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Neurologist

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https://www.readbyqxmd.com/read/28009771/spontaneous-spinal-subdural-hematoma
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27801767/pontine-warning-syndrome-a-chameleon-of-ischemic-stroke
#14
Alejandro Enriquez-Marulanda, Pablo Amaya-Gonzalez, Jorge L Orozco
INTRODUCTION: Crescendo transient ischemic attacks or "Stroke Warning Syndromes" consist of stereotyped frequent short-lasting episodes of focal neurological deficits. This is explained by intermittent hypoperfusion of the vascular territory of terminal arteries with insufficient collateral flow, presenting a high risk for subsequent infarction. Pontine warning syndrome (PWS) is a subtype of this atypical presentation of stroke/transient ischemic attack and is considered a challenge for diagnosis...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801766/cessation-of-smoking-and-alcohol-addiction-following-thalamic-hemorrhage
#15
Fatima Najeeb, Brian Silver, Muhib Khan
INTRODUCTION: We describe a case of thalamic intracerebral hemorrhage leading to cessation of smoking. CASE REPORT: A 53-year-old female presented to the emergency department with right-sided weakness and dysarthria. Initial systolic blood pressure was 220 mm Hg. Computed tomography scan showed a left thalamic hemorrhage with associated edema and hemorrhage extending into the left lateral and third ventricle. She recovered uneventfully and was discharged to inpatient rehabilitation and eventually transitioned home...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27801765/should-we-treat-a-patient-s-symptoms-or-angiography-image-in-tia-two-case-reports
#16
Hana Karpatová, Jana Jankových, Robert Mikulík
OBJECTIVES: Data on vascular status in the first hours after onset of transient ischemic attack (TIA) and its clinical significance are missing. Also, it is not known whether arterial occlusion, if present in TIA, should be the target for revascularization. We present 2 patients to demonstrate that TIA can be due to acute major intracranial arterial occlusion and to show how such arterial occlusion may affect the outcome. CASE REPORTS: Two patients (54 and 63 years old) were diagnosed with TIA and at the same time had occlusion of the middle cerebral artery...
November 2016: Neurologist
https://www.readbyqxmd.com/read/27564078/transient-impact-of-rituximab-in-h1n1-vaccination-associated-narcolepsy-with-severe-psychiatric-symptoms
#17
Tomi Sarkanen, Reija Alén, Markku Partinen
INTRODUCTION: Narcolepsy type 1 is an organic sleep disorder caused by the destruction of hypocretin producing neurons in hypothalamus. In addition to daytime sleepiness, the spectrum and severity of symptoms are very variable. Psychiatric comorbidity and phenomena resembling psychotic symptoms are also common. Current treatment options for narcolepsy are symptomatic but there are few case reports of positive effect of immunotherapy. We report a very severely affected young boy treated with rituximab (RXB)...
September 2016: Neurologist
https://www.readbyqxmd.com/read/27564077/palatal-and-oromandibular-tremor-secondary-to-degenerative-olivary-hypertrophy-after-ependymoma-surgery
#18
Alberto Lozano-Ros, Jahir A Miranda-Acuña, Milagros Hidalgo-de la Cruz, Pilar Fernández-García, Andreu Massot-Tarrús, José M García-Domínguez
Palatal tremor (PT) is a rare movement disorder that involves pharynx, tongue, and other facial muscles. Symptomatic PT is due to lesions on the dentate-rubro-olivary pathways. We present an illustrative case of PT due to degenerative olivary hypertrophy after ependymoma surgery.
September 2016: Neurologist
https://www.readbyqxmd.com/read/27564076/extensive-postradiation-ocular-and-diffuse-cranial-neuromyotonia-mimicking-myasthenia-gravis
#19
Todd A Hardy, Andrew W Lee, Con Yiannikas, Celia S Chen, Stephen W Reddel
BACKGROUND: Ocular neuromyotonia is a rare, but well-recognized, complication of cranial irradiation. CASE REPORT: Using figures and videos, we report a 52-year-old man with extensive ocular, brainstem, and lower cranial nerve neuromyotonia postradiation therapy for a fourth ventricle glioma who, in the context of an apparently positive edrophonium test, was initially misdiagnosed with myasthenia gravis. CONCLUSIONS: This is the first case of postirradiation neuromyotonia to be reported with such extensive cranial nerve and brainstem involvement...
September 2016: Neurologist
https://www.readbyqxmd.com/read/27564075/neurological-management-of-von-hippel-lindau-disease
#20
REVIEW
Trent S Hodgson, Sarah M Nielsen, Maciej S Lesniak, Rimas V Lukas
Von Hippel-Lindau disease is a genetic condition due to mutation of the Von Hippel-Lindau gene, which leads to an increased risk in the development of hemangioblastomas of the brain and spinal cord. The pathophysiology of disease and its clinical manifestations, as they pertain to the general neurologist, are discussed. Therapeutic management of central nervous system hemangioblastomas ranging from neurosurgical resection, radiation therapy, and systemic therapies is reviewed.
September 2016: Neurologist
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