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https://www.readbyqxmd.com/read/28931621/minimal-clinically-important-difference-for-safe-and-simple-novel-acute-ischemic-stroke-therapies
#1
Jessica S Cranston, Brett D Kaplan, Jeffrey L Saver
BACKGROUND AND PURPOSE: Determining the minimal clinically important difference (MCID) is essential for evaluating novel therapies. For acute ischemic stroke, expert surveys have yielded MCIDs that are substantially higher than the MCIDs observed in actual expert behavior in guideline writing and clinical practice, potentially because of anchoring bias. METHODS: We administered a structured, internet-based survey to a cross-section of academic stroke neurologists in the United States...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28930814/neurologic-and-functional-morbidity-in-critically-ill-children-with-bronchiolitis
#2
Steven L Shein, Katherine N Slain, Jason A Clayton, Bryan McKee, Alexandre T Rotta, Deanne Wilson-Costello
OBJECTIVES: Neurologic and functional morbidity occurs in ~30% of PICU survivors, and young children may be at particular risk. Bronchiolitis is a common indication for PICU admission among children less than 2 years old. Two single-center studies suggest that greater than 10-25% of critical bronchiolitis survivors have neurologic and functional morbidity but those estimates are 20 years old. We aimed to estimate the burden of neurologic and functional morbidity among more recent bronchiolitis patients using two large, multicenter databases...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28926420/seronegative-paraneoplastic-limbic-encephalitis-associated-with-thymoma
#3
Jaime Toro, David Cuellar-Giraldo, Alejandra Duque, Karla Minota, Jorge Patiño, Manuel García
Paraneoplastic limbic encephalitis is an autoimmune syndrome characterized by the acute or subacute onset of encephalopathy, memory loss, confusion, temporal lobe seizures, and behavioral and mood changes. Although most patients with paraneoplastic limbic encephalitis have antineuronal antibodies, advances in the field now permit the diagnosis without autoantibody test results. In this case illustrating the new diagnostic criteria, we report a 70-year-old woman who was brought to the emergency room after the acute onset of cognitive impairment, altered mental status, and choreoathetoid movements...
September 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/28914735/palliative-care-in-neuromuscular-diseases
#4
Marianne de Visser, David J Oliver
PURPOSE OF REVIEW: Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. Neuromuscular disorders (NMDs) are characterized by progressive muscle weakness, leading to pronounced and incapacitating physical disabilities. Most NMDs are not amenable to curative treatment and would thus qualify for palliative care. Amyotrophic lateral sclerosis is a relentlessly progressive disease, which leads to death about 2 years after onset due to respiratory muscle weakness...
September 13, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28904990/the-multiple-faces-of-spinocerebellar-ataxia-type-2
#5
REVIEW
Antonella Antenora, Carlo Rinaldi, Alessandro Roca, Chiara Pane, Maria Lieto, Francesco Saccà, Silvio Peluso, Giuseppe De Michele, Alessandro Filla
Spinocerebellar ataxia type 2 (SCA2) is among the most common forms of autosomal dominant ataxias, accounting for 15% of the total families. Occurrence is higher in specific populations such as the Cuban and Southern Italian. The disease is caused by a CAG expansion in ATXN2 gene, leading to abnormal accumulation of the mutant protein, ataxin-2, in intracellular inclusions. The clinical picture is mainly dominated by cerebellar ataxia, although a number of other neurological signs have been described, ranging from parkinsonism to motor neuron involvement, making the diagnosis frequently challenging for neurologists, particularly when information about the family history is not available...
September 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28899525/restless-legs-syndrome-after-high-risk-tia-and-minor-stroke-association-with-reduced-quality-of-life
#6
Mark I Boulos, Anthony Wan, Sandra E Black, Andrew S Lim, Richard H Swartz, Brian J Murray
BACKGROUND: Restless legs syndrome (RLS) is a movement disorder that is associated with poor quality of life and depressive symptoms in the general population. Emerging evidence suggests that RLS is closely associated with cerebrovascular disease. We assessed the effect of RLS on quality of life after stroke and transient ischemic attack (TIA). METHODS: In this single-center prospective study, we recruited patients within 14 days of high-risk TIA or minor stroke...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28874252/-neurosyphilis-as-differential-diagnosis-in-psychiatry
#7
Rikke Maria Nielsen, Elena Sadovina
A 46-year-old previously healthy man was referred to a psychiatric department after debuting with persecutory delusions. He had symptoms of Parkinson's disease as well as a significant impairment of memory and cognitive function. Neurological tests detected discrete balance and rigidity problems. Paraclinical tests were normal, and neurologists explained the symptoms as side effects to the antipsychotic medication. A lumbar puncture showed high concentrations of leukocytes and protein, and syphilis screening was positive...
