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Neurologist

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https://www.readbyqxmd.com/read/28248918/stroke-associated-with-varicella-zoster-vasculopathy-a-clinicoradiological-profile-of-3-patients
#1
Pradeep K Maurya, Dinkar Kulshreshtha, Ajai K Singh, Anup K Thacker
INTRODUCTION: Varicella zoster (VZ) vasculopathy is a rare but well recognized cause of stroke. In the absence of zoster rash and infection in remote past, the disease can pose diagnostic challenge. We report 3 cases of anterior circulation stroke occurring in close temporal relation to VZ. Their clinical, radiologic, and angiographic features are discussed. CASE REPORT: Of the 3 patients, 2 had stroke within a span of 4 to 6 weeks of herpes zoster ophthalmicus while the third patient had zoster of cervical dermatome...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248917/ischemic-stroke-in-young-adults-profile-of-sarah-hospital-bras%C3%A3-lia-from-2008-to-2012
#2
Vinícius V A Montanaro, Denise D S Freitas, Miguel C M Ruiz, Eduardo B U Cavalcanti, Patricia B C Marinho, Maria C D N B Freitas, Eleonora M J D Oliveira
INTRODUCTION: The societal and economic impact of ischemic stroke in young adults is considerable. The etiological investigation of ischemic stroke in this population is also challenging. OBJECTIVE: To describe the characteristics of young patients with ischemic stroke admitted to a neurological rehabilitation program in Brazil. METHODS: This transversal retrospective study analyzed data from the electronic health records of 134 patients aged 18 to 45 years with ischemic stroke admitted from 2008 to 2012...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248916/light-induced-hemiplegia-an-atypical-case-of-retinal-steal-syndrome
#3
David Kerek, Sami Al Kasab, Michael U Antonucci, Raymond D Turner, Tanya N Turan
Atherosclerosis affecting the carotid arteries accounts for up to 20% of ischemic strokes 1. The clinical effects of atherosclerotic occlusive disease vary according to multiple factors, one of which is collateral circulation. In response to a chronic decrease in cerebral perfusion from atherosclerotic occlusion, alternative flow pathways, or collaterals, develop in a variety of patterns. In the setting of carotid occlusion, flow from the Circle of Willis, if complete, often comprises the main cerebral collateral network...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248915/-phacing-a-new-cause-of-carotid-artery-dissection
#4
Caterina Kulyk, Filippo Farina, Anna Palmieri, Federica Viaro, Francesco Causin, Anna M Laverda, Claudio Baracchini
INTRODUCTION: Cervical arterial dissection (CAD) is a frequent and preventable cause of ischemic stroke in young patients. Several arguments suggest that genetic and developmental disorders could play an important role as part of a multifactorial predisposition of sporadic CAD.We present 2 cases of young patients with CAD in association with cutaneous lesions and nonatherosclerotic multivessel arteriopathy. CASE REPORTS: Our first patient was a 17-year-old white girl with sudden onset of weakness in her right upper limb...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248914/creutzfeldt-jakob-disease-presenting-as-stroke-a-case-report-and-systematic-literature-review
#5
REVIEW
Divya K Sharma, Mike Boggild, Annemarie W van Heuven, Richard P White
BACKGROUND: Creutzfeldt-Jacob disease (CJD) is a human prion disease generally characterized by subacute changes in behavior and intellectual function, often followed by ataxia, vision changes, and myoclonus. Ten percent of cases may present atypically, both symptomatically and in respect to initial investigations. METHODS: We report a case of CJD mimicking acute stroke and review all similar cases in the magnetic resonance imaging era reported in English, identified through a PubMed and SCOPUS search...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248913/pitfalls-and-rewards-for-implementing-ocular-motor-testing-in-acute-vestibular-syndrome-a-pilot-project
#6
Oana M Dumitrascu, Sam Torbati, Mourad Tighiouart, David E Newman-Toker, Shlee S Song
OBJECTIVES: Isolated acute vestibular syndrome (iAVS) presentations to the emergency department (ED) pose management challenges, given the concerns for posterior circulation strokes. False-negative brain imaging may erroneously reassure clinicians, whereas HINTS-plus examination outperforms imaging to screen for strokes in iAVS. We studied the feasibility of implementing HINTS-plus testing in the ED, aiming to reduce neuroimaging in patients with iAVS. METHODS: We launched an institutional Quality Improvement initiative, using DMAIC methodology...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28248912/pres-and-epilepsy-a-potential-long-term-consequence-of-a-reversible-syndrome
#7
Ryan T Fitzgerald, Jarod Santoro, Archana Hinduja, Rohan S Samant, Manoj Kumar, Edgardo J Angtuaco
Epilepsy is very rarely attributed to posterior reversible encephalopathy syndrome (PRES). We report the case of a previously healthy 21-year-old who developed epilepsy with mesial temporal sclerosis following an episode of PRES related to a complicated Cesarean delivery. Neuroimaging at the time of PRES and 3 months after revealed the development of unilateral hippocampal volume loss following resolution of acute PRES-related brain edema. We discuss the incidence and importance of "non-reversible" sequelae of PRES and their implications for patient care...
