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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
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
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
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
I Vanessa Marin Collazo, William O Tatum
Sudden unexpected death in epilepsy (SUDEP) is a devastating direct epilepsy-related cause of death. Although its occurrence has some risk factors, it is unanticipated and very traumatic to the families of affected patients. Effective preventive measures for SUDEP are lacking; therefore, efforts are directed at modifiable risk factors. The majority of caregivers of patients with epilepsy and SUDEP wish they would have known more about the topic before the terminal event. SUDEP is a difficult topic for physicians and clearly even more challenging to discuss with patients and caregivers...
July 2016: Neurologist
Ivana Vodopivec, Tracey A Cho, Joseph F Rizzo, Matthew P Frosch, Katherine B Sims
INTRODUCTION: Establishing a diagnosis of mitochondrial disease in adults remains a clinician's challenge. We report a case of syndrome reminiscent of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) in an adult patient who carries m.10158T>C mutation in complex I respiratory chain gene MT-ND3 (mitochondrially encoded NADH dehydrogenase 3). CASE REPORT: This 26-year-old man from Thailand presented with new-onset headaches, seizures, stroke-like episodes, and poor vision due to optic neuropathy and cortical blindness...
July 2016: Neurologist
Carter S Gerard, Leo Verhagen Metman, Gian Pal, Jessica Karl, Sepehr Sani
INTRODUCTION: Symptomatic edema around a deep-brain stimulation (DBS) lead is a rare complication of DBS surgery. Although this phenomenon is not fully understood, clinical presentation of DBS lead edema can be severe enough to prompt treatment. There is a paucity of literature on the clinical course and treatment of DBS lead edema. CASE REPORT: We present a 65-year-old man with Parkinson disease who developed unilateral DBS lead edema after bilateral subthalamic nucleus lead placement...
July 2016: Neurologist
Mariko Takeuchi, Kozue Saito, Katsufumi Kajimoto, Kazuyuki Nagatsuka
INTRODUCTION: Spontaneous vasoconstriction of the extracranial internal carotid artery (SVEICA) is a rare cause of cerebral infarction. Most patients with SVEICA suffer recurrent attacks of vasoconstriction. The standard treatment for this condition has not been established and its long-term prognosis is unclear. CASE REPORT: A 25-year-old man with a history of refractory vasospasm angina presented with transient alternating hemiplegia in both the right and left side...
July 2016: Neurologist
Nese Celebisoy, Hale Karapolat, Figen Gokcay, Cem Bilgen, Gulnur Ozgen, Tayfun Kirazli, Timur Kose
OBJECTIVE: To establish a questionnaire and check its validity and reliability for the diagnosis of vestibular migraine in patients reporting recurrent vestibular symptoms. BACKGROUND: Vestibular migraine is the most common cause for recurrent spontaneous vertigo. However, it is still underdiagnosed needing validated and reliable screening instruments such as ID Migraine, that can be used in primary care settings, dizziness, and migraine clinics. MATERIALS AND METHOD: Sixty consecutive patients referred to our dizziness clinic with recurring vestibular symptoms were given a questionnaire that they filled in, consisting of 8 short and simple questions...
July 2016: Neurologist
Shriram Varadharajan, Jitender Saini, Sarbesh Tiwari, Arun K Gupta
No abstract text is available yet for this article.
May 2016: Neurologist
Cristiane N Soares
BACKGROUND: Mononeuritis multiplex due to hepatitis C infection and cryoglobulinemia has no specific treatment guidelines. Despite the favorable evolution of the liver disease after treatment with interferon and ribavirin, neurological symptoms might not respond very efficiently to antiviral therapy. CASE REPORT: We report the case of a 50-year-old woman, with a mononeuritis multiplex related to cryoglobulinemia and hepatitis C virus infection, who was treated with rituximab...
May 2016: Neurologist
César F Romero, José L Soto-Hernández, Cecilia Bonnet, Graciela Cárdenas
INTRODUCTION: Currently, AIDS is the worldwide leading cause of death among 15- to 59-year-old individuals. This trend has had particularly harsh social and economic consequences in sub-Saharan Africa, where more than half of global AIDS deaths take place. In the United States, an estimated 1.2 million people are infected with HIV. In 2012, a worldwide estimate of 1.7 million deaths due to AIDS-related causes was reported.About 10% to 12% of all AIDS patients will develop intracranial tumors...