September 4, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28872032/atlas-of-electroencephalography-3rd-edition
#8
Ali Akbar Asadi-Pooya, Dennis Dlugos, Christopher Skidmore, Michael R Sperling
Electroencephalography (EEG) is the recording of the electrical activity of the brain. EEG is a reliable test to assess cerebral function. It aids in diagnosis, classification, and management of patients with epilepsy. It also has practical uses in conditions other than epilepsy. Moreover, it is harmless and inexpensive. EEG is an important tool for evaluating patients with epilepsy. It may help classify the syndrome, identify the likely source of focal seizures, and confirm a diagnosis of status epilepticus...
September 5, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28870585/medical-decision-making-capacity-and-its-cognitive-predictors-in-progressive-ms-preliminary-evidence
#9
Adam Gerstenecker, Kathleen Lowry, Terina Myers, Khurram Bashir, Kristen L Triebel, Roy C Martin, Daniel C Marson
BACKGROUND: Medical decision-making capacity (MDC) refers to the ability to make informed decisions about treatment and declines in cognition are associated with declines in MDC across multiple disease entities. However, although it is well known that cognitive impairment is prevalent in multiple sclerosis (MS), little is known about MDC in the disease. METHODS: Data from 22 persons with progressive MS and 18 healthy controls were analyzed. All diagnoses were made by a board-certified neurologist with experience in MS...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28861039/intracerebral-hemorrhage-with-intraventricular-extension-getting-the-prognosis-right-early
#10
Christoph Stretz, Catherine Gao, David M Greer, Caitlin Loomis, Emily J Gilmore, Adam J Kundishora, Charles C Matouk, David Y Hwang
BACKGROUND: Early accurate outcome prognostication for patients with intracerebral hemorrhage (ICH) and accompanying intraventricular hemorrhage (IVH) is often challenging (1). Acute hydrocephalus often contributes to a poor clinical exam (2) and can portend significant morbidity and mortality (3). Accordingly, the inpatient neurologist may feel inclined to recommend limitations of care for an ICH patient admitted with a large IVH burden and poor exam. CASE PRESENTATION: We present a patient with significant IVH and minimal ICH who deteriorated rapidly to coma after presentation...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28859570/sanger-brown-and-edward-sch%C3%A3-fer-before-heinrich-kl%C3%A3-ver-and-paul-bucy-their-observations-on-bilateral-temporal-lobe-ablations
#11
Prasad S S V Vannemreddy, James L Stone
Fifty years before a report on the complete bitemporal lobectomy syndrome in primates, known as the Klüver-Bucy syndrome, was published, 2 talented investigators working at the University College in London, England-neurologist Sanger Brown and physiologist Edward Schäfer-also made this discovery. The title of their work was "An investigation into the functions of the occipital and temporal lobes of the monkey's brain," and it involved excisional brain surgery in 12 monkeys. They were particularly interested in the then-disputed primary cortical locations relating to vision and hearing...
September 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28856071/prediction-of-functional-outcome-in-ischemic-stroke-patients-an-observational-study-on-egyptian-population
#12
Mohamed Mahmoud Fouad, Sherien Mohamed Farag, Mohamed I Hegazy, Mohamed Abd Elalem Aziz
Introduction Determining the prognosis of ischemic stroke is important for neurologists and patients. The aim is to study the predictors of three months clinical outcome in ischemic stroke patients. Materials and methods A total of 397 patients were classified according to three months modified Rankin Scale score (mRS score) into two groups, favorable and unfavorable outcome. Favorable outcome was assumed if the score was zero or one, or unchanged if the score was ≥ 1 before the onset of the most recent event...
June 26, 2017: Curēus
https://www.readbyqxmd.com/read/28854884/a-multi-center-randomized-controlled-trial-to-assess-the-efficacy-of-optimization-of-drug-prescribing-in-an-elderly-population-at-18%C3%A2-months-of-follow-up-in-the-evolution-of-functional-autonomy-the-optim-study-protocol
#13
Virginie Dauphinot, Elodie Jean-Bart, Pierre Krolak-Salmon, Christelle Mouchoux
BACKGROUND: Pharmacotherapy is necessary for the management of many diseases which number increased with aging. However, potentially inappropriate prescriptions and polymedication increases iatrogenic risks and can lead to adverse events. To limit the consequences of potentially harmful prescriptions, optimization of drug prescribing is a major stake of improving quality and safety of care in the elderly. The purpose of the OPTIM study is to study the impact of the optimization of drug prescribing on the evolution of functional autonomy at 18 months of follow-up...
