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clinical examination neurology

Naseem Jamnia, Janice H Urban, Grace Beth Stuzmann, Sarah Chiren, Emily Reisenbigler, Robert Marr, Daniel A Peterson, Dorothy A Kozlowski
Repeat concussions (RC) can result in significant long-term neurological consequences and increased risk for neurodegenerative disease compared to single concussion (SC). Mechanisms underlying this difference are poorly understood and best elucidated using an animal model. To the best of our knowledge, there is no closed-head model in the adult rat using a commercially available device. We developed a novel and clinically relevant closed-head injury (CHI) model of both single and multiple concussions in the adult rat using a controlled cortical impact (CCI) device...
October 20, 2016: Journal of Neurotrauma
Marilena Vecchi, Carmen Barba, Debora De Carlo, Micol Stivala, Renzo Guerrini, Emilio Albamonte, Domiziana Ranalli, Domenica Battaglia, Giada Lunardi, Clementina Boniver, Benedetta Piccolo, Francesco Pisani, Gaetano Cantalupo, Giuliana Nieddu, Susanna Casellato, Silvia Cappanera, Elisabetta Cesaroni, Nelia Zamponi, Domenico Serino, Lucia Fusco, Alessandro Iodice, Filippo Palestra, Lucio Giordano, Elena Freri, Ilaria De Giorgi, Francesca Ragona, Tiziana Granata, Isabella Fiocchi, Stefania Maria Bova, Massimo Mastrangelo, Alberto Verrotti, Sara Matricardi, Elena Fontana, Davide Caputo, Francesca Darra, Bernardo Dalla Bernardina, Francesca Beccaria, Giuseppe Capovilla, Maria Pia Baglietto, Alessandra Gagliardi, Aglaia Vignoli, Maria Paola Canevini, Egle Perissinotto, Stefano Francione
OBJECTIVE: To describe the clinical, neuropsychological, and psychopathologic features of a cohort of children with a new diagnosis of symptomatic or presumed symptomatic focal epilepsy at time of recruitment and through the first month. The selected population will be followed for 2-5 years after enrollment to investigate the epilepsy course and identify early predictors of drug resistance. METHODS: In this observational, multicenter, nationwide study, children (age 1 month-12...
October 20, 2016: Epilepsia
David Gloss, Jay K Varma, Tamara Pringsheim, Marc R Nuwer
OBJECTIVE: To evaluate the evidence for EEG theta/beta power ratio for diagnosing, or helping to diagnose, attention-deficit/hyperactivity disorder (ADHD). METHODS: We identified relevant studies and classified them using American Academy of Neurology criteria. RESULTS: Two Class I studies assessing the ability of EEG theta/beta power ratio and EEG frontal beta power to identify patients with ADHD correctly identified 166 of 185 participants...
October 19, 2016: Neurology
Zühtü Özbek, Hasan Emre Aydin, Atacan Emre Koçman, Emre Özkara, Erdem Söztutar, Ezgi Bektur, Murat Vural, Aydan Köse, Ali Arslantaş, Cengiz Bayçu
AIM: In this study, we investigated the effects of genistein in a rat model of sciatic nerve crush injury and complete sciatic nerve transection. The effects of genistein were compared with those of gabapentin, which is widely used in clinical practice for peripheral nerve injury. MATERIAL AND METHODS: Forty-eight rats were randomly divided into six groups (n = 8 for all groups): group 1 (sham); group 2, sciatic nerve crush injury (control); group 3, sciatic nerve crush injury + genistein 20 mg/kg; group 4, sciatic nerve crush injury + gabapentin 90 mg/kg; group 5, sciatic nerve transection + genistein 20 mg/kg; group 6, sciatic nerve transection + gabapentin 90 mg/kg...
September 21, 2016: Turkish Neurosurgery
Ignacio Jusué-Torres, Lee H Jeon, Eric W Sankey, Jennifer Lu, Tito Vivas-Buitrago, Joshua A Crawford, Mikhail V Pletnikov, Jiadi Xu, Ari Blitz, Daniel A Herzka, Barbara Crain, Alicia Hulbert, Hugo Guerrero-Cazares, Oscar Gonzalez-Perez, James P McAllister, Alfredo Quiñones-Hinojosa, Daniele Rigamonti
BACKGROUND: The pathogenesis of adult chronic hydrocephalus is not fully understood, and the temporal relationship between development of the radiological changes and neurological deterioration is unknown. OBJECTIVE: To clarify the progression of radiological-histological changes and subsequent clinical manifestations of adult chronic hydrocephalus. METHODS: Kaolin was injected bilaterally into the subarachnoid space overlying the cranial convexities in 20 adult rats...
November 2016: Neurosurgery
Catherine Mazzola, Lissa C Baird, David F Bauer, Alexandra Beier, Susan Durham, Paul Klimo, Alexander Y Lin, Catherine McClung-Smith, Laura Mitchell, Dimitrios Nikas, Mandeep S Tamber, Rachana Tyagi, Ann Marie Flannery
BACKGROUND: No evidence-based guidelines exist for the imaging of patients with positional plagiocephaly. OBJECTIVE: The objective of this systematic review and evidence-based guideline is to answer the question, Is imaging necessary for infants with positional plagiocephaly to make a diagnosis? METHODS: The National Library of Medicine Medline database and the Cochrane Library were queried with the use of MeSH headings and key words relevant to imaging as a means to diagnose plagiocephaly...
November 2016: Neurosurgery
Ke-Wei Tian, Fan Zhang, Hong Jiang, Beibei Wang, Shu Han
Multiple sclerosis (MS) is a chronic neurological disorder that affects the central nervous system (CNS), and results in CNS inflammation and damage to myelin. In this study, we examined the possible synergistic effects of C16, angiopoietin-1 (Ang-1) and regeneration gene protein 2 (Reg-2) in alleviating inflammation in an acute experimental autoimmune encephalomyelitis (EAE) model. We employed multiple histological, morphological and iconographic assays to examine the effect of those drugs on disease onset, clinical scores and behavioral deficits...
October 19, 2016: Journal of Anatomy
Monish M Maharaj, Kevin Phan, Soumya Hariswamy, Prashanth J Rao
BACKGROUND: Surfers myelopathy can be a rapidly devastating disease and little is known surrounding the pathophysiology of the condition. Although the classical pattern of illness has been well reported, it has never been observed in a non-surfing setting. METHODS: A 51-year-old demolition worker presented with acute non-traumatic myelopathy. Clinical examination revealed sensory loss to the level of L2. T2-MRI and MRI-DWI revealed a hyperintense signal suggestive of an ischaemic event...
September 2016: J Spine Surg
Yu Ding, Di-Ke Ruan, Qing He, Li Sheng Hou, Jian Ning Lin, Hong Peng Cui
STUDY DESIGN: The