannopoulos, Vassili; Benoist, Jean-François; Pinard, Jean-Marc; Simard, Gilles; Douay, Olivier; Deiva, Kumaran; Afenjar, Alexandra; Héron, Delphine; Rivier, François; Chabrol, Brigitte; Prieur, Fabienne; Cartault, François; Pitelet, Gaëlle; Goldenberg, Alice; Bekri, Soumeya; Gerard, Marion; Delorme, Richard; Tardieu, Marc; Porchet, Nicole; Vianey-Saban, Christine; Vamecq, Joseph

2012-01-01

43

Panic with a twist: an unusual presentation of combined psychiatric and neurologic symptoms in a tactical jet aviator.  

PubMed

A 28-yr-old Naval F-14 aviator presented with complaints of flight-related anxiety occurring intermittently over an 18-mo period. Symptoms included sensation of strangeness, concern over the welfare of his radar intercept officer, flushing, nausea, and intense need to immediately land the aircraft. He also described a 6-mo history of episodes wherein he would see "shooting stars" in the periphery of his vision, accompanied by dizziness and disorientation. These latter attacks were always precipitated by head turning, usually in combination with positive Gz maneuvers, and were relieved by head straightening. The anxiety symptoms were consistent with a form of panic attack, but the neurological symptoms provoked further workup. Magnetic resonance cerebral angiogram demonstrated a dominant right vertebral artery and hypoplastic left vertebral artery. All symptoms resolved once the aviator was removed from flying the aircraft. After a year of follow-up with an aviation psychiatrist, he remained asymptomatic and was reassigned to maritime patrol aircraft. This case illustrates a difficult diagnostic, therapeutic, and disposition challenge. This aviator suffered from a complex interaction of neurologic and psychiatric manifestations having a common inciting stimulus, namely flying the F-14 Tomcat. A promising aviation career was preserved upon removal of that stimulus. PMID:9056030

Krentz, M J; Hopkins, E W; Moore, J L

1997-03-01

44

Sinus pericranii with severe symptom due to transient disorder of venous return--case report.  

PubMed

The authors report a case of sinus pericranii in a 22-year-old female presenting with severe headache, vomiting, bradycardia, and bradypnea following excessive distention of the tumor. After tumor removal, the symptoms were completely relieved. The symptoms were thought to be due to transient impairment of blood flow in the superior sagittal sinus. PMID:1717865

Anegawa, S; Hayashi, T; Torigoe, R; Nakagawa, S; Ogasawara, T

1991-05-01

45

Enterovirus 71-associated hand, foot and mouth diseases with neurologic symptoms, a university hospital experience in Korea, 2009  

PubMed Central

Purpose Hand-foot-mouth disease (HFMD) is a common viral illness in children, which is usually mild and self-limiting. However, in recent epidemics of HFMD in Asia, enterovirus 71 (EV71) has been recognized as a causative agent with severe neurological symptoms with or without cardiopulmonary involvement. HFMD was epidemic in Korea in the spring of 2009. Severe cases with complications including death have been reported. The clinical characteristics in children with neurologic manifestations of EV71 were studied in Ewha Womans University Mokdong Hospital. Methods Examinations for EV71 were performed from the stools, respiratory secretion or CSF of children who presented neurologic symptoms associated with HFMD by realtime PCR. Clinical and radiologic data of the patients were collected and analyzed. Results EV71 was isolated from the stool of 16 patients but not from respiratory secretion or CSF. Among the 16 patients, meningitis (n=10) was the most common manifestation, followed by Guillain-Barré syndrome (n=3), meningoencephalitis (n=2), poliomyelitis-like paralytic disease (n=1), and myoclonus (n=1). Gene analysis showed that most of them were caused by EV71 subgenotype C4a, which was prevalent in China in 2008. Conclusion Because EV71 causes severe complications and death in children, a surveillance system to predict upcoming outbreaks should be established and maintained and adequate public health measures are needed to control disease.

Cho, Hye Kyung; Lee, Na Yong; Lee, Hyunju; Kim, Hae Soon; Seo, Jeong Wan; Hong, Young Mi; Lee, Seung Joo; Lee, Sun Wha; Cheon, Doo Sung; Hong, Ji Young; Kang, Byung Hak; Kim, Jong-Hyun

2010-01-01

46

The Cerebro-Morphological Fingerprint of a Progeroid Syndrome: White Matter Changes Correlate with Neurological Symptoms in Xeroderma Pigmentosum  

PubMed Central

Background Xeroderma pigmentosum (XP) is a rare autosomal recessive progeroid syndrome. It has recently been shown that the underlying DNA repair defect plays a central role in the aging process. In addition to skin symptoms, various premature neurological abnormalities have been reported. Methodology/Principal Findings We present the clinical neurological phenotype in 14 XP patients (seven subtypes), in seven of these patients together with conventional and multiparametric advanced MRI data to assess the macrostructural and microstructural cerebral morphology in comparison to controls, including volumetric measurements, MR spectroscopy (1H MRS), and diffusion tensor imaging (DTI). Clinical hallmarks were spinocerebellar ataxia, pyramidal tract signs, and mild cognitive deficits. DTI demonstrated significantly reduced WM directionality in all regions investigated, i.e. the thalamus, the corticospinal tracts and the dorsal corpus callosum. Single patients showed a marked relative hippocampal volume reduction, but the patients were not different from controls in the volumetric measurements of hippocampal and whole brain volumes at group level. However, 1H MRS demonstrated that the hippocampal formation was metabolically altered. Conclusions The most prominent feature was the white matter affectation, as assessed by DTI, with volume and directionality reductions of the fiber projections involving both the craniocaudal fibers and the interhemispheric connections. These findings, although heterogeneous among the study sample, could be correlated with the clinico-neurological symptoms. The imaging findings support the position that myelin structures degrade prematurely in the brain of XP patients.

Kassubek, Jan; Sperfeld, Anne-Dorte; Pinkhardt, Elmar H.; Unrath, Alexander; Muller, Hans-Peter; Scharffetter-Kochanek, Karin; Ludolph, Albert C.; Berneburg, Mark

2012-01-01

47

Sentomist: Unveiling Transient Sensor Network Bugs via Symptom Mining  

Microsoft Academic Search

Wireless Sensor Network (WSN) applications are typi- cally event-driven. While the source codes of these ap- plications may look simple, they are in fact executed with a complicated concurrency model, which frequently intro- duces software bugs, in particular, transient bugs. Such buggy logics may only be triggered by some occasionally in- terleaved events that bear implicit dependency, but can lead

Yangfan Zhou; Xinyu Chen; Michael R. Lyu; Jiangchuan Liu

2010-01-01

48

Neurological disorders in essential thrombocythemia.  

PubMed

Patients with essential thrombocythemia often complain of various subjective neurological symptoms. This prospective study aims to assess their incidence and response to therapy. Among 37 consecutive patients with essential thrombocythemia, 11 presented with neurological symptoms. Among them 4 had thrombotic events, 7 complained of transient or fluctuating subjective symptoms, and one had both. Brain magnetic resonance imagery failed to detect any substratum in patients with subjective symptoms. JAK2V617F mutation was found in 9 of 11 patients with neurological symptoms versus 14 of 26 patients without symptoms. Ten patients received low-dose aspirin for these symptoms: complete resolution was observed in 3, improvement with persisting episodes in 2, and resistance to aspirin in 2 patients, in whom addition of cytoreductive therapy became necessary to resolve those disabling symptoms. In this prospective cohort, 30% of patients with essential thrombocythemia presented neurological symptoms. Aspirin was fully efficient in only 30% of cases. JAK2V617F mutation could be a risk factor for such symptoms. PMID:21933860

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

2011-12-01

49

Assessment of Peripheral Neuropathy in Patients With Rheumatoid Arthritis Who Complain of Neurologic Symptoms  

PubMed Central

Objective To assess the prevalence of peripheral neuropathy in patients with rheumatoid arthritis (RA) having neuropathic symptoms, and to investigate the relationship between electrophysiological findings of peripheral neuropathy and clinical findings of RA. Methods Patients with a clinical diagnosis of RA and who had tingling or burning sensation in any extremity were electrophysiologically examined for evidence of peripheral neuropathy. Study parameters, including age, gender, laboratory parameters, duration of RA, and medication, were recorded. The symptoms and signs of neuropathy were quantified with the neuropathy symptom score, and the functional statuses of these patients were assessed. Results Out of a total of 30 RA patients, 10 (33%) had peripheral neuropathy: 2 had bilateral carpal tunnel syndrome (CTS), 5 had unilateral CTS, 1 had sensory polyneuropathy, and 2 had motor-sensory polyneuropathy. The mean ages of the patients with and without peripheral neuropathy were 69.4 and 56.5 years, respectively (p<0.05). A significant relationship was found between peripheral neuropathy and anti-cyclic citrullinated peptide (anti-CCP) antibody. However, no relationship was found between peripheral neuropathy and the type of medication, RA duration, the patients' functional status, neuropathic symptoms, erythrocyte sedimentation rate, and C-reactive protein values. Conclusion Neuropathic symptoms are common in RA patients, and it is difficult to distinguish peripheral neuropathy symptoms from those of arthritis. Patients with RA, particularly elderly patients and anti-CCP antibody positive patients who complain of neuropathic symptoms should undergo electrophysiological examination.

Sim, Mi Kyung; Yoon, Jisun; Park, Dae Hwan; Kim, Yong-Gil

2014-01-01

50

Severe Gouty Arthritis and Mild Neurologic Symptoms Due to F199C, a Newly Identified Variant of the Hypoxanthine Guanine Phosphoribosyltransferase  

PubMed Central

A deficiency in hypoxanthine guanine phosphoribosyltransferase (HPRT) activity leads to overproduction of uric acid. According to the degree of enzymatic deficiency, a large spectrum of neurologic features can also be observed, ranging from mild or no neurologic involvement to complete Lesch-Nyhan disease. Herein, we describe a patient with hyperuricemia, juvenile-onset gouty arthritis, nephrolithiasis, and mild neurologic symptoms, attributed to a newly identified variant of the hprt gene, c.596T>G, resulting in the amino acid change p.F199C. Residual HPRT activity (8%) protected against severe neurologic involvement in this patient. Modeling of the mutated protein was used to predict the mechanisms that led to partial enzymatic activity. Careful neurologic examination is warranted in juvenile and middle-aged patients with gout, in order to detect mild symptoms that may lead to a diagnosis of HPRT deficiency.

Ea, Hang-Korng; Bardin, Thomas; Jinnah, H. A.; Aral, Bernard; Liote, Frederic; Ceballos-Picot, Irene

2010-01-01

51

Cobalamin deficiency manifested with seizures, mood oscillations, psychotic features and reversible dementia in the absence of typical neurologic and hematologic signs and symptoms: a case report.  

PubMed

Cobalamin deficiency is associated with a wide spectrum of hematologic, neurologic, gastroenterologic and psychiatric disorders or symptoms. We report a case of a 50-year-old man with complex partial seizures with secondary generalization, mood oscillations and psychotic symptoms alternating with confusion and reversible dementia secondary to cobalamin deficiency in the absence of typical neurologic and/or hematologic symptoms and signs. Exclusion of epilepsy, acute, atrophic or expansive lesion of central nervous system and usual etiology associated with reversible dementia (infectious diseases, an endocrine etiology and deficiency of vitamins other than cobalamin); finding of cobalamin deficiency only and complete neuropsychiatric recovery after substitution, confirmed etiology. Typical and atypical psychiatric manifestations due to cobalamin deficiency that precede neurologic and/or hematologic signs and symptoms can recover completely after adequate replacement therapy. PMID:23697293

Vilibi?, Maja; Juki?, Vlado; Vidovi?, Andelko; Breci?, Petrana

2013-03-01

52

Xeroderma pigmentosum group D patient bearing lentigo maligna without neurological symptoms.  

PubMed

A 35-year-old Japanese female patient with xeroderma pigmentosum (XP), registered as XP114TO, was assigned to complementation group D by the cell fusion complementation test. The patient had manifested moderate solar sensitivity and freckles by the age of 6 years. The skin phototest using 290- and 300-nm monochromatic ultraviolet (UV) light revealed slightly lowered minimal erythema doses at 24 h after irradiation. The XP114TO skin fibroblasts exhibited about the 6-fold higher sensitivity to the lethal effect of 254-nm UV as did normal cells. Unscheduled DNA synthesis (UDS) induced in XP114TO cells by 254-nm UV (10 J/m2) was 33% of normal, falling into the group D range of 25-50% UDS. The patient developed lentigo maligna on the right side of the nose. Unlike the typical XP group D cases in the West, she showed no neurological abnormalities. PMID:2242781

Fukuro, S; Yamaguchi, J; Mamada, A; Kondo, S; Satoh, Y

1990-01-01

53

[Mucolipidosis type I. Sialidosis due to alpha-2-6-neuraminidase deficiency with neurological symptoms].  

PubMed

A case close to mucolipidosis I was observed and the description of this mucolipidosis has to be revised since there were initially some confusions with mannosidosis. Three types of abnormalities appear to be important in its distinction from the other types of oligosaccharidoses: presence on the fundus of a cherry-red spot; in the bone marrow, reticulo-histiocytic cells, whose central nucleus is surrounded by multiple optically empty droplets; very elective overload of the Kupffer cells. 3a neurological syndrome with cerebellar ataxia appears in the evolution. However, it is not present in our patient nor the electroencephalogram changes. This latter point does not authorize the definite identification of our case with Spranger and Wiedemann description of mucolipidosis I especially as the neuraminidase deficiencies are certainly heterogenous. PMID:666524

Maroteaux, P; Poissonnier, M; Tondeur, M; Strecker, G; Lemonnier, M

1978-03-01

54

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.

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

55

Non-Epileptic Seizures and Other Functional Neurological Symptoms: Predisposing, Precipitating, and Perpetuating Factors  

Microsoft Academic Search

This naturalistic study describes potential etiological factors in outpatients with functional neuro- logical symptoms recorded during a screening interview with a single psychotherapist in 59 con- secutive patients. The most commonly identified predisposing\\/precipitating factors were trauma (78.0%), family dysfunction (62.7%), and bereavement (62.7%). Family dysfunction (54.2%) and affective disorder (42%) were the commonest perpetuating factors. Trauma was more common in

MARKUS REUBER; STEPHANIE HOWLETT; AJJAZ KHAN; RICHARD A. GRUNEWALD

2007-01-01

56

[Development of the locomotive and neurologic symptoms in the offspring of schizophrenics during the first few years of life].  

PubMed

The author provides the neurological characteristics and the follow-up data on the development of locomotion in 36 children aged 3 months to 3 years born to schizophrenic patients. Three variants of motor development were distinguished: the first one--early and proper development; the second one--short-term retardation at some stages, namely before the age of 1 year and 4 months, with intermittent episodes in the development and a proper or little changed formula of the postural and motor development; the third one--appreciable retardation and perversion of the motor developmental formula, insufficiency of the extrapyramidal and cortical components of the motor act, preserved even after 3 years of age. Among the discovered neurological symptoms, disorders in the system of gaze innervation, vocal and motor disorders, motor stereotypies, disturbances of the extrapyramidal and cortical component of the motor act, the hydrocephalic syndrome can be attributed to more specific ones as regards the schizotypic dysontogenesis. They were distinguished for using in further follow-up of the children. PMID:1701598

Goriunova, A V

1990-01-01

57

Intra-Erythrocyte Infusion of Dexamethasone Reduces Neurological Symptoms in Ataxia Teleangiectasia Patients: Results of a Phase 2 Trial  

PubMed Central

Background Ataxia Teleangiectasia [AT] is a rare neurodegenerative disease characterized by early onset ataxia, oculocutaneous teleangiectasias, immunodeficiency, recurrent infections, radiosensitivity and proneness to cancer. No therapies are available for this devastating disease. Recent observational studies in few patients showed beneficial effects of short term treatment with betamethasone. To avoid the characteristic side effects of long-term administration of steroids we developed a method for encapsulation of dexamethasone sodium phosphate (DSP) into autologous erythrocytes (EryDex) allowing slow release of dexamethasone for up to one month after dosing. Aims of the study were: the assessment of the effect of EryDex in improving neurological symptoms and adaptive behaviour of AT patients; the safety and tolerability of the therapy. Methods Twenty two patients (F:M?=?1; mean age 11.2?±?3.5) with a confirmed diagnosis of AT and a preserved or partially supported gait were enrolled for the study. The subjects underwent for six months a monthly infusion of EryDex. Ataxia was assessed by the International Cooperative Ataxia Rating Scale (ICARS) and the adaptive behavior by Vineland Adaptive Behavior Scales (VABS). Clinical evaluations were performed at baseline and 1, 3, and 6 months. Results An improvement in ICARS (reduction of the score) was detected in the intention-to-treat (ITT) population (n?=?22; p?=?0.02) as well as in patients completing the study (per protocol PP) (n?=?18; p?=?0.01), with a mean reduction of 4 points (ITT) or 5.2 points (PP). When compared to baseline, a significant improvement were also found in VABS (increase of the score) (p?neurologically impaired patients. Finally, a 19 month-extension study involving a subgroup of patients suggested that Erydex treatment can possibly delay the natural progression of the disease. EryDex was well tolerated; the most frequent side effects were common AT pathologies. Conclusions EryDex treatment led to a significant improvement in neurological symptoms, without association with the typical steroid side effects. Trial registration Current Controlled Trial 2010-022315-19SpA

2014-01-01

58

A 76-year-old man with cognitive and neurological symptoms.  

PubMed

A 76-year-old man presented with cognitive symptoms, followed by headache and weakness of the lower limbs and left arm. The clinical course was progressive but fluctuating. On magnetic resonance imaging (MRI), a contrast-enhancing lesion 1 cm in diameter was seen in the left temporal lobe. This lesion became attenuated and a new contrast-enhancing lesion 1 x 2 cm was seen in the left frontal lobe on a subsequent MRI. Following additional tests, treatment with corticosteroids for presumptive neurosarcoidosis was started, however, he soon expired. At autopsy, there was a tumor-like mass in the left frontal lobe. Pathologic evaluation revealed a primary T-cell lymphoma of the central nervous system (CNS). CNS T-cell lymphomas may be difficult to diagnose, even histologically, due to their frequent small cell morphology and lack of significant atypia. PMID:19744045

Brunnström, Hans; Dictor, Michael; Nilsson, Christer; Gülich, Dag; Englund, Elisabet

2009-10-01

59

Diffuse large B-cell lymphoma presenting with neurolymphomatosis and intravascular lymphoma: a unique autopsy case with diverse neurological symptoms  

PubMed Central

A 78-year-old Japanese male noticed a difficulty in the beginning of standing up, followed by 7a progressive numbness of extremities with pain, Bell’s palsy, dysarthria, and difficulty in swallowing. A clinician had suspected cancer of unknown primary origin, accompanied by the diverse and elusive neurological symptoms, likely presenting as painful mononeuropathy simplex and cranial neuropathy. He developed dysbasia over weeks and died 1?month after the symptom onset. At autopsy, an ill-defined large and soft tumor mass in the right lobe of the liver with direct invasion into the right adrenal gland was observed. The left adrenal gland or right iliopsoas muscle was also involved. Microscopic findings showed a monotonous proliferation of medium-sized to large atypical lymphoid cells, which were diffusely positive for CD20 in immunohistochemistry, consistent with diffuse large B-cell lymphoma (DLBL). Furthermore, the lymphoma cells aggressively infiltrated endoneurial and subperineurial spaces not only in the peripheral nerves and plexuses, but partly in the spinal nerve roots, and intravascular spaces in various tissues. Therefore, systemic lymphoma (DLBL) complicated with neurolymphomatosis (NL) and intravascular lymphoma (IVL) was diagnosed. Very early diagnosis and treatment are necessary for the NL patients with poor prognosis. Virtual slides The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5862472377020448.

2012-01-01

60

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

PubMed Central

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

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

2012-01-01

61

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

PubMed Central

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

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

2011-01-01

62

HEALTH EFFECTS OF CHRONIC EXPOSURE TO ARSENIC VIA DRINKING WATER IN INNER MONGOLIA. III. NEUROLOGICAL SYMPTOMS AND PIN-PRICK MEASURES  

EPA Science Inventory

Health Effects of Chronic Exposure to Arsenic via Drinking Water in Inner Mongolia: III. Neurological Symptoms and Pin-prick Measures Yanhong Li, M.D.,Yajuan.Xia, M.D., Kegong Wu, M.D., Inner Mongolia Center For Endemic Disease Control and Research, Ling Ling He, B.S., Zhi...

63

Histo- and immunopathological features of terminal AIDS. An autopsy case of a Japanese man with neurological signs as initial symptoms.  

PubMed

An autopsy case of a 37-year-old Japanese man, confirmed as an AIDS patient infected by an undetermined route of transmission, is presented. The initial symptoms of full-blown AIDS in this case were neurological, and the patient died of severe pneumonia 9 months after onset. The main histo- and immunopathological features were a marked depletion of helper-inducer T cells and dendritic reticulum cells in the lymphoid tissues, opportunistic infections, and some neuropathologic changes. Very few cells, possibly macrophages, immunoreactive with a monoclonal antibody (VAK-5) against HIV-gag protein P24 were found in the mediastinal lymph nodes. Numerous pathogens had induced opportunistic infections in many organs: severe and generalized cytomegalovirus infection, Pneumocystis carinii pneumonia, bronchopneumonia (possibly due to Pseudomonas aeruginosa), candidiasis in the tongue and oral cavity, and atypical mycobacteriosis in the pulmonic hilar lymph nodes. Vascular proliferation was found in the perinodal regions of some lymph nodes, but this was not neoplastic vascular proliferation compatible with that of localized Kaposi's sarcoma. PMID:3218510

Miyayama, H; Takeya, M; Takahashi, K; Koito, A; Hattori, T; Takatsuki, K

1988-10-01

64

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.

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

2014-01-01

65

CBT-based group therapy intervention for nonepileptic attacks and other functional neurological symptoms: A pilot study.  

PubMed

Despite the high prevalence and disabling nature of nonepileptic attacks (NEAs) and other types of functional neurological symptoms (FNSs), treatment trials are few. Preliminary evidence supports the efficacy of cognitive behavioral therapy (CBT) approaches, and CBT-based group therapies have the potential to improve cost-effectiveness and deliverability of treatment. This pilot study was undertaken to evaluate whether CBT-based group therapy would offer a feasible treatment option for patients with NEAs and other FNSs. We evaluated the outcomes of an information and management intervention within a neuropsychiatry service, which included weekly CBT-based group therapy sessions for patients with NEAs and other FNSs. Outcomes pertaining to quality of life and physical and emotional well-being were measured using the 36-item Short-Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), and the Clinical Global Impression (CGI) scale. Data were collected from 16 patients, of whom 10 presented with NEAs. Significant improvements were selectively reported in the 'emotional well-being' (p=0.04) and 'role limitation due to emotional well-being' (p=0.04) subscores of the SF-36. Improvements in overall quality-of-life scores (p=0.22), as well as in HADS anxiety (p=0.34) and depression (p=0.46) scores, did not reach statistical significance. These trends were supported by a positive mean CGI improvement scale score of 2.4, indicating minimal-to-considerable improvement. Group therapy intervention with a CBT-based approach is a feasible treatment option in the management of NEAs and other FNSs, as shown by significant improvements in emotional domains of quality of life in this low power pilot study. PMID:24717763

Conwill, Martin; Oakley, Louise; Evans, Kerry; Cavanna, Andrea E

2014-05-01

66

[Neurological signs in aortic dissection].  

PubMed

A substantial number of patients suffering from aortic dissection will show neurological signs. These can dominate the clinical picture and hinder an accurate diagnosis of this life-threatening disease. We present a case of lower extremity pain and a case of transient global amnesia caused by aortic dissection. A third patient suffered from acute cerebral ischemia accompanied by hypotension and back pain, suggestive of aortic dissection. In this third case, aortic dissection was excluded before systemic thrombolytic therapy was administered, for the patient could have suffered disastrous complications caused by this emergency stroke therapy. Clinicians should be aware that a wide range of cerebral, spinal and peripheral neurological signs can be caused by aortic dissection. An unusual combination of symptoms can be a clue for underlying aortic disease. High-risk clinical features are predisposing factors in medical history, typical acute onset back or chest pain, and pulse deficit, blood pressure asymmetry or a new cardiac murmur on physical examination. These features should be explicitly evaluated in patients with an acute neurological deficit. If neurological symptoms and a high-risk clinical feature are present, immediate aortic imaging should be considered since early detection can be life saving. PMID:24330794

Walma, Rinske A; Vermeij, Frederique H; Bakker, Stef L M

2013-01-01

67

Occupational neurology.  

PubMed Central

The nervous system is vulnerable to the effects of certain chemicals and physical conditions found in the work environment. The activities of an occupational neurologist focus on the evaluation of patients with neurological disorders caused by occupational or environmental conditions. When one is making a differential diagnosis in patients with neurological disorders, the possibility of toxic exposure or encounters with physical factors in the workplace must not be overlooked. Central to an accurate clinical diagnosis is the patient's history. A diagnosis of an occupational or environmental neurological problem requires a careful assessment of the clinical abnormalities and confirmation of these disabilities by objective tests such as nerve conduction velocity, evoked potentials, electroencephalogram, neuropsychological batteries, or nerve biopsy. On the basis of information about hazards in the workplace, safety standards and environmental and biological monitoring can be implemented in the workplace to reduce the risks of undue injury. Clinical manifestations of headache, memory disturbance, and peripheral neuropathy are commonly encountered presentations of the effects of occupational hazards. Physicians in everyday clinical practice must be aware of the signs and symptoms associated with exposure to possible neurotoxins and work methods. Occupational and environmental circumstances must be explored when evaluating patients with neurologic disorders.

Feldman, R. G.

1987-01-01

68

Neurology of rheumatologic disorders.  

PubMed

Rheumatologic diseases encompass autoimmune and inflammatory disorders of the joints and soft tissues that often involve multiple organ systems, including the central and peripheral nervous systems. Common features include constitutional symptoms, arthralgia and arthritis, myalgia, and sicca symptoms. Neurological manifestations may present in patients with preexisting rheumatologic diagnoses, occur concurrently with systemic signs and symptoms, or precede systemic manifestations by months to years. Rheumatic disorders presenting as neurological syndromes may pose diagnostic challenges. Advances in immunosuppressive treatment of rheumatologic disease have expanded the treatment armamentarium. However, serious neurotoxic effects have been reported with both old and newer agents. Familiarity with neurological manifestations of rheumatologic diseases, diagnosis, and potential nervous system consequences of treatment is important for rapid diagnosis and appropriate intervention. This article briefly reviews the diverse neurological manifestations and key clinical features of rheumatic disorders and the potential neurological complications of agents commonly used for treatment. PMID:24871965

Nouh, Amre; Carbunar, Olimpia; Ruland, Sean

2014-07-01

69

Alveolar echinococcosis of liver presenting with neurological symptoms due to brain metastases with simultaneous lung metastasis: a case report.  

PubMed

Alveolar echinococcosis (AE) is a chronic and serious, even lethal, parasitic infection caused by the helminth Echinococcus multilocularis (EM). AE is an endemic disease in Turkey and it is particularly common in people living in the eastern Anatolia Region. In addition to various clinical presentations, symptoms which lead to diagnosis, however, are usually associated with the metastatic lesions. We herein reported a 62-year-old man who had liver alveolar hydatid disease with simultaneous lung and brain metastasis. We think there was only one therapeutic option, namely medical treatment with albendazol, which is the usual treatment for patients living in eastern Anatolia and who are admitted late resulting in a subsequent inoperable situation. Thus, radiological screening studies for the public in this region may increase the possibility of surgical treatment for alveolar hydatid disease. PMID:19156614

Aydinli, Bülent; Aydin, Unal; Yazici, Pinar; Oztürk, Gürkan; Onba?, Omer; Polat, K Yalçin

2008-01-01

70

Premature death of TDP-43 (A315T) transgenic mice due to gastrointestinal complications prior to development of full neurological symptoms of amyotrophic lateral sclerosis  

PubMed Central

Abnormal distribution, modification and aggregation of transactivation response DNA-binding protein 43 (TDP-43) are the hallmarks of multiple neurodegenerative diseases, especially frontotemporal lobar degeneration with ubiquitin-positive inclusions (FTLD-U) and amyotrophic lateral sclerosis (ALS). Transgenic mouse lines overexpressing wild-type or mutant TDP-43 exhibit ALS-like symptom, motor abnormalities and early paralysis followed by death. Reports on lifespan and phenotypic behaviour in Prp-TDP-43 (A315T) vary, and these animals are not fully characterized. Although it has been proposed that the approximate 20% loss of motor neurons at end stage is responsible for the severe weakness and death in TDP-43 mice, this degree of neurologic damage appears insufficient to cause death. Hence we studied these mice to further characterize and determine the reason for the death. Our characterization of TDP-43 transgenic mice showed that these mice develop ALS-like symptoms that later become compounded by gastrointestinal (GI) complications that resulted in death. This is the first report of a set of pathological evidence in the GI track that is strong indicator for the cause of death of Prp-hTDP-43 (A315T) transgenic mice.

Esmaeili, Mohammad A; Panahi, Marzieh; Yadav, Shilpi; Hennings, Leah; Kiaei, Mahmoud

2013-01-01

71

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

72

A novel adult case of juvenile-onset Alexander disease: complete remission of neurological symptoms for over 12 years, despite insidiously progressive cervicomedullary atrophy.  

PubMed

We present here a 25-year-old woman with genetically confirmed (p.R276L mutation in the GFAP gene) juvenile-onset AxD. Episodic vomiting appeared at age nine, causing anorexia and insufficient growth. Brain MRI at age 11 showed a small nodular lesion with contrast enhancement in the left dorsal portion of the cervicomedullary junction. Her episodic vomiting improved spontaneously at age 13, and she became neurologically asymptomatic. The enhancement of the lesion disappeared simultaneously, although the plaque remained. Longitudinal MRI observations, however, revealed insidiously progressive cervicomedullary atrophy without a signal change. This case broadens our knowledge of AxD: (1) molecular analysis of the GFAP gene is warranted in patients with MRI evidence of tumor-like lesions in the brainstem, particularly if they present with isolated episodic vomiting and/or anorexia; (2) the disease can be self-remitting for at least 12 years; (3) cervicomedullary atrophy, characteristic of the adult form, can be insidiously progressive without a signal change before the clinical symptoms appear. PMID:22198646

Namekawa, Michito; Takiyama, Yoshihisa; Honda, Junko; Sakoe, Kumi; Naoi, Tametou; Shimazaki, Haruo; Yamagata, Takanori; Momoi, Mariko Y; Nakano, Imaharu

2012-12-01

73

Abdominal manifestations of neurologic disorders.  

