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Practical Neurology

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https://www.readbyqxmd.com/read/27903766/sudden-unexpected-death-in-epilepsy-measures-to-reduce-risk
#1
REVIEW
Brendan Mclean, Rohit Shankar, Jane Hanna, Caryn Jory, Craig Newman
This review looks at the strategies that may help to reduce the risk of sudden unexpected death in epilepsy beyond that of trying to achieve seizure cessation, which is not possible for up to 30% of patients with epilepsy. These strategies include seizure safety checklists, mobile phone technology, telehealth and various devices currently available or in development. We highlight interventions where there is evidence of benefit, and draw attention for the need both to involve patients with epilepsy in risk reduction and to improve communication with those at risk...
November 30, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27903765/the-mini-mental-state-examination-pitfalls-and-limitations
#2
Emma Devenney, John R Hodges
No abstract text is available yet for this article.
November 30, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27903764/epilepsy-and-music-practical-notes
#3
REVIEW
M Maguire
Music processing occurs via a complex network of activity far beyond the auditory cortices. This network may become sensitised to music or may be recruited as part of a temporal lobe seizure, manifesting as either musicogenic epilepsy or ictal musical phenomena. The idea that sound waves may directly affect brain waves has led researchers to explore music as therapy for epilepsy. There is limited and low quality evidence of an antiepileptic effect with the Mozart Sonata K.448. We do not have a pathophysiological explanation for the apparent dichotomous effect of music on seizures...
November 30, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27895189/how-to-do-it-bedside-ultrasound-to-assist-lumbar-puncture
#4
Stefan Williams, Modar Khalil, Asoka Weerasinghe, Anu Sharma, Richard Davey
For many neurologists, lumbar puncture is the only practical procedure that they undertake on a regular basis. Although anaesthetists and emergency physicians routinely employ ultrasound to assist lumbar puncture, neurologists do not. In this article, we outline the technique that we use for an ultrasound-assisted lumbar puncture, together with the evidence base that suggests that ultrasound has significant benefits. We aim to raise awareness of a method that can make lumbar puncture more likely to succeed and to be more comfortable for the patient...
November 28, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27888234/neuromyelitis-optica-presenting-as-acute-bilateral-ptosis
#5
Purwa Joshi, Jeremy Lanford, David Bourke
Acute bilateral ptosis can be a hallmark of several serious neurological conditions. We present the first case of acute bilateral near-complete ptosis secondary to neuromyelitis optica spectrum disorder. We suggest that clinicians should consider this disorder among the differential diagnosis of acute bilateral ptosis, especially if there are other brainstem signs.
November 25, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27888233/neurological-letter-from-cape-town
#6
Jonathan Carr
No abstract text is available yet for this article.
November 25, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27872170/spinal-cord-infarction-after-cocaine-use
#7
John Williamson, Michael Bonello, Matthew Simpson, Anu Jacob
No abstract text is available yet for this article.
November 21, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27872169/myelopathy-chameleons-and-mimics
#8
Lionel Ginsberg
The diagnosis of spinal cord disease may be delayed or missed if the presentation does not conform to the expected pattern of a symmetrical spastic paraparesis with sphincter dysfunction and a sensory level. This may occur when a myelopathy has yet to evolve fully, or is highly asymmetrical, as in Brown-Séquard syndrome. Other potential distractions include fluctuating symptoms, as may accompany spinal cord demyelination, and pseudoneuropathic features, as seen acutely in spinal shock and in the chronic setting with some high cervical cord lesions...
November 21, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27811128/a-hill-walker-with-long-chains
#9
David P Breen, Victoria Stinton, Rajith N De Silva
No abstract text is available yet for this article.
November 3, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27811127/collet-sicard-syndrome-a-rare-but-important-presentation-of-internal-jugular-vein-thrombosis
#10
Shermyn Neo, Kim En Lee
We describe a rare neurological presentation of internal jugular vein thrombosis induced by central venous catheter placement in a patient with cancer. A 71-year-old man gave a 3-week history of dysphagia and dysarthria with left-sided neck pain and headache. He was receiving chemotherapy for appendiceal adenocarcinoma. On examination, he had left 9th-12th cranial neuropathies, manifesting as voice hoarseness, decreased palatal movement, absent gag reflex, weakness of scapular elevation and left-sided tongue wasting...
November 3, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27807107/asterixis
#11
Mark A Ellul, Timothy J Cross, Andrew J Larner
Adams and Foley described asterixis in the 1940s in patients with hepatic encephalopathy, but it has since been associated with a wide range of potential causes, both in neurology and general medicine. Here, we review the history, characteristics and clinical significance of this important clinical sign.