March 2017: Neurologist
https://www.readbyqxmd.com/read/28009771/spontaneous-spinal-subdural-hematoma
#8
REVIEW
Marlijn H de Beer, Marjolein M Eysink Smeets, Hille Koppen
OBJECTIVE: Spinal subdural hematomas (SSDHs) are rare. Causes are (1) posttraumatic, (2) iatrogenic (following surgery or lumbar puncture), (3) spontaneous including underlying malformations or coagulation deficits. With a systematic review of literature we want to shed light on the last group: symptomatology, etiology, treatment and outcome will we discussed. METHODS: Systematic review of literature on PubMed for cases of acute nontraumatic noniatrogenic SSDHs in adults (≥18 y of age)...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009770/fatal-morvan-syndrome-associated-with-myasthenia-gravis
#9
Madhu Nagappa, Anita Mahadevan, Sanjib Sinha, Parayil S Bindu, Pavagada S Mathuranath, Cheminikara Bineesh, Rose D Bharath, Arun B Taly
INTRODUCTION: Morvan syndrome is a rare and complex autoimmune disorder affecting multiple sites of neuraxis. CASE REPORT: We present fulminant Morvan syndrome, developing on a background of chronic myasthenia gravis. A 54-year-old gentleman presented with fluctuating ophthalmoplegia and proximal muscles weakness of 7 years duration that remitted with pyridostigmine and prednisolone. He developed insomnia of 2 months duration, worsening of myasthenic symptoms and respiratory distress, dysautonomia, encephalopathy, and peripheral nerve hyperexcitability...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009769/movement-disorders-induced-by-the-atypical-antipsychotic-aripiprazole
#10
Karim Selfani, Valérie L Soland, Sylvain Chouinard, Philippe Huot
OBJECTIVES: Aripiprazole is an antipsychotic that acts as a partial agonist at dopamine D2 receptors. Because of its partial agonist activity, it was believed that aripiprazole would be less susceptible than typical antipsychotics to induce extrapyramidal side effects. However, a few case-reports and case-series detailing aripiprazole-induced movement disorders have been published, suggesting that aripiprazole-induced movement disorders may arise. Here, we seek to report further cases of aripiprazole-induced movement disorders to raise the awareness of clinicians on this adverse effect...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009768/thrombus-in-transit-a-potentially-life-threatening-complication-of-cerebral-sinus-thrombosis
#11
Martina Petracca, Rosalinda Calandrelli, Aldobrando Broccolini, Pietro Caliandro, Giacomo Della Marca, Giovanni Frisullo, Roberta Morosetti, Paolo Profice, Priscilla Lamendola, Faustino Pennestrì, Fabio Pilato
We report the case of a 41-year-old, 7-weeks-pregnant patient, presenting with headache and generalized seizure due to cerebral venous thrombosis complicated by jugular thrombosis and thrombus dislocation into right cardiac cavities. The patient was treated with intravenous heparin, and underwent embolectomy in extracorporeal circulation. This case illustrates the variability of cerebral venous thrombosis progression and a potentially life-threatening condition even during anticoagulant therapy.
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009767/transient-sensory-recovery-in-stroke-patients-after-pulsed-radiofrequency-electrical-stimulation-on-dorsal-root-ganglia-a-case-series
#12
Seza Apiliogullari, Ilknur A Gezer, Funda Levendoglu
INTRODUCTION: The integrity of the somatosensory system is important for motor recovery and neuroplasticity after strokes. Peripheral stimulation or central stimulation in patients with central nervous system lesions can be an effective modality in improving function and in facilitating neuroplasticity. CASE REPORT: We present 2 hemiplegic cases with sensory motor deficit and the result of the pulsed radiofrequency (PRF) electrical stimulation to the dorsal root ganglia...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009766/urgent-bypass-surgery-following-failed-endovascular-treatment-in-acute-symptomatic-stroke-patient-with-mca-occlusion
#13
Chang Yeob Lee, Chang Hyun Kim, Chang-Young Lee, Sung-Il Sohn, Jeong-Ho Hong
INTRODUCTION: Although the benefits of extracranial-intracranial bypass surgery remain controversial, there is some surgical rationale for the augmentation of cerebral blood flow in cases of acute ischemic stroke with hemodynamic instability. CASE REPORT: We report a case of a 62-year-old woman who suddenly developed right hemiplegia and global aphasia. Initial magnetic resonance imaging and magnetic resonance angiography revealed a small acute ischemic lesion in left parietal lobe with occlusion at the left middle cerebral artery...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009765/autoimmune-encephalitides-a-broadening-field-of-treatable-conditions
#14
REVIEW
Bernadette Kalman
BACKGROUND: Neurology has been continuously transforming by the refinement of molecular diagnostics and the development of disease-modifying treatments. The discovery of new antibody markers has elucidated the pathogenesis, provided the means of diagnostics, and offered cure or treatment for several immune-mediated neurological and neuropsychiatric disorders. The identification of pathogenic and marker autoantibodies has also facilitated defining the associated phenotypic spectra and the overlap among the phenotypes linked to individual immune markers...