PubMed

A variety of disorders-including infectious, inflammatory, hereditary, and metabolic diseases-may affect both the brain and abdominal cavity, and the findings in one region may help establish the diagnosis or limit the differential diagnosis. Establishing an accurate early diagnosis enables clinicians to adequately manage these unusual diseases and potentially avert life-threatening complications. For example, an early diagnosis of Gardner syndrome enables annual sigmoid- or colonoscopy and ultrasonography. In many conditions, abdominal manifestations precede neurologic manifestations and may have prognostic significance. Patients with celiac disease more often present with abdominal manifestations such as duodenitis, slow transit time, reversal of the jejunal-ileal fold pattern, and transient small bowel intussusception than with intracranial manifestations. In other conditions, the neurologic manifestations may be the same as the presenting symptoms. For example, patients with Gardner syndrome may initially present with multiple mandibular or sinonasal osteomas. In addition, sarcoidosis may manifest with multifocal enhancing dural masses. Abdominal and neurologic manifestations may even occur simultaneously, as in several of the phakomatoses such as neurofibromatosis type 1, tuberous sclerosis complex, and von Hippel-Lindau syndrome. Ultimately, familiarity with the appearances of these conditions allows radiologists to pinpoint a diagnosis, even when imaging findings in either location are nonspecific. PMID:23322834

Bhavsar, Anil S; Verma, Sadhna; Lamba, Ramit; Lall, Chandana G; Koenigsknecht, Vincent; Rajesh, Arumugam

2013-01-01

74

Some mental symptoms in neurology  

PubMed Central

Cases are presented in which cerebral disease was associated with schizophrenic-like or manic-depressive-like psychoses, anxiety or obsessional states i.e. psychiatric disorders usually classed as ‘functional’. Evidence is presented to suggest that this association is not due to chance. The cerebral structural changes are characterized either by the presence of ‘focal’ lesions, e.g. multiple sclerosis, or by neuronal loss e.g. Huntington's chorea. The probable mechanisms whereby these two types of structural changes effect psychiatric disturbances are discussed. It is inferred that psychiatric disturbances will occur insofar as these cerebral structural changes exert an influence on the limbic systems.

Behrman, Simon

1971-01-01

75

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

76

Depression and neurological disorders.  

PubMed

Depression is the most common psychiatric disorder in neurological disorders such as epilepsy, multiple sclerosis, stroke, and Parkinsons disease. It is associated with reduction of quality of life, functional impairment, and higher mortality. The diagnosis of depression in neurological disorders is difficult because of the overlapping symptoms. Neurological disorders are usually associated with sleep and appetite disturbances, fatigue, apathy, and lack of concentration, which is similar to those of depression. The etiology of depression with neurological disorders is unknown, but the interaction between biological, psychosocial, and neuropathological factors could be responsible for it. Few controlled trials have been carried out to investigate the efficacy of psychotherapeutic and pharmacological interventions in this population, and it seems that they are effective in improving depression, quality of life, and survival. Studies pertaining to prevention of depression in neurological disorders are promising. PMID:21048620

Bassiony, Medhat M

2009-07-01

77

Psychiatric disorders in neurology.  

PubMed

Psychiatric disorders (PDs) in neurology are more frequent then it verified in routine exam, not only in the less developed but also in large and very developed neurological departments. Furthermore, psychiatric symptoms (PSs) in neurological disorders (NDs) among primary health care physicians and other specialties are often neglected. Anxiety and depression are most common, but hallucinations, delusions, obsessive-compulsive disorder and delirium or confusional state are also frequent comorbidity in many neurological conditions such as stroke, epilepsy, multiple sclerosis (MS), Parkinson disease (PD). Depression and NDs also have a bidirectional relationship, as not only are patients, for example with stroke at greater risk of developing depression, but patients with depression have a two-fold greater risk of developing a stroke, even after controlling for other risk factors. Dementia or cognitive impairment are part of clinical picture of PD, stroke patients, patients with MS, Huntington disease etc. The prototype of dementia in PD and other NDs is a dysexecutive syndrome with impaired attention, executive functions and secondarily impaired memory. So-called "functional" (or psychogenic or hysterical/conversion) symptoms are relatively infrequent in "neurological" conditions, but very often unrecognized and not properly treated. Treatment of PSs in neurology, basically are not different then treatment of these symptoms in psychiatry and should be include pharmacotherapy and psychiatry. This presentation gives an overview of frequency and type of PSs underlying necessity to recognize these disorders in every day routine exam and properly treatment. PMID:23114812

Sinanovi?, Osman

2012-10-01

78

Cerebral perfusion and haemodynamics measured by SPET in symptom-free patients with transient ischaemic attack: clinical implications.  

PubMed

Transient ischaemic attacks (TIAs) are heterogeneous from the clinical, physiopathological, aetiological and prognostic points of view. Single-photon emission tomography (SPET) may influence patient management by helping to define the vascular topography and by suggesting the probable mechanism (embolic or haemodynamic). However, the variables predicting focal regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) abnormalities on SPET and their clinical correlation are poorly known. Our objective in this study was to assess the value of rCBF and CVR measured by SPET in a prospective series of 42 patients with recent (within the preceding 30 days) first-ever TIA Two SPET examinations [baseline and post-acetazolamide (ACZ)] were consecutively performed, and region/reference ratios were obtained using an irregular region of interest (ROI) method. Percentages of interhemispheric asymmetry between homologous brain regions were used to identify abnormalities on baseline SPET, and the percentage changes in asymmetry between the baseline and post-ACZ SPET studies were used to identify abnormal responses to the vasodilator stimulus. Mean baseline and test-retest values previously obtained in normals were used as a reference. The relationship of SPET findings with clinical data and results of complementary examinations was assessed. Most patients (98%) had abnormal findings on either baseline (43%), post-ACZ (19%) or both SPET studies (36%). Thus, 33 patients had hypoperfusion on baseline SPET (78.5%, symptom related in 45%). In 23 patients, a poor response to ACZ was found (55%, symptom related in 21.5%). No predictors for rCBF or CVR impairment were found. Most patients with a first-ever TIA episode present focal hypoperfusion on SPET, either with or without correlation with TIA symptoms. Post-ACZ SPET increases the probability of finding cerebrovascular abnormalities, and orients attention towards an haemodynamic compromise. Focal hypoperfusion on SPET should not be viewed as clinically insignificant because it probably reflects previous or ongoing clinical and/or subclinical episodes of cerebral ischaemia. PMID:11734922

Martí-Fàbregas, J A; Catafau, A M; Marí, C; Mendoza, G; Sanahuja, J; Lleó, A; Martí-Vilalta, J L

2001-12-01

79

[A case with severe neurological involvement due to vitamin B1 deficiency associated with megaduodenum].  

PubMed

We reported a case of 4-year-old boy with multiple vitamin deficiencies, especially vitamin B1 deficiency. He had megaduodenum associated with membranous stenosis on upper jejunum. He showed recurrent vomiting at his infantile period, and recently intermittent neurological symptoms. When he was admitted to our hospital, he could not walk and showed masked face, absent deep tendon reflexes, horizontal and vertical nystagmus, proximally dominant muscle weakness and multiple vitamin deficiencies. Oral administration of small doses of vitamin B1 (20 mg/day) could make remarkable clinical improvements. At three weeks after the treatment he could walk and run. Before the admission he had febrile convulsions and showed transiently striatal low density on CT image. We concluded that his neurological symptoms were due to vitamin B1 deficiency associated with megaduodenum. When a patient with intestinal anomaly shows neurological symptoms, we should think of vitamin deficiency. PMID:8461166

Tojo, M; Nitta, H; Matsui, T; Nakano, T; Watanabe, W

1993-03-01

80

Occupational exposure of healthcare and research staff to static magnetic stray fields from 1.5-7 Tesla MRI scanners is associated with reporting of transient symptoms  

PubMed Central

Objectives Limited data is available about incidence of acute transient symptoms associated with occupational exposure to static magnetic stray fields from MRI scanners. We aimed to assess the incidence of these symptoms among healthcare and research staff working with MRI scanners, and their association with static magnetic field exposure. Methods We performed an observational study among 361 employees of 14 clinical and research MRI facilities in The Netherlands. Each participant completed a diary during one or more work shifts inside and/or outside the MRI facility, reporting work activities and symptoms (from a list of potentially MRI-related symptoms, complemented with unrelated symptoms) experienced during a working day. We analysed 633 diaries. Exposure categories were defined by strength and type of MRI scanner, using non-MRI shifts as the reference category for statistical analysis. Non-MRI shifts originated from MRI staff who also participated on MRI days, as well as CT radiographers who never worked with MRI. Results Varying per exposure category, symptoms were reported during 16–39% of the MRI work shifts. We observed a positive association between scanner strength and reported symptoms among healthcare and research staff working with closed-bore MRI scanners of 1.5 Tesla (T) and higher (1.5?T OR=1.88; 3.0?T OR=2.14; 7.0?T OR=4.17). This finding was mainly driven by reporting of vertigo and metallic taste. Conclusions The results suggest an exposure-response association between exposure to strong static magnetic fields (and associated motion-induced time-varying magnetic fields) and reporting of transient symptoms on the same day of exposure. Trial registration number 11-032/C

Schaap, Kristel; Christopher-de Vries, Yvette; Mason, Catherine K; de Vocht, Frank; Portengen, Lutzen; Kromhout, Hans

2014-01-01

81

Symptoms and Diagnosis  

MedlinePLUS

Symptoms and Diagnosis If you are new to dystonia, it can be a challenging disorder to understand. ... as primary, secondary, or dystonia-plus . ? If the dystonia occurs with symptoms of additional neurological disorders. Dystonia ...

82

Neurologic running injuries.  

PubMed

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

McKean, Kelly A

2008-02-01

83

Neurologic running injuries.  

PubMed

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

McKean, Kelly A

2009-02-01

84

Neurological channelopathies  

PubMed Central

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

Graves, T; Hanna, M

2005-01-01

85

Neurologic toxicities of cancer therapies  

Microsoft Academic Search

Neurologic dysfunction is a well-recognized adverse effect of cancer therapeutics. The most common manifestations include\\u000a peripheral neuropathy and encephalopathy. Often, symptoms resolve or improve upon removal of the offending agent; therefore,\\u000a it is essential that clinicians recognize the symptoms and signs of injury. Occasionally, symptoms persist or develop after\\u000a discontinuation of medication and may culminate in disability and diminished quality

Robert Cavaliere; David Schiff

2006-01-01

86

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

ERIC Educational Resources Information Center

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

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

2009-01-01

87

Neurological disorders  

Microsoft Academic Search

Historically, policy makers and researchers have used mortality statistics as the principal measure of the seriousness of diseases, based on which countries and organizations have launched disease control programs. Mortality statistics alone, however, underestimate the suffering caused by diseases that may be non- fatal but cause substantial disability. Many neurological and psychiatric conditions belong in this category. The absence of

Vijay Chandra; Rajesh Pandav; Ramanan Laxminarayan; Caroline Tanner; Bala Manyam; Sadanand Rajkumar; Donald Silberberg; Carol Brayne; Jeffrey Chow; Susan Herman; Fleur Hourihan; Scott Kasner; Luis Morillo; Adesola Ogunniyi; William Theodore; Zhen-Xin Zhang

1999-01-01

88

Neurological diseases and pain  

PubMed Central

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

2012-01-01

89

The use of Cincinnati prehospital stroke scale during telephone dispatch interview increases the accuracy in identifying stroke and transient ischemic attack symptoms  

PubMed Central

Background Timely and appropriate hospital treatment of acute cerebrovascular diseases (stroke and Transient Ischemic Attacks - TIA) improves patient outcomes. Emergency Medical Service (EMS) dispatchers who can identify cerebrovascular disease symptoms during telephone requests for emergency service also contribute to these improved outcomes. The Italian Ministry of Health issued guidelines on the management of AC patients in pre-hospital emergency service, including Cincinnati Prehospital Stroke Scale (CPSS) use. We measured the sensitivity and Positive Predictive Value (PPV) of EMS dispatchers’ ability to recognize stroke/TIA symptoms and evaluated whether the CPSS improves accuracy. Methods A cross-sectional multicentre study was conducted to collect data from 38 Italian emergency operative centres on all cases identified with stroke/TIA symptoms at the time of dispatch and all cases with stroke/TIA symptoms identified on the scene by the ambulance personnel from November 2010 to May 2011. Results The study included 21760 cases: 18231 with stroke/TIA symptoms at dispatch and 9791 with symptoms confirmed on the scene. The PPV of the dispatch stroke/TIA symptoms identification was 34.3% (95% CI 33.7-35.0; 6262/18231) and the sensitivity was 64.0% (95% CI 63.0-64.9; 6262/9791). Centres using CPSS more often (>10% of cases) had both higher PPV (56%; CI 95% 57–60 vs 18%; CI 95% 17–19) and higher sensitivity (71%; CI 95% 87–89 vs 52%; CI 95% 51–54). In the multivariate regression a centre’s CPSS use was associated with PPV (beta 0.48 p?=?0.014) and negatively associated with sensitivity (beta -0.36; p?=?0.063); centre sensitivity was associated with CPSS (beta 0.32; p?=?0.002), adjusting for PPV. Conclusions Centres that use CPSS more frequently during phone dispatch showed greater agreement with on-the-scene prehospital assessments, both in correctly identifying more cases with stroke/TIA symptoms and in giving fewer false positives for non-stroke/TIA cases. Our study shows an extreme variability in the performance among OCs, highlighting that form many centres there is room for improvement in both sensitivity and positive predictive value of the dispatch. Our results should be used for benchmarking proposals in the effort to identify best practices across the country.

2013-01-01

90

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

PubMed Central

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

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

2008-01-01

91

Acute neurological problems: frequency, consultation patterns and the uses of a rapid access neurology clinic.  

PubMed

In secondary care, some patients with acute neurological symptoms are never seen by a neurologist. Rapid access neurology clinics could provide patients with timely access to neurology services. We analysed a retrospective cohort of 12,024 consecutive patients attending the 'immediate care' area of the emergency department or the acute medical admissions unit of the Royal Infirmary of Edinburgh. A total of 1,036 patients (9%) presented with a neurological complaint, of whom 680 (66%) did not have any contact with neurology services. The most common problems were epileptic seizure, cerebrovascular diseases and headache. Of the patients with epileptic seizure or headache who were not seen by a neurologist, about 40% might have benefited from neurological assessment. Following the introduction of a weekly rapid access neurology clinic, the most common problems seen were headache, symptoms that turned out to be medically unexplained and epileptic seizure. PMID:21152464

Chapman, F A; Pope, A E; Sorensen, D; Knight, R S; Al-Shahi Salman, R

2009-12-01

92

Neurologic complications of arrhythmia treatment.  

PubMed

An arrhythmia is defined as an abnormal heart rhythm. Certain arrhythmias have much higher rates of neurologic complications, including stroke, cognitive impairment, and dementia. The purpose of this paper is to review both the direct and indirect causes of neurologic problems caused by arrhythmias. Direct complications from arrhythmia can include stroke, transient ischemic attack (TIA), and varying disorders of cognition. According to the Stroke Data Bank, which divided potential direct causes of cardioembolic stroke into strong and weak sources, both atrial fibrillation and sick-sinus syndrome were considered to be strong sources of this type of ischemic stroke. Indirect causes of neurologic complications include cardiopulmonary resuscitation, medications, cardiology procedures, and cardiac surgical procedures used to treat arrhythmias. PMID:24365293

Leary, Megan C; Veluz, Jeffrey S; Caplan, Louis R

2014-01-01

93

Ocular pain: a neurological perspective.  

PubMed

Ocular pain and related symptoms are frequent manifestations of primary and secondary headache disorders. Neurologists are often the first physician to evaluate patients affected by these clinical features. The cause of eye pain may be attributed both to pathological disorders with abnormal neurologic and neuro-ophthalmologic findings and to diseases with no apparent eye disturbances. A thorough clinical approach is necessary for an appropriate diagnosis and a correct specific management. PMID:20464596

Colombo, Bruno; Dalla Libera, Dacia; Comi, Giancarlo

2010-06-01

94

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.

2011-01-01

95

Neurological complications after allogeneic hematopoietic stem cell transplantation in children, a single center experience.  

PubMed

In this study, we retrospectively examined the data of children who underwent allo-HSCT from HLA-matched family donors. We analyzed the incidence, etiological factors, clinical characteristics, possible reasons, risk factors, and follow-up of neurologic complications. BU-based conditioning regimens were used in most of the cases (n = 62). The median duration of follow-up for the 89 patients was 20 months (range 1-41 months). Eleven percent of transplanted children developed one or more neurological symptoms after HSCT with a median observation time of two months (range -6 days to 18 months). The median age of the four girls and six boys with neurological complication was 13 yr (range 5.3-17.6 yr). Cylosporine A neurotoxicity was diagnosed in five children, four of them were PRES. The rest of complications were BU and lorazepam toxicity, an intracranial hemorrhage, a sinovenous thrombosis, and a transient ischemic attack during extracorpereal photopheresis. No difference was found between groups of neurological complication according to age, gender, diagnosis, hospitalization time, neutrophil and platelet engraftment time, stem cell source, and conditioning regimen, acute and chronic GVHD or VOD. Neurological complication was the cause of death in one patient (1.1%). PMID:24802348

Azik, Fatih; Yazal Erdem, Arzu; Tavil, Betül; Bayram, Cengiz; Tunç, Bahattin; Uçkan, Duygu

2014-06-01

96

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.

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

2012-01-01

97

[Transient myopia].  

PubMed

Although transient myopia is an extremely rare symptom, systemic diseases which can also lead to a life-threatening condition should also be considered in cases of sudden deterioration of vision. Therefore, the initial diagnosis in an ophthalmological clinic or practice plays a decisive role. PMID:21590350

Borkenstein, A F; Hausberger, S; Mayer, C; Faschinger, C

2011-07-01

98

Neurologic toxicities of cancer therapies.  

PubMed

Neurologic dysfunction is a well-recognized adverse effect of cancer therapeutics. The most common manifestations include peripheral neuropathy and encephalopathy. Often, symptoms resolve or improve upon removal of the offending agent; therefore, it is essential that clinicians recognize the symptoms and signs of injury. Occasionally, symptoms persist or develop after discontinuation of medication and may culminate in disability and diminished quality of life. As our understanding of neurotoxicity improves, medications with less potential for injury may be developed. In addition, potential antidotes to prevent or reverse injury may emerge. This review focuses on the clinical features, mechanisms, and possible therapeutics of the neurotoxicity of chemotherapy. In particular, oxaliplatin, thalidomide, methotrexate, ifosfamide, cytarabine, amifostine, acetyl-L-carnitine, methylene blue, cytokines, and neurotrophins are discussed. PMID:16635431

Cavaliere, Robert; Schiff, David

2006-05-01

99

The blockade of the transient receptor potential vanilloid type 1 and fatty acid amide hydrolase decreases symptoms and central sequelae in the medial prefrontal cortex of neuropathic rats  

PubMed Central

Background Neuropathic pain is a chronic disease resulting from dysfunction within the "pain matrix". The basolateral amygdala (BLA) can modulate cortical functions and interactions between this structure and the medial prefrontal cortex (mPFC) are important for integrating emotionally salient information. In this study, we have investigated the involvement of the transient receptor potential vanilloid type 1 (TRPV1) and the catabolic enzyme fatty acid amide hydrolase (FAAH) in the morphofunctional changes occurring in the pre-limbic/infra-limbic (PL/IL) cortex in neuropathic rats. Results The effect of N-arachidonoyl-serotonin (AA-5-HT), a hybrid FAAH inhibitor and TPRV1 channel antagonist, was tested on nociceptive behaviour associated with neuropathic pain as well as on some phenotypic changes occurring on PL/IL cortex pyramidal neurons. Those neurons were identified as belonging to the BLA-mPFC pathway by electrical stimulation of the BLA followed by hind-paw pressoceptive stimulus application. Changes in their spontaneous and evoked activity were studied in sham or spared nerve injury (SNI) rats before or after repeated treatment with AA-5-HT. Consistently with the SNI-induced changes in PL/IL cortex neurons which underwent profound phenotypic reorganization, suggesting a profound imbalance between excitatory and inhibitory responses in the mPFC neurons, we found an increase in extracellular glutamate levels, as well as the up-regulation of FAAH and TRPV1 in the PL/IL cortex of SNI rats. Daily treatment with AA-5-HT restored cortical neuronal activity, normalizing the electrophysiological changes associated with the peripheral injury of the sciatic nerve. Finally, a single acute intra-PL/IL cortex microinjection of AA-5-HT transiently decreased allodynia more effectively than URB597 or I-RTX, a selective FAAH inhibitor or a TRPV1 blocker, respectively. Conclusion These data suggest a possible involvement of endovanilloids in the cortical plastic changes associated with peripheral nerve injury and indicate that therapies able to normalize endovanilloid transmission may prove useful in ameliorating the symptoms and central sequelae associated with neuropathic pain.

2011-01-01

100

Introduction to Aerospace Neurology.  

National Technical Information Service (NTIS)

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

M. S. Katchen

1991-01-01

101

[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

102

Immunotherapy for neurological diseases  

Microsoft Academic Search

The burden of neurological diseases in western societies has accentuated the need to develop effective therapies to stop the progression of chronic neurological diseases. Recent discoveries regarding the role of the immune system in brain damage coupled with the development of new technologies to manipulate the immune response make immunotherapies an attractive possibility to treat neurological diseases. The wide repertoire

Pablo Villoslada; Beatriz Moreno; Ignacio Melero; Jose L. Pablos; Gianvito Martino; Antonio Uccelli; Xavier Montalban; Jesus Avila; Serge Rivest; Laia Acarin; Stanley Appel; Samia J. Khoury; Patrick McGeer; Isidro Ferrer; Mario Delgado; Jose Obeso; Michal Schwartz

2008-01-01

103

Avoiding Misdiagnosis in Patients with Neurological Emergencies  

PubMed Central

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

Pope, Jennifer V.; Edlow, Jonathan A.

2012-01-01

104

Neurological Complications of Lyme Disease  

MedlinePLUS

NINDS Neurological Complications of Lyme Disease Information Page Synonym(s): Lyme Disease - Neurological Complications Table of Contents (click to jump to sections) What are Neurological Complications of ...

105

The gluten syndrome: a neurological disease.  

PubMed

Hypothesis: Gluten causes symptoms, in both celiac disease and non-celiac gluten-sensitivity, by its adverse actions on the nervous system. Many celiac patients experience neurological symptoms, frequently associated with malfunction of the autonomic nervous system. These neurological symptoms can present in celiac patients who are well nourished. The crucial point, however, is that gluten-sensitivity can also be associated with neurological symptoms in patients who do not have any mucosal gut damage (that is, without celiac disease). Gluten can cause neurological harm through a combination of cross reacting antibodies, immune complex disease and direct toxicity. These nervous system affects include: dysregulation of the autonomic nervous system, cerebella ataxia, hypotonia, developmental delay, learning disorders, depression, migraine, and headache. If gluten is the putative harmful agent, then there is no requirement to invoke gut damage and nutritional deficiency to explain the myriad of the symptoms experienced by sufferers of celiac disease and gluten-sensitivity. This is called "The Gluten Syndrome". PMID:19406584

Ford, Rodney Philip Kinvig

2009-09-01

106

Paraneoplastic neurological disorders.  

PubMed

Paraneoplastic Neurological Disorders (PND) are uncommon but important because they frequently present before a cancer is diagnosed and because they cause severe neurological disability. Current thinking is that they are caused by an autoimmune response to 'onconeural' antigens, shared by the tumour and the nervous system, although the precise immunopathogenic mechanism is unknown. It is likely that there is an important cellular immune response as evidenced by the presence of lymphocytic infiltration and activated cytotoxic T lymphocytes, found in the CSF of affected patients. PND may affect any part of the nervous system either focally (e.g. cerebellar degeneration) or diffusely (e.g. encephalomyelitis). Both the Central and Peripheral Nervous System may be affected, with antigenic targets being either intracellular (both nuclear and cytoplasmic) or extracellular (receptors and ion channels). As a general rule, PND associated with antibodies against intracellular targets cause predominantly CNS disorders while those associated with antibodies against extracellular antigens cause predominantly neuromuscular disorders. PND affecting the CNS are commonly associated with specific anti-neuronal antibodies, which are present in both serum and CSF. A suspected diagnosis of PND should prompt a search for what may be a very small tumour, sometimes not visible with conventional imaging techniques. Fluoro-deoxyglucose-Positron Emission Tomography (FDG-PET) scanning is helpful in this regard as it can visualise tumours down to a resolution of 6-8?mm anywhere in the body and is sometimes positive when chest X-ray and CT are negative. Current recommendations are that the search for cancer should continue for up to 5 years after diagnosis, except for Lambert Eaton Myasthenic Syndrome (LEMS) associated with Small cell Lung Cancer, where 2 years are sufficient. Most CNS syndromes respond poorly to immunomodulatory treatment although occasional improvement is seen when the underlying tumour is treated. In contrast, disorders affecting the Neuromuscular Junction e.g. LEMS do improve with treatments that remove the relevant antibodies, directed against Voltage-Gated Calcium Channels. Traditonally, PNS affect older patients with malignant tumours. Recently the spectrum of paraneoplasia has been broadened to include younger patients with benign tumours e.g. ovarian teratoma presenting with prodromal flu-like symptoms, psychiatric disturbance progressing to coma, movement disorders, autonomic instability and respiratory failure. These disorders are associated with antibodies directed against NMDA receptors in the hippocampi and improve with removal of the teratoma and plasma exchange. The prognosis for the majority of PND is poor, even if the tumour is detected and treated, and patients may live in a severely disabled state for many years. PMID:25009323

Rees, Jeremy

2014-08-01

107

[Neurology! Adieau? (Part 2)].  

PubMed

The education of neurologists is debilitated worldwide. University professors are engaged in teaching, research and patient-care. This triple challenge is very demanding, and results in permanent insecurity of University employees. To compensate for the insufficient clinical training, some institutes in the USA employ academic staff members exclusively for teaching. The formation of new subspecialties hinders the education and training of general neurologists. At present, four generations of medical doctors are working together in hospitals. The two older generations educate the younger neurologists who have been brought up in the world of limitless network of sterile information. Therefore their manual skills at the bedside and their knowledge of emergency treatment are deficient. Demographics of medical doctors changed drastically. Twice as many women are working in neurology and psychiatry than men. Integrity of neurology is threatened by: (1) Separation of the cerebrovascular diseases from general neurology. Development of "stroke units" was facilitated by the better reimbursement for treatment and by the interest of the pharmaceutical companies. Healthcare politics promoted the split of neurology into two parts. The independent status of "stroke departments" will reduce the rest of clinical neurology to outpatient service. (2) The main argumentation to segregate the rare neurological diseases was that their research will provide benefit for the diseases with high prevalence. This argumentation serves territorial ambitions. The separation of rare diseases interferes with the teaching of differential diagnostics in neurological training. The traditional pragmatic neurology can not be retrieved. The faculty of neurology could retain its integrity by the improvement of diagnostic methods and the ever more effective drugs. Nevertheless, even the progression of neurological sciences induces dissociation of clinical neurology. Neurology shall suffer fragmentation if the professional authorities fail to control the separation of subspecialties, if teaching of future neurologists, including practical knowledge and skills of diagnostic decision making, is not supported. PMID:20648779

Szirmai, Imre

2010-05-30

108

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

PubMed Central

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

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

2013-01-01

109

Neurological complications of alcohol and misuse of drugs  

Microsoft Academic Search

The nature of many of the symptoms associated with substance and alcohol use means that patients often present to neurologists. The frequently catastrophic consequences of overlooking these patients makes this an important cause to identify. Here I will discuss various acute and non-acute substance misuse associated presentations, with particular emphasis on the neurology. As neurological sequelae are particularly common in

Killian A Welch

2011-01-01

110

Male sexual dysfunction and infertility associated with neurological disorders  

Microsoft Academic Search

Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments

Mikkel Fode; Sheila Krogh-Jespersen; Nancy L Brackett; Dana A Ohl; Charles M Lynne; Jens Sønksen

2012-01-01

111

Contagious Weakness in an Elderly Couple with Neurologic Emergencies  

PubMed Central

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

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

2011-01-01

112

The neurology in Shakespeare.  

PubMed

William Shakespeare's 37 plays and poetry contain many references of interest for almost all of the medical specialties. To support that the Bard could be considered a Renaissance neurologist, the following important neurological phenomena have been selected from his repertoire for discussion: tremors, paralysis and stroke, sleep disturbances, epilepsy, dementia, encephalopathies, and the neurology of syphilis. PMID:2667505

Fogan, L

1989-08-01

113

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

Microsoft Academic Search

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

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

2000-01-01

114

Neurology and orthopaedics  

PubMed Central

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

Houlden, Henry; Charlton, Paul; Singh, Dishan

2007-01-01

115

Developmental and neurologic correlates of treatment response in schizophrenia.  

PubMed Central

Reliable predictors of outcome in schizophrenia remain elusive, and assessment of unidimensional variables is unlikely to provide new information. We examined developmental, neurologic and psychosocial variables together to assess their correlation with several separate aspects of outcome in male schizophrenic patients (N = 31) treated with neuroleptics for a minimum of six months. Outcome measures evaluating social performance were significantly inter-correlated, but these measures did not correlate significantly with "positive" symptom measures. Persistent positive symptoms were predicted by post-natal neurologic impairment. Persistent negative symptoms and social dysfunction were predicted by psychosocial dysfunction during the developmental years. Poor early treatment response significantly correlated with persistent positive symptoms and psychosocial dysfunction. Impairment on neurobehavioral testing correlated significantly with post-natal neurologic impairment and with persistent positive symptoms.

Whelton, C L; Cleghorn, J M; Atley, S; Durocher, G J; MacCrimmon, D

1992-01-01

116

Peripheral neurological complications of aortoiliac vascular disease.  

PubMed

Six patients with an aortoiliac vascular disease and a peripheral neurological deficit are presented. Clinical and electromyographic findings revealed lumbosacral plexus, sciatic and femoral nerve lesions. A correlation is made between the level of the vascular lesion (aortic, aortoiliac or distally) and the type of peripheral nerve deficit observed. In a patient complaining of pain, weakness, or numbness in a leg, the differential diagnosis should include aortoiliac vascular disease. The peripheral neurological symptoms may be the initial manifestation of the vascular disease or may appear in the early post-operative period. PMID:3038289

D'Amour, M L; Lebrun, L H; Rabbat, A; Trudel, J; Daneault, N

1987-05-01

117

Neurologic complications after surgery for obesity.  

