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Journal of Neurology

A Schrag, S Modi, S Hotham, R Merritt, K Khan, L Graham
OBJECTIVE: To report patients' own experiences of receiving a diagnosis of Parkinson's disease (PD) and to identify factors influencing this experience. METHODS: A survey by the European Parkinson's Disease Association in 11 European countries. RESULTS: 1775 patients with an average age of 69.7 years participated of whom 54% were male. Those living in rural areas reported having waited longer to seek medical help (p < 0.05). A possible diagnosis of PD was made at the first appointment in a third of respondents...
March 15, 2018: Journal of Neurology
Doreen Huppert, Dominik Straumann, Mans Magnusson, Ilmari Pyykkö, Thomas Brandt
A common European Community driving licence was established in 1980. However, there are major differences among the countries as regards medical conditions that legally affect driving ability. This article discusses various assessment guidelines for dizzy patients. These range from a total absence of specified binding requirements in Finland or regulations open to clinical interpretation in Switzerland, to inappropriately strict regulations in Germany. We focus on requirements for patients with vestibular disorders in Germany which have been in force since 2014...
March 13, 2018: Journal of Neurology
Doreen Huppert, Thomas Brandt
Seasickness, fear of heights, and adverse effects of alcohol were the major areas where descriptions of vertigo and dizziness were found in Roman, Greek, and Chinese texts from about 730 BC-600 AD. A few detailed accounts were suggestive of specific vestibular disorders such as Menière's attacks (Huangdi Neijing, the Yellow Thearch's Classic of Internal Medicine) or vestibular migraine (Aretaeus of Cappadocia). Further, the etymological and metaphorical meanings of the terms and their symptoms provide fascinating historical insights, e...
March 12, 2018: Journal of Neurology
Michael Strupp, Ludwig Kraus, Franz Schautzer, Dan Rujescu
OBJECTIVES: Since oral betahistine has a very high first-pass effect (ca. 99%), metabolized by monoamine oxidases (MAO), the benefits of a high-dosage betahistine monotherapy were compared with those of a lower dosage of betahistine in combination with the MAO-B inhibitor (MAO-B) selegiline on the frequency of acute attacks of vertigo in patients with Menière's disease (MD). METHODS: Thirteen adults aged 40-75 years (mean 58.9 years; six females) had initially been treated with a high dosage of betahistine dihydrochloride for at least 1 year...
March 12, 2018: Journal of Neurology
Shinji Aoyama, Masahiro Mori, Akiyuki Uzawa, Tomohiko Uchida, Hiroki Masuda, Ryohei Ohtani, Satoshi Kuwabara
BACKGROUND: The risk of developing progressive multifocal leukoencephalopathy in natalizumab-treated multiple sclerosis (MS) patients is related to serum anti-JCV antibody (JCVAb) index. However, the correlation of JCVAb index with other disease-modifying treatments (DMTs) is not well understood. OBJECTIVE: In this study, we investigated the JCVAb seropositivity rate/JCVAb indexes and its correlation with clinical profiles in Japanese MS patients, and the relationship between JCVAb indexes and DMTs...
March 12, 2018: Journal of Neurology
Virginia Devonshire, Richard Phillips, Hilary Wass, Gerald Da Roza, Peter Senior
Alemtuzumab is a humanized anti-CD52 monoclonal antibody approved in more than 65 countries for the treatment of relapsing-remitting multiple sclerosis (RRMS). Compared with subcutaneous interferon-beta-1a, alemtuzumab significantly reduced clinical disease activity and the rate of brain volume loss, and improved disability outcomes in patients with active RRMS who were either treatment naive (CARE-MS I study) or who had an inadequate response (≥ 1 relapse after ≥ 6 months of treatment) to prior therapy (CARE-MS II study)...
March 10, 2018: Journal of Neurology
Duncan McLauchlan, Neil P Robertson
No abstract text is available yet for this article.
March 9, 2018: Journal of Neurology
J S Barajas, D S Peterson
BACKGROUND: Protective steps are critical for fall prevention and are altered in people with Parkinson's disease (PD). Previous work suggests that perturbation training, in which patients are exposed to repeated slips, may improve protective postural responses. However, these studies typically take the average performance of several postural responses before and after training. To reduce falls in the community, training must improve protective stepping after the first perturbation exposure...