August 30, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28838026/-acute-care-rehabilitation-is-the-first-link-in-a-chain-of-rehabilitation-interventions
#14
Joachim Beyer, Egbert J Seidel
An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation)...
August 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28832234/deferring-the-decision-point-treatment-assertions-in-neurology-outpatient-consultations
#15
Merran Toerien
Recommendations can be implied by asserting some generalisation about a treatment's benefit without overtly directing the patient to take it. Focusing on a collection of assertions in UK neurology consultations, this paper shows that these are overwhelmingly receipted as "merely" doing informing and argues that this is made possible by their ambiguous design: their relatively depersonalised formats convey that the neurologist is simply telling the patient what's available, but the link made between the treatment and the patient's condition implies that it will be of benefit...
August 23, 2017: Health Communication
https://www.readbyqxmd.com/read/28830030/multivariate-trajectories-across-multiple-domains-of-health-related-quality-of-life-in-children-with-new-onset-epilepsy
#16
Tolulope T Sajobi, Meng Wang, Mark A Ferro, Anita Brobbey, Shane Goodwin, Kathy N Speechley, Samuel Wiebe
The diagnosis of epilepsy in children is known to impact the trajectory of their health-related quality of life (HRQOL) over time. However, there is limited knowledge about variations in longitudinal trajectories across multiple domains of HRQOL. This study aims to characterize the heterogeneity in HRQOL trajectories across multiple HRQOL domains and to evaluate predictors of differences among the identified trajectory groups in children with new-onset epilepsy. Data were obtained from the Health Related Quality of Life in Children with Epilepsy Study (HERQULES), a prospective multi-center study of 373 children newly diagnosed with new-onset epilepsy who were followed up over 2years...
August 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28798722/autonomic-neuropathy-and-albuminocytologic-dissociation-in-cerebrospinal-fluid-as-the-presenting-features-of-primary-amyloidosis-a-case-report
#17
Jingjing Li, Yi Li, Hongbing Chen, Shihui Xing, Huiyu Feng, Dawei Liu, Dilong Wang, Jinsheng Zeng, Yuhua Fan
OBJECTIVE: Primary amyloidosis is a disease with a poor prognosis and multi-organ involvement. Here, we report the clinical and pathological features of a patient with primary amyloidosis featuring autonomic neuropathy as the initial symptom and albuminocytologic dissociation in the cerebrospinal fluid (CSF). METHODS: The patient was a 60-year-old Chinese male with numbness, orthostatic hypotension, and gastrointestinal symptoms. For diagnosis, we performed an electromyogram (EMG), lumbar puncture, Bence Jones protein urine test, serum electrophoresis blood test, sural nerve and rectal membrane biopsies, transthyretin (TTR) gene sequencing, and bone marrow puncture...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28781912/nursing-review-section-of-surgical-neurology-international-part-1-lumbar-disc-disease
#18
Nancy E Epstein, Renee D Hollingsworth
BACKGROUND: Patients with lumbar disc disease may present with low back pain, pain that radiates down into the lower extremity (radiculopathy), and leg pain that increases with ambulation (neurogenic claudication). Patients may first undergo diagnostic studies [(magnetic resonance imaging (MRI) and computed tomographic (CT) examinations] to determine whether there is any significant nerve root or thecal sac compression. METHODS: Increasingly, patients with low back pain with/without radiculopathy are being screened by nurses rather than by neurologists or neurosurgeons/orthopedists...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28777176/circadian-rhythm-sleep-wake-disorders
#19
Milena Pavlova
PURPOSE OF REVIEW: The endogenous circadian rhythms are one of the cardinal processes that control sleep. They are self-sustaining biological rhythms with a periodicity of approximately 24 hours that may be entrained by external zeitgebers (German for time givers), such as light, exercise, and meal times. This article discusses the physiology of the circadian rhythms, their relationship to neurologic disease, and the presentation and treatment of circadian rhythm sleep-wake disorders...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28768356/-singultus-diagnostic-workup-and-therapy
#20
Ohlrich Marcus, Georg Royl
A hiccup is a reflex movement with diffusely distributed afferents and efferents in the thorax; its functional relevance is controversial. In its physiological form, it is mostly a minor complaint that stops spontaneously and rarely leads to medical consultation. However, prolonged agonizing hiccups represent serious deterioration of quality of life. Chronic hiccups by definition last for more than 48 h, with gastroesophageal reflux being the frequent underlying disease. Various other causes affect multiple organ systems, some with serious underlying diseases...
July 2017: Laryngo- Rhino- Otologie
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