May 2016: Neurologist
Mary A O'Neal, Barbara A Dworetzky
Patients with functional neurological symptoms are commonly seen in neurological practice. They have significant disability that may not improve and their care is costly. This article will use case histories to underline the important aspects of caring for patients with functional neurological disorders, including important features of the history, examination, neurobiology, appropriate investigations, and an approach to treatment.
May 2016: Neurologist
Jayantee Kalita, Satish Chandra, Bishwanath Kumar, Vikas Bansal, Usha K Misra
OBJECTIVE: The prognosis of cerebral venous sinus thrombosis (CVST) may be dependent on underlying causes and magnetic resonance imaging findings. We report the clinical, laboratory, and radiologic spectrum, and outcome of consecutive patients with CVST. METHODS: Consecutive patients with CVST over the last 15 years were subjected to detailed history, clinical examination, and laboratory tests as per fixed protocol. The diagnosis of CVST was based on MR venography...
May 2016: Neurologist
Michele Pistacchi, Manuela Gioulis, Sandro Zambito Marsala
No abstract text is available yet for this article.
March 2016: Neurologist
Zhongxing Peng-Chen, Amanda Thompson, Ramon L Rodriguez
Anterocollis is a type of cervical dystonia characterized by simultaneous and repetitive antagonist muscles contractions, resulting in abnormal neck flexion. It was described with a frequency of 6.8% from 399 patients with diagnosis of cervical dystonia and usually coexists with torticollis and/or laterocollis, as mixed cervical dystonia patterns. Botulinum toxin is usually a practical and effective treatment for cervical dystonia. The target muscles to inject in anterocollis are usually sternocleidomastoid and scalene muscles...
March 2016: Neurologist
Nesrin Helvaci Yilmaz, Burcu Polat, Lutfu Hanoglu
INTRODUCTION: Pharmacotherapy and thalamic stimulation are the most accepted methods used for the treatment of essential tremor (ET). Transcranial direct current stimulation (tDCS) is a noninvasive method for brain stimulation, especially to treat pain, cerebrovascular disease, and depression. tDCS applied to the cerebellar region has been shown to exhibit a modulating effect on the excitability of Purkinje cells and to cause primary motor cortex inhibition through the regulation of synaptic dentato-thalamo-cortical excitability...
March 2016: Neurologist
Pasquale F Finelli, Andrew L McCabe
Considering computers are more efficient at processing large amounts of information than the human brain, speaks to the need to explore more intelligent computer-assisted diagnostic approaches. Two diagnostic checklist programs, one for single key term entry (NeurologyINDEX), and another, with more advanced algorithms to process multiple key terms and perform additional functions (NeurologicDx) are discussed. Both programs are internet based, access the same database, and are designed to generate diagnostic checklists and disease profiles accessible with hand-held or other computer device...
March 2016: Neurologist
Lauren N Bowen, David F Moore, Michael S Okun
BACKGROUND: Given the recent interest in blast injury spurred by returning soldiers from overseas conflicts, we sought to research the early historical descriptions of blast injuries and their treatments. Consideration was given to specific descriptions of survivors of closed head injury and their treatment. METHODS: A review of the medical and nonmedical literature was undertaken, with particular emphasis on pre-1800 descriptions of volcanic eruptions and mining accidents...
March 2016: Neurologist
Kristin E Yu, Justin M Murphy, Jack W Tsao
Because of the sharp increase in the number of military personnel exposed to explosive blasts in combat, research has been dedicated toward understanding the impact of explosions on the brain. It is important to consider that potential injuries that military personnel sustain may be both in the form of physical injury as well as "invisible" neuronal and psychological damage. Since the inception of the study of blast science in the Medieval and Renaissance eras, significant improvements have been made in the historical record keeping and biomedical analysis of blast injuries...
March 2016: Neurologist
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