PubMed

Bariatric surgical procedures are increasingly common. In this review, we characterize the neurologic complications of such procedures, including their mechanisms, frequency, and prognosis. Literature review yielded 50 case reports of 96 patients with neurologic symptoms after bariatric procedures. The most common presentations were peripheral neuropathy in 60 (62%) and encephalopathy in 30 (31%). Among the 60 patients with peripheral neuropathy, 40 (67%) had a polyneuropathy and 18 (30%) had mononeuropathies, which included 17 (94%) with meralgia paresthetica and 1 with foot drop. Neurologic emergencies including Wernicke's encephalopathy, rhabdomyolysis, and Guillain-Barré syndrome were also reported. In 18 surgical series reported between 1976 and 2004, 133 of 9996 patients (1.3%) were recognized to have neurologic complications (range: 0.08-16%). The only prospective study reported a neurologic complication rate of 4.6%, and a controlled retrospective study identified 16% of patients with peripheral neuropathy. There is evidence to suggest a role for inflammation or an immunologic mechanism in neuropathy after gastric bypass. Micronutrient deficiencies following gastric bypass were evaluated in 957 patients in 8 reports. A total of 236 (25%) had vitamin B(12) deficiency and 11 (1%) had thiamine deficiency. Routine monitoring of micronutrient levels and prompt recognition of neurological complications can reduce morbidity associated with these procedures. PMID:15973660

Koffman, Boyd M; Greenfield, L John; Ali, Imran I; Pirzada, Noor A

2006-02-01

118

Immunotherapies in neurologic disorders.  

PubMed

Therapy for autoimmune demyelinating disorders has evolved rapidly over the past 10 years to include traditional immunosuppressants as well as novel biologicals. Antibody-mediated neuromuscular disorders are treated with therapies that acutely modulate pathogenic antibodies or chronically inhibit the humoral immune response. In other inflammatory autoimmune disorders of the peripheral and central nervous system, corticosteroids, often combined with conventional immunosuppression, and immunomodulatory treatments are used. Because autoimmune neurologic disorders are so diverse, evidence from randomized controlled trials is limited for most of the immunotherapies used in neurology. This review provides an overview of the immunotherapies currently used for neurologic disorders. PMID:22703853

Graves, Donna; Vernino, Steven

2012-05-01

119

William Shakespeare's neurology.  

PubMed

Many of Shakespeare's plays contain characters who appear to be afflicted by neurological or psychiatric disorders. Shakespeare, in his descriptive analysis of his protagonists, was contributing to the understanding of these disorders. In fact, Charcot frequently used Shakespearean references in his neurological teaching sessions, stressing how acute objective insight is essential to achieving expert clinical diagnosis. Charcot found in Shakespeare the same rigorous observational techniques for which he himself became famous. This chapter describes many of Shakespearean characters suffering from varied neurological disorders, including Parkinsonism, epilepsy, sleeping disturbances, dementia, headache, prion disease, and paralyses. PMID:24290473

Paciaroni, Maurizio; Bogousslavsky, Julien

2013-01-01

120

Transient tachypnea - newborn  

MedlinePLUS

TTN; Wet lungs - newborns; Retained fetal lung fluid; Transient RDS; Prolonged transition ... usually within 1 - 2 hours. Symptoms include: Bluish skin color (cyanosis) Rapid breathing, which may occur with ...

121

TIA (Transient Ischemic Attack)  

MedlinePLUS

... risk and understand your condition. TIA and Stroke: Medical Emergencies When someone has shown symptoms of a stroke or a TIA (transient ischemic attack), they require immediate medical attention. A doctor will gather information and make ...

122

Neurological Effects of INH.  

National Technical Information Service (NTIS)

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

D. Bochneak J. E. Jordan S. Sheilds

1971-01-01

123

PET in Clinical Neurology  

Microsoft Academic Search

PET in clinical neurology is most useful when complemented by meticulous clinical information and other investigational modalities\\u000a such as MRI. Its major applications in clinical neurology are localization of seizure foci in potential candidates for epilepsy\\u000a surgery, especially where other imaging findings are negative or inconclusive, and as an adjunct to clinical diagnosis in\\u000a equivocal cases of dementia and Parkinsonian

Yen F. Tai; Paola Piccini

124

Clinical and neurological abnormalities in adult celiac disease.  

PubMed

We assessed the occurrence of neurological signs and symptoms in adult patients with celiac disease and evaluated the correlation between neurological features and diet. A total of 176 patients and 52 age-matched controls underwent a semistructural interview and a neurologic examination. The effect of gluten-free diet was evaluated by comparing the prevalence of signs and symptoms among patients adhering to a gluten-free diet and patients on an unrestricted diet. The occurrence of headache, dysthymia and signs of peripheral neuropathy was significantly higher in patients with celiac disease than in control subjects. Adherence to a strict gluten-free diet was associated with a significant reduction of headache, dysthymia, cramps and weakness, but did not modify the occurrence of paresthesia or hyporeflexia. Neurological signs and symptoms are associated with celiac disease and can be ameliorated by a gluten-free diet. PMID:14716525

Cicarelli, G; Della Rocca, G; Amboni, M; Ciacci, C; Mazzacca, G; Filla, A; Barone, P

2003-12-01

125

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.

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

2014-01-01

126

A cohort study of early neurological consultation by telemedicine on the care of neurological inpatients  

PubMed Central

Objectives: To find out the effect of early neurological consultation using a real time video link on the care of patients with neurological symptoms admitted to hospitals without neurologists on site. Methods: A cohort study was performed in two small rural hospitals: Tyrone County Hospital (TCH), Omagh, and Erne Hospital, Enniskillen. All patients over 12 years of age who had been admitted because of neurological symptoms, over a 24 week period, to either hospital were studied. Patients admitted to TCH, in addition to receiving usual care, were offered a neurological consultation with a neurologist 120 km away at the Neurology Department of the Royal Victoria Hospital, Belfast, using a real time video link. The main outcome measure was length of hospital stay; change of diagnosis, mortality at 3 months, inpatient investigation, and transfer rate and use of healthcare resources within 3 months of admission were also studied. Results: Hospital stay was significantly shorter for those admitted to TCH (hazard ratio 1.13; approximate 95% CI 1.003 to 1.282; p = 0.045). No patients diagnosed by the neurologist using the video link subsequently had their diagnosis changed at follow up. There was no difference in overall mortality between the groups. There were no differences in the use of inpatient hospital resources and medical services in the follow up period between TCH and Erne patients. Conclusions: Early neurological assessment reduces hospital stay for patients with neurological conditions outside of neurological centres. This can be achieved safely at a distance using a real time video link.

Craig, J; Chua, R; Russell, C; Wootton, R; Chant, D; Patterson, V

2004-01-01

127

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

PubMed Central

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

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

2012-01-01

128

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

129

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.

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

2013-01-01

130

The Neurological Presentation of Sick Sinus Syndrome  

PubMed Central

There is growing awareness of sick sinus syndrome (SSS) and related arrhythmias as treatable causes of epilepsy, syncope, dizziness, confusion and some psychoses, as well as non-neurological symptoms such as episodic congestive heart failure, pulmonary edema and palpitations. Six cases are presented which occurred in family practice in a period of 18 months; four required ventricular pacing, one declined and one is asymptomatic.

Hart, W. J.

1979-01-01

131

Early detection of neurological manifestations in achondroplasia  

Microsoft Academic Search

.   Achondroplasia (ACh) is the most frequent bone dysplasia. The mode of inheritance is autosomal dominant. The incident of\\u000a neurological complications ranges between 20% and 47%; frequently the symptoms are subtle but are due to such serious conditions\\u000a as cervicomedullary compressive snydromes, syringomyelia or hydrocephalus; thus, the early identification of this disorder\\u000a is very important. We made a prospective study

M. Ruiz-Garcia; A. Tovar-Baudin; V. Del Castillo-Ruiz; H. P. Rodriguez; M. A. Collado; T. M. A. Mora; F. Rueda-Franco; A. Gonzalez-Astiazaran

1997-01-01

132

Neurological manifestations of Erdheim-Chester disease  

PubMed Central

Erdheim-Chester disease is a rare sporadic systemic histiocytic disease of unknown aetiology that affects multiple organ systems. The case records of all patients with Erdheim-Chester disease who had been seen at the Mayo Clinic between 1975 and 1996 were reviewed to assess the neurological manifestations of the disease. Two of 10 patients had neurological involvement. A 42 year old woman developed central diabetes insipidus and a progressive cerebellar syndrome. Brain MRI showed a lesion in the left pons with patchy gadolinium enhancement and T2 weighted signal abnormalities extending into both cerebellar peduncles and the medulla. Biopsy of the brainstem mass showed a xanthogranulomatous lesion. The second patient was a 53 year old man with retroperitoneal fibrosis secondary to xanthogranulomatous infiltration. Although he had no neurological symptoms and a normal neurological examination, MRI of the head showed multiple uniformly enhancing extra-axial masses along the dura of both convexities and the falx, and a mass in the left orbital apex. Both patients had the characteristic radiographic and bone scan findings of Erdheim-Chester disease. Review of the literature disclosed a wide variety of neurological manifestations in Erdheim-Chester disease. The most frequent CNS manifestations are diabetes insipidus, cerebellar syndromes, orbital lesions, and extra-axial masses involving the dura.??

Wright, R; Hermann, R.; Parisi, J.

1999-01-01

133

Five-year neurological and EEG outcome after open-heart surgery.  

PubMed Central

A five-year neurological and EEG follow-up was carried on 55 patients who had undergone open-heart surgery for valve replacement in order to investigate the long-term results of the treatment. The five-year survival rate was 89%. The prevalence of permanent neurological abnormalities after operation was 9%. Transient ischaemic attacks occurred in five patients but no more severe cerebrovascular accidents were encountered. The rate of embolic events was 2.8 per 100 patient-years. Various subjective symptoms and complaints showed a highly beneficial outcome. Also the five-year EEG outcome was encouraging; the prevalence of abnormal EEG had fallen from the value before operation of 45% to 25%. The harmful influence of long perfusion time (extracorporeal circulation) during operation was found to be reflected in the long-term EEG outcome and, significantly, not only in the patients who had, but also in those who had not developed clinical abnormalities complicating the immediate course after operation. Although a valvular surgery patient faces a number of CNS problems before, during and after operation, the overall long-term outcome of successful surgery seems highly beneficial in neurological terms.

Sotaniemi, K

1985-01-01

134

[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

135

Are aluminium potroom workers at increased risk of neurological disorders?  

PubMed Central

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

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

1997-01-01

136

Neurological manifestations, diagnosis, and treatment of celiac disease: A comprehensive review  

PubMed Central

Celiac disease or gluten sensitivity may initially present as one or more neurological signs and/or symptoms. On the other hand, it may be associated with or complicated by neurological manifestations. Neurological presentations are rare in children but as many as 36% of adult patients present with neurological changes. With severe malnutrition after progression of celiac disease, different vitamin deficiencies may develop. Such problems can in turn overlap with previous neurological abnormalities including ataxia, epilepsy, neuropathy, dementia, and cognitive disorders. In this study, we aimed to review the neurological aspects of celiac disease. Early diagnosis and treatment could prevent related disability in patients with celiac disease.

2012-01-01

137

Neurologic complications of immunization.  

PubMed

In the United States and many other developed countries, active immunization of children has virtually eliminated poliomyelitis, measles, rubella, tetanus, and other diseases, such as disease due to Haemophilus influenzae type b. Individual vaccines can produce systemic or neurologic reactions ranging from minor events, such as pain and erythema at the injection site, to major complications, such as seizures, shock, encephalopathy, or death. Immunization programs have also generated considerable controversy, as witnessed by recent concerns regarding the relationship between vaccines or their constituents and autism or multiple sclerosis. This review summarizes current information regarding vaccines, the diseases that they prevent, and the potential relationships between vaccines and neurologic disease. PMID:15446387

Bale, James F

2004-06-01

138

Paraneoplastic neurological syndromes.  

PubMed

Paraneoplastic neurological syndromes are immune-mediated erroneous attacks on the central or peripheral nervous systems, or both, directed originally against the tumour itself. They have been known for more than 40 years, but recently the discovery of new subgroups of paraneoplastic encephalitis syndromes with a remarkably good response to immune therapy has ignited new clinical and scientific interest. Knowledge of these subgroups and their associated autoantibodies is important in therapeutic decision-making. However, the abundance of new autoantibodies and syndromes can be confusing. This review paper summarizes current knowledge and new developments in the field of paraneoplastic neurological syndromes, their classification, pathophysiology and treatment. PMID:23937626

Leypoldt, F; Wandinger, K-P

2014-03-01

139

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

Diamond, I; Messing, R O

1994-01-01

140

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

141

Transient global amnesia: disease or syndrome?  

PubMed

Transient global amnesia (TGA) has been defined as the presence of an impairment of short-term memory, retrograde amnesia and repetitive queries, without any other neurological signs or symptoms. The precise pathophysiology of TGA is unclear, although thromboembolic, epileptic, migrainous and metabolic mechanisms have been suggested. We have studied the clinical, biohumoral, electroencephalographic and neuro-imaging data relating to 25 patients with TGA, and found a prevalence of hypertension and hypercholesterolemia. We also found a higher incidence of electrical changes in the patients whose TGA was of shorter duration, whereas brain CT scans revealed ischemic lesions more frequently in the patients with TGA of longer duration. Our findings seem to confirm the hypothesis that TGA is a heterogeneous clinical syndrome consisting of pure and ischemic forms. PMID:8856411

Moccia, F; Aramini, A; Montobbio, P; Altomonte, F; Greco, G

1996-06-01

142

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

143

Neurology Practice Study Report.  

National Technical Information Service (NTIS)

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

R. C. Mendenhall

1979-01-01

144

Neurology of ciguatera  

Microsoft Academic Search

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

J Pearn

2001-01-01

145

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

146

Cerebral amyloid angiopathy: a transient ischaemic attack mimic.  

PubMed

Cerebral amyloid angiopathy is a commonly occurring condition that is not familiar to most clinicians. A common presenting feature may be transient focal neurological symptoms leading to the potential for clinical misdiagnosis as transient ischaemic attack. This may result in the inappropriate use of anti-platelets and anticoagulants or radiological misdiagnosis. It is also being increasingly recognised as an important cause of spontaneous intracerebral haemorrhage and cognitive impairment in the elderly. Cerebral amyloid angiopathy can be diagnosed based on clinical and radiological findings, but clinicians need a high index of suspicion to ensure appropriate investigations are requested. In this article we aim to cover the pathophysiology, clinical findings, radiological appearances and approach to management of cerebral amyloid angiopathy. PMID:24889568

Illsley, Amy; Ramadan, Hawraman

2014-06-01

147

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

148

Antroduodenal motility in neurologically handicapped children with feeding intolerance  

PubMed Central

Background Dysphagia and feeding intolerance are common in neurologically handicapped children. The aim is to determine the etiologies of feeding intolerance in neurologically handicapped children who are intolerant of tube feedings. Methods Eighteen neurologically handicapped children, followed in the Tube Feeding Clinic at the Children's Hospital of Wisconsin who were intolerant of gastrostomy feedings. The charts of these 18 patients were reviewed. Past medical history, diagnoses, history of fundoplication and results of various tests of gastrointestinal function including barium contrast radiography, endoscopy and antroduodenal manometry were documented. Results Five of 11 children had abnormal barium upper gastrointestinal series. Seven of 14 had abnormal liquid phase gastric emptying tests. Two of 16 had esophagitis on endoscopy. All 18 children had abnormal antroduodenal motility. Conclusions In neurologically handicapped children foregut dysmotility may be more common than is generally recognized and can explain many of the upper gastrointestinal symptoms in neurologically handicapped children.

Werlin, Steven L

2004-01-01

149

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.

2013-01-01

150

Aortic Valve Fibroelastoma Masquerading as Transient Ischaemic Attack  

PubMed Central

The following paper is on a 49-year-old man who presented to accident and emergency department having experienced five hours of left-sided chest pain, tightness in the chest, and shortness of breath. He also reported paresthesia and an ache in the left arm. Further investigations revealed an aortic valve papillary fibroelastoma. Although histologically papillary fibroelastomas are described as benign, they carry with them considerable risk of morbidity and mortality. This patient experienced recurrent transient ischemic attacks (TIAs'). He was taken to theatre on urgent basis to remove the papillary fibroelastoma. His aortic valve was preserved during the operation. The patient had an uneventful recovery following the surgery. His neurologic symptoms resolved following the operation. The operation was curative and no further symptoms were reported at followup.

Gowland, Penelope-Anne; Hasan, Ragheb

2012-01-01

151

Hereditary channelopathies in neurology.  

PubMed

Ion channelopathies are caused by malfunction or altered regulation of ion channel proteins due to hereditary or acquired protein changes. In neurology, main phenotypes include certain forms of epilepsy, ataxia, migraine, neuropathic pain, myotonia, and muscle weakness including myasthenia and periodic paralyses. The total prevalence of monogenic channelopathies in neurology is about 35:100,000. Susceptibility-related mutations further increase the relevance of channel genes in medicine considerably. As many disease mechanisms have been elucidated by functional characterization on the molecular level, the channelopathies are regarded as model disorders for pathogenesis and treatment of non-monogenic forms of epilepsy and migraine. As more than 35% of marketed drugs target ion channels, there is a high chance to identify compounds that counteract the effects of the mutations. PMID:20824453

Jurkat-Rott, Karin; Lerche, Holger; Weber, Yvonne; Lehmann-Horn, Frank

2010-01-01

152

[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

153

Pediatric Neurological Emergencies  

Microsoft Academic Search

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

J. W. J. McCann; E. Phelan

154

Neurologic Complications of Leukemia  

Microsoft Academic Search

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

Marc C. Chamberlain

155

Eye drop neurology.  

PubMed

Eye drops can help to diagnose and prevent complications of neurological disorders. Guttae ophthalmicae (eye drops) are generally safe because the drugs rarely achieve significant systemic concentrations, although there are rare exceptions. This article covers contemporary pharmacological pupil testing; how to dilate a pupil safely; common reasons why pupils do not respond to drops; and corneal lubrication to prevent complications of weak eye closure. PMID:24520179

Bennetto, Luke; Guly, Catherine; Ormerod, Ian; Plant, Gordon T

2014-06-01

156

Neurologic paraneoplastic syndromes  

Microsoft Academic Search

Paraneoplastic disorders can affect any part of the central or peripheral nervous system. Although relatively uncommon, these\\u000a disorders are a significant cause of severe neurologic disability among cancer patients. Many paraneoplastic disorders are\\u000a believed to be caused by an autoimmune response directed against shared neural tumor antigens. This article summarizes the\\u000a clinical features, possible autoimmune pathophysiology, and management issues for

Edward J. Dropcho

2004-01-01

157

Paraneoplastic neurological syndromes  

Microsoft Academic Search

Paraneoplastic neurological syndromes (PNS) can be defined as remote effects of cancer that are not caused by the tumor and its metastasis, or by infection, ischemia or metabolic disruptions. PNS are rare, affecting less than 1\\/10,000 patients with cancer. Only the Lambert-Eaton myasthenic syndrome is relatively frequent, occurring in about 1% of patients with small cell lung cancer. PNS can

Jérôme Honnorat; Jean-Christophe Antoine

2007-01-01

158

[Psychiatry and neurology: a commitment with obligations].  

PubMed

Neurology and psychiatry differ from the other branches of medicine by their narrow implication with the nervous system. However, owing to the quantitative importance of neuroses in daily practice, an unbridgeable gap might appear between psychiatry, concerning the mind, and neurology, concerning the body. That gap cannot be justified, because the most psychogenic mental disease is associated with organic components and, on the other side, the most organic mental disorder is associated with psychological components; failing to appreciate purely psychical disturbances as preliminary symptoms of certain organic brain-disorders may have a fatal issue for the patient. Only the organic investigation, in the broadest sense of the term, of the nervous system may, in our time, allow an always closer approach to the background of psychiatric diseases that were considered, in earlier times, as purely psychogenic. The author chose Alzheimer's disease as an instance of the necessary intercourse between psychiatry and neurology. The author discusses the epidemiology, the symptomatology, the anatomopathology, the biochemistry and the therapy of this disease. In comparison with the course of things concerning Parkinson's disease, we may be sure that our knowledge concerning Alzheimer's disease will depend upon a narrow collaboration between psychiatry and the different branches of neurology. PMID:2800686

Van Laere, J

1989-01-01

159

Paediatric Neurology in Africa: A Ugandan Report  

PubMed Central

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

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

1972-01-01

160

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.

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

2014-01-01

161

Neurological susceptibility to a skull defect  

PubMed Central

Background: There continues to be considerable interest in the use of decompressive craniectomy in the management of neurological emergencies. The procedure is technically straightforward; however, it is becoming increasingly apparent that it is associated with significant complications. One complication that has received relatively little attention is the neurological dysfunction that can occur due to the absence of the bone flap and the subsequent distortion of the brain under the scalp as cerebral swelling subsides. The aim of this narrative review was to examine the literature available regarding the clinical features described, outline the proposed pathophysiology for these clinical manifestations and highlight the implications that this may have for rehabilitation of patients with a large skull defect. Methods: A literature search was performed in the MEDLINE database (1966 to June 2012). The following keywords were used: Hemicraniectomy, decompressive craniectomy, complications, syndrome of the trephined, syndrome of the sinking scalp flap, motor trephined syndrome. The bibliographies of retrieved reports were searched for additional references. Results: Various terms have been used to describe the different neurological signs and symptoms with which patients with a skull defect can present. These include; syndrome of the trephined, posttraumatic syndrome, syndrome of the sinking scalp flap, and motor trephined syndrome. There is, however, considerable overlap between the conditions described and a patient's individual clinical presentation. Conclusion: It is becoming increasingly apparent that certain patients are particularly susceptible to the presence of a large skull defect. The term “Neurological Susceptibility to a Skull Defect” (NSSD) is therefore suggested as a blanket term to describe any neurological change attributable to the absence of cranial coverage.

Honeybul, Stephen

2014-01-01

162

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

163

Child Neurology Services in Africa  

PubMed Central

The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level.

Wilmshurst, Jo M.; Badoe, Eben; Wammanda, Robinson D.; Mallewa, Macpherson; Kakooza-Mwesige, Angelina; Venter, Andre; Newton, Charles R.

2013-01-01

164

Consciousness: a neurological perspective.  

PubMed

Consciousness is a state so essentially entwined with human experience, yet so difficult to conceptually define and measure. In this article, we explore how a bidimensional model of consciousness involving both level of arousal and subjective awareness of the contents of consciousness can be used to differentiate a range of healthy and altered conscious states. These include the different sleep stages of healthy individuals and the altered states of consciousness associated with neurological conditions such as epilepsy, vegetative state and coma. In particular, we discuss how arousal and awareness are positively correlated in normal physiological states with the exception of REM sleep, while a disturbance in this relationship is characteristic of vegetative state, minimally conscious state, complex partial seizures and sleepwalking. PMID:21447904

Cavanna, Andrea E; Shah, Sachin; Eddy, Clare M; Williams, Adrian; Rickards, Hugh

2011-01-01

165

Soviet Neurological Science Today  

PubMed Central

Neurological sciences in the U.S.S.R. are healthy but have middle-age spread, as judged from an intensive personal tour of facilities as a guest of the Soviet Academy of Sciences during the autumn of 1963. Many of the recent Western enthusiasms in ultrastructure, cytogenetics and molecular genetics appear not to have inflamed many imaginations. However, Soviet neurologists are contributing to the same types of electrophysiological research as are current in the West. The full realization of the talents of many well-trained young investigators is hindered by the strong emphasis on Pavlovian theory and technique, the rigid multi-layered structure of research institutes, and the relative isolation from undergraduate medical schools of most research.

Basmajian, J. V.

1964-01-01

166

Astroglia in neurological diseases  

PubMed Central

Astroglia encompass a subset of versatile glial cells that fulfill a major homeostatic role in the mammalian brain. Since any brain disease results from failure in brain homeostasis, astroglial cells are involved in many, if not all, aspects of neurological and/or psychiatric disorders. In this article, the roles of astrocytes as homeostatic cells in healthy and diseased brains are surveyed. These cells can mount the defence response to the insult of the brain, astrogliosis, when and where they display hypertrophy. Interestingly, astrocytes can alternatively display atrophy in some pathological conditions. Various pathologies, including Alexander and Alzheimer's diseases, amyotrophic lateral sclerosis, stroke and epilepsy, to mention a few, are discussed. Astrocytes could represent a novel target for medical intervention in the treatment of brain disorders.

Verkhratsky, Alexei; Rodriguez, Jose J; Parpura, Vladimir

2013-01-01

167

Collaborative Screening of Psychiatric and Language Disorders in Pediatric Neurology.  

ERIC Educational Resources Information Center

This study evaluated 102 patients (ages 5 to 13) at the Medical University of South Carolina's Pediatric Neurology Clinic for incidence of psychiatric or language disorders. Parents completed the Pediatric Symptom Checklist (PSC), the Child Behavior Checklist, and the Language Problems Scale; phone interviews were conducted to determine child…

Spratt, Eve G.; Anderson, Deborah; Pagano, Maria; Macias, Michelle

168

[Copper deficiency with pancytopenia, bradycardia and neurologic symptoms].  

PubMed

A 48-year-old man was referred to our hospital in December, 2005 because of general fatigue, gait disturbance and bradycardia. He had a history of polysurgery due to recurrent ileus and had been treated with home total parenteral nutrition for the short-bowel syndrome since 2003. Clinical findings on admission included marked emaciation and severe weakness of the extremities. Pancytopenia was noted in the peripheral blood. The serum levels of copper and ceruloplasmin were 3 microg/dl and 3 mg/dl, respectively, while Vit. B12 and folate were within the normal range. The bone marrow demonstrated cytoplasmic vacuolation in the myeloid and megakaryocytic series, and sideroblastic changes. No evidence of hematologic malignancies was presented. The diagnosis was copper deficiency and the patient was treated with copper supplementation. Four weeks after copper therapy, the serum level of copper rose to 50 microg/dl and ceruloplasmin to 14 mg/dl. Significant improvements in the hematologic profile, ECG findings and weakness of extremities were noted. Although bicytopenia (anemia and neutropenia) is considered to be a feature of hematologic disorders caused by copper deficiency, the present case showed pancytopenia. The exact mechanism of the unusual association of thrombocytopenia and other abnormalities with copper deficiency remains to be elucidated. PMID:17441478

Miki, Hirokazu; Kuwayama, Yasuharu; Hara, Tomoko; Oaki, Keiji; Kanezaki, Yoshiko; Yoshida, Tomonori; Shintani, Yasumi; Miya, Keiko; Goto, Tetsuya

2007-03-01

169

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

170

Symptom Management  

MedlinePLUS

... TBI Educational Materials Research DVBIC Locations Press Symptom Management A brain injury can affect a person physically ... Diagnosis and Assessment Treatment and Recovery Caregiving Symptom Management Life After TBI Defense and Veterans Brain Injury ...

171

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

172

Neurological Consequences of Cytomegalovirus Infection  

MedlinePLUS

NINDS Neurological Consequences of Cytomegalovirus Infection Information Page Synonym(s): Giant Cell Inclusion Disease, Cytomegalovirus Infection, Salivary Gland Disease, Cytomegalic Inclusion Body Disease Table of Contents (click ...

173

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.

Pengiran, T; Wills, A; Holmes, G

2002-01-01

174

Neurologic complications of diabetes.  

PubMed

Neuropathy as a complication of diabetes is common and presents in a wide variety of clinical scenarios. Often the work-up is one of exclusion tempered with monitoring the response of symptoms to treatment options. The collaboration of a neurologist is often crucial to determining the best course of action for the patient. This review will address proposed pathogenic mechanisms and potential therapeutic interventions, both pharmacologic and nonpharmacologic. PMID:24817097

Charnogursky, Gerald A; Emanuele, Nicholas V; Emanuele, Mary Ann

2014-07-01

175

[Neurological disease and facial recognition].  

PubMed

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

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

2012-07-01

176

Prevalence of Toscana sandfly fever virus antibodies in neurological patients and control subjects in Sicily.  

PubMed

Toscana sandfly fever virus (TOSV) is an arthropod-borne virus transmitted to humans by sandfly vectors. It has been associated with human cases of meningitis and meningo-encephalitis mainly occurring during the warm season. We performed a retrospective serological study to evaluate TOSV circulation in Palermo, Sicily, and to compare TOSV seroprevalence in patients with neurological symptoms and in a control group of patients without neurological symptoms. When sera from 155 patients with and without neurological symptoms were evaluated, the rate of overall TOSV IgG reactivity was 17.4%. Patients with neurological symptoms showed a higher percentage of TOSV IgG positivity than control patients (25% versus 10.8%). TOSV exposure was confirmed by virus neutralization tests which also detected a Naples virus (SFNV) infection. TOSV should be considered as an etiologic agent in the differential diagnosis of fever and meningo-encephalitis in Sicily. PMID:22707128

Colomba, Claudia; Saporito, Laura; Ciufolini, Maria Grazia; Marchi, Antonella; Rotolo, Valentina; De Grazia, Simona; Titone, Lucina; Giammanco, Giovanni M

2012-04-01

177

Klinefelter syndrome and neurological disease  

Microsoft Academic Search

Six patients with Klinefelter syndrome (47,XXY) and different neurological disease are described. Essential tremor has been reported repeatedly but its significance deserves further studies. The prevalence of epilepsy with the Klinefelter syndrome is higher in comparison with the normal population, but it is not greater than expected in the population of a mental hospital. Therefore we suggest that the neurological

E. Boltshauser; M. Meyer; T. Deonna

1978-01-01

178

Neurologic complications due to catheterization  

Microsoft Academic Search

In our university cardiac center, the incidence of a cohort of children with acute neurologic complications resulting from cardiac catheterization performed for acyanotic or cyanotic congenital heart disease is 0.38% (14 children of a total of 3,648 catheterization procedures). Neurologic complications consisted of convulsion (n = 10), stroke (n = 6), intracranial hemorrhage (n = 2), extrapyramidal features (n =

Xiao-Yan Liu; Virginia Wong; Maurice Leung

2001-01-01

179

Neurologic Morbidity Associated With Achondroplasia  

Microsoft Academic Search

Neurologic morbidity has long been appreciated in adults with achondroplasia and has recently been recognized to be common in children. Neurologic complications result from bony stenosis involving the entire vertebral column and the base of the skull. These complications are reviewed with special attention to the findings in children. (J Child Neurol 1990;5:84-97).

Jacqueline T. Hecht; Ian J. Butler

1990-01-01

180

Neurological soft signs in nursing home residents with Alzheimer's disease.  

PubMed

Neurological soft signs (NSS), i.e., minor motor and sensory changes, are a common feature in psychiatric disorders related to brain changes. Nevertheless, they have rarely been investigated in patients with Alzheimer's disease (AD). NSS were examined in 104 nursing home residents with AD with respect to dementia severity, neuropsychiatric symptoms, and Parkinsonian signs as well as potential medication effects. 16 cognitively unimpaired residents served as a control group. NSS scores were significantly higher in residents with AD and were associated with both severity of cognitive deficits and non-cognitive symptoms, in particular apathy, but neither with Parkinsonian signs nor with antipsychotic medication. Our results demonstrate that NSS increase with progression of AD and one may hypothesize that they are linked to degenerative cerebellar changes. NSS in AD are clinically significant and thus, besides other neurological symptoms, are to be considered in diagnostics and therapy. PMID:19584453

Seidl, Ulrich; Thomann, Philipp A; Schröder, Johannes

2009-01-01

181

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.