March 8, 2018: Journal of Neurology
Alessandro Tessitore, Pietro Marano, Nicola Modugno, Francesco E Pontieri, Nicola Tambasco, Margherita Canesi, Anna Latorre, Leonardo Lopiano, Mariachiara Sensi, Rocco Quatrale, Paolo Solla, Giovanni Defazio, Gabriella Melzi, Anna Maria Costanzo, Giuliana Gualberti, Umberto di Luzio Paparatti, Angelo Antonini
INTRODUCTION: Caring for a person with Parkinson's disease (PD) is associated with an increased risk of psychiatric morbidity and persistent distress. The objective of this study was to describe the burden and the related factors of caregivers of advanced PD (APD) patients either treated with continuous dopaminergic delivery systems or standard therapy. METHODS: This cross-sectional, epidemiologic study conducted in 13 Italian sites enrolled PD patients treated with continuous dopaminergic delivering systems [either levodopa/carbidopa intestinal gel (LCIG) infusion or continuous subcutaneous apomorphine infusion (CSAI)] or continuation of standard of care (SOC) with a caregiver...
March 7, 2018: Journal of Neurology
Carlo Alberto Artusi, Ashar Farooqi, Alberto Romagnolo, Luca Marsili, Roberta Balestrino, Leonard L Sokol, Lily L Wang, Maurizio Zibetti, Andrew P Duker, George T Mandybur, Leonardo Lopiano, Aristide Merola
BACKGROUND: In uncommon tremor disorders, clinical efficacy and optimal anatomical targets for deep brain stimulation (DBS) remain inadequately studied and insufficiently quantified. METHODS: We performed a systematic review of and Relevant articles were identified using the following keywords: "tremor", "Holmes tremor", "orthostatic tremor", "multiple sclerosis", "multiple sclerosis tremor", "neuropathy", "neuropathic tremor", "fragile X-associated tremor/ataxia syndrome", and "fragile X...
March 6, 2018: Journal of Neurology
E C Tallantyre, D H Whittam, S Jolles, D Paling, C Constantinesecu, N P Robertson, A Jacob
B-cell depleting anti-CD20 monoclonal antibody therapies are being increasingly used as long-term maintenance therapy for neuroinflammatory disease compared to many non-neurological diseases where they are used as remission-inducing agents. While hypogammaglobulinaemia is known to occur in over half of patients treated with medium to long-term B-cell-depleting therapy (in our cohort IgG 38, IgM 56 and IgA 18%), the risk of infections it poses seems to be under-recognised. Here, we report five cases of serious infections associated with hypogammaglobulinaemia occurring in patients receiving rituximab for neuromyelitis optica spectrum disorders...
March 6, 2018: Journal of Neurology
Tilman Hottenrott, Elisabeth Schorb, Kristina Fritsch, Rick Dersch, Benjamin Berger, Daniela Huzly, Sebastian Rauer, Ludger Tebartz van Elst, Dominique Endres, Oliver Stich
Some patients with primary central nervous system lymphoma (PCNSL) may initially present with similar clinical, magnetic resonance imaging, and routine cerebrospinal fluid (CSF) findings as those observed in multiple sclerosis (MS). The MRZ reaction (MRZR), composed of the three respective antibody indices (AIs) against measles, rubella, and varicella zoster virus, appears to be the most specific CSF marker for MS. This study aimed to determine whether a positive MRZR and other routine CSF markers help differentiate between MS and PCNSL...
March 6, 2018: Journal of Neurology
Chiara Pane, Teresa Costabile, Adriana Salvati, Dalila Luisa Aurisicchio, Filomena Abate, Angese Liguori, Francesca Paciello, Silvio Peluso, Fiore Manganelli, Giuseppe De Michele, Alessandro Filla, Francesco Saccà
BACKGROUND: During neurological evaluation, dysarthria is not rated using quantitative measures, but rather using a qualitative approach. OBJECTIVE: Aim of our study was to validate and acquire normative values for the PATA Rate Task (PRT), a quantitative test used to measure the severity of dysarthria. METHODS: For the PRT probands are invited to repeat the syllables "PA-TA" as quickly as possible during a 10-s interval. The score consists in the number of correct repetition of both syllables...