January 2017: Neurologist
https://www.readbyqxmd.com/read/27801773/chemotherapy-associated-posterior-reversible-encephalopathy-syndrome-a-case-report-and-review-of-the-literature
#15
REVIEW
Joan How, Margaret Blattner, Susan Fowler, Andrea Wang-Gillam, Suzanne E Schindler
INTRODUCTION: There are increasing reports of posterior reversible encephalopathy syndrome (PRES) associated with the use of chemotherapeutic agents. Recognition of PRES is crucial given its reversibility with appropriate supportive management. We report a patient presenting with PRES after treatment with Rituximab, Cyclophosphamide, Hydroxydaunorubicin/Adriamycin, Oncovin/Vincristine, Prednisone (R-CHOP) and intrathecal methotrexate. We also perform a systematic review of the literature on chemotherapy-associated PRES...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801772/cranial-nerve-vi-palsy-as-the-main-clinical-manifestation-of-neurosarcoidosis
#16
Zaid A Al-Qudah, Hussam A Yacoub, Nizar Souayah
INTRODUCTION: Sarcoidosis is a chronic, systemic, inflammatory disorder that is characterized by the formation of noncaseating granulomas. Patients may present with cranial nerve palsy, paresthesia, paresis, pyramidal signs, progressive cognitive decline, urinary retention, seizures, or hypothalamic-pituitary syndrome. Although the diagnosis of neurosarcoidosis can be challenging, neurological manifestations of sarcoidosis occur more frequently than previously described. CASE REPORT: A 23-year-old African American man presented to our emergency department with diplopia, which was worsened on left horizontal gaze...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801771/asymmetric-acute-motor-axonal-neuropathy-with-unilateral-tongue-swelling-mimicking-stroke
#17
Man Sum Chi, Shi Hon Ng, Lok Yiu Chan
A 60-year-old man presented with acute onset of left hemiparesis and left hypoglossal nerve palsy with ipsilateral tongue swelling. He then progressed to tetraparesis in a few days. Cerebrospinal fluid showed cell protein dissociation. A nerve conduction study showed motor axonal neuropathy with sensory sparing. A subsequent blood test revealed anti-GD1b IgG antibody positivity. He was diagnosed to have acute motor axonal neuropathy (AMAN) and treated with a course of intravenous immunoglobulin with slow improvement...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801770/dehydration-status-is-associated-with-more-severe-hemispatial-neglect-after-stroke
#18
Mona N Bahouth, Zainab Bahrainwala, Argye E Hillis, Rebecca F Gottesman
BACKGROUND: Many stroke patients are clinically dehydrated at the time of hospital presentation, which could lead to an increase in blood viscosity and alteration in cerebral perfusion. Impaired cerebral perfusion can cause hemispheric dysfunction, which can be rapidly quantified with bedside tests of hemispatial neglect. We hypothesized that hospitalized patients with laboratory markers consistent with dehydration or a volume contracted state (VCS) would have more severe cerebral dysfunction defined by greater degree of neglect...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801769/adult-onset-opsoclonus-myoclonus-syndrome-associated-with-ganglionic-acetylcholine-receptor-autoantibody
#19
Jonathan R Galli, Stacey L Clardy, M Mateo Paz Soldán
INTRODUCTION: Opsoclonus-myoclonus syndrome (OMS) may have a toxin induced, parainfectious, or paraneoplastic etiology. Several autoantibodies have been associated with adult-onset OMS, most commonly antineuronal nuclear antibody 2 (Ri), and it is most frequently associated with breast or small cell lung cancer. The nicotinic ganglionic acetylcholine receptor autoantibody (α3-AChR Ab) has not been described in association. CASE REPORT: A 46-year-old woman was evaluated for symptoms of oscillopsia, tremor, gait imbalance, and mild cognitive deficits that began 6 weeks prior...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801768/severe-relapse-after-cessation-of-immunosuppressive-therapy-in-a-patient-with-neuromyelitis-optica-spectrum-disorder
#20
Jae-Won Hyun, Gayoung Kim, Yeseul Kim, In Hye Jeong, Su-Hyun Kim, Ho Jin Kim
INTRODUCTION: The optimal duration of immunosuppressive therapy (IT) for neuromyelitis optica spectrum disorder (NMOSD) has not been established. Here, we report a case of severe relapse after early cessation of IT. CASE REPORT: A 32-year-old woman presented with a 2-week history of intractable vomiting and hiccups followed by quadriplegia with respiratory insufficiency. Spinal cord MRI showed longitudinally extensive transverse myelitis (LETM) and aquaporin-4-immunoglobulin-G (AQP4-IgG) was positive...
November 2016: Neurologist
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