Coughlin, Steven S; Sher, Leo

2013-01-01

182

Transient osteoporosis of the knee  

Microsoft Academic Search

We report 12 cases of transient osteoporosis in 10 patients. The presenting symptoms, diagnostic investigations and management are considered here as well as a discussion on the aetiology and the pathology. Arthroscopic surgery was carried out in some of the patients to exclude intraarticular pathology. Resolution of symptoms occurred in all patients within 6 months and the MRI findings returned

G Vardi; P. J Turner

2004-01-01

183

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.

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

184

Neurological effects of pesticide use among farmers in China.  

PubMed

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

2014-04-01

185

Neurologic aspects and falls  

PubMed Central

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

Fasano, Alfonso; Plotnik, Meir

2012-01-01

186

[Can music therapy for patients with neurological disorders?].  

PubMed

Recent developments in brain research and in the field of music therapy have led to the development of music-based methods specifically aimed at relieving symptoms of Parkinson's disease and other neurologic disorders. Rhythmic auditory stimulation uses external rhythmic auditory cues from song, music or metronome to aid patients improving their walking functioning and has been shown to be effective both within sessions and as a result of training over time. Melodic intonation therapy and related vocal techniques can improve expressive dysphasia and aid rehabilitation of neurologic disorders, particularly Parkinson's disease, stroke and developmental disorders. PMID:15608775

Myskja, Audun

2004-12-16

187

Association between hepatitis E and neurological disorders: two case studies and literature review.  

PubMed

Hepatitis E (HEV) is an emerging disease in our developed countries, but is not routinely tested for in case of liver cytolysis. However, a growing number of extra-hepatic manifestations of HEV infection associated with acute hepatitis are reported. In this article, we discuss two cases of HEV with neurological symptoms, one with encephalitis, and the other with Parsonage Turner syndrome. All these disorders appeared concomitantly with liver cytolysis and disappeared quickly, following the viral kinetics. Only twenty cases of neurological manifestation of HEV have been described before. The use of HEV serology in patients with concurrent liver cytolysis and neurological symptoms has to be improved. PMID:24583064

Deroux, A; Brion, J P; Hyerle, L; Belbezier, A; Vaillant, M; Mosnier, E; Larrat, S; Morand, P; Pavese, P

2014-05-01

188

Neurological complications of celiac disease and autoimmune mechanisms: a prospective study.  

PubMed

Humoral immune mechanisms may have a role in the neurological complications of celiac disease (CD). We assessed 71 CD patients for neurologic manifestations and presence of serum antibodies to neural antigens. Sixteen patients (22.5%) were found to have neurological deficits including headache, depression, entrapment syndromes, peripheral neuropathy, and epilepsy. Antibody reactivity to neural antigens was detected in 30/71 (42.2%) patients. There was no clear correlation between anti-neural reactivity and neurologic dysfunction. Follow-up of 62 patients did not reveal change in electrophysiology or antibodies, regardless of diet. However, in 2 patients with neuropathy, symptoms improved or worsened depending on the diet. PMID:18343508

Briani, Chiara; Zara, Gabriella; Alaedini, Armin; Grassivaro, Francesca; Ruggero, Susanna; Toffanin, Elisabetta; Albergoni, Maria Paola; Luca, Milena; Giometto, Bruno; Ermani, Mario; De Lazzari, Franca; D'Odorico, Anna; Battistin, Leontino

2008-03-01

189

Neuromarketing and consumer neuroscience: contributions to neurology  

PubMed Central

Background ‘Neuromarketing’ is a term that has often been used in the media in recent years. These public discussions have generally centered around potential ethical aspects and the public fear of negative consequences for society in general, and consumers in particular. However, positive contributions to the scientific discourse from developing a biological model that tries to explain context-situated human behavior such as consumption have often been neglected. We argue for a differentiated terminology, naming commercial applications of neuroscientific methods ‘neuromarketing’ and scientific ones ‘consumer neuroscience’. While marketing scholars have eagerly integrated neuroscientific evidence into their theoretical framework, neurology has only recently started to draw its attention to the results of consumer neuroscience. Discussion In this paper we address key research topics of consumer neuroscience that we think are of interest for neurologists; namely the reward system, trust and ethical issues. We argue that there are overlapping research topics in neurology and consumer neuroscience where both sides can profit from collaboration. Further, neurologists joining the public discussion of ethical issues surrounding neuromarketing and consumer neuroscience could contribute standards and experience gained in clinical research. Summary We identify the following areas where consumer neuroscience could contribute to the field of neurology: First, studies using game paradigms could help to gain further insights into the underlying pathophysiology of pathological gambling in Parkinson’s disease, frontotemporal dementia, epilepsy, and Huntington’s disease. Second, we identify compulsive buying as a common interest in neurology and consumer neuroscience. Paradigms commonly used in consumer neuroscience could be applied to patients suffering from Parkinson’s disease and frontotemporal dementia to advance knowledge of this important behavioral symptom. Third, trust research in the medical context lacks empirical behavioral and neuroscientific evidence. Neurologists entering this field of research could profit from the extensive knowledge of the biological foundation of trust that scientists in economically-orientated neurosciences have gained. Fourth, neurologists could contribute significantly to the ethical debate about invasive methods in neuromarketing and consumer neuroscience. Further, neurologists should investigate biological and behavioral reactions of neurological patients to marketing and advertising measures, as they could show special consumer vulnerability and be subject to target marketing.

2013-01-01

190

Physician Requirements - 1990 for Neurology.  

National Technical Information Service (NTIS)

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

L. P. Garrison

1982-01-01

191

Depressive syndromes in neurological disorders.  

PubMed

Depressive syndromes represent a common and often characteristic feature in a number of neurological disorders. One prominent example is the development of post-stroke depression, which can be observed in more than one-third of stroke survivors in the aftermath of an ischemic stroke. Thus, post-stroke depression represents one of the most prevalent, disabling, and potentially devastating psychiatric post-stroke complications. On the other hand, depressive syndromes may also be considered as a risk factor for certain neurological disorders, as recently revealed by a meta-analysis of prospective cohort studies, which demonstrated an increased risk for ischemic events in depressed patients. Moreover, depressive syndromes represent common comorbidities in a number of other neurological disorders such as Parkinson's disease, multiple sclerosis, or epilepsy, in which depression has a strong impact on both quality of life and outcome of the primary neurological disorder. PMID:24077889

Hellmann-Regen, Julian; Piber, Dominique; Hinkelmann, Kim; Gold, Stefan M; Heesen, Christoph; Spitzer, Carsten; Endres, Matthias; Otte, Christian

2013-11-01

192

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

193

Neurology in the developing world.  

PubMed

The social and economic impact of neurologic disorders is being increasingly recognized in the developing world. Demographic transition, especially in large Asian populations, has resulted in a significant increase in the elderly population, bringing to the fore neurologic illnesses such as strokes, Alzheimer's disease, and Parkinson's disease. CNS infections such as retroviral diseases, tuberculosis, and malaria still account for high mortality and morbidity. Traumatic brain injury due to traffic accidents takes a high toll of life. Epilepsy continues to be a major health concern with large segments of the developing world's population receiving no treatment. A significant mismatch between the provision of specialized neurologic services and the requirement for them exists, especially in rural areas. Also, health insurance is not available for the majority, with patients having bear the costs themselves, thus limiting the procurement of available healthcare facilities. Neurologic training centers are few and the availability of laboratory facilities and equipment is largely limited to the metropolitan areas. Cultural practices, superstitious beliefs, ignorance, and social stigma may also impede the delivery of neurologic care. Optimizing available human resources, integrating primary, secondary, and tertiary healthcare tiers and making medical treatment more affordable will improve the neurologic care in the developing world. PMID:24365446

Singhal, B S; Khadilkar, Satish V

2014-01-01

194

Morphological and functional imaging in neurological and non-neurological Wilson's patients.  

PubMed

Wilson's disease causes disturbances of the central nervous system, affecting it both directly through copper toxicity and indirectly subject to a copper-induced hepatopathy, resulting in morphological and physiological changes in brain structures that can be captured by means of magnetic resonance imaging (MRI), (123) I-?-CIT (2?-carbomethoxy-3? (4-iodophenyl)tropane)-SPECT (single photon emission computed tomography), (123) I-IBZM (benzamide)-SPECT and [(18) F]FDG -PET (fluorodeoxyglucose-positron emission tomography). MRI can reveal even slight morphological changes in non-neurological Wilson's patients. More marked findings in neurological Wilson's patients become evident in T1- and T2-weighted MRI. T1-weighted MRI predominantly detects atrophic changes, whereas T2-weighted MRI regularly records signal changes in the putamen. With the aid of these three nuclear-medicine examinations, nigrostriatal and metabolic disturbances are identified in neurological Wilson's patients only. Sufficient decoppering therapy prevents progression and even tends to improve symptoms. A correlation between any of the imaging findings in patients with the genetic phenotype and the incidence of the most common mutation H1069Q (homozygote or compound heterozygote) or other mutations could not be substantiated. PMID:24495036

Hermann, Wieland

2014-05-01

195

Neurological manifestation of methyl bromide intoxication.  

PubMed

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

Suwanlaong, Kanokrat; Phanthumchinda, Kammant

2008-03-01

196

Neurologic disorders responsive to folic acid therapy.  

PubMed Central

Six women aged 31 to 70 years had folate deficiency and neuropsychiatric disorders. The three with acquired folate deficiency were depressed and had permanent muscular and intellectual fatigue, mild symptoms of restless legs, depressed ankle jerks, diminution of vibration sensation in the legs, stocking-type hypoesthesia and long-lasting constipation; D-xylos absorption was abnormal. The bone marrow was megaloblastic in only one patient, and she and one other had atrophy of the jejunal mucosa. The third was a vegan. All three recovered after folic acid therapy. The other three were members of a family with the restless legs syndrome, fatigability and diffuse muscular pain. One also had subacute combined degeneration of the spinal cord and kidney disease but no megaloblastosis; she improved spectacularly after receiving large daily doses of folic acid. The other two also had minor neurologic signs, controlled with 5 to 10 mg of folic acid daily. Unrecognized and treatable folate deficiency (with low serum folic acid values but normal erythrocyte folate values) may be the basis of a well defined syndrome of neurologic, psychiatric and gastroenterologic disorders, and the restless legs syndrome may represent the main clinical expression of acquired and familial (or inborn) folate deficiency in adults. Images FIG. 1 FIG. 2

Botez, M. I.; Cadotte, M.; Beaulieu, R.; Pichette, L. P.; Pison, C.

1976-01-01

197

Rotavirus Symptoms  

MedlinePLUS

... message, please visit this page: About CDC.gov . Rotavirus Facebook Reccomend Twitter Tweet Share Compartir Add this ... Favorites Delicious Digg Google Bookmarks Symptoms Español: Síntomas Rotavirus disease is most common in infants and young ...

198

Syphilis Symptoms  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Syphilis Skip Content Marketing Share this: Main Content Area ... occurs in four stages that sometimes overlap. Primary Syphilis The first symptom of primary syphilis is often ...

199

Neurologic aspects of plasma cell disorders.  

PubMed

Plasma cell disorders make up a broad spectrum of diseases that are characterized by the appearance of an abnormal clone of plasma cells, which typically manifests as a production of monoclonal immunoglobulin protein (monoclonal gammopathy). The overproduction of plasma cells and subsequent monoclonal gammopathy may be malignant or a premalignant process. Monoclonal gammopathy of undetermined significance (MGUS) is an example of a benign process with a malignant potential. Multiple myeloma, Waldenström macroglobulinemia, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome, and AL amyloidosis (immunoglobulin light chain amyloidosis) are examples of malignant plasma cell disorders which require treatment. Neurologic manifestations of an underlying plasma cell disorder can be variable and typically challenging to treat. They can range from mild symptoms resulting from therapy to treat the disorder to clinically significant and life-threatening complications related to the disease itself. The peripheral nervous system is more commonly affected than the central nervous system. Peripheral neuropathy is a frequent manifestation and is associated with all of the plasma cell disorders (MGUS, multiple myeloma, POEMS syndrome, Waldenström macroglobulinemia and AL amyloidosis) with notable differences in the signs and symptoms among the different groups. Examples of central nervous system manifestations include spinal cord pathology, such as spinal cord compression from vertebral collapse or plasmacytoma. Intracranial involvement is rare but can occur from brain parenchyma infiltration, leptomeningeal involvement, and tumor-like lesions, such as amyloidoma in AL amyloidosis and plasmacytoma in multiple myeloma. Encephalopathy can occur due to metabolic disturbances related to the underlying plasma cell disorder, including hypercalcemia and uremia in multiple myeloma and hyperviscosity in Waldenström macroglobulinemia. Included in this chapter is a detailed discussion of the various plasma cell disorders and their spectrum of neurologic manifestations. PMID:24365373

Sobol, Urszula; Stiff, Patrick

2014-01-01

200

POLG mutations associated with remitting/relapsing neurological events.  

PubMed

Recent experimental data underline the relationship between mitochondria and immune function. Clinical reports of patients presenting with mitochondrial dysfunction associated with dysimmune responses in the central nervous system reinforce this new concept. We describe the first case of a woman presenting with symptoms related to a novel compound heterozygous mutation of the mitochondrial polymerase ? (POLG) gene, associated with neurological events suggestive of a demyelinating process. Clinical examination revealed bilateral ptosis, progressive external ophthalmoplegia and axonal sensitive polyneuropathy suggestive of a mitochondrial disease. In line with this, muscle biopsy showed ragged red fibers, and sequencing of POLG revealed two heterozygous mutations. In addition, the patient exhibited relapsing neurological symptoms, and cerebral and spinal MRI mimicking multiple sclerosis. This patient stresses the relationship between mitochondrial dysfunction and inflammation. Recent studies suggest that targeting mitochondrial dysfunction could provide benefits in treating some inflammatory diseases. PMID:23830586

Degos, Bertrand; Laforêt, Pascal; Jardel, Claude; Sedel, Frédéric; Jossay-Winter, Murielle; Romero, Norma B; Lyon-Caen, Olivier; Tourbah, Ayman

2014-01-01

201

An overview of psychiatric symptoms in Huntington’s disease  

Microsoft Academic Search

Huntington’s disease (HD) is an inherited autosomal dominant disorder characterized by neurologic, cognitive, and psychiatric\\u000a symptomatology. Psychiatric symptoms in HD are often amenable to treatment, and relief of these symptoms may provide significant\\u000a improvement in quality of life. This review will briefly describe neurologic, neuropsychologic and brain imaging data, and\\u000a then review psychiatric syndromes seen in HD and their treatment.

Karen E. Anderson; Karen S. Marder

2001-01-01

202

Neuropsychiatric symptoms and interleukin-6 serum levels in acute stroke.  

PubMed

The role of interleukin-6 (IL-6) as a risk factor for developing depressive symptoms, neuropsychological impairment, and related functional and neurological symptom severity during the acute phase of ischemic stroke is still underexplored. Here, the authors assessed this issue, in 48 patients without significant clinical history for major medical illnesses or other factors that promote inflammation, 72 hours after a first-ever acute ischemic stroke. In the acute phase of ischemic stroke, increased IL-6 plays a key role in the onset of depressive disorders, apathy/amotivation, somatic symptoms of depression, and neurological/functional symptoms, resulting in higher disability and poor outcome of stroke patients. PMID:24247852

Spalletta, Gianfranco; Cravello, Luca; Imperiale, Francesca; Salani, Francesca; Bossù, Paola; Picchetto, Livio; Cao, Marina; Rasura, Maurizia; Pazzelli, Floriana; Orzi, Francesco; Caltagirone, Carlo; Robinson, Robert G; Cacciari, Claudia

2013-01-01

203

Occupational neurological disorders in Korea.  

PubMed

The purpose of this article was to provide a literature review of occupational neurological disorders and related research in Korea, focusing on chemical hazards. We reviewed occupational neurological disorders investigated by the Occupational Safety and Health Research Institute of Korean Occupational Safety and Health Agency between 1992 and 2009, categorizing them as neurological disorders of the central nervous system (CNS), of the peripheral nervous system (PNS) or as neurodegenerative disorders. We also examined peer-reviewed journal articles related to neurotoxicology, published from 1984 to 2009. Outbreaks of occupational neurological disorder of the CNS due to inorganic mercury and carbon disulfide poisoning had helped prompt the development of the occupational safety and health system of Korea. Other major neurological disorders of the CNS included methyl bromide intoxication and chronic toxic encephalopathy. Most of the PNS disorders were n-hexane-induced peripheral neuritis, reported from the electronics industry. Reports of manganese-induced Parkinsonism resulted in the introduction of neuroimaging techniques to occupational medicine. Since the late 1990s, the direction of research has been moving toward degenerative disorder and early effect of neurotoxicity. To understand the early effects of neurotoxic chemicals in the preclinical stage, more follow-up studies of a longer duration are necessary. PMID:21258587

Kim, Eun-A; Kang, Seong-Kyu

2010-12-01

204

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

205

Neurologic Complications in Percutaneous Nephrolithotomy  

PubMed Central

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

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

2013-01-01

206

Neurologic disorders of mineral metabolism and parathyroid disease.  

PubMed

Disorders of mineral metabolism may cause neurologic manifestations of the central and peripheral nervous systems. This is because plasma calcium stabilizes excitable membranes in the nerve and muscle tissue, magnesium is predominantly intracellular and is required for activation of many intracellular enzymes, and extracellular magnesium affects synaptic transmission. This chapter reviews abnormalities in electrolytes and minerals which can be associated with several neuromuscular symptoms including neuromuscular irritability, mental status changes, cardiac and smooth muscle changes, etc. PMID:24365349

Agrawal, Lily; Habib, Zeina; Emanuele, Nicholas V

2014-01-01

207

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

PubMed

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

Sato, Shoichiro; Minematsu, Kazuo

2013-07-01

208

[Differential sciatica pain diagnosis from the neurologic viewpoint].  

PubMed

Low back pain and sciatica with or without neurological deficits represent frequent disorders in clinical practice. Both, history and neurological examination are essential for localizing underlying lesions and initiating appropriate investigations. Pain location, sensory symptoms, motor signs and reflexes are extremely reliable in indicating which motor root(s) or peripheral nerve(s) are affected. Sometimes, pain and/or paraesthesia are the only presenting symptoms. Therefore differential diagnosis of low back pain and sciatica is various. This article summarizes the differential diagnosis of low back pain and sciatica according to the site of the lesion as follows: 1. lesions of the spinal cord, 2. lesions of the nerve roots (L4, L5, S1-S3), 3. lesions of the lumbosacral plexus, 4. peripheral nerve lesions (sciatic nerve, peroneal nerve), 5. low back pain and sciatica due to neuropathies, and 6. low back pain and sciatica as a symptom of other neurological disorders. Additionally, the status of neuroradiological procedures in establishing diagnosis is discussed. PMID:9297065

Lindner, A; Zierz, S

1997-06-15

209

Neurological manifestation of colonic adenocarcinoma  

PubMed Central

Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

Sio, Terence T.; Paredes, Mercedes; Uzair, Chaudhary

2012-01-01

210

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

211

Neurological Aspects of Reading Disability.  

ERIC Educational Resources Information Center

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

Nelson, Louis R.

212

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; Paola, Luciano de; Munhoz, Renato Puppi

2014-06-01

213

A Program for Neurological Organization.  

ERIC Educational Resources Information Center

A program for neurological organization is explained and its purposes are stated. Hints are given for working with both child and parents; and form for evaluating measures of neuromotor fitness is included. Also provided is a checklist for rating motor exploration, including movements performed lying on the back, on the knees, or standing or on…

Bowers, Louis

214

Education Research: Neurology training reassessed  

PubMed Central

Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-01-01

215

Neurological conditions at altitude that fall outside the usual definition of altitude sickness.  

PubMed

Altitude sickness in its commonly recognized forms consists of acute mountain sickness and the two life-threatening forms, high altitude cerebral and pulmonary edema. Less well known are other conditions, chiefly neurological, that may arise completely outside the usual definition of altitude sickness. These, often focal, neurological conditions are important to recognize so that they do not become categorized as altitude sickness because, besides oxygen and descent, treatment may be vastly different. Transient ischemic attacks, cerebral venous thrombosis, seizures, syncope, double vision, and scotomas are some of the well-documented neurological disturbances at high altitude discussed here in order to enhance their recognition and treatment. PMID:15265338

Basnyat, Buddha; Wu, Tianyi; Gertsch, Jeffrey H

2004-01-01

216

Management of neurological complications of infective endocarditis in ICU patients.  

PubMed

Patients with infective endocarditis (IE) are generally referred to the intensive care unit (ICU) for one or more organ dysfunctions caused by complications of IE. Neurologic events are frequent causes of ICU admission in patients with IE. They can arise through various mechanisms consisting of stroke or transient ischemic attack, cerebral hemorrhage, mycotic aneurysm, meningitis, cerebral abscess, or encephalopathy. Most complications occur early during the course of IE and are a hallmark of left-sided abnormalities of native or prosthetic valves. Occlusion of cerebral arteries, with stroke or transient ischemic attack, accounts for 40% to 50% of the central nervous system complications of IE. CT scan is the most easily feasible neuroimaging in critically unstable patients. However, magnetic resonance imaging is more sensitive and when performed should follow a standardized protocol. In patients with ischemic stroke who are already receiving oral anticoagulant therapy, this treatment should be replaced by unfractionated heparin for at least 2 weeks with a close monitoring of coagulation tests. Mounting evidence shows that, for both complicated left-sided native valve endocarditis and Staphylococcus aureus prosthetic valve endocarditis, valve replacement combined with medical therapy is associated with a better outcome than medical treatment alone. In a recent series, approximately 50% of patients underwent valve replacement during the acute phase of IE before completion of antibiotic treatment. After a neurological event, most patients have at least one indication for cardiac surgery. Recent data from literature suggest that after a stroke, surgery indicated for heart failure, uncontrolled infection, abscess, or persisting high emboli risk should not be delayed, provided that the patient is not comatose or has no severe deficit. Neurologic complications of IE contribute to a severe prognosis in ICU patients. However, patients with only silent or transient stroke had a better prognosis than patients with symptomatic events. In addition, more than neurologic event per se, a better predictor of mortality is neurologic dysfunction, which is associated with location and extension of brain damage. Patients with severe neurological impairment and those with brain hemorrhage have the worse outcome. PMID:21906336

Sonneville, Romain; Mourvillier, Bruno; Bouadma, Lila; Wolff, Michel

2011-01-01

217

[A report from neurological practice].  

PubMed

It was one of the great pleasures to have fulfilled my long-held dream in 1986, newly opened the Kitasato University East Hospital (KUEH). In 1965, I served at chronic ward of Baltimore City Hospitals as a resident of neurology, where most of the patients were relaxed and enjoyed their hospital life. Since then, my dream had been growing that chronic ward for neurological diseases was necessary in Japan, good for chronic cares as well as clinical research. KUEH include 89 beds for neurological diseases, uniquely enough, of which 15 beds specially prepared for the patients with respiratory distress suffering from intractable neurological diseases. KUEH gave us a lot of medical informations, developed to clinical research. Some of them will be introduced briefly as follows; firstly, in three patients with Guillain-Barré syndrome (GBS) we found high titers of serum IgM and IgG antibodies associated with acute cytomegalovirus (CMV) infections. They also had high titers of IgM and IgG anti-GM2 antibodies. The titers of anti-GM2 antibodies decreased on absorption with CMV-infected cells. These new findings suggested that anti-GM2 antibodies are associated with acute CMV infections in GBS patients. Secondly, we have patients with autosomal dominant familial Parkinsonism in Sagamihara, Kanagawa. Their clinical features are not essentially different from solitary Parkinson disease, and they respond well to levodopa treatment. Three autopsied cases, however, revealed neuropathological findings much different from those of classical Parkinson disease, such as rather mild to moderate loss of melanin-containing cells, well-maintained locus ceruleus neurons in number and no Lewy bodies detected at all. There are no reports in literatures of familial Parkinsonism from clinical and neuropathological points of view. Thirty-eight years have passed since establishment of the Japan Neurological Society, meanwhile the expertise neurologists come out. Neurology is, however, still minor in medical practice. This is my opinion that neurologist should take leadership in clinical medicine as well as in academic fields. We need tell people our work, how our neurologic expertise can help them treat various disorders such as stroke, pain, sleep, and headache, epilepsy as well as physical and mental rehabilitation for the establishment of our identity. PMID:9577650

Kowa, H

1997-12-01

218

Treating Psychotic Symptoms in Elderly Patients  

PubMed Central

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

Targum, Steven D.

2001-01-01

219

Neurological soft signs in mentally disordered offenders.  

PubMed

The study used the Neurological Evaluation Scale to assess neurological soft signs in 351 offenders and 80 healthy comparison subjects. Offenders were also interviewed using the Structured Clinical Interview for DSM-IV and the Hare Psychopathy Checklist. Neurological signs were significantly increased in offenders compared with healthy subjects. Offenders with repeated misdemeanors had higher rates of neurological signs than those with a single felony. Neurological scores were significantly predicted by lifetime diagnoses of psychotic, anxiety, and substance use disorders. Each diagnostic category was associated with a distinct pattern of neurological abnormalities. PMID:18070845

Assadi, Seyed Mohammad; Noroozian, Maryam; Shariat, Seyed Vahid; Yahyazadeh, Omid; Pakravannejad, Mahdi; Aghayan, Shahrokh

2007-01-01

220

Transient global amnesia.  

PubMed

30 patients aged between 45 and 78 years and who had suffered from transient global amnesia (TGA), were seen at the Department of Neurology, Pordenone Public Hospital, in the period 1978 to 1982. 25 patients had one or more risk factors for cerebrovascular disease, such as hypertension, cardiac abnormalities, diabetes and hyperlipidemia. EEG examination revealed abnormal activity only in 7 patients. Brain Computed Tomography showed cerebral atrophy in 10 and hypodense lesions in 3 patients. 16 patients had been followed up for a mean interval of 20 months. During the follow-up period, 4 patients had recurrent TGA and one had a transient ischemic attack in the vertebrobasilar arterial system. In the follow-up group, 15 patients showed permanent memory impairment. The high incidence of risk factors for cerebrovascular disease seems to confirm that TGA is probably due to transient cerebral ischemia. The high rate of permanent memory impairment, almost always connected with the coexistence of cerebrovascular risk factors, is not in agreement with the postulated good prognosis of TGA. PMID:6516786

Cattaino, G; Querin, F; Pomes, A; Piazza, P

1984-12-01

221

Menopausal Symptoms  

Microsoft Academic Search

Menopause is considered to be a major turning point in a women's life. It is accompanied by a variety of physical and psychological\\u000a changes that can significantly impair one's quality of life. Menopausal symptoms among cancer survivors often occur at an\\u000a earlier age, and can be more frequent, last longer, and be more severe than are seen in women experiencing

Debra L. Barton; Aditya Bardia; Charles Loprinzi

222

Factitious disorder presenting with acute cardiovascular symptoms.  

PubMed

A 23-year-old female student exhibited all the characteristics of chronic factitious disorder with physical symptoms (Munchhausen's syndrome): deliberate simulation of illness, peregrination, fantastic pseudology and dramatic circumstances on admittance. The patient induced impressive blood pressure peaks by the Valsalva manoeuvre. She also simulated arrhythmias, seizures and unconsciousness. Her symptoms had previously led to comprehensive cardiological, neurological and endocrinological evaluations and treatment in at least three different countries in two continents. A literature survey suggests that facitious cardiovascular symptoms have become more frequent during recent decades. PMID:7989905

Ludwigs, U; Ruiz, H; Isaksson, H; Matell, G

1994-12-01

223

Neurology  

Microsoft Academic Search

\\u000a \\u000a neuroepithelial\\u000a \\u000a \\u000a \\u000a \\u000a gliomas\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a astrocytoma (30%)—pilocytic (grade 1), fibrillary (grade 2), anaplastic (grade 3), glioblastoma multiforme (grade 4, 20% of all brain\\u000a tumors)\\u000a \\u000a \\u000a \\u000a \\u000a oligodendroglioma (4%)—well differentiated, anaplastic, mixed; 50% have 1p19q co-deletion

David Hui

224

VPA Alleviates Neurological Deficits and Restores Gene Expression in a Mouse Model of Rett Syndrome  

PubMed Central

Rett syndrome (RTT) is a devastating neurodevelopmental disorder that occurs once in every 10,000–15,000 live female births. Despite intensive research, no effective cure is yet available. Valproic acid (VPA) has been used widely to treat mood disorder, epilepsy, and a growing number of other disorders. In limited clinical studies, VPA has also been used to control seizure in RTT patients with promising albeit somewhat unclear efficacy. In this study we tested the effect of VPA on the neurological symptoms of RTT and discovered that short-term VPA treatment during the symptomatic period could reduce neurological symptoms in RTT mice. We found that VPA restores the expression of a subset of genes in RTT mouse brains, and these genes clustered in neurological disease and developmental disorder networks. Our data suggest that VPA could be used as a drug to alleviate RTT symptoms.

Otsuka I., Maky; Irie, Koichiro; Igarashi, Katsuhide; Nakashima, Kinichi; Zhao, Xinyu

2014-01-01

225

Motor conversion symptoms and pseudoseizures: a comparison of clinical characteristics  

Microsoft Academic Search

The authors prospectively studied consecutive neurological inpatients with either motor conversion symptoms or pseudoseizures of recent onset. Patients were administered a structured psychiatric diagnostic interview, a measure of perceived parental care, and a life events inventory. They found that patients with pseudoseizures (N=20, mean age=27 years): 1) were younger than patients with motor conversion symptoms (N=30, mean age=39 years), 2)

Jon Stone; Michael Sharpe; Michael Binzer

2004-01-01

226

[Seroprevalence of HIV infection in a population of neurological patients in the Central African Republic].  

PubMed

In order to evaluate the predictivity of neurological signs and symptoms in african patients, in Bangui's National Hospital Center (Central African Republic), 79 inpatients (aged 15-65 years) presenting with neurological manifestations (vascular attack, proved metabolic coma, or neuro-paludism excluded), and 64 age and sex matched controls in the same ward, without neurological or AIDS-related symptoms, were tested for the presence of HIV1-antibodies. 51/79 (65%) patients with neurological manifestations were HIV1-seropositive, and 10 (16%) of 64 controls (P less than 0.001). The positive predictive value (PPV) for HIV1 was 100% for patients with cutaneous zona (9 cases), Bell's palsy (4 cases) or cryptococcal meningitis (8 cases). The PPV for HIV1 was less important for the other neurological disorders: 43% for purulent meningitis (21 cases), 62% for major involvements of the central nervous system, without diagnosed etiology (32 cases; in which 13 were meningo-encephalitis, 16 focal deficits and 3 possible meningeal tuberculosis). In central Africa, the predictivity of neurological manifestations is high for HIV1 infection that emphasises the need for including neurological signs in clinical case definitions of AIDS in Africa. PMID:2285996

Di Costanzo, B; Belec, L; Testa, J; Georges, A J; Martin, P M

1990-01-01

227

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

228

Constructing a Neurology of Anger  

Microsoft Academic Search

\\u000a In keeping with general neurological principles, earlier stage processing of verbal and visual triggers for anger must involve\\u000a posterior and middle temporal cortices. As this processing typically evolves, it evokes memory of related events (e.g., past\\u000a insults) and other relevant information from more anterior temporal areas. This mutual interaction shapes perceptions of anger-provoking\\u000a challenges which activate cortical\\/subcortical circuits that prime

Michael Potegal; Gerhard Stemmler

229

Neurological complications in Behçet's syndrome.  