November 2, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27803046/cd8-encephalitis-a-severe-but-treatable-hiv-related-acute-encephalopathy
#12
Angeliki Zarkali, Nikos Gorgoraptis, Robert Miller, Laurence John, Ashirwad Merve, Stefanie Thust, Rolf Jager, Dimitri Kullmann, Orlando Swayne
Rapidly progressive encephalopathy in an HIV-positive patient presents a major diagnostic and management challenge. CD8+ encephalitis is a severe but treatable form of HIV-related acute encephalopathy, characterised by diffuse perivascular and intraparenchymal CD8+ lymphocytic infiltration. It can occur in patients who are apparently stable on antiretroviral treatment and probably results from viral escape into the central nervous system. Treatment, including high-dose corticosteroids, can give an excellent neurological outcome, even in people with severe encephalopathy and a very poor initial neurological status...
November 1, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27777325/remarkable-motor-recovery-after-riboflavin-therapy-in-adult-onset-brown-vialetto-van-laere-syndrome
#13
James A Bashford, Fahmida A Chowdhury, Chris E Shaw
The clinical diagnosis of Brown-Vialetto-Van Laere syndrome in this woman with rapidly progressive pontobulbar palsy led to empirical high-dose oral riboflavin (1200 mg/day) therapy. This resulted in a dramatic improvement in her motor function from being anarthric, dysphagic, tetraparetic and in ventilatory failure to living independently with mild dysarthria and distal limb weakness. DNA sequencing of the SLC52A3 gene found compound heterozygous C-terminus mutations, V413A1/D461Y, consistent with recent reports of mutations within the riboflavin transporter genes (SLC52A2 and SLC52A3) in this condition...
October 24, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27697916/ruptured-intracranial-dermoid-cyst
#14
David J T McArdle, Sumit J Karia
No abstract text is available yet for this article.
October 3, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27679862/telephone-review-for-people-with-epilepsy
#15
Phil Smith
Telephone consultations are well suited to epilepsy review, particularly for those ineligible to drive. Careful patient selection and a courtesy call beforehand, by an administrator, increases efficiency and saves patient anxiety and clinician time. This paper gives advice based upon the author's experience of telephone review of patients with epilepsy.
September 27, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27679861/open-eyes-to-sensory-testing
#16
Phil Smith
No abstract text is available yet for this article.
September 27, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27671993/steak-and-stupor-seizures-and-e-coli-o157-infection
#17
Sherri A Braksick, Jennifer M Martinez-Thompson, Eelco F M Wijdicks
Neurological complications of haemolytic uraemic syndrome (HUS) include altered states of consciousness, seizures, ischaemic stroke and encephalopathy. Adult-onset HUS is uncommon, and there is only a limited literature reporting neurological complications in this population. We report an adult with Shiga toxin-associated HUS complicated by focal-onset non-convulsive status epilepticus, who made a full neurological recovery.
September 26, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27660311/clinical-challenges-in-the-diagnosis-and-management-of-postural-tachycardia-syndrome
#18
Pearl K Jones, Brett H Shaw, Satish R Raj
Postural tachycardia syndrome (POTS) is a multifactorial clinical syndrome defined by an increase in heart rate of ≥30 bpm on standing from supine position (or ≥40 bpm in children). It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve when in supine position. Patients often have additional symptoms including severe fatigue and difficulty concentrating. There are several possible pathophysiologic mechanisms including hypovolaemia, small-fibre peripheral neuropathy and hyperadrenergic states...
September 22, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27651498/ovarioleukodystrophy-due-to-eif2b5-mutations
#19
R T Ibitoye, S A Renowden, H J Faulkner, N J Scolding, C M Rice
Ovarioleukodystrophy-the co-occurrence of leukodystrophy and premature ovarian failure-is a rare presentation now recognised to be part of the clinical spectrum of vanishing white matter disease. We describe a woman with epilepsy and neuroimaging changes consistent with leukoencephalopathy who presented with non-convulsive status epilepticus after starting hormone replacement therapy in the context of premature ovarian failure. Genetic testing confirmed her to be a compound heterozygote for EIF2B5 mutations; the gene encodes a subunit of eukaryotic translation initiation factor 2B...
September 20, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27613277/acute-demyelination-following-radiotherapy-for-glioma-a-cautionary-tale
#20
Marina Milic, Jeremy H Rees
Radiotherapy is the mainstay of treatment after surgery for high-grade gliomas and is usually well tolerated. Radiation toxicity in the brain is usually classified according to the timing of side effects in relation to treatment, as either acute (during radiotherapy), early delayed (within 12 weeks of radiotherapy) or late delayed (months to years after radiotherapy). We report two cases of young women who developed severe acute demyelination within 4 months of radiotherapy for glioma, one of whom had a previous history of transverse myelitis...
September 9, 2016: Practical Neurology
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