March 6, 2018: Journal of Neurology
R Schniepp, J C Boerner, J Decker, K Jahn, T Brandt, Max Wuehr
OBJECTIVES: To examine the mechanism underlying previously reported ameliorating effects of noisy galvanic vestibular stimulation (GVS) on balance performance in patients with bilateral vestibulopathy (BVP) and determine those patients (incomplete versus complete vestibular loss) that might benefit from this intervention. METHODS: Vestibulospinal reflex thresholds were determined in 12 patients with BVP [2 with complete loss (cBVP) and 10 with residual function (rBVP)]...
March 5, 2018: Journal of Neurology
Lorena Lorefice, Giuseppe Fenu, Roberta Pitzalis, Giulia Scalas, Jessica Frau, Giancarlo Coghe, Luigina Musu, Vincenzo Sechi, Maria Antonietta Barracciu, Maria Giovanna Marrosu, Eleonora Cocco
BACKGROUND: Several studies indicated that multiple sclerosis (MS) is frequently associated with other autoimmune diseases. However, it is little known if the coexistence of these conditions may influence the radiologic features of MS, and in particular the brain volumes. OBJECTIVES: To evaluate the effect of autoimmune comorbidities on brain atrophy in a large case-control MS population. METHODS: A group of MS patients affected by a second autoimmune disorder, and a control MS group without any comorbidity, were recruited...
March 5, 2018: Journal of Neurology
Matthias Ertl, M Klimek, R Boegle, T Stephan, M Dieterich
No abstract text is available yet for this article.
March 5, 2018: Journal of Neurology
Nese Celebisoy
HINTS battery involving head impulse test (HIT), nystagmus, and test of skew is the critical bedside examination to differentiate acute unilateral peripheral vestibulopathy from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). The highest sensitivity component of the battery has been reported to be the horizontal HIT, whereas skew deviation is defined as the most specific but non-sensitive sign for PCS. Video-oculography-based HIT (vHIT) may have an additional power in making the differentiation...
March 5, 2018: Journal of Neurology
Stephen Keddie, Ashok Adams, Andrew R C Kelso, Benjamin Turner, Klaus Schmierer, Sharmilee Gnanapavan, Andrea Malaspina, Gavin Giovannoni, Ian Basnett, Alastair J Noyce
BACKGROUND: Whilst the dangers of 'legal highs' have been widely publicised in the media, very few cases of the neurological syndrome associated with the inhalation of nitrous oxide (N2 O) have been reported. Here we set out to raise awareness of subacute degeneration of the spinal cord arising from recreational N2 O use so that formal surveillance programs and public health interventions can be designed. METHODS: Case series documenting the clinical and investigational features of ten consecutive cases of subacute degeneration of the spinal cord presenting to a hospital with a tertiary neurosciences service in East London...
March 3, 2018: Journal of Neurology
F Ali, J L Whitwell, P R Martin, M L Senjem, D S Knopman, C R Jack, V J Lowe, R C Petersen, B F Boeve, K A Josephs
Corticobasal syndrome (CBS) is a phenotypic manifestation of diverse pathologies, including Alzheimer's disease and 4-repeat tauopathies. Predicting pathology in CBS is unreliable and, hence, molecular neuroimaging may prove to be useful. The aim of this study was to assess regional patterns of uptake on [18 F] AV-1451 PET in CBS and determine whether patterns of uptake differ according to beta-amyloid deposition or differing clinical presentations. Fourteen patients meeting criteria for CBS underwent Pittsburgh Compound B (PiB) and [18 F] AV-1451 PET...
March 1, 2018: Journal of Neurology
Mona N Bahouth, R F Gottesman, S L Szanton
BACKGROUND AND PURPOSE: Hydration status at the time of stroke has been acknowledged as an important determinant in early stroke recovery. However, the diagnosis of dehydration, or more accurately, a volume-contracted state, at the time of stroke is challenging since there are currently no consensus diagnostic criteria. In this systematic review, we gather the available evidence about diagnosis and treatment of dehydration after stroke. METHODS: Studies of hospitalized ischemic stroke patients that reported rates of dehydration from January 1997 to March 2017 were screened for inclusion via a systematic search of PubMed, CINAHL, Cochrane, and Scopus using keywords hydration, dehydration, hemodilution, viscosity, volume status, and thirst...
March 1, 2018: Journal of Neurology
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