PubMed

The neurological complications of Behçet's syndrome have not been characterized with clarity. We present the clinical features, imaging characteristics and CSF findings of a series of 50 patients seen at the National Hospital for Neurology and Neurosurgery over the past 10 years. In this series, vascular complications had a low prevalence, whereas involvement of the brainstem was common; spinal cord lesions, hemisphere lesions and meningoencephalitis also occurred. Optic neuropathy, vestibulocochlear and peripheral nerve involvement occurred, but were rare. The prognosis for recovery was in general good, and the majority of those followed-up over a median of 3 years (range 1-19 years) had only single attacks. One-third of patients underwent further attacks, and four underwent progressive deterioration leading to disability. Factors suggesting a poor prognosis are repeated attacks, incomplete recovery, progressive disease course and a high level of CSF leucocytosis during acute attack. These data should be of help in the further definition of the clinical characteristics of this rare neurological disorder and in the planning of treatment trials. PMID:10545402

Kidd, D; Steuer, A; Denman, A M; Rudge, P

1999-11-01

230

[Neurologic syndromes in Lyme disease].  

PubMed

Lyme borreliosis, multisystem disease, when involve neurologic system is named neuroborrelosis. Symptomatology of neuroborreliosis is rich and various. Difficulties in recognition are connected usually with long period from tick bite to late neurological signs. Any headache and psychiatric disorder in the course of Lyme disease could be an early manifestation of invasion of the CNS by the spirochaetes. Each part of neurologic system could be involved. The most common clinical picture of neuroborreliosis is meningitis with cranial or peripheral neuropathies connected with radiculalgia, less common are encephalitis and myelitis, neuropathies and polyneuropathies, encephalopathies. Encephalomyelitis is the most serious form of neuroborreliosis. From the pathophysiologic point of view all cranial and peripheral neuropathies are forms of mononeuritis multiplex. Vasculitis and autoimmunology processes are present. Encephalopathy is due to neuroimmunomodulators, like lymphokines and by toxico-metabolic effect could be connected with each form of systemic borreliosis. Spheroplast L-form of borrelia could be responsible for difficulties with their eradication. Diagnosis of neuroborreliosis is based on culturing of B. burgdorferi from CSF, detection of specific antispirochaetal antibodies produced in subarachnoid space, detection of activated lymphocytes, other antigens detection in CSF (also after dissociation of complexes) or borrelial DNA sequences. PMID:11081332

Zajkowska, J M; Hermanowska-Szpakowicz, T; Kondrusik, M; Pancewicz, S A

2000-08-01

231

[Neurological manifestations of Behçet's disease].  

PubMed

Neurological manifestations of Behçet's disease (BD) occur in 5.3 to more than 50% of patients. They are divided into two major forms: "parenchymal" lesions, which include mainly meningoencephalitis as opposed to "extra-parenchymal" lesions (i.e. cerebral venous thrombosis and arterial aneurysms). Myelitis or peripheral neuropathy is exceptional. The neuro-Behçet syndrome (NBS) should be considered in the setting of neurological manifestations, particularly headache and pyramidal signs, in a young man diagnosed with BD. However, its recognition may be difficult when neurological manifestations are the presenting features of BD (one third of cases), and requires a thorough knowledge of clinical manifestations and morphological lesions. Thus, parenchymal NB lesions classically exhibit inflammatory characteristics on MRI and are located at the meso-diencephalic junction and in the brainstem, rarely with a supratentorial extension. Meningitis is not systematically associated, and may be absent in about 30% of cases. The pathogenesis of these lesions is incompletely understood, but inflammatory infiltrates include mainly neutrophils and activated T cells (mainly Th17). Differential diagnoses include infectious diseases (herpes, listeria, tuberculosis), and inflammatory diseases (i.e. multiple sclerosis and sarcoidosis). A prompt recognition of NBS should lead to initiate adequate therapies in order to limit the risk of sequelae, relapses or death. PMID:24290030

Noel, N; Drier, A; Wechsler, B; Piette, J-C; De Paz, R; Dormont, D; Cacoub, P; Saadoun, D

2014-02-01

232

Neurologic complications of cardiac transplantation.  

PubMed

Between 1984 and 1989, orthotopic cardiac transplantations were done in 90 patients from 10 to 65 years of age for end-stage, refractory congestive cardiomyopathy. Two patients had had ischemic strokes 5 months and 18 years, respectively, before transplantation. Six patients (7%) suffered acute neurologic events perioperatively. Three patients suffered cerebral infarctions. In 1 case this occurred 10 days before transplantation--probably as a result of systemic hypoperfusion--with the placement of ventricular assist devices. Two others suffered infarctions 5 and 21 days, respectively, after transplantation, each of probable embolic origin. Two patients had an acute intracerebral hemorrhage 21 and 36 days, respectively, after transplantation; both were located within the basal ganglia and subcortical regions. Both patients had moderate to severe hypertension, and in 1, renal failure and a coagulopathy developed before hemorrhage. Tremor, seizures, and an altered level of consciousness developed in 1 patient as an apparent toxic reaction to cyclosporine treatment. Only 1 patient died as a result of the neurologic complication--of an acute intracerebral hemorrhage. Three patients recovered fully, 2 partially. Only the case of drug toxicity could be directly attributed to the transplantation procedure itself. We conclude that the risk of an acute neurologic insult with orthotopic cardiac transplantation is low but may result from drug toxicity, cerebral ischemia, or hemorrhagic mechanisms. PMID:2219870

Andrews, B T; Hershon, J J; Calanchini, P; Avery, G J; Hill, J D

1990-08-01

233

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

234

Neurological Research: Summaries of Current Research.  

National Technical Information Service (NTIS)

Abstracts are given for research articles in the following fields: Neurological disorders of early life; Neurological disorders of adult life; Cerebro-vascular disorders; Convulsive disorders; Degenerative disorders of the nervous system; Muscle disorders...

1969-01-01

235

Influenza vaccination and treatment in children with neurologic disorders  

PubMed Central

Influenza viruses cause substantial morbidity in children each year, especially among children with specific chronic conditions. In particular, neurologic disorders have emerged as a strong risk factor for influenza-related complications. Children with these disorders may be vulnerable due to diminished respiratory muscle strength, decreased muscle tone or impaired mobility, which can compromise pulmonary function and the ability to handle secretions. Although they represent a small fraction of the general pediatric population, children with neurologic disorders make up a disproportionately high number of those children who are hospitalized and die as a result of influenza-associated complications. Annual vaccination is the most effective way to prevent influenza and its complications, and is recommended for all children 6 months through 18 years of age, including children with neurologic disorders. Family members and those who work with these children in institutional, educational and daycare settings should also be vaccinated against influenza annually. However, there have been few studies of influenza vaccination specifically in this population. In addition, vaccine effectiveness may vary from year to year and vaccination will not prevent all infections. Early empiric antiviral treatment should be started promptly in these children if they present to healthcare providers with symptoms suspicious for influenza. This article reviews influenza epidemiology in children with neurologic disorders and what is known about vaccines and other methods of protecting this vulnerable population from influenza-related complications.

Fry, Alicia; Peacock, Georgina; Finelli, Lyn

2014-01-01

236

Influenza vaccination and treatment in children with neurologic disorders.  

PubMed

Influenza viruses cause substantial morbidity in children each year, especially among children with specific chronic conditions. In particular, neurologic disorders have emerged as a strong risk factor for influenza-related complications. Children with these disorders may be vulnerable due to diminished respiratory muscle strength, decreased muscle tone or impaired mobility, which can compromise pulmonary function and the ability to handle secretions. Although they represent a small fraction of the general pediatric population, children with neurologic disorders make up a disproportionately high number of those children who are hospitalized and die as a result of influenza-associated complications. Annual vaccination is the most effective way to prevent influenza and its complications, and is recommended for all children 6 months through 18 years of age, including children with neurologic disorders. Family members and those who work with these children in institutional, educational and daycare settings should also be vaccinated against influenza annually. However, there have been few studies of influenza vaccination specifically in this population. In addition, vaccine effectiveness may vary from year to year and vaccination will not prevent all infections. Early empiric antiviral treatment should be started promptly in these children if they present to healthcare providers with symptoms suspicious for influenza. This article reviews influenza epidemiology in children with neurologic disorders and what is known about vaccines and other methods of protecting this vulnerable population from influenza-related complications. PMID:24982759

Havers, Fiona; Fry, Alicia; Peacock, Georgina; Finelli, Lyn

2014-07-01

237

Subacute Neurological Deterioration with Selective Axonal Injury in Patients with Acute Ischemic Stroke following Reperfusion of Middle Cerebral Artery Occlusion  

PubMed Central

To date, the long-term effects of reperfusion on the salvaged brain tissues have not been addressed in the literature. We report 4 cases presenting subacute neurological deteriorations with selective axonal injury following reperfusion therapies for acute ischemic stroke. Our case series based on 4 patients showed common features distinct from those of early reperfusion injury in that (1) the neurological symptoms developed after 1-2 months of reperfusion therapies, (2) these symptoms were accompanied by the subcortical white matter changes on brain MRI, and (3) these findings were mostly reversible with time. This suggests that axons in the reperfused brain may be vulnerable to further neurological injury.

Hwang, Yang-Ha; Kim, Yong-Won; Kim, Jongyeol; Kim, Yong-Sun; Park, Sung-Pa; Suh, Chung-Kyu

2011-01-01

238

The fibrotic scar in neurological disorders.  

PubMed

Tissue fibrosis, or scar formation, is a common response to damage in most organs of the body. The central nervous system (CNS) is special in that fibrogenic cells are restricted to vascular and meningeal niches. However, disruption of the blood-brain barrier and inflammation can unleash stromal cells and trigger scar formation. Astroglia segregate from the inflammatory lesion core, and the so-called "glial scar" composed of hypertrophic astrocytes seals off the intact neural tissue from damage. In the lesion core, a second type of "fibrotic scar" develops, which is sensitive to inflammatory mediators. Genetic fate mapping studies suggest that pericytes and perivascular fibroblasts are activated, but other precursor cells may also be involved in generating a transient fibrous extracellular matrix in the CNS. The stromal cells sense inflammation and attract immune cells, which in turn drive myofibroblast transdifferentiation. We believe that the fibrotic scar represents a major barrier to CNS regeneration. Targeting of fibrosis may therefore prove to be a valuable therapeutic strategy for neurological disorders such as stroke, spinal cord injury and multiple sclerosis. PMID:24946078

Fernández-Klett, Francisco; Priller, Josef

2014-07-01

239

Intravenous immunoglobulin treatment of neurological autoimmune diseases  

Microsoft Academic Search

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

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

1998-01-01

240

Neurological complications in obstetric regional anaesthesia  

Microsoft Academic Search

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

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

2000-01-01

241

Gestational transient thyrotoxicosis.  

PubMed

Gestational transient thyrotoxicosis refers to non-autoimmune hyperthyroidism in pregnant women and it is associated with hyperemesis gravidarum. During pregnancy, there are some alterations in thyroid gland, such as elevation of thyroxine binding globulin, increased iodium clearance in kidneys, and stimulation of thyroid gland by human chorionic gonadotropin. Hitherto, the pathophysiology underlying the development of gestational transient thyrotoxicosis has not been fully recognized. Studies showed that human chorionic gonadotropin, an agonist of thyroid stimulating hormone, may stimulate thyroid stimulating hormone receptor, leading to increased thyroid hormone. Diagnosis of gestational transient thyrotoxicosis is established based on inexistence history of previous hyperthyroidism, elevation of thyroid hormone, absence of hyperthyroid abnormalities signs on physical examination (such as: enlargement of thyroid gland, exophthalmia), and the absent of positive thyroid autoantibody. Generally, gestational transient thyrotoxicosis does not require medication, unless if hyperemesis gravidarum is present, thus the patient has to be hospitalized to receive intravenous rehydration, electrolyte correction and antiemetic medication. On cases with worsened or prolonged symptoms, anti-thyroid agents such as short term propiltiourasil is needed. PMID:19390130

Albaar, M Taha; Adam, John M F

2009-04-01

242

The correlation between neurological evaluations and neurological outcome in acute encephalitis: A hospital-based study  

Microsoft Academic Search

Acute encephalitis is a common CNS infectious disease in children. However, there are limited studies concerning about the correlation between the clinical evaluations and neurological outcome. To investigate the value of neurological evaluations, and the correlation between these evaluations and neurological outcomes of acute encephalitis, in the present study we retrospectively evaluated the neurological outcome of 0- to 16-year-old children

I-Jen Wang; Ping-Ing Lee; Li-Ming Huang; Chien-Jen Chen; Chi-Ling Chen; Wang-Tso Lee

2007-01-01

243

Neurologic complications of influenza A(H1N1)pdm09  

PubMed Central

Objective: We sought to determine the range and extent of neurologic complications due to pandemic influenza A (H1N1) 2009 infection (pH1N1?09) in children hospitalized with influenza. Methods: Active hospital-based surveillance in 6 Australian tertiary pediatric referral centers between June 1 and September 30, 2009, for children aged <15 years with laboratory-confirmed pH1N1?09. Results: A total of 506 children with pH1N1?09 were hospitalized, of whom 49 (9.7%) had neurologic complications; median age 4.8 years (range 0.5–12.6 years) compared with 3.7 years (0.01–14.9 years) in those without complications. Approximately one-half (55.1%) of the children with neurologic complications had preexisting medical conditions, and 42.8% had preexisting neurologic conditions. On presentation, only 36.7% had the triad of cough, fever, and coryza/runny nose, whereas 38.7% had only 1 or no respiratory symptoms. Seizure was the most common neurologic complication (7.5%). Others included encephalitis/encephalopathy (1.4%), confusion/disorientation (1.0%), loss of consciousness (1.0%), and paralysis/Guillain-Barré syndrome (0.4%). A total of 30.6% needed intensive care unit (ICU) admission, 24.5% required mechanical ventilation, and 2 (4.1%) died. The mean length of stay in hospital was 6.5 days (median 3 days) and mean ICU stay was 4.4 days (median 1.5 days). Conclusions: Neurologic complications are relatively common among children admitted with influenza, and can be life-threatening. The lack of specific treatment for influenza-related neurologic complications underlines the importance of early diagnosis, use of antivirals, and universal influenza vaccination in children. Clinicians should consider influenza in children with neurologic symptoms even with a paucity of respiratory symptoms.

Khandaker, Gulam; Zurynski, Yvonne; Buttery, Jim; Marshall, Helen; Richmond, Peter C.; Dale, Russell C.; Royle, Jenny; Gold, Michael; Snelling, Tom; Whitehead, Bruce; Jones, Cheryl; Heron, Leon; McCaskill, Mary; Macartney, Kristine; Elliott, Elizabeth J.

2012-01-01

244

Pediatric Neurological Complications of 2009 Pandemic Influenza A (H1N1)  

PubMed Central

Objective To analyze the spectrum of neurological manifestations in children hospitalized with pandemic influenza A H1N1 virus of 2009 (pH1N1). Design Retrospective case series of children hospitalized from May 1, 2009, through November 30, 2009. Setting Tertiary-care children’s hospital in Colorado. Patients All hospitalized patients with pH1N1 with neurological consult or diagnosis, lumbar puncture, electroencephalogram, or neuroimaging were selected as suspected cases. These were systematically reviewed and selected for final analysis if confirmed by pre-established definitions as a neurological complication. Results Of 307 children with pH1N1, 59 were selected as having suspected cases of neurological complications. Twenty-three children were confirmed to have a neurological complication. Of these 23, 15 (65%) required intensive care monitoring. The median length of stay was 4 days. Seventeen (74%) had a preexisting neurological diagnosis. The most common manifestation was seizure with underlying neurological disease (in 62% of cases) followed by encephalopathy with or without neuroimaging changes (in 26% of cases). Results from a lumbar puncture showed elevated protein levels in 3 of 6 patients but no significant pleocytosis. Seven of the 9 electroencephalograms showed diffuse slowing, and findings from magnetic resonance imaging were abnormal in 5 of 6 children. Deaths occurred in 13% of patients, and short-term disability in 22%. Conclusions Children infected with pH1N1 presented with a wide spectrum of neurological manifestations, which occurred primarily in individuals with preexisting neurological conditions. These individuals had a severe disease course, evidenced by need for intensive care services and relatively high rates of mortality or neurological disability. Children with underlying neurological conditions should be particularly targeted for influenza prevention and aggressive supportive treatment at the onset of influenzalike symptoms.

Kedia, Sita; Stroud, Britt; Parsons, Julie; Schreiner, Teri; Curtis, Donna J.; Bagdure, Dayanand; Brooks-Kayal, Amy R.; Glode, Mary P.; Dominguez, Samuel R.

2011-01-01

245

Hypoxic ischemic encephalopathy associated with neonatal seizures without other neurological abnormalities  

Microsoft Academic Search

We reported three term or near-term infants with parasagittal infarcts. Their Apgar scores were low and the amniotic fluid was meconium-stained. Resuscitation was necessary immediately after birth, but they were not stuporous and no neurological abnormalities were recognized on admission. They showed metabolic acidosis and transient hypoglycemia, and two showed hematoemesis. Seizures were observed between 2 and 15 h of

Yoshiaki Sato; Akihisa Okumura; Toru Kato; Fumio Hayakawa; Kuniyoshi Kuno; Kazuyoshi Watanabe

2003-01-01

246

Neurology outside Paris following Charcot.  

PubMed

The Middle Ages saw the development of numerous universities in the different provinces that later became the kingdom of France. In 1794, Napoleon I established 3 medical schools in Paris, Montpellier and Strasbourg, which were transformed into medical faculties in 1808. France had always been a highly centralized country, but during the 19th century, this trend started to change with the creation of medical faculties in Nancy (1872), Lille (1877), Lyon (1878), Bordeaux (1879), Toulouse (1891), Algiers (1910) and Marseille (1930). Following the creation of the 12 foundation courses, specialized chairs were progressively established in Paris, but for a long time this remained restricted to the French capital. However, with the emergence of medicine as an academic discipline in several towns outside Paris, came the development of neurology. This was greatly influenced by former students of Jean-Martin Charcot, local personalities, and the interactions between the two. Leading figures included Albert Pitres in Bordeaux, Léon Ingelrans in Lille, Eugène Devic and Jules Froment in Lyon, Lucien Cornil in Marseille, Joseph Grasset in Montpellier, and Marcel Riser in Toulouse. The interaction between French and Germanic medical communities also developed at this turbulent time under the influence of several great physicians such as Wilhelm Waldeyer, Adolf Kussmaul, and later Jean Alexandre Barré in Strasbourg, and Hippolyte Bernheim in Nancy. There are a number of other university towns outside Paris in which the development of neurology was probably influenced by the same interactions with psychiatry. It would be worth carrying out a thorough analysis of these towns in order to present an exhaustive overview of the development of neurology in France. PMID:20938155

Moulin, Thierry; Clarac, François; Petit, Henri; Broussolle, Emmanuel

2011-01-01

247

Clinical neurology in lung transplantation.  

PubMed

Lung transplantation is the only established therapeutic option for several end-stage respiratory diseases. Limited mostly by lack of suitable allografts, the results have measurably improved over the last decade. Numerous surgical and pharmaceutical improvements have had positive impact on outcomes. The potential for critical care issues and the need for interdisciplinary management remains paramount. Cardiac, renal, and metabolic complications are frequently encountered in the acute postoperative phase. Allograft rejection and infectious diseases as well as problems related to immunosuppressive regimen are seen later after lung transplantation. Neurologic manifestations with a range of etiologies are discussed here in this context. PMID:24365415

Wigfield, Christopher H; Love, Robert B

2014-01-01

248

Clinical pearls in pediatric neurology.  

PubMed

The authors present three neurological cases (common and uncommon), that have important management implications. The specific diagnosis can be suspected clinically if the clinician is aware of the entities. Besides clinical clues, the recognition of important findings in MRI brain is highlighted. The first case is a child with developmental delay, the second case is a child with acute encephalitis like presentation, the third is a child with deteriorating school performance and the fourth is a child with raised intracranial pressure. The authors also present concise review of the topics. PMID:24532338

Singhi, Pratibha; Sahu, Jitendra Kumar; Sankhyan, Naveen; Singhi, Sunit

2014-07-01

249

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

250

Neurological effects of blast injury.  

PubMed

Over the last few years, thousands of soldiers and an even greater number of civilians have suffered traumatic injuries due to blast exposure, largely attributed to improvised explosive devices in terrorist and insurgent activities. The use of body armor is allowing soldiers to survive blasts that would otherwise be fatal due to systemic damage. Emerging evidence suggests that exposure to a blast can produce neurologic consequences in the brain but much remains unknown. To elucidate the current scientific basis for understanding blast-induced traumatic brain injury (bTBI), the NIH convened a workshop in April 2008. A multidisciplinary group of neuroscientists, engineers, and clinicians were invited to share insights on bTBI, specifically pertaining to: physics of blast explosions, acute clinical observations and treatments, preclinical and computational models, and lessons from the international community on civilian exposures. This report provides an overview of the state of scientific knowledge of bTBI, drawing from the published literature, as well as presentations, discussions, and recommendations from the workshop. One of the major recommendations from the workshop was the need to characterize the effects of blast exposure on clinical neuropathology. Clearer understanding of the human neuropathology would enable validation of preclinical and computational models, which are attempting to simulate blast wave interactions with the central nervous system. Furthermore, the civilian experience with bTBI suggests that polytrauma models incorporating both brain and lung injuries may be more relevant to the study of civilian countermeasures than considering models with a neurologic focus alone. PMID:20453776

Hicks, Ramona R; Fertig, Stephanie J; Desrocher, Rebecca E; Koroshetz, Walter J; Pancrazio, Joseph J

2010-05-01

251

Neurologic complications after liver transplantation  

PubMed Central

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

Zivkovic, Sasa A

2013-01-01

252

Neurological Effects of Blast Injury  

PubMed Central

Over the last few years, thousands of soldiers and an even greater number of civilians have suffered traumatic injuries due to blast exposure, largely attributed to improvised explosive devices in terrorist and insurgent activities. The use of body armor is allowing soldiers to survive blasts that would otherwise be fatal due to systemic damage. Emerging evidence suggests that exposure to a blast can produce neurological consequences in the brain, but much remains unknown. To elucidate the current scientific basis for understanding blast-induced traumatic brain injury (bTBI), the NIH convened a workshop in April, 2008. A multidisciplinary group of neuroscientists, engineers, and clinicians were invited to share insights on bTBI, specifically pertaining to: physics of blast explosions, acute clinical observations and treatments, preclinical and computational models, and lessons from the international community on civilian exposures. This report provides an overview of the state of scientific knowledge of bTBI, drawing from the published literature, as well as presentations, discussions, and recommendations from the workshop. One of the major recommendations from the workshop was the need to characterize the effects of blast exposure on clinical neuropathology. Clearer understanding of the human neuropathology would enable validation of preclinical and computational models, which are attempting to simulate blast wave interactions with the central nervous system. Furthermore, the civilian experience with bTBI suggests that polytrauma models incorporating both brain and lung injuries may be more relevant to the study of civilian countermeasures than considering models with a neurological focus alone.

Hicks, Ramona R.; Fertig, Stephanie J.; Desrocher, Rebecca E.; Koroshetz, Walter J.; Pancrazio, Joseph J.

2010-01-01

253

What micronutrient deficiencies should be considered in distinct neurological disorders?  

PubMed

The expanding understanding of the biochemical and physiologic role of micronutrients, commonly referred to as vitamins and minerals, is driving the identification of their consequences in both deficiency and toxicity. Neural tissue is quite sensitive to physiologic changes, and as such, micronutrient deficiencies can have significant and profound effects on the functioning of both the central and peripheral nervous systems. Understanding which micronutrients can affect the nervous system can aid physician identification of these neurological symptoms and signs, leading to diagnostic testing and appropriate therapy. PMID:23715884

Maxwell, Pinckney J; Montgomery, Stephanie C; Cavallazzi, Rodrigo; Martindale, Robert G

2013-07-01

254

Neurologic complications of polycythemia and their impact on therapy  

SciTech Connect

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

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

1990-03-01

255

Atlantic Conjunctures in Anglo-American Neurology:  

PubMed Central

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

Casper, Stephen T.

2008-01-01

256

Bladder compliance in neurologically intact women.  

PubMed

No data currently exist to define normal bladder compliance (C) in women. This study was undertaken to establish normative data for C in neurologically intact women and to determine if detrusor instability (DI) is associated with changes in C. The multichannel urodynamic tracings of 270 patients (195 stable, 75 unstable) were reviewed according to a standard written protocol. Vesical and abdominal pressures (Pves, Pabd) were measured during retrograde filling after a stable baseline was established (< 50 ml) and just prior to cessation of infusion. If a detrusor contraction occurred, measurements were taken during a 5-sec window preceding onset of contraction. The vesical volume used to calculate C was the total bladder volume determined by completely emptying the bladder at the end of cystometry. Compliance was calculated by dividing this volume by the change in detrusor pressure (Pdet). For the purpose of some analyses, infinite C, i.e., no observed rise in Pdet, was arbitrarily assigned a value of 1,000. Overall, 47.6% of women had no increase in Pdet with filling to maximum cystometric capacity (MCC) and had infinite C. Women with instability were significantly less likely to have infinite C than those with stable bladders (32% vs. 53%; P = 0.003). In 75% of women, C was > 130 ml/cm; in 90%, C was > 60 ml/cm; and in 95%, C was > 40 ml/cm. There were significant differences between the distribution of stable and unstable bladders above and below each of these percentile cutoffs. Only 2 women, both of whom had unstable bladders, had C < 20 ml/cm water. Ninety-five percent of neurologically intact women have C > 40 ml/cm, and nearly half have no increase in Pdet during filling to MCC. Patients with DI have significantly less compliant bladders than do those with stable bladders. If C is < 40 ml/cm, a woman is 16 times more likely to have DI. Decreased C may suggest the diagnosis of DI in patients with urge incontinence whose symptoms are not reproduced in the laboratory. PMID:8857616

Harris, R L; Cundiff, G W; Theofrastous, J P; Bump, R C

1996-01-01

257

Speech symptoms associated with early signs of Shy Drager syndrome.  

PubMed Central

Speech disturbances reflecting impaired laryngeal control were found in ten patients whose autonomic dysfunction was associated with central neurological disease (Shy Drager Syndrome). In contrast, ten patients with progressive autonomic failure without evidence of CNS involvement had no difficulties on speech function tasks in comparison with normal controls. Presence of speech symptoms may aid in the clinical differentiation between patients with pure autonomic dysfunction and those with central neurological involvement.

Bassich, C J; Ludlow, C L; Polinsky, R J

1984-01-01

258

Care Seeking after Stroke Symptoms  

PubMed Central

Objective To assess risk factors associated with seeking care for stroke symptoms. Methods Using data from the population-based national cohort study (REasons for Geographic And Racial Differences in Stroke) conducted January 25, 2003–February 28, 2007 (N = 23,664), we assessed care-seeking behavior among 3,668 participants who reported a physician diagnosis of stroke/transient ischemic attack (n = 647) or stroke symptoms (n = 3,021) during follow-up. Care seeking was defined as seeking medical attention after stroke symptoms or a physician diagnosis. Results Overall, 58.5% of participants (2,146/3,668) sought medical care. In multivariable models, higher income was associated with greater likelihood of seeking care ( p = 0.02): participants with income of ?$75,000 had odds 1.43 times (95% confidence interval [CI], 1.02–2.02) greater than those with income of less than $20,000. Diabetes and previous heart disease were associated with increased care seeking: odds ratio (OR) of 1.23 (95% CI, 1.04 –1.47) and OR of 1.26 (95% CI, 1.06– 1.49), respectively. Participants with previous stroke symptoms but no stroke history were less likely to seek care than those with stroke history or without previous symptoms (OR, 0.80; 95% CI, 0.67– 0.96). Past smoking was associated with lower likelihood (OR, 0.71; 95% CI, 0.59–0.85; p = 0.0003) of seeking care relative to nonsmokers. Interpretation Only approximately half of participants with stroke symptoms sought care. This is despite the encouragement of advocacy groups to seek prompt attention for stroke symptoms. Our results highlight the importance of identifying characteristics associated with care-seeking behavior. Recognizing factors that contribute to delays provides opportunities to enhance education on the importance of seeking care for stroke symptoms.

Howard, Virginia J.; Lackland, Daniel T.; Lichtman, Judith H.; McClure, Leslie A.; Howard, George; Wagner, Libby; Pulley, LeaVonne; Gomez, Camilo R.

2013-01-01

259

Can lower risk patients presenting with transient ischaemic attack be safely managed as outpatients?  

PubMed

This study aimed to examine outcome in low risk transient ischaemic attack (TIA) patients presenting to emergency departments (ED) in a regional Australian setting discharged on antiplatelet therapy with expedited neurology review. All patients presenting to Gosford or Wyong Hospital ED with TIA, for whom faxed referrals to the neurology department were received between October 2008 and July 2010, were included in this prospective cohort study. Classification of low risk was based on an age, blood pressure, clinical features, duration of symptoms and diabetes (ABCD2) score <4 and the absence of high risk features, including known carotid disease, crescendo TIA, or atrial fibrillation. Patients with ABCD2 scores > or =4 or with high risk features were discussed with the neurologist on call (a decision regarding discharge or admission was then made at the neurologist's discretion). Patients were investigated with a brain CT scan and/or CT angiography, routine pathology, and an electrocardiogram. All discharged patients were commenced on antiplatelet therapy and asked to follow up with their local medical officer within 7 days. The patients were contacted by the neurology department to arrange follow-up. Our primary outcome was the number of subsequent strokes occurring within 90 days. Of 200 discharged patients for whom referrals were received, three patients had a stroke within 90 days. None of these would have been prevented through hospitalisation. In conclusion, medical assessment, expedited investigation with immediate commencement of secondary prevention and outpatient neurology review may be a reasonable alternative to admission for low risk patients presenting to the ED with TIA. PMID:23683740

Griffiths, D; Sturm, J; Heard, R; Reyneke, E; Whyte, S; Clarke, T; O'Brien, W; Crimmins, D

2014-01-01

260

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

261

Neurological complication after low-voltage electric injury: a case report.  

