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https://www.readbyqxmd.com/read/27801773/chemotherapy-associated-posterior-reversible-encephalopathy-syndrome-a-case-report-and-review-of-the-literature
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27348142/sudden-unexpected-death-in-epilepsy-sudep-are-all-your-patients-informed
#14
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
https://www.readbyqxmd.com/read/27348141/mitochondrial-encephalopathy-and-optic-neuropathy-due-to-m-10158-mt-nd3-complex-i-mutation-presenting-in-an-adult-patient-case-report-and-review-of-the-literature
#15
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
https://www.readbyqxmd.com/read/27348140/severe-symptomatic-self-limited-unilateral-dbs-lead-edema-following-bilateral-subthalamic-nucleus-implantation-case-report-and-review-of-the-literature
#16
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
https://www.readbyqxmd.com/read/27348139/successful-corticosteroid-treatment-of-refractory-spontaneous-vasoconstriction-of-extracranial-internal-carotid-and-coronary-arteries
#17
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
https://www.readbyqxmd.com/read/27348138/establishing-a-vestibular-migraine-diagnosis-questionnaire-and-testing-its-validity
#18
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
https://www.readbyqxmd.com/read/27119278/cervical-artery-dissection-spotting-the-zebra-among-the-horses
#19
Shriram Varadharajan, Jitender Saini, Sarbesh Tiwari, Arun K Gupta
No abstract text is available yet for this article.
May 2016: Neurologist
https://www.readbyqxmd.com/read/27119277/refractory-mononeuritis-multiplex-due-to-hepatitis-c-infection-and-cryoglobulinemia-efficient-response-to-rituximab
#20
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
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