PubMed

Electrical shock can result in neurological complications, involving both peripheral and central nervous systems, which may present immediately or later on. However, delayed neurological complications caused by low-voltage electric shock are rarely reported. Here, a case of a man suffering from weakness and aphasia due to the delayed-onset of the peripheral nerve injury and ischemic stroke following an electrical shock is presented. Possible mechanisms underlying the neurological complications include thermal injury to perineural tissue, overactivity of the sympathetic nervous system, vascular injury, and histological or electrophysiological changes. Moreover, vasospasms caused by low-voltage alternating current may predispose individuals to ischemic stroke. Therefore, clinicians should consider the possibility of neurological complications, even if the onset of the symptoms is delayed, and should perform diagnostic tests, such as electrophysiology or imaging, when patients present with weakness following an electric injury. PMID:24855625

Kim, Ha Min; Ko, Yeong-A; Kim, Joon Sung; Lim, Seong Hoon; Hong, Bo Young

2014-04-01

262

Neurological Complication After Low-Voltage Electric Injury: A Case Report  

PubMed Central

Electrical shock can result in neurological complications, involving both peripheral and central nervous systems, which may present immediately or later on. However, delayed neurological complications caused by low-voltage electric shock are rarely reported. Here, a case of a man suffering from weakness and aphasia due to the delayed-onset of the peripheral nerve injury and ischemic stroke following an electrical shock is presented. Possible mechanisms underlying the neurological complications include thermal injury to perineural tissue, overactivity of the sympathetic nervous system, vascular injury, and histological or electrophysiological changes. Moreover, vasospasms caused by low-voltage alternating current may predispose individuals to ischemic stroke. Therefore, clinicians should consider the possibility of neurological complications, even if the onset of the symptoms is delayed, and should perform diagnostic tests, such as electrophysiology or imaging, when patients present with weakness following an electric injury.

Kim, Ha Min; Ko, Yeong-A; Kim, Joon Sung; Lim, Seong Hoon

2014-01-01

263

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

264

Neurology is psychiatry--and vice versa.  

PubMed

This paper explores the relationship between neurology and psychiatry. It marshals evidence that disorders of the brain typically have neurological and psychological-cognitive, affective, behavioural-manifestations, while disorders of the psyche are based in the brain. Given the inseparability of neurological and psychiatric disorders, their disease classifications should eventually fuse, and joint initiatives in training, service and research should be strongly encouraged. PMID:24492438

Zeman, Adam

2014-06-01

265

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.

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

2006-01-01

266

Pathogens and chronic or long-term neurologic disorders.  

PubMed

Infections of the central nervous system may provoke glial and autoimmune responses but a definitive linkage between these infections and the pathogenesis of chronic neurologic disorders is still elusive. There are controversial reports implicating infectious agents in the pathogenetic mechanisms of chronic or long-term neurologic disorders, such as multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, Alzheimer's disease and autistic spectrum disorders, but the specific role of bacterial or viral infections in the pathogenesis of these medical entities has not been fully elucidated. Up till now, the evidence is distant from definite, but certain cases may be attributed to infections in the millieu of multiple toxic events such as trauma, nutritional deficits, immune dysregulation and excitotoxicity in genetically vulnerable indiniduals. There is an ongoing debate concering the direct involvement of various infectious agents in the neurodegenerative and neurobehavioral diseases pathogenesis and/or their contribution to the deterioration of the disease or co-morbidity in these patients. These patients are exceptionally difficult to be treated by using single therapeutic modalities, because their disese is multifocal and treatment is aimed to control signs and symptoms rather than the true causes of the disease and its progressive course. Furthermore, even if these causative links were indetifiable, our therapeutic interventions would come too late due to the irreversible damages at the time of the initiation of treatment. Our aim is to comprehensively review all available data suggesting that infections could be common antecedent events of progressive neurologic degenerative or behavioural diseases. PMID:21446901

Starakis, Ioannis; Panos, George; Koutras, Angelos; Mazokopakis, Elias E

2011-03-01

267

Clinical evaluation of early cognitive symptoms.  

PubMed

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

McCarten, J Riley

2013-11-01

268

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

PubMed

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

Kodama, Hiroko; Fujisawa, Chie; Bhadhprasit, Wattanaporn

2011-03-01

269

Narcolepsy with cataplexy as presenting symptom of occult neuroblastoma.  

PubMed

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

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

2013-07-01

270

Pteridines and mono-amines: relevance to neurological damage.  

PubMed Central

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

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

1986-01-01

271

[Status and perspectives in modern neurology. Problems of organization of neurologic services worldwide and in Croatia].  

PubMed

Modern neurology has completely changed in its concepts of science and medical discipline regarding the etiologies and the capabilities in the diagnostics, management, rehabilitation and prevention of neurological diseases. Advances in neurological sciences produced a rapid growth in the number of neurologists, new subspecialties and neurological institutions worldwide, opening questions on their possible application due to financial restrictions in many countries. Neurology in Croatia followed the modern tendencies in the world: in line with its humanistic tradition its orientation to the patient early appeared. From this experience developed a care on the optimal organization of neurological services, later on initiated in the Research Group on the Organization and Delivery of Neurological Services, founded in the World Federation of Neurology. The main activities and the Recommendations related to Neurology in Public Health are described, with the proposed levels of organization of neurological services, aiming at the optimal and rational neurological care. Problems of international collaboration on cost-effectiveness in neurology are accentuated. PMID:12152417

Barac, Bosko

2002-05-01

272

Paraneoplastic neurological degenerations: keys to tumour immunity  

Microsoft Academic Search

Paraneoplastic neurological degenerations (PNDs) are neurological disorders that develop in patients with cancer. PNDs are triggered by an effective antitumour immune response against neuronal antigens that are expressed in cancer cells, which subsequently develops into autoimmune neurodegenerative disease. Studying patients with PND has offered the opportunity to gain unique insights into mechanisms of tumour immunity and has provided the potential

Matthew L. Albert; Robert B. Darnell

2004-01-01

273

Neurologic Course of Congenital Disorders of Glycosylation  

Microsoft Academic Search

Congenital disorders of glycosylation, formerly called carbohydrate-deficient glycoprotein syndrome, may present in infancy with slowly progressive neurologic deficits including cognitive impairment, ataxia, pigmentary retinal degeneration, and neuropathy. The metabolic defect is in N-linked oligosaccharide synthesis, and diagnosis is made by a serum transferrin isoelectric focusing. We reviewed the neurologic course of 10 children with congenital disorders of glycosylation (ages 13

Phillip L. Pearl; Donna Krasnewich

2001-01-01

274

Incidence of sexual dysfunction in neurologic disability  

Microsoft Academic Search

Patients and their families are frequently faced with changes in sexual behavior after the onset of a neurologic disability. Health professionals who familiarize themselves with the physical and psychological problems affecting sexuality can facilitate diagnosis and enhance the success of treatment programs. This article will review the available literature on the incidence of sexual dysfunction in neurologic disabilities frequently seen

Fae H. Garden

1991-01-01

275

Neurological illness following treatment with fludarabine.  

PubMed Central

Fludarabine is a comparatively new drug for the treatment of low-grade lymphoid malignancy. This report describes five cases of unusual neurological illnesses occurring after treatment with fludarabine. These suggest that caution should be exercised in patients receiving fludarabine who develop neurological abnormalities, with prompt investigation and if necessary cessation of the drug. Images Figure 1

Johnson, P. W.; Fearnley, J.; Domizio, P.; Goldin, J.; Nagendran, K.; Gawler, J.; Rohatiner, A. Z.; Lister, T. A.

1994-01-01

276

[Registries for neurological drugs landscape].  

PubMed

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

Vanacore, Nicola

2013-06-01

277

Transient osteoporosis of the hip  

Microsoft Academic Search

We report four cases of transient hip osteoporosis studied between 1995 and 1997. All patients were men. The diagnosis was\\u000a based on clinical symptoms, absence of abnormal laboratory tests, increased uptake in the femoral head and neck on Tc-99 bone\\u000a scans and magnetic resonance imaging showing Oedema of the bone marrow. In three patients radiographs showed osteopenia of\\u000a the head

J. Ribera Zabalbeascoa; A. Santos Rodas; M. Mella Sousa; P. Uceda Carrascosa; M. Benito Caparros

1999-01-01

278

Symptoms of Pneumocystis pneumonia  

MedlinePLUS

... Favorites Delicious Digg Google Bookmarks Symptoms of Pneumocystis pneumonia The symptoms of PCP are fever, dry cough, ... Diagnosis & Testing Treatment & Outcomes Statistics Additional Information Pneumocystis pneumonia Definition Symptoms People at Risk & Prevention Sources Diagnosis & ...

279

[Gene therapy of neurological diseases].  

PubMed

In hereditary neurological diseases, gene transfer into neurons is made difficult by: the nature of the cells (postmitotic cells, that cannot be cultured, genetically modified ex vivo, then retransplanted), sometimes, their widespread localization, the blood-brain barrier. However, three viral vectors derived from adenovirus, Herpes simplex virus and adeno-associated virus have been shown to be very efficient in transferring DNA into brain cells. All of these vectors can infect resting cells, especially neurons, and are efficient in vivo. Retroviral vectors which can infect dividing cells only are mainly used for ex vivo genetic modification of cells (neural progenitor cells, myoblasts, fibroblasts) followed by intracerebral transplantation. Alternatively, genetically modified cells can be transplanted in a peripheral site if the transgene product is able to cross the blood-brain barrier or to be transported retrogradely from the nerve terminals. We have especially investigated the potential interest of adenoviral vectors to transfer foreign genes into brain cells and to treat animal models of neurological diseases. These vectors allowed us to transfer the lacZ gene into any neural cell type, including neurons, glia, photoreceptors and olfactory receptors, ex vivo, in cell culture, and in vivo, by stereotactic administration. In addition, axonal transport of adenoviral vectors has been demonstrated, e.g. in the substantia nigra after injection into the striatum, in the olfactory bulb after intranasal instillation and in spinal motor neurons after intramuscular injection. After intracerebroventricular injection, ependymal cells are massively infected and express the transgene for several months, as this is also observed in neurons. Through the spinal canal and cerebrospinal fluid, the vector can diffuse to a considerable distance from the injection point, e.g. to the lumbar spinal cord after injection in the suboccipital region. To test the biological function of transgenes transferred through adenoviral vectors, we have constructed vectors with cDNAs or genes for various neutrophic factors: CNTF, NT3, BDNF and GDNF. These vectors were biologically active on target cells, ex vivo and in vivo. In the pmn mouse model of progressive motor neuronal degeneration, some of these vectors, alone or combined, allowed for prolongation of life of homozygous animals by more than two fold, and for decrease in the demyelination of phrenic nerve axons. Finally, we have also constructed an adenoviral vector carrying the alpha-hexosaminidase cDNA, encoding the enzyme subunit deficient in Tay Sachs patients. This vector permitted to normalize ganglioside metabolism in Tay Sachs fibroblasts and is currently tested in knock out mice deficient in hexosaminidase A. In spite of all these encouraging results, we are nevertheless aware that progress in vector design and delivery strategies will be needed before gene therapy can become a realistic therapeutical strategy in humans. PMID:8881264

Kahn, A; Haase, G; Akli, S; Guidotti, J E

1996-01-01

280

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

281

Transient osteoporosis of pregnancy.  

PubMed

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

Maliha, George; Morgan, Jordan; Vrahas, Mark

2012-08-01

282

The history of Kazan neurological school.  

PubMed

The historical prerequisites for the foundation and teaching of neurology at Kazan University are described; the relationship between the history of Kazan Imperial University Kazan medical university and neurology school is shown. Brief biographies of outstanding representatives of Kazan Neuroscience (D.P. Skalozubov, V.M. Bekhterev, L.O. Darkshevich, N.O. Kovalevsky, N.A. Mislavsky, A.V. Kibyakov, A.S. Dogel, A.V. Favorsky, L.I. Omorokov, and Y.Y. Popelyansky) are presented. The description of scientific interests of the Kazan neurological school and its specific features related to the one century period since 1885 are described. PMID:17365557

Amirov, N Kh; Bogdanov, E I; Guryleva, M E; Zefirov, A L; Ismagilov, M F; Mukhamedzyanov, R Z; Sozinov, A S

2007-01-01

283

Medical Marijuana in Certain Neurological Disorders  

MedlinePLUS

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

284

Neurologic Sequelae of Plumbism in Children  

Microsoft Academic Search

Prevention is still the best treatment for lead poisoning and its sequelae.Here is a survey on the nature and in cidence of the neurologic sequelae of lead intoxication among 425 patients over a ten-year period.

Meyer A. Perlstein; Ramzy Attala

1966-01-01

285

Neurological Basis of Attention Deficit Hyperactivity Disorder.  

ERIC Educational Resources Information Center

This article reviews various models in the neurological conceptualization of attention deficit disorder (ADD), with and without hyperactivity. It discusses neuroanatomical, neurochemical, and neurophysiological perspectives on ADD. (Author/DB)

Riccio, Cynthia A.; And Others

1993-01-01

286

Obsessive-compulsive symptoms among patients with Sydenham chorea  

Microsoft Academic Search

Background: Among patients with tic disorders, a distinctive clinical profile of obsessive-compulsive symptomatology has been described. The present investigation was designed to document the phenomenology of obsessive-compulsive symptoms (OCS) among patients with Sydenham chorea (SC), the neurologic variant of rheumatic fever. We hypothesized that OCS occurring in association with SC would be similar to those among patients with tic disorders.

Fernando R. Asbahr; Marjorie A. Garvey; Lisa A. Snider; Dirce M. Zanetta; Helio Elkis; Susan E. Swedo

2005-01-01

287

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

288

Sleep apnea in pediatric neurological conditions  

Microsoft Academic Search

Sleep apnea in neurologically compromised children is common but underrecognized. It can be secondary to diseases at all locations\\u000a on the neuroaxis and may independently alter their presentation, severity, and course. As a primary and secondary illness,\\u000a it is associated with significant neurological morbidities. In its severe manifestation, it can cause life-threatening short-\\u000a and long-term systemic morbidities. The authors review

Gabor Szuhay; Josh Rotenberg

2009-01-01

289

Neurological Monitoring for Congenital Heart Surgery  

Microsoft Academic Search

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

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

2004-01-01

290

Osteoporotic vertebral collapse with late neurological complications  

Microsoft Academic Search

This paper describes 27 patients who had a spinal fracture and underwent an anterior or a posterior spinal decompression, with or without spinal instrumentation, for late neurological compromise secondary to post-traumatic vertebral collapse associated with osteoporosis. Five males and 22 females were studied, with an average follow-up of 3.7 years. The patients developed delayed neurological compromise due to osteoporotic vertebral

H Baba; Y Maezawa; K Kamitani; N Furusawa; S Imura; K Tomita

1995-01-01

291

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

292

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

ERIC Educational Resources Information Center

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

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

2012-01-01

293

A Norse contribution to the history of neurological diseases.  

PubMed

Multiple sclerosis (MS) is prevalent in areas with many inhabitants of Scandinavian descent, and a 'Viking gene' hypothesis has been suggested for the dissemination of the disease. It is therefore relevant to search Norse sagas for descriptions of clinical pictures which could have been MS. The saga of Bishop Thorlak describes a woman named Halldora, who suffered from transient paresis between 1193 and 1198. The diagnosis is uncertain, but the story shows that symptoms associated with MS were known in Iceland at the end of the 11th century. PMID:16479124

Holmøy, Trygve

2006-01-01

294

Indapamide-induced transient myopia with supraciliary effusion: case report  

PubMed Central

Background Ingestion of sulphonamide-derived drugs has been reported to possibly have ocular side-effects. Authors aimed to present a rare case of indapamide-induced transient myopia with ciliary body edema and supraciliary effusion. Case presentation A 39 years old caucasian female patient presented at the Department of Neurology with headache and sudden bilateral loss of distant vision. Neurological assessment and cranial CT scans were unremarkable. For her hypertension, twice a day bisoprolol 2.5 mg and once a day indapamide 1.5 mg tablets were prescribed several days before. At her presenting, ophthalmic findings were as follows: visual acuity 0.08-7.25Dsph?=?1.0 and 0.06-7.25Dsph?=?1.0; IOP 25 mmHg and 24 mmHg, anterior chamber depth (ACD) 2.32 mm and 2.49 mm, lens thickness (L) 4.02 mm and 4.09 mm in the right and the left eye, respectively. By means of ultrasound biomicroscopy (UBM), thickened (720 / 700 micron) and detached ciliary body, its forward movement (ciliary body-cornea angle 108? / 114?) and forward rotated ciliary processes were seen. Angle opening distance (AOD500) were 300 / 314 microns. By the following days, the myopia gradually diminished, and a week after her first symptoms, her uncorrected visual acuity was 1.0 in both eyes, IOP 13 mmHg and 17 mmHg, ACD 3.68 mm and 3.66 mm, L 3.78 mm and 3.81 mm in the right and the left eye, respectively. Ciliary body edema and detachment disappeared (ciliary body thickness 225 / 230 micron), both of the ciliary body-cornea angle 134? / 140? and the AOD500 (650 / 640 microns) increased. At this point, the patient admitted that she had stopped taking indapamide two days before. Conclusions Our case report is the third one in the literature to present indapamide-induced transient myopia, and the first to employ UBM for describing the characteristics of this rare condition. According to the findings, authors suggest that both ciliary muscle contraction and ciliary body edema may play role in the pathomechanism. UBM seems to be a useful tool in the differential diagnosis of acute myopia. Further, authors wish to draw attention to one of the potential adverse effects of this drug which was not listed by its package insert.

2013-01-01

295

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

PubMed Central

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

Thickbroom, Gary W; Mastaglia, Frank L

2009-01-01

296

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.

2013-01-01

297

Experimental Concussion: (Section of Neurology).  

PubMed

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

Denny-Brown, D E; Russell, W R

1941-09-01

298

Central and peripheral neurological complications of primary Sjögren's syndrome.  

PubMed

Primary Sjögren's syndrome (pSS) is an autoimmune inflammatory disorder characterized by lymphocytic infiltration of exocrine glands, mainly the lacrimal and salivary glands leading to a chronic sicca syndrome. However, extraglandular organ systems may frequently be involved, including both central and peripheral nervous systems. Clinically significant neurologic manifestations affect approximately 20% of patients and may be the first manifestation of the disease in at least 25% of the cases. The spectrum of pSS-related neuropathies is wide including sensory neuropathies, neuronopathies, sensory-motor neuropathies, mononeuritis multiplex related to vasculitis… Central nervous system involvement is composed by multiple sclerosis-like manifestations including acute and chronic myelopathies and by more diffuse manifestations (cognitive dysfunction, subacute aseptic meningitis, encephalopathy, psychiatric symptoms, chorea, seizures…). The diagnosis and treatment of such pSS-related manifestations must be optimized in order to avoid severe disability. PMID:22840992

Fauchais, Anne-Laure; Magy, Laurent; Vidal, Elisabeth

2012-09-01

299

Neurologic complications of disorders of the adrenal glands.  

PubMed

Disorders of the adrenal glands frequently have secondary neurological manifestations, while some diseases that involve the central nervous system are accompanied by adrenal gland dysfunction. Excessive corticosteroid secretions in primary or secondary Cushing's syndrome causes muscle weakness and behavioral disturbances, such as emotional lability and sometimes depression, while adrenal insufficiency may cause fatigue, weakness, and depression. Adrenoleukodystrophy and adrenoneuromyelopathy are X-linked recessive disorders of the metabolism of very long chain fatty acids that manifest with white matter abnormalities of the brain, myelopathy and/or neuropathy, as well as adrenal insufficiency. Other disorders of the adrenal glands include hyperaldosteroidism, which may cause weakness from hypokalemia. Dysfunction of the adrenal medulla causes excessive or deficient secretion of catecholamines, primarily causing cardiovascular symptoms. This chapter reviews the clinical manifestations and diagnostic aspects and treatment of the various disorders of the adrenal glands. Some of the congenital adrenal diseases are also discussed. PMID:24365350

Bertorini, Tulio E; Perez, Angel

2014-01-01

300

Immediate neurological recovery following perispinal etanercept years after brain injury.  

PubMed

Positron emission tomographic brain imaging and pathological examination have revealed that a chronic, intracerebral neuroinflammatory response lasting for years after a single brain injury may occur in humans. Evidence suggests the immune signaling molecule, tumor necrosis factor (TNF), is centrally involved in this pathology through its modulation of microglial activation, role in synaptic dysfunction, and induction of depressive symptoms and neuropathic pain. Etanercept is a recombinant TNF receptor fusion protein and potent TNF inhibitor that has been found to reduce microglial activation and neuropathic pain in multiple experimental models. We report that a single dose of perispinal etanercept produced an immediate, profound, and sustained improvement in expressive aphasia, speech apraxia, and left hemiparesis in a patient with chronic, intractable, debilitating neurological dysfunction present for more than 3 years after acute brain injury. These results indicate that acute brain injury-induced pathologic levels of TNF may provide a therapeutic target that can be addressed years after injury. Perispinal administration of etanercept is capable of producing immediate relief from brain injury-mediated neurological dysfunction. PMID:24647830

Tobinick, Edward; Rodriguez-Romanacce, Helen; Levine, Arthur; Ignatowski, Tracey A; Spengler, Robert N

2014-05-01

301

Male sexual dysfunction and infertility associated with neurological disorders  

PubMed Central

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

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

2012-01-01

302

Plasma leptin level predicts hematoma growth and early neurological deterioration after acute intracerebral hemorrhage.  

PubMed

Higher plasma leptin levels have been associated with poor clinical outcomes after intracerebral hemorrhage. Nevertheless, their links with hematoma growth and early neurological deterioration are unknown. Therefore, we aimed to investigate the relationship between plasma leptin levels, hematoma growth, and early neurological deterioration in patients with acute intracerebral hemorrhage. We prospectively studied 102 consecutive patients with acute spontaneous basal ganglia hemorrhage presenting within 6h from symptoms onset. Significant hematoma growth was defined as hematoma enlargement >33% at 24h. Early neurological deterioration was defined as an increase of ?4 points in National Institute of Health Stroke Scale score at 24h from symptoms onset. We measured plasma leptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma leptin level emerged as the independent predictor of hematoma growth (odds ratio, 1.182; 95% confidence interval, 1.061-2.598; P=0.008) and early neurological deterioration (odds ratio, 1.193; 95% confidence interval, 1.075-2.873; P=0.004). Using receiver operating characteristic curves, we calculated areas under the curve for hematoma growth (area under curve, 0.844; 95% confidence interval, 0.759-0.908) and early neurological deterioration (area under curve, 0.857; 95% confidence interval, 0.774-0.918). The predictive performance of leptin was similar to, but did not obviously improve that of hematoma volume. Thus, leptin may help in the prediction of hematoma growth and early neurological deterioration after intracerebral hemorrhage. PMID:23659863

Du, Quan; Yang, Ding-Bo; Shen, Yong-Feng; Yu, Wen-Hua; Zhang, Zu-Yong; Zhu, Qiang; Che, Zhi-Hao; Liu, Qun-Jie; Wang, Hao; Dong, Xiao-Qiao

2013-07-01

303

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.

Takahashi, Noriko; Hashizume, Masahiro

2014-01-01

304

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

305

Neuroprotective effects of preischemia subcutaneous magnesium sulfate in transient cerebral ischemia 1  

Microsoft Academic Search

Objective: Neurological injury due to transient cerebral ischemia is a potential complication of cardiovascular surgery. The neuropro- tective effect of magnesium, when given subcutaneously before the ischemia, was assessed in a rat model of transient global cerebral ischemia. Methods: Thirty-six male Wistar albino rats were included to this randomized, controlled, prospective study. In 24 animals, ischemia was induced with four-vessel

Bekir Hayrettin Sirin; Erdal Coskun; Levent Yilik; Ragip Ortacd; Hadiye Sirin; Cihat Tetik

306

The Nature of Psychotic Symptoms in Senile Dementia of the Alzheimer Type  

Microsoft Academic Search

The Alzheimer Disease Research Center at Washington University's medical school has gathered a large sample of subjects with senile dementia of the Alzheimer type (SDAT) who are free of other potentially complicating medical, neurologic and psychiatric disorders. Using this homogeneous population, we have characterized psychotic symptoms associated with SDAT. Three groups of symptoms occur commonly: paranoid delusions, misidentification syndromes, and

Eugene H. Rubin; Wayne C. Drevets; William J. Burke

1988-01-01

307

Enterovirus 71-Induced Neurological Disorders in Young Gerbils, Meriones unguiculatus: Development and Application of a Neurological Disease Model  

PubMed Central

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

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

2012-01-01

308

[Specialized care of neurological diseases in Colombia].  

PubMed

This study sought to reveal the patterns of medical care given to patients with neurologic diseases in Colombia. To that end, it tracked the daily activities of 30 neurologists chosen from a representative sample of 119 neurologists registered in Colombia in 1993. The information was requested by means of a previously standardized questionnaire and was complemented by demographic and epidemiologic data. The results showed that demand for specialized neurologic care depended more on cultural perceptions than on objective measures of prevalence. Moreover, it was found that education in neurology should place greater emphasis on ambulatory treatment as an alternative to hospital treatment. The survey also offered preliminary information on the prevalence and incidence of the primary neurologic diseases in the country. The prevalence of these diseases far exceeds the supply of specialized neurologic care. Finally, the results point out the advantages and deficiencies of this type of care, findings that might guide future efforts in this field in other countries and under different circumstances. PMID:9011172

Rosselli, D; Eslava-Cobos, J; Calderón, C; Menken, M

1996-11-01

309

[Inaugural audiovisual impairment disclosing specific neurological disorders].  

PubMed

The association of visual and auditory impairments, simultaneously or consecutively, is a rare condition at the onset of neurological diseases. To determine whether audiovisual impairment can be associated with a specific group of neurological disorders at onset, we performed a prospective study of 307 patients over 6 months in a specialized neurological unit in inflammatory diseases. Six patients (2%) experienced inaugural audiovisual impairments. The mean age of patients at onset was 39.5 ± 14.7 years, with a male:female ratio of 1:2. Both deficiencies were reported in three cases, including loss of visual acuity with tinnitus (two cases) or hearing loss (one case). Initial visual dysfunction, characterised by loss of visual acuity, was noted in one patient. Initial auditory impairment, characterised by dizziness and hearing loss, was noted in two patients. The mean interval between the occurrence of visual and auditory impairments was 3.8 ± 4.3 months. A neurological diagnosis was made in four cases (67%) at a mean time of 4.6 ± 4.6 months after disease onset. Visual impairments were optic neuritis for multiple sclerosis, serous retinal detachment for Vogt-Koyanagi-Harada's disease, a central retinal artery occlusion for Susac's syndrome and a retinal vasculitis for Cogan's syndrome. The systematic investigation of inaugural audiovisual impairment in young patients could help shorten the time to a specific neurological diagnosis. PMID:21122882

Bourre, B; Aupy, J; Saleh, M; Gaucher, D; Thomas, L; Tranchant, C; De Seze, J; Collongues, N

2010-12-01

310

CFS transferrin in various neurological diseases.  

PubMed

The introduction of isoelectrofocusing on polyacrylamide gel followed by direct immunofixation, in the analysis of CSF proteins, emphasized the interest in transferrin examination, mainly in order to find eventual abnormalities in patients with neurological diseases. Stibler (1979), using these techniques, demonstrated the presence in CSF of two subtypes of transferrin C, called C1 and C2, transmitted by autosomal codominant inheritance, according to the C1, C2 and C2-1 phenotypes. The rather frequently occurring variant of transferrin in CSF is the C2-1 subtype: a double banded pattern, which is focused at pH 5.9, consisting of two very closely spaced bands with a pI difference of less than 0.1. This transferrin pattern is peculiar to CSF and is absent in the serum of the same subjects. This subtype of transferrin has been observed in various neurological disorders, as well as in healthy populations, by several investigators. They also found a much higher incidence of double tau-transferrin in inherited degenerative neurological diseases, such as Friedreich's ataxia and hereditary spastic paraplegia, than in neurological ailments without a hereditary component. The aim of our study is to verify the incidence of the C2-1 variant of transferrin in a control group and in a mixed group of neurological patients, with particular attention to hereditary degenerative pathologies. PMID:7188234

Merelli, E; Sola, P; Faglioni, P; Pavarotti, V

1982-01-01

311

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

Microsoft Academic Search

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

Ursula von Schenck; Christine Bender-Götze; Berthold Koletzko

1997-01-01

312

Acute neurological presentation due to copper deficiency in a hemodialysis patient following gastric bypass surgery.  

PubMed

Acquired copper deficiency has been recently recognized as a cause of myelopathy, and has been reported to occur many years after gastric bypass surgery performed to aid weight reduction in morbidly obese patients. We report a case of a young woman treated by hemodialysis who presented with acute neurological symptoms 5 months after gastric bypass surgery for severe obesity. She had symptoms and signs of cerebellar, spinal cord and peripheral nerve disease, which improved following parenteral copper supplementation. Now that gastric bypass surgery is being offered to morbidly obese hemodialysis patients, this case highlights the importance of monitoring copper levels in hemodialysis patients following gastric bypass surgery. PMID:20979948

Rounis, E; Laing, C M; Davenport, A

2010-11-01

313

Transient ischemic attacks and stroke.  

PubMed Central

Transient ischemic attacks (TIAs) constitute the most specific and powerful warnings of impending stroke. They are defined as brief, focal neurological events of sudden onset. Their proper recognition and treatment rank second only to the modification of risk factors in importance for stroke prevention. Carotid endarterectomy, although widely used to treat TIAs, remains unproven; randomized clinical trials are attempting to define its role. Anticoagulant therapy appears worth while for suspected cardiac embolism and possibly for disabling TIAs. Acetylsalicylic acid is the only agent that has been found to be effective in controlled trials, but questions persist about its dosage, its efficacy in women and its use after stroke. Another platelet inhibitor, ticlopidine hydrochloride, is being investigated and may prove to be an effective alternative.

Mirsen, T R; Hachinski, V C

1988-01-01

314

Schizophrenia: The Characteristic Symptoms  

Microsoft Academic Search

The specific symptoms that have been felt to characterize schizophrenia have varied widely over time and across cultures, as has the diagnostic and prognostic importance placed on these symptoms. In this report, the historical concepts of what constitutes the \\

Nancy C. Andreasen; Michael Flaum

1991-01-01

315

Initial Symptoms of ALS  

MedlinePLUS

... Symptoms can begin in the muscles of speech, swallowing or in the hands, arms, legs or feet. Not all people with ALS experience the same symptoms or the same sequences or patterns of progression. But, progressive muscle weakness and paralysis ...

316

Pertussis Signs & Symptoms  

MedlinePLUS

... Disclaimer policy. Print page View page in Español (Spanish) Contact Us: Centers for Disease Control and Prevention ... Pertussis Homepage About Pertussis Causes & Transmission Causes & Transmission-Spanish Signs & Symptoms Symptoms-Spanish Complications Complications-Spanish Diagnosis & ...

317

Symptoms, Diagnosis & Treatment  

MedlinePLUS

... grow into (and restore) the body's blood cells. Hodgkin's Lymphoma Symptoms Painless, swollen lymph nodes in the ... leukemia" or "lymphoma" in the search box) Non-Hodgkin's Lymphoma Symptoms Swollen, painless lymph nodes in the ...

318

Hepatitis B Symptoms  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Hepatitis B Skip Content Marketing Share this: Main Content Area Symptoms Hepatitis B does not always cause obvious symptoms. Children are ...

319

Psoriasis: Signs and Symptoms  

MedlinePLUS

... Diseases and treatments M - P Psoriasis Signs, symptoms Psoriasis: Signs and symptoms What you see and feel ... listed below, or you may have many. Plaque psoriasis (also called psoriasis vulgaris) Raised, reddish patches on ...

320

Variable expression of neurological phenotype in autosomal recessive oculodentodigital dysplasia of two sibs and review of the literature.  

PubMed

Individuals with oculodentodigital dysplasia (ODDD) have a characteristic facial appearance and variable involvement of the eyes, teeth and fingers. Gutmann et al. (Am J Med Genet 41:18, 1990) drew attention to neurological symptoms as a feature in a proportion of individuals with ODDD and demonstrated white matter changes on cranial magnetic resonance imaging. The majority of cases described previously have family histories compatible with autosomal dominant inheritance. Until now, five families have been reported where autosomal recessive inheritance is more likely. Neurological symptoms were described in only one of these families but cerebral imaging was not performed. We describe clinical, including neurological and radiological findings, in two sisters with autosomal recessive ODDD. PMID:17476528

Joss, Shelagh K; Ghazawy, Sam; Tomkins, Susan; Ahmed, Mushtaq; Bradbury, John; Sheridan, Eamonn

2008-03-01

321

Prenatal Antecedents of Newborn Neurological Maturation  

PubMed Central

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

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

2009-01-01

322

Mitochondria in Neuroplasticity and Neurological Disorders  

PubMed Central

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

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

2009-01-01

323

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

324

[Advance of genetics and genomics in neurology].  

PubMed

Studies of genomic background of neurological disorders are very actual in view of their high population prevalence, severe course, serious impact on patients' disability and progressive mental and physical de-adaptation. In the paper, problems of genetic heterogeneity of hereditary neurological disorders and character of the respective genetic burden in the regions of Russian Federation are discussed in detail, a 'dynamic' type of mutations (increase in number of microsatellite repeats copies) attributable to many neurodegenerative diseases is analyzed, and achievements of Russian researchers in the identification of genes for hereditary neurological disorders and in the realization of pilot protocols of gene therapy are presented. Problems related to studies of genetic predisposition to common multifactorial diseases of the nervous system are discussed. PMID:23166984

Ginter, E K; Illarioshkin, S N

2012-01-01

325

Neurological Adverse Effects in Patients of Advanced Colorectal Carcinoma Treated with Different Schedules of FOLFOX  

PubMed Central

The study is designed to assess the frequency and severity of few dose limiting neurological adverse effects of four different schedules of FOLFOX. Patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study. Toxicity was graded according to CTC v 2.0. The frequency of grade 3 and 4 adverse effects was comparatively assessed in each treatment arm. The difference in the pattern of toxicity between the treatment schedule was evaluated. The most frequent adverse symptom of neurological adverse effect was grade 1 paresthesia in the patients treated with FOLFOX4 schedule. Grade 4 peripheral neuropathy was reported in few patients of FOLFOX7 treatment arm. Frequency and onset of neurological adverse effects like paresthesia, dizziness, and hypoesthesia were significantly different (P < 0.05), whereas frequency and onset of peripheral neuropathy were highly significant (P < 0.01) in each treatment arm of FOLFOX. Peripheral neuropathy was associated with electrolyte imbalance and diabetes in few patients. Frequency of symptoms, for example, paresthesia, is associated with increased number of recurrent exposure to oxaliplatin (increased number of cycles) even at low doses (85?mg/m2), whereas severity of symptoms, for example, peripheral neuropathy, is associated with higher dose (130?mg/m2) after few treatment cycles.

Najam, Rahila; Mateen, Ahmed

2013-01-01

326

[Mental pain: is it a symptom?].  

PubMed

The psychiatrist is confronted by a variety of emotional states, ranging from sadness to exaltation. The term "psychache "has been used to describe depression with melancholic features. But can such mental pain be defined without reference to visible lesions or precise physical symptoms? We report pathophysiological evidence supporting this concept and show that it has implications for both treatment and prognosis. Cognitive studies have shown that the neurological substrate of physical pain is also activated by mental pain. Mental pain is associated with a risk of suicide and can be improved by analgesics, including opiates and ketamine. PMID:21171250

Gaillard, Raphaël; Loo, Henry; Olie, Jean-Pierre

2010-03-01

327

Neurological rehabilitation of severely disabled cardiac arrest survivors. Part II. Life situation of patients and families after treatment  

Microsoft Academic Search

Background: About half of out-of-hospital cardiac arrest survivors experience secondary anoxic brain damage. Neurological outcome can be influenced by rehabilitative treatment approaches, but the nature and severity of persistent disabilities remain unclear. The aim of the study was to explore persistent neuropsychiatric symptoms, global function and life situation of these patients, and to evaluate quality of life in families. Methods:

Gisela Pußwald; Elisabeth Fertl; Margit Faltl; Eduard Auff

2000-01-01

328

Emergency neurological care of strokes and bleeds  

PubMed Central

Ischemic stroke and brain hemorrhage are common and challenging problems faced by emergency physicians. In this article, important details in the diagnosis and clinical management of these neurological emergencies are presented with the following goals: 1) To provide a more comprehensive understanding of the approach to the identification and management of patients who have sustained ischemic and hemorrhagic strokes; 2) to explain the importance and application of commonly used national stroke scoring and outcome scales; 3) to improve the ability to recognize important aspects in the approach and comprehensive treatment of ruptured and unruptured intracranial aneurysms; and 4) to demonstrate the difficulties in the neurological, neurosurgical, and endovascular treatment of these catastrophic diseases.

Birenbaum, Dale

2010-01-01

329

Neurologic aspects of cobalamin (B12) deficiency.  

PubMed

Optimal functioning of the central and peripheral nervous system is dependent on a constant supply of appropriate nutrients. Particularly important for optimal functioning of the nervous system is cobalamin (vitamin B12). Cobalamin deficiency is particularly common in the elderly and after gastric surgery. Many patients with clinically expressed cobalamin deficiency have intrinsic factor-related malabsorption such as that seen in pernicious anemia. The commonly recognized neurological manifestations of cobalamin deficiency include a myelopathy with or without an associated neuropathy. This review deals with neurological aspects of vitamin B12 deficiency and attempts to highlight recent developments. PMID:24365360

Kumar, Neeraj

2014-01-01

330

Neurological outcome after emergency radiotherapy in MSCC of patients with non-small cell lung cancer - a prospective trial  

PubMed Central

Background The aim of this trial was to investigate neurological outcome after emergency RT in MSCC of NSCLC patients with acute neurological deficit. Methods This pilot trial was prospective, non-randomized, and monocentre, ten patients were treated from July 2012 until June 2013. After onset of neurological symptoms RT was started within 12 hours. The neurological outcome was assessed at baseline, and six weeks after RT using the ASIA Impairment Scale (AIS). Results The results showed an improved neurological outcome in one patient (10%), one patient (10%) had a decreased, and five patients (50%) a constant outcome after six weeks. Three patients (30%) died within the first six weeks following RT, additional 4 patients (40%) died within 4 month due to tumor progression. Conclusion In this group of NSCLC patients we were able to show that emergency RT in MSCC with acute neurological deficit had no considerable benefit in neurological outcome. Therefore, short-course regime or best supportive care due to poor survival should be considered for these patients with additional distant metastases. Patients with favorable prognosis may be candidates for long-course RT. Trial Registration Clinical trial identifier NCT 02000518.

2013-01-01

331

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.

2013-01-01

332

Motor conversion symptoms and pseudoseizures: a comparison of clinical characteristics.  

PubMed

The authors prospectively studied consecutive neurological inpatients with either motor conversion symptoms or pseudoseizures of recent onset. Patients were administered a structured psychiatric diagnostic interview, a measure of perceived parental care, and a life events inventory. They found that patients with pseudoseizures (N=20, mean age=27 years): 1) were younger than patients with motor conversion symptoms (N=30, mean age=39 years), 2) were more likely to have a borderline personality disorder), 3) were more likely to have a lower perception of parental care and to report incest, and 4) reported more life events in the 12 months before symptom onset. These differences in their characteristics and associated factors raised the question of whether it is helpful to group patients with pseudoseizures and motor conversion symptoms in a single diagnostic category of conversion disorder. An alternative view, that gives primacy to the symptoms rather than a disorder, may enable more precise research questions to be posed. PMID:15546826

Stone, Jon; Sharpe, Michael; Binzer, Michael

2004-01-01

333

Topical Review: Neurologic Complications of Immunization  

Microsoft Academic Search

In the United States and many other developed countries, active immunization of children has virtually eliminated poliomyelitis, measles, rubella, tetanus, and other diseases, such as disease due to Haemophilus influenzae type b. Individual vaccines can produce systemic or neurologic reactions ranging from minor events, such as pain and erythema at the injection site, to major complications, such as seizures, shock,

James F. Bale

2004-01-01

334

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

335

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

336

Prenatal Antecedents of Newborn Neurological Maturation  

ERIC Educational Resources Information Center

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

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

2010-01-01

337

Image processing in the neurologic sciences  

Microsoft Academic Search

Imaging modalities like MRI and PET play an important role in neurologic diagnostics. More than just displaying the examination data as an image, a computer-aided processing can reveal quantitative descriptions of tissue lesions and properties, the nature of the participating structures and their changes in time. On a quantitative basis, more profound statements about structure function relationships and therapeutic implications

F. Kruggel; A. Horsch; G. Mittelhausser; M. Schnabel

1994-01-01

338

Long-term neurological sequelae in achondroplasia  

Microsoft Academic Search

Two children with achondroplasia and neurologic sequelae secondary to foramen magnum compression were found to have syringomyelia. In one patient, the cyst was associated with a subependymal glioma. These findings suggest that foramen magnum stenosis may lead to irreversible spinal cord damage.

Jacqueline T. Hecht; Ian J. Butler; Charles I. Scott Jr

1984-01-01

339

The Neurology of Autism Spectrum Disorders  

PubMed Central

Purpose of review Neurological comorbidities in autism spectrum disorders (ASD) are not only common, but they are also associated with more clinical severity. This review highlights the most recent literature on three of autism’s most prevalent neurological comorbidities: motor impairment, sleep disorders, and epilepsy. Recent findings Motor impairment in ASD manifests as both delays and deficits, with delays found in gross and fine motor domains and deficits found in praxis, coordination, and gait, all of which affect other cognitive and behavioral domains. Sleep disorders, especially insomnia, occur in up to 83% of children with ASD and recent studies have begun to explore the underlying biochemical and behavioral basis of the impairment, which has bolstered treatment studies. Epilepsy is reported in up to one-third of children with ASD, and new studies have focused on identifying the genetic causes of this association. Summary Better characterization of the phenotype, developmental trajectory, and underlying pathophysiology of these neurological comorbidities will enable us to define neurological endophenotypes within the autism spectrum. Future studies must investigate the emergence of these comorbidities prospectively in order to determine whether they lie on the causal pathway to ASD or whether they reflect epiphenomena of the disorder. Since epilepsy and sleep disorders can be treated and may contribute significantly to behavioral and cognitive abnormalities in ASD, their identification is of high clinical relevance.

Jeste, Shafali Spurling

2011-01-01

340

Neurological Complications after Cardiopulmonary Bypass: An Update  

Microsoft Academic Search

Introduction: Neurological complications are, at the present time, considered among the most important causes of morbidity and mortality after heart surgery. We evaluated their importance and risk factors. Patients and Methods: We retrospectively reviewed 2,528 consecutive patients who underwent cardiopulmonary bypass in a single center. In each one, we attended to previous vascular risk factors, such as surgical and postoperative

Y. Carrascal; A. L. Guerrero; L. C. Maroto; J. M. Cortina; J. E. Rodríguez; E. Renes; J. J. Rufilanchas

1999-01-01

341

Major neurological sequelae of lumbar epidural anesthesia  

Microsoft Academic Search

We here report the major permanent neurological complications that developed in three patients after epidural anesthesia. MR clearly showed that paraplegia, which arose one and nine days after anesthesia, was due to epi-subdural haematoma in the first case and epidural abscess in the second. The sudden left lower limb palsy in the third patient was caused by a paracentral ischemic

F. Barontini; P. Conti; G. Marello; S. Maurri

1996-01-01

342

Neurological abnormalities associated with celiac disease  

Microsoft Academic Search

Background Celiac disease (CD) is a gluten-sensitive enteropathy in genetically susceptible individuals. Anecdotal reports suggest that the nervous system might be affected in the disorder, but the severity and prevalence of such an involvement have not been systematically evaluated. Materials and methods Analysis of files of CD patients diagnosed between 1980 and 1999 for neurological abnormalities. Diagnosis of CD was

Adi Vaknin; Rami Eliakim; Zvi Ackerman; Israel Steiner

2004-01-01

343

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

344

Capnography in patients with severe neurological impairment.  

PubMed

Respiratory disease is a common reason for hospitalization and mortality in persons with severe intellectual and developmental disability. Capnography is the measurement and numerical display of end-tidal carbon dioxide (EtCO2). This was a prospective, case controlled, cross sectional study to assess differences of baseline EtCO2 values between neurologically impaired patients and healthy individuals. 86 neurologically impaired patients were evaluated in the study group. Their mean age±SD was 25.65±10.48 years with 41% males. 53 healthy children and young adults were evaluated in the control group. Their mean age±SD was 21.95±10.38 years with 54.7% males. Patients with severe neurological impairment had higher baseline EtCO2 values than healthy individuals. Kyphoscoliosis and the use of antipsychotic drugs were the major factors to increase EtCO2 levels. Knowing the patient's baseline EtCO2 value, as well as baseline oximetry, could guide treatment decisions, when assessing the patient's oxygenation and ventilation during acute respiratory illness, and can potentially prevent unnecessary laboratory and imaging investigations as well as over treatment. Future research can shed light on the utility of capnometry and clinical implications of higher baseline EtCO2 values among neurologically impaired patients. PMID:24685942

Jacob, Ron; Nelkenbaum, Annette; Merrick, Joav; Brik, Riva

2014-06-01

345

TRPC Channels and their Implications for Neurological Diseases  

PubMed Central

Calcium is an essential intracellular messenger and serves critical cellular functions in both excitable and non-excitable cells. Most of the physiological functions in these cells are uniquely regulated by changes in cytosolic Ca2+ levels ([Ca2+]i), which are achieved via various mechanisms. One of these mechanism(s) is activated by the release of Ca2+ from the endoplasmic reticulum (ER), followed by Ca2+ influx across the plasma membrane (PM). Activation of PM Ca2+ channels is essential for not only refilling of the ER Ca2+ stores, but is also critical for maintaining [Ca2+]i that regulates biological functions, such as neurosecretion, sensation, long term potentiation, synaptic plasticity, gene regulation, as well as cellular growth and differentiation. Alterations in Ca2+ homeostasis have been suggested in the onset/progression of neurological diseases, such as Parkinson's, Alzheimer's, bipolar disorder, and Huntington's diseases. Available data on transient receptor potential conical (TRPC) protein indicate that these proteins initiate Ca2+ entry pathways and are essential in maintaining cytosolic, ER, and mitochondrial Ca2+ levels. A number of biological functions have been assigned to these TRPC proteins. Silencing of TRPC1 and TRPC3 has been shown to inhibit neuronal proliferation and loss of TRPC1 is implicated in neurodegeneration. Thus, TRPC channels not only contribute towards normal physiological processes, but are also implicated in several human pathological conditions. Overall, it is suggested that these channels could be used as potential therapeutic targets for many of these neurological diseases. Thus, in this review we have focused on the functional implication of TRPC channels in neuronal cells along with the elucidation of their role in neurodegeneration.

Selvaraj, Senthil; Sun, Yuyang; Singh, Brij B.

2010-01-01

346

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

PubMed Central

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

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

1996-01-01

347

Transient regional osteoporosis.  

PubMed

Transient regional osteoporosis (TRO) is a disease that predisposes to fragility fracture in weight bearing joints of mid-life women and men. Pregnant women may also suffer the process, usually at the hip. The prevalence of TRO is lower than the systemic form, associated with postmenopause and advanced age, but may be falsely diminished by under-diagnosis. The disease may be uni- or bilateral, and may migrate to distinct joints. One main feature of TRO is spontaneous recovery. Pain and progressive limitation in the functionality of the affected joint(s) are key symptoms. In the case of the form associated with pregnancy, difficulties in diagnosis derive from the relatively young age at presentation and from the clinical overlapping with the frequent aches during gestation. Densitometric osteoporosis in the affected region is not always present, but bone marrow edema, with or without joint effusion, is detected by magnetic resonance. There are not treatment guidelines, but the association of antiresorptives to symptomatic treatment seems to be beneficial. Surgery or other orthopedic interventions can be required for specific indications, like hip fracture, intra-medullary decompression, or other. PMID:24582491

Cano-Marquina, Antonio; Tarín, Juan J; García-Pérez, Miguel-Ángel; Cano, Antonio

2014-04-01

348

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

ERIC Educational Resources Information Center

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

Derouesne, C.; Salamon, R.

1977-01-01

349

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

PubMed

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

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

2011-04-01

350

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.

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

2014-01-01

351

Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties  

PubMed Central

Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era.

Faulkner, L.R.; Juul, D.; Pascuzzi, R.M.; Aminoff, M.J.; Crumrine, P.K.; DeKosky, S.T.; Jozefowicz, R.F.; Massey, J.M.; Pirzada, N.; Tilton, A.

2010-01-01

352

What is called symptom?  

PubMed

There is one concept in medicine which is prominent, the symptom. The omnipresence of the symptom seems, however, not to be reflected by an equally prominent curiosity aimed at investigating this concept as a phenomenon. In classic, traditional or conventional medical diagnostics and treatment, the lack of distinction with respect to the symptom represents a minor problem. Faced with enigmatic conditions and their accompanying labels such as chronic fatigue syndrome, fibromyalgia, medically unexplained symptoms, and functional somatic syndromes, the contestation of the symptom and its origin is immediate and obvious and calls for further exploration. Based on a description of the diagnostic framework encompassing medically unexplained conditions and a brief introduction to how such symptoms are managed both within and outside of the medical clinic, we argue on one hand how unexplained conditions invite us to reconsider and re-think the concept we call a "symptom" and on the other hand how the concept "symptom" is no longer an adequate and necessary fulcrum and must be enriched by socio-cultural, phenomenological and existential dimensions. Consequently, our main aim is to expand both our interpretative horizon and the linguistic repertoire in the face of those appearances we label medically unexplained symptoms. PMID:23877313

Eriksen, Thor Eirik; Risør, Mette Bech

2014-02-01

353

E. coli Symptoms  

MedlinePLUS

... Events NIAID > Health & Research Topics > E. coli > Understanding E. coli Understanding Overview Cause Transmission Symptoms Diagnosis Treatment Prevention Complications Research Skip Website Tools Website Tools Print ...

354

Neurology as career option among postgraduate medical students  

PubMed Central

Background: In the context of inadequacy of neurology workforce in India, it is important to understand factors that post-graduate medical students consider for and against choosing neurology as their career option. Understanding these factors will help in planning strategies to encourage students to pursue a career in neurology. At present, there is a paucity of studies addressing this issue in India. Aims and Objectives: (1) To analyze factors, which post-graduate students consider for and against choosing neurology as a career specialty. (2) To access the level and quality of neurology exposure in the current MBBS and MD curricula. Materials and Methods: Statewide questionnaire based study was conducted in the state of Maharashtra for students eligible to take DM neurology entrance examination (MD Medicine and MD Pediatrics). Results: In this survey, 243 students were enrolled. Factors bringing students to neurology were - intellectual challenge and logical reasoning (72%), inspired by role model teachers (63%), better quality-of-life (51%) and scope for independent practice without expensive infrastructure (48%). Factors preventing students from taking neurology were - perception that most neurological diseases are degenerative (78%), neurology is mainly an academic specialty (40%), neurophobia (43%) and lack of procedures (57%). Inadequate exposure and resultant lack of self-confidence were common (31%, 70-80%). 84% of the students felt the need for a short term certification course in neurology after MD. Conclusions: To attract more students to neurology, “role model” teachers of neurology could interact and teach students extensively. Neurologists’ efforts to shed their diagnostician's image and to shift their focus to therapeutics will help change the image of neurology. Out-patient neurology clinics should be incorporated early in the student's career. Procedures attract students; hence, they should be made conversant with procedures and interventions. Increasing the level of neurological exposure in our current MBBS and MD curriculum is necessary. A case could be made for consideration of short certification course in neurology for physicians.

Gupta, Namit B.; Khadilkar, Satish V.; Bangar, Sachin S.; Patil, Tukaram R.; Chaudhari, Chetan R.

2013-01-01

355

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

356

Influence of Neurological Medication on Nutritional Status  

Microsoft Academic Search

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

Marianne S. Aloupis; Ame L. Golaszewski

357

Positive clinical neuroscience: explorations in positive neurology.  

PubMed

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

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

2013-08-01

358

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.

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

2014-01-01

359

Psychiatry and neurology: from dualism to integration.  

PubMed

The two objectives of the following paper are: to make few remarks on the topic absorbing neurologists, psychiatrists, and neuropsychiatrists - integration and division of their specialties; and to describe the situation in Poland, reflected in the latest literature. The authors describe the former and present processes of approaches and divisions in psychiatry and neurology. They indicate dissemination of mutual methods of structural and action brain neuroimaging, neurophysiology, neurogenetics, and advanced neurophysiology diagnostics. As it seems, even the effectiveness of psychotherapy, has recently been associated with changes in brain in functional and even structural markers. The authors indicate the value of the strive to join the still divided specialties, reflected worldwide in attempts of common education and clinical cooperation of physicians. It can be expected that subsequent years will bring further triumphs of neuropsychiatry - a field that combines psychiatry and neurology. PMID:24375004

Soba?ski, Jerzy A; Dudek, Dominika

2013-01-01

360

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.

Macleod, S; Appleton, R E

2007-01-01

361

Neurological complications of ankylosing spondylitis: neurophysiological assessment.  

PubMed

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

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

2009-07-01

362

Neuroprotective and Neurological Properties of Melissa officinalis  

Microsoft Academic Search

Melissa officinalis has traditionally been used due to its effects on nervous system. Both methanolic and aqueous extracts were tested for protective\\u000a effects on the PC12 cell line, free radical scavenging properties and neurological activities (inhibition of MAO-A and acetylcholinesterase\\u000a enzymes and affinity to the GABAA-benzodiazepine receptor). The results suggest that the plant has a significant (P < 0.05) protective effect on

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

2009-01-01

363

Understanding recruitment and retention in neurological research.  

PubMed

Cognitive deficits in participants and the abrupt and traumatic way in which many neurological conditions present are two examples of the unique challenges in recruiting and retaining participants with neurological injury for research studies. The purpose of this investigation was to identify obstacles to recruitment and retention in three ongoing research studies. These studies involve persons with neurological disorders across the continuum of care, from those newly diagnosed and with emergent presentation to those with more established chronic neurological conditions. For this analysis, we evaluated the effectiveness of the strategies employed to improve participation rates. The first study was a project funded by the National Institutes of Health designed to identify biomarkers of vasospasm in persons (n = 496) with aneurysmal subarachnoid hemorrhage who presented to the neurovascular intensive care unit (National Institute of Nursing Research, R01 NR004339). The purpose of the second study was to examine biobehavioral interactions in family caregivers (n = 59) of persons with a primary malignant brain tumor recruited in the community setting. The third project involved recruiting persons (n = 1,019) within an outpatient neurosurgical center to participate in a research registry. To determine differential effectiveness of strategies, consent and attrition rates were calculated at serial points over time in three studies, and recruitment and retention strategies were compared. Sentinel time points in participants' disease trajectories played a key role in determining whether those who were approached to participate gave consent and were retained, particularly in the studies involving persons with aneurysmal subarachnoid hemorrhage (consent = 85%; retention = 89%) and persons with primary malignant brain tumors and their caregivers (consent = 68%; retention = 83%). In addition, several specific recruiter and interviewer training techniques were associated with higher recruitment and retention. Targeted strategies to improve participation rates are vital for neuroscience nurses involved in any aspect of clinical research, including those who conduct studies, assist with data collection, and recruit potential participants. PMID:20187349

Newberry, Alyssa; Sherwood, Paula; Hricik, Allison; Bradley, Sarah; Kuo, Jean; Crago, Elizabeth; Hoffman, Leslie A; Given, Barbara A

2010-02-01

364

Neural Principles of Neurological and Psychiatric Disorders  

Microsoft Academic Search

Recent progress in understanding the neurobiology and pharmacology of brain neurotransmitters and their neural circuits and\\u000a pathways has been remarkable and serves as the foundation for in-depth preclinical research on neurological and psychiatric\\u000a disorders. Most of the neurotransmitter receptors have been cloned and their anatomical localization and distribution have\\u000a been clarified using advanced neurochemical methods. Novel discoveries have greatly stimulated

Frank I. Tarazi; Marc J. Kaufman

365

Neurologic manifestations of varicella zoster virus infections  

Microsoft Academic Search

Varicella zoster virus (VZV) causes acute viral exanthema in childhood, becomes latent, and can reactivate years later to\\u000a produce neurologic disease. Primary VZV infection is associated with acute cerebellitis and stroke, particularly in childhood.\\u000a VZV reactivation may result in neuropathy, myelitis, stroke, and encephalitis, the latter two syndromes the result of small\\u000a and large vessel vasculopathy. Prompt diagnosis and treatment

Catherine Amlie-Lefond; Burk Jubelt

2009-01-01

366

The Evolution of Psychiatry and Neurology  

Microsoft Academic Search

This chapter traces the evolution of psychiatry and neurology with special emphasis placed on the European scene. For a long\\u000a time, there was hardly any distinction between these two disciplines that are now considered quite separate. They started\\u000a together and they may well be in the process of reuniting, particularly in certain domains. We may see, and as the Germans

François Boller; Gianfranco Dalla Barba

367

Neurological Complications of Hematopoietic Stem Cell Transplantation  

Microsoft Academic Search

Complications following hematopoietic stem cell transplantation have long been recognized. The causes are numerous, including\\u000a chemoradiotoxicity, medication toxicity, metabolic abnormalities, organ failure, graft versus host disease, infection, pancytopenia,\\u000a and platelet dysfunction. This chapter summarizes the disorders affecting the nervous system associated with hematopoietic\\u000a stem cell transplantation. As the number of transplants performed annually increases, potential neurologic complications are\\u000a being seen

Eudocia Quant; Patrick Y. Wen

368

Neurologic uses of botulinum neurotoxin type A  

PubMed Central

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

Ney, John P; Joseph, Kevin R

2007-01-01

369

Radiopharmaceutical Stem Cell Tracking for Neurological Diseases  

PubMed Central

Although neurological ailments continue to be some of the main causes of disease burden in the world, current therapies such as pharmacological agents have limited potential in the restoration of neural functions. Cell therapies, firstly applied to treat different hematological diseases, are now being investigated in preclinical and clinical studies for neurological illnesses. However, the potential applications and mechanisms for such treatments are still poorly comprehended and are the focus of permanent research. In this setting, noninvasive in vivo imaging allows better understanding of several aspects of stem cell therapies. Amongst the various methods available, radioisotope cell labeling has become one of the most promising since it permits tracking of cells after injection by different routes to investigate their biodistribution. A significant increase in the number of studies utilizing this method has occurred in the last years. Here, we review the different radiopharmaceuticals, imaging techniques, and findings of the preclinical and clinical reports published up to now. Moreover, we discuss the limitations and future applications of radioisotope cell labeling in the field of cell transplantation for neurological diseases.

Rosado-de-Castro, Paulo Henrique; Pimentel-Coelho, Pedro Moreno; Gutfilen, Bianca; Lopes de Souza, Sergio Augusto; de Freitas, Gabriel Rodriguez; Mendez-Otero, Rosalia; Barbosa da Fonseca, Lea Mirian

2014-01-01

370

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

371

The Neurological Sequelae of Electrical Injury  

PubMed Central

Electricity is a potentially very dangerous commodity. Community safeguards, however, result in remarkably efficient control of this hazard. Mortality figures appear to be small and constant. No satisfactory morbidity figures are available with regard to general and neurological complications in non-fatal cases. Study of relevant features of such electrical phenomena as voltage level, resistance factors, current pathway, current diffusion and grounding reveals many difficulties in reconstruction of the sequence of events involved in these injuries. These features underline our frequent inability to understand the mechanisms of initiation of unconsciousness and even of differentiation between death by cardiac arrest and death by respiratory paralysis. Fourteen cases of electrical injury with a variety of neurological complications and sequelae are discussed, and the findings in these cases are compared with those of other observers. An attempt is made to present a comprehensive picture of immediate, secondary and late neurological effects, and to illustrate some of the pathological findings in electrocution material. ImagesFigs. 1 and 2Fig. 3Fig. 4Fig. 5Figs. 6 and 7Fig. 8Fig. 9Fig. 10Fig. 11

Silversides, John

1964-01-01

372

Chronic neurological sequelae to organophosphate pesticide poisoning.  

PubMed Central

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

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

1994-01-01

373

NIRS in clinical neurology - a 'promising' tool?  

PubMed

Near-infrared spectroscopy (NIRS) has become a relevant research tool in neuroscience. In special populations such as infants and for special tasks such as walking, NIRS has asserted itself as a low resolution functional imaging technique which profits from its ease of application, portability and the option to co-register other neurophysiological and behavioral data in a 'near natural' environment. For clinical use in neurology this translates into the option to provide a bed-side oximeter for the brain, broadly available at comparatively low costs. However, while some potential for routine brain monitoring during cardiac and vascular surgery and in neonatology has been established, NIRS is largely unknown to clinical neurologists. The article discusses some of the reasons for this lack of use in clinical neurology. Research using NIRS in three major neurologic diseases (cerebrovascular disease, epilepsy and headache) is reviewed. Additionally the potential to exploit the established position of NIRS as a functional imaging tool with regard to clinical questions such as preoperative functional assessment and neurorehabilitation is discussed. PMID:23558099

Obrig, Hellmuth

2014-01-15

374

78 FR 24221 - National Institute of Neurological Disorders and Stroke  

Federal Register 2010, 2011, 2012, 2013

...of Health National Institute of Neurological Disorders and Stroke Pursuant to...Linda L. Porter, Ph.D., Health Science Policy Advisor, Officer of the Director, National Institute of Neurological Disorders and Stroke, NIH,...

2013-04-24

375

Identification of a primarily neurological phenotypic expression of xeroderma pigmentosum complementation group A in a Tunisian family.  

PubMed

Xeroderma pigmentosum (XP) is a rare genodermatosis predisposing to skin cancers. The disease is classified into eight groups. Among them, XP group A (XP-A) is characterized by the presence of neurological abnormalities in addition to cutaneous symptoms. In the present study, we report a particular family with XP-A in which some members showed an atypical clinical presentation, i.e. unexplained neurological abnormalities with discrete skin manifestations. Molecular investigation allowed identification of a novel XPA mutation and complete phenotype-genotype correlation for this new phenotypic expression of XP-A. PMID:20199544

Messaoud, O; Ben Rekaya, M; Kefi, R; Chebel, S; Boughammoura-Bouatay, A; Bel Hadj Ali, H; Gouider-Khouja, N; Zili, J; Frih-Ayed, M; Mokhtar, I; Abdelhak, S; Zghal, M

2010-04-01

376

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.

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

2014-01-01

377

Lemierre's Syndrome presenting with neurological and pulmonary symptoms: Case report and review of the literature.  

PubMed

Lemierre's Syndrome (LS) is a potentially life-threatening condition, characterized by clinical or radiologic evidence of internal jugular vein thrombosis following an oropharyngeal infection, most commonly by Fusobacterium necrophorum. A high index of suspicion and early recognition is important for successful management and to prevent systemic complications like multiorgan failure with extremely high morbidity, prolonged hospitalization and, not uncommonly, death. We are reporting a rare case of LS that was complicated with internal jugular vein and cavernous sinus thrombosis along with lung metastatic lesions, which was diagnosed and treated at our institute. PMID:23956578

Aggarwal, Sushil Kumar; Nath, Alok; Singh, Rajni; Keshri, Amit

2013-04-01

378

Lemierre's Syndrome presenting with neurological and pulmonary symptoms: Case report and review of the literature  

PubMed Central

Lemierre’s Syndrome (LS) is a potentially life-threatening condition, characterized by clinical or radiologic evidence of internal jugular vein thrombosis following an oropharyngeal infection, most commonly by Fusobacterium necrophorum. A high index of suspicion and early recognition is important for successful management and to prevent systemic complications like multiorgan failure with extremely high morbidity, prolonged hospitalization and, not uncommonly, death. We are reporting a rare case of LS that was complicated with internal jugular vein and cavernous sinus thrombosis along with lung metastatic lesions, which was diagnosed and treated at our institute.

Aggarwal, Sushil Kumar; Nath, Alok; Singh, Rajni; Keshri, Amit

2013-01-01

379

Symptoms of Celiac Disease  

MedlinePLUS

... symptoms tend to appear in children and adults? Children tend to have the more classic signs of celiac disease, including growth problems (failure to thrive, chronic diarrhea/constipation, recurring abdominal bloating and pain, fatigue and irritability. Adults tend to have symptoms ...

380

Neurologic function among termiticide applicators exposed to chlorpyrifos.  

PubMed Central

Chlorpyrifos is a moderately toxic organophosphate pesticide. Houses and lawns in the United States receive a total of approximately 20 million annual chlorpyrifos treatments, and 82% of U.S. adults have detectable levels of a chlorpyrifos metabolite (3,5, 6-trichloro-2-pyridinol; TCP) in the urine. The U.S. Environmental Protection Agency has estimated that there are 5,000 yearly reported cases of accidental chlorpyrifos poisoning, and approximately one-fourth of these cases exhibit symptoms. Organophosphates affect the nervous system, but there are few epidemiologic data on chlorpyrifos neurotoxicity. We studied neurologic function in 191 current and former termiticide applicators who had an average of 2.4 years applying chlorpyrifos and 2.5 years applying other pesticides, and we compared them to 189 nonexposed controls. The average urinary TCP level for 65 recently exposed applicators was 629.5 microg/L, as compared to 4.5 microg/L for the general U.S. population. The exposed group did not differ significantly from the nonexposed group for any test in the clinical examination. Few significant differences were found in nerve conduction velocity, arm/hand tremor, vibrotactile sensitivity, vision, smell, visual/motor skills, or neurobehavioral skills. The exposed group did not perform as well as the nonexposed group in pegboard turning tests and some postural sway tests. The exposed subjects also reported significantly more symptoms, including memory problems, emotional states, fatigue, and loss of muscle strength; our more quantitative tests may not have been adequate to detect these symptoms. Eight men who reported past chlorpyrifos poisoning had a pattern of low performance on a number of tests, which is consistent with prior reports of chronic effects of organophosphate poisoning. Overall, the lack of exposure effects on the clinical examination was reassuring. The findings for self-reported symptoms raise some concern, as does the finding of low performance for those reporting prior poisoning. Although this was a relatively large study based on a well-defined target population, the workers we studied may not be representative of all exposed workers, and caution should be exercised in generalizing our results.

Steenland, K; Dick, R B; Howell, R J; Chrislip, D W; Hines, C J; Reid, T M; Lehman, E; Laber, P; Krieg, E F; Knott, C

2000-01-01

381

Gait analysis as a measure of neurological function in dogs  

Microsoft Academic Search

Evaluation of gait of neurologically impaired dogs is usually conducted using subjective techniques. This research was conducted to validate the use of gait analysis as an objective measure of neurological function in dogs and to develop a comprehensive gait analysis protocol using temporospatial, kinetic, kinematic, and paw pressure data thus facilitating gait analysis as a diagnostic tool for neurologically impaired

Jongmin Kim

2009-01-01

382

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

383

[Medical history aspects of the development of neurology in Switzerland].  

PubMed

The development of neurology in the five medical faculties of our country as well as in non academic institutions of Switzerland is described. Some remarks are added on the history of the Swiss Neurological Society as well as the only neurological Journal of Switzerland. PMID:2445030

Mumenthaler, M

1987-01-01

384

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.

385

The Tullio phenomenon: a neurologically neglected presentation  

Microsoft Academic Search

The Tullio phenomenon refers to sound-induced disequilibrium or oscillopsia. Patients with this condition frequently present\\u000a to neurologists, many of whom are unfamiliar with the condition and its diagnostic criteria. Indeed, due to the unusual nature\\u000a of the symptoms patients are often misdiagnosed as having psychiatric disturbances. Tullio patients describe disequilibrium,\\u000a auditory and visual symptoms, which are recurrent, brief, and often

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

386

[Neurological soft signs in schizophrenia: correlations with age, sex, educational status and psychopathology].  

PubMed

Though the pathobiology of schizophrenia can be examined in multiple levels, the organic notion of brain disease suggests that neurological features will be present. One straightforward, inexpensive method of investigating brain dysfunction in schizophrenia is thought the bedside assessment of neurological abnormalities with a standard neurological examination. Neurological abnormalities are traditionally classified as "hard signs" (impairments in basic motor, sensory, and reflex behaviors, which do not appear to be affected in schizophrenia) and "soft signs", which refer to more complex phenomena such as abnormalities in motor control, integrative sensory function, sensorimotor integration, and cerebral laterality. Additionally, neurological soft signs (NSS) are minor motor and sensory abnormalities that are considered to be normal in the course of early development but abnormal when elicited in later life or persist beyond childhood. Soft signs also, have no definitive localizing significance but are indicative of subtle brain dysfunction. Most authors believe that they are a reflection not only of deficient integration between the sensory and motor systems, but also of dysfunctional neuronal circuits linking subcortical brain structures such as the basal ganglia, the brain stem, and the limbic system. Throughout the last four decades, studies have consistently shown that NSS are more frequently present in patients with schizophrenia than in normal subjects and non-psychotic psychiatric patients. However, the functional relevance of NSS remains unclear and their specificity has often been challenged, even though there is indication for a relative specificity with regard to diagnosis, or symptomatology. Many studies have considered soft signs as categorical variables thus hampering the evaluation of fluctuation with symptomatology and/or treatment, whereas other studies included insufficient number of assessed signs, or lacked a comprehensive assessment of extrapyramidal symptomatology. Factors such as sex, age or family history of schizophrenia, are said to influence the performance of neurological examination, whereas relative few studies have provided longitudinal follow-up data on neurological soft signs in a sufficient number of patients, in order to address a possible deterioration of neurological functions. Finally, one additional difficulty when analyzing the NSS literature lies in the diversity of symptoms that are evaluated in the studies and/or non-standardized procedures or scoring. We will review some basic issues concerning recurrent difficulties in the measurement and definition of soft signs, as well as controversies on the significance of these signs with respect to clinical subtyping of schizophrenia, and social and demographic variables. PMID:24486976

Panagiotidis, P; Kaprinis, G; Iacovides, A; Fountoulakis, K

2013-01-01

387

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

PubMed Central

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

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

2012-01-01

388

Characteristics of persons with overactive bladder of presumed neurologic origin: Results from the Boston Area Community Health (BACH) Survey  

PubMed Central

Aims To compare the descriptive epidemiology of overactive bladder (OAB) of presumed neurologic origin (NOAB) to OAB of non-neurologic origin (N-NOAB). Methods 5,503 community-dwelling persons aged 30-79 were interviewed regarding urologic symptoms (2002-2005). NOAB was defined as symptoms of urgency and/or urgency incontinence among those with a self-reported history of health care provider diagnosed stroke (N=98), multiple sclerosis (N=21), or Parkinson’s disease (N=7). N-NOAB was defined identically but occurring among those not reporting neurologic disease (ND). Prevalence estimates were weighted to reflect sampling design; chi-square, Fisher’s exact, or t-tests were used to test differences. Urologic symptom interference was assessed using the Epstein scale, while the impact of urinary incontinence (UI) on health-related quality-of-life (HRQOL) was measured using a modification of the Incontinence Impact Questionnaire-7. Results 45 (31.0%) of 125 persons with ND and 994 (16.7%) of 5378 persons without ND reported OAB symptoms. The overall prevalence of NOAB and N-NOAB was 0.6% and 16.4%, respectively. Persons with NOAB had higher (worse) mean American Urologic Association Symptom Index scores (13.0 vs. 10.0, p=0.09) compared to those with N-NOAB, and were significantly more likely to have diabetes, high blood pressure, cardiac disease and fair/poor self-reported health (all p<0.05). Mean symptom interference and UI HRQOL scores were significantly higher (worse) in the NOAB group compared to persons with N-NOAB (all p<0.05). Conclusions Persons with NOAB appeared to have a greater burden of urologic illness with respect to symptom interference and HRQOL compared to persons with N-NOAB.

Hall, Susan A.; Curto, Teresa M.; Onyenwenyi, Ahunna; Lemack, Gary E.; Tennstedt, Sharon L.; Link, Carol L.; McKinlay, John B.

2012-01-01

389

Herpes simplex encephalitis: clinical presentation, neurological sequelae and new prognostic factors. Ten years of experience.  

PubMed

Herpes simplex encephalitis (HSE) is the most important viral encephalitis due to its high mortality and neurological sequelae. The aim of this study was to contribute to better characterise the HSE. We retrospectively analysed patients with a diagnosis of HSE in our hospital during 2000 and 2010. We included those patients who had a positive result for PCR for herpes simplex virus in cerebrospinal fluid and those with a negative result presenting with a consistent clinical and neuroimage profile. We included 26 patients (10 men, 16 women). Mean age was 58 years. Most frequent symptoms at admission were fever, confusion, aphasia and seizures. Mortality rate was 11 %. 2 patients presented a clinical relapse. In conclusion, the most frequent neurological sequelae were aphasia and amnesia. Disorientation, hyponatremia and abnormalities in initial brain CT were identified as new prognostic factors. PMID:23780666

Riancho, Javier; Delgado-Alvarado, Manuel; Sedano, Maria Jose; Polo, Jose Miguel; Berciano, Jose

2013-10-01

390

Extreme hyponatraemia with intact neurological outcome in a young child with Addison's disease.  

PubMed

The authors present the case of a 6-year-old boy with a good neurological outcome from extreme hyponatraemia caused by autoimmune hypoadrenalism. He presented with 1 week of reduced appetite, lethargy, vomiting and one episode of diarrhoea. He was described as being slightly unsteady on his feet. Clinically he was alert, although intermittently confused, with dry mucous membranes and sunken eyes. Serum sodium was 96 mmol/l with normal serum potassium and renal function. He was initially treated with 3% saline intravenously, and his serum sodium increased to 128 mmol/l by day 3. He developed slurred speech and ataxia on day 4, although MRI brain showed no evidence of pontine myelinosis, and the symptoms resolved over 1 week. A Synacthen test on day 10 confirmed a diagnosis of Addison's disease and he was commenced on hydrocortisone and fludrocortisone replacement therapy. At 5 months follow-up there are no obvious neurological or developmental sequelae. PMID:22679234

Smith, John-Paul; Burren, Christine; Cherinet, Yonas

2011-01-01

391

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.

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

2013-01-01

392

Tibolone and climacteric symptoms.  

PubMed

Tibolone (Livial) has advantages over other forms of hormone replacement therapy (HRT); it is easy to use and does not induce withdrawal bleeding in postmenopausal women. The evidence for the effect of tibolone on climacteric symptoms is reviewed and shows that tibolone is effective in reducing vasomotor symptoms and vaginal dryness. Tibolone's effect on a range of other symptoms such as headache and insomnia is unclear. There are reports that tibolone improves mood and libido but much of this research is methodologically flawed. Methodologically sound research is required to investigate tibolone's effect on mood and libido; such a study is in progress. PMID:7752950

Ross, L A; Alder, E M

1995-02-01

393

Dissociative symptoms and epilepsy.  

PubMed

This article considers the relationship between various types of dissociative symptoms, including symptoms of depersonalization, derealization, and conversion disorders, and epilepsy. After introductory remarks concerning dissociation, this relationship is discussed through two main themes: firstly, the phenomenology and mechanisms of so-called 'dreamy states' in epilepsy and their closest analogs in psychiatric disorders, and secondly, the similarities and differences between epileptic seizures and psychogenic nonepileptic attacks. Although epileptic and dissociative symptoms may appear similar to observers, they arise through different mechanisms and have different experiential qualities. PMID:24196397

Medford, Nick

2014-01-01

394

Interventional neurology: botulinum toxin as a potent symptomatic treatment in neurology.  

PubMed

Local injections of botulinum toxin is a well-accepted treatment for focal dystonias, hemifacial spasms and strabismus. Its use by skilled neurologists has been reported to be safe and effective. We report our experience with botulinum toxin injections in 108 patients with various central nervous system disorders. Botox was effective in upper face dystonia (86% improvement), spastic dysphonia (92% improvement), platysma muscle spasms and spasmodic torticollis (range of movement 61%, pain and tension 90%). It was also very effective in a few patients with apraxia of eyelid opening, parkinsonian jaw tremor, teeth clenching, palatal myoclonus and adductor leg spasticity. No serious side effects were recorded. Botulinum toxin is a useful symptomatic treatment for many neurological disorders, and one of the leading mode of treatments in the new subspecialty in neurology called "Interventional neurology." PMID:7982770

Giladi, N; Meer, J; Kidan, C; Greenberg, E; Gross, B; Honigman, S

1994-11-01

395

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

396

Association of Pesticide Exposure with Neurologic Dysfunction and Disease  

PubMed Central

Poisoning by acute high-level exposure to certain pesticides has well-known neurotoxic effects, but whether chronic exposure to moderate levels of pesticides is also neurotoxic is more controversial. Most studies of moderate pesticide exposure have found increased prevalence of neurologic symptoms and changes in neurobehavioral performance, reflecting cognitive and psychomotor dysfunction. There is less evidence that moderate exposure is related to deficits in sensory or motor function or peripheral nerve conduction, but fewer studies have considered these outcomes. It is possible that the most sensitive manifestation of pesticide neurotoxicity is a general malaise lacking in specificity and related to mild cognitive dysfunction, similar to that described for Gulf War syndrome. Most studies have focused on organophosphate insecticides, but some found neuro-toxic effects from other pesticides, including fungicides, fumigants, and organochlorine and carbamate insecticides. Pesticide exposure may also be associated with increased risk of Parkinson disease; several classes of pesticides, including insecticides, herbicides, and fungicides, have been implicated. Studies of other neurodegenerative diseases are limited and inconclusive. Future studies will need to improve assessment of pesticide exposure in individuals and consider the role of genetic susceptibility. More studies of pesticides other than organophosphates are needed. Major unresolved issues include the relative importance of acute and chronic exposure, the effect of moderate exposure in the absence of poisoning, and the relationship of pesticide-related neurotoxicity to neurodegenerative disease.

Kamel, Freya; Hoppin, Jane A.

2004-01-01

397

[Delirium in patients with neurological diseases : Diagnosis, management and prognosis].  

PubMed

Delirium is a common acute neuropsychiatric syndrome. It is characterized by concurrent disturbances of consciousness and attention, perception, reasoning, memory, emotionality, the sleep-wake cycle as well as psychomotor symptoms. Delirium caused by alcohol or medication withdrawal is not the subject of the current review. Specific predisposing and precipitating factors have been identified in delirium which converge in a common final pathway of global brain dysfunction. The major predisposing factors are older age, cognitive impairment or dementia, sensory deficits, multimorbidity and polypharmacy. Delirium is always caused by one or more underlying pathologies which need to be identified. In neurology both primary triggers of delirium, such as stroke or epileptic seizures and also secondary triggers, such as metabolic factors or medication side effects play a major role. Nonpharmacological interventions are important in the prevention of delirium and lead to an improvement in prognosis. Delirium is associated with increased mortality and in the long term the development of cognitive deficits and functional impairment. PMID:24668399

Hüfner, K; Sperner-Unterweger, B

2014-04-01

398

Paraneoplastic neurologic syndrome: A practical approach  

PubMed Central

Paraneoplastic neurological syndromes (PNS) are rare disorders associated with cancer, not caused by direct invasion, metastasis or consequences of treatment. They are usually autoimmune in nature. Often, PNS precedes the manifestations of cancer. Onconeural antibodies are important in the diagnosis and management of these disorders. These antibodies are specific for the malignancy rather than for a particular neurological syndrome. Often, there are different antibodies associated with the same syndrome. Multiple antibodies are also known to coexist in a given patient with malignancy. While investigating a patient for suspected PNS, the entire gamut of onconeural antibodies should be investigated so as not to miss the diagnosis. In 30–40% of the cases, PNS can occur without antibodies. Investigations for identifying the underlying cancer can be directed by the antibody panel. If conventional screening for cancer is negative, a positron emission scanning/computed tomography scan can be useful. Patients need follow-up surveillance for cancer if not detected in the first instance. Cancer detection and treatment, immunotherapy and supportive care are important components of treatment of PNS. Immunotherapy is very effective in PNS associated with cell membrane-associated antibodies like voltage-gated potassium channel complex, NMDA receptor antibodies and voltage-gated calcium channel antibodies. Immunotherapy includes steroids, IVIgG, plasmaphereis, cytotoxic medications and rituximab. Supportive therapy includes symptomatic treatment with antiepileptic and analgesic medications, physiotherapy, speech therapy and occupational therapy. PNS can mimic any neurologic syndrome. A high index of clinical suspicion is important for early diagnosis and prompt management and better outcome.

Kannoth, Sudheeran

2012-01-01

399

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

400

On data modeling for neurological application  

NASA Astrophysics Data System (ADS)

The aim of this paper is to design and implement information system containing large database dedicated to support neurological-psychiatric examinations focused on human brain after stroke. This approach encompasses the following steps: analysis of software requirements, presentation of the problem solving concept, design and implementation of the final information system. Certain experiments were performed in order to verify the correctness of the project ideas. The approach can be considered as an interdisciplinary venture. Elaboration of the system architecture, data model and the tools supporting medical examinations are provided. The achievement of the design goals is demonstrated in the final conclusion.

Wo?niak, Karol; Mulawka, Jan

2012-05-01

401

"The choice for death" and neurology.  

PubMed

In the last decade, "end-of-life" issues have gained prominence in political and social debates in many countries. The deliberate ending of the life of a patient upon his/her own request has become a hotly contested topic. This paper discusses the implications of this debate and of corresponding policy and legal developments for neurology. We discuss the nomenclature of the "choices for death", euthanasia, doctor-assisted suicide and palliative care as well as the social dynamics underlying these developments. We suggest that we need a more nuanced and empirically based understanding of the process of the "choice for death and its implications for medical practice." PMID:20393857

Durnová, Anna; Gottweis, Herbert

2010-07-01

402

Somatic mutation, genomic variation, and neurological disease.  

PubMed

Genetic mutations causing human disease are conventionally thought to be inherited through the germ line from one's parents and present in all somatic (body) cells, except for most cancer mutations, which arise somatically. Increasingly, somatic mutations are being identified in diseases other than cancer, including neurodevelopmental diseases. Somatic mutations can arise during the course of prenatal brain development and cause neurological disease-even when present at low levels of mosaicism, for example-resulting in brain malformations associated with epilepsy and intellectual disability. Novel, highly sensitive technologies will allow more accurate evaluation of somatic mutations in neurodevelopmental disorders and during normal brain development. PMID:23828942

Poduri, Annapurna; Evrony, Gilad D; Cai, Xuyu; Walsh, Christopher A

2013-07-01

403

[Recent progress in pediatric neurological rehabilitation].  

PubMed

New challenges in rehabilitation for children with neurological diseases directly depend on advances made in medical research and on the quality of the environment. This is relevant to motor function as a whole, to new therapeutic avenues in spasticity, to global approaches in the evaluation of cognitive and learning disabilities, as well as curative perspectives in neuromuscular disease. Networking with the family and other actors in the environmental field is essential to achieve a better social integration. A true collaboration between physicians and pediatricians is necessary to work toward more progress. PMID:11865554

Leroy-Malherbe, V; Laurent-Vannier, A; Brugel, D G; Urtizberea, J A

2002-01-01

404

[Applications of botulinum toxin in Neurology].  

PubMed

At present, botulinum toxin (BT) is one of the most fundamental available drugs in Neurology, only comparable with levodopa. BT is currently used in those entities characterized by excessive muscle contraction, including dystonia and spasticity. In addition, BT has been used to control pain associated with increased muscle contraction in dystonia and spasticity, but also is useful to control chronic pain not associated with muscle contraction, such as chronic daily headache. Finally, BT is useful in sialorrhoea and bruxism. The mechanism of action is complex, mainly acting on terminal neuromuscular junction, but also exhibiting analgesic properties, probably through inhibition of pain neurotransmitters release. PMID:23434466

Garcia-Ruiz, Pedro J

2013-07-01

405

[Neurological complications and therapy in herpesvirus diseases].  

PubMed

An overview on the diversity of neurologic complications of infections with different human herpes virus strains is given. Encephalitis, meningoencephalitis and the Guillain-Barré-syndrome are of major importance. Affection of single cranial nerves and mononeuropathies occur in a lesser frequency, while myelitis and isolated disturbances of the autonomic nervous system are rare complications. Therapeutically the application of acyclovir in herpes simplex and varicella zoster virus infections has given encouraging outlooks, whereas no convincing results exist with respect to cytomegalovirus and Epstein-Barr virus infections. PMID:3013738

Bleistein, J; Tackmann, W

1986-06-01

406

Signs and Symptoms  

MedlinePLUS

... tachypnea) when lying down or with exertion, poor appetite and slow weight gain. Older children may show ... symptoms are difficulty breathing, excessive sweating (diaphoresis), poor appetite and failure to thrive. Older children with obstructive ...

407

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.

408

Insect Sting Allergy: Symptoms  

MedlinePLUS

... Director, Health Initiatives View full profile Insect Sting Allergy: Symptoms Insect sting reactions can be classified as ... Calendar Read the News View Daily Pollen Count Allergy Treatment Programs At National Jewish Health, some of ...

409

Symptoms of Tickborne Illness  

MedlinePLUS

... symptoms include headache, fatigue, and muscle aches. With Lyme disease you may also experience joint pain. The severity ... disease and the patient's personal tolerance level. Rash: Lyme disease , southern tick-associated rash illness (STARI) , Rocky Mountain ...

410

Amblyopia: Lazy Eye Symptoms  

MedlinePLUS

... Reduced Vision Tearing See all Symptoms > Glasses, Contacts & LASIK Contact Lenses Colored Contact Lenses Eyeglasses IOLs Refractive Surgery & LASIK Sunglasses Living EyeSmart About Ophthalmologists Adults Under 40 ...

411

Bell's Palsy Symptoms  

MedlinePLUS

... Reduced Vision Tearing See all Symptoms > Glasses, Contacts & LASIK Contact Lenses Colored Contact Lenses Eyeglasses IOLs Refractive Surgery & LASIK Sunglasses Living EyeSmart About Ophthalmologists Adults Under 40 ...

412

Managing Concussion Symptoms  

MedlinePLUS Videos and Cool Tools

... Symptoms HealthDay May 12, 2014 Related MedlinePlus Pages Children's Health Concussion Transcript Concussions can pack a long-lasting ... head injury. The findings published in the journal Pediatrics are based on the experiences of 235 concussion ...

413

Rosacea: Signs and Symptoms  

MedlinePLUS

... treatment. Subtype 1: Facial redness, flushing, visible blood vessels Signs and symptoms Flushing and redness in the center of the face. Visible broken blood vessels (spider veins). Swollen skin. Skin may be very ...

414

Symptoms of Uterine Cancer  

MedlinePLUS

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415

[Neurological examination in patients undergoing sedation with propofol: a descriptive study].  

PubMed

INTRODUCTION. The neurological examination is a resource used in evaluating patients who are in coma. Anaesthesia can be a factor that exerts an influence on the findings. We evaluated the examination of the comatose patient in the case of patients anaesthetised with propofol in order to define its clinical value. PATIENTS AND METHODS. A prospective study was conducted among those who had undergone heart surgery in the intensive care unit of a tertiary hospital during the months of April and May 2011. Aspects that were analysed were the examination of the anaesthetic coma, pharmacological or medical factors that can have an influence and a full neurological examination following recovery. Patients with previous neurological symptoms were excluded. RESULTS. Thirty patients were selected (16 males and 14 females); mean age: 72 ± 10 years. All the patients were sedated with propofol. During sedation, 17 (46.7%) presented unreactive pupils. No spontaneous eye movements were observed in 100% of the sample. Ocular alterations in primary position were observed in 23.3% of them. Oculocephalic reflexes were absent in 93.3% and oculovestibular reflexes, in 100%; the corneal reflex, was absent in 70% (with asymmetry), as was the ciliospinal reflex, in 83.3%. The algesic motor response was absent in 93.3%, as were the cutaneous plantar extensor reflexes, in 20%; and 66.7% were indifferent. Following anaesthesia, the neurological examination was normal in 80%, there were slight orientation impairments in 16.7% and a hemispheric syndrome was found in one patient. CONCLUSIONS. Anaesthesia with propofol alters the reversible cutaneous-plantar, pupillary, trunk and motor response reflexes on withdrawing sedation. The alterations may be asymmetrical. Neurological examinations should not be used in the case of patients sedated with propofol in order to make clinical decisions. PMID:24915029

Ordas-Bandera, C M; Sanchez-Marcos, C; Janeiro-Lumbreras, D; Jimenez-Martin, M J; Muniz-Castrillo, S; Cuadrado-Perez, M L; Porta-Etessam, J

2014-06-16

416

The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders  

PubMed Central

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.

Stafstrom, Carl E.; Rho, Jong M.

2012-01-01

417

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

418

A maternal hypomethylation syndrome presenting as transient neonatal diabetes mellitus  

Microsoft Academic Search

The expression of imprinted genes is mediated by allele-specific epigenetic modification of genomic DNA and chromatin, including parent of origin-specific DNA methylation. Dysregulation of these genes causes a range of disorders affecting pre- and post-natal growth and neurological function. We investigated a cohort of 12 patients with transient neonatal diabetes whose disease was caused by loss of maternal methylation at

D. J. G. Mackay; S. E. Boonen; J. Clayton-Smith; J. Goodship; J. M. D. Hahnemann; S. G. Kant; P. R. Njølstad; N. H. Robin; D. O. Robinson; R. Siebert; J. P. H. Shield; H. E. White; I. K. Temple

2006-01-01

419

Neurological complications of chronic kidney disease.  

PubMed

Chronic kidney disease (CKD) is a critical and rapidly growing global health problem. Neurological complications occur in almost all patients with severe CKD, potentially affecting all levels of the nervous system, from the CNS through to the PNS. Cognitive impairment, manifesting typically as a vascular dementia, develops in a considerable proportion of patients on dialysis, and improves with renal transplantation. Patients on dialysis are generally weaker, less active and have reduced exercise capacity compared with healthy individuals. Peripheral neuropathy manifests in almost all such patients, leading to weakness and disability. Better dialysis strategies and dietary modification could improve outcomes of transplantation if implemented before surgery. For patients with autonomic neuropathy, specific treatments, including sildenafil for impotence and midodrine for intradialytic hypotension, are effective and well tolerated. Exercise training programs and carnitine supplementation might be beneficial for neuromuscular complications, and restless legs syndrome in CKD responds to dopaminergic agonists and levodopa treatment. The present Review dissects the pathophysiology of neurological complications related to CKD and highlights the spectrum of therapies currently available. PMID:19724248

Krishnan, Arun V; Kiernan, Matthew C

2009-10-01

420

Chapter 3: neurology in ancient Egypt.  

PubMed

Neurology, in the modern sense, did not exist in ancient Egypt, where medicine was a compound of natural, magical and religious elements, with different practitioners for each form of healing. Nevertheless, Egyptian doctors made careful observations of illness and injury, some of which involved the nervous system. Modern scholars have three sources of information about Egyptian medicine: papyri, inscriptions, and mummified remains. These tell us that the Egyptians had words for the skull, brain, vertebrae, spinal fluid and meninges, though they do not say if they assigned any function to them. They described unconsciousness, quadriparesis, hemiparesis and dementia. We can recognize neurological injuries, such as traumatic hemiparesis and cervical dislocation with paraplegia, in the well known Edwin Smith surgical papyrus. Similarly recognizable in the Ebers papyrus is a description of migraine. An inscription from the tomb of the vizier Weshptah, dated c. 2455 BCE, seems to describe stroke, and Herodotus describes epilepsy in Hellenistic Egypt. We have very little understanding of how Egyptian physicians organized these observations, but we may learn something of Egyptian culture by examining them. At the same time, modern physicians feel some connection to Egyptian physicians and can plausibly claim to be filling a similar societal role. PMID:19892106

York, George K; Steinberg, David A

2010-01-01

421

Clinical applications of intravenous immunoglobulins in neurology  

PubMed Central

Intravenous immunoglobulin (IVIg) is used increasingly in the management of patients with neurological conditions. The efficacy and safety of IVIg treatment in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Guillain–Barré syndrome (GBS) have been established clearly in randomized controlled trials and summarized in Cochrane systematic reviews. However, questions remain regarding the dose, timing and duration of IVIg treatment in both disorders. Reports about successful IVIg treatment in other neurological conditions exist, but its use remains investigational. IVIg has been shown to be efficacious as second-line therapy in patients with dermatomyositis and suggested to be of benefit in some patients with polymyositis. In patients with inclusion body myositis, IVIg was not shown to be effective. IVIg is also a treatment option in exacerbations of myasthenia gravis. Studies with IVIg in patients with Alzheimer's disease have reported increased plasma anti-A? antibody titres associated with decreased A? peptide levels in the cerebrospinal fluid following IVIg treatment. These changes at the molecular level were accompanied by improved cognitive function, and large-scale randomized trials are under way.

Hughes, R A C; Dalakas, M C; Cornblath, D R; Latov, N; Weksler, M E; Relkin, N

2009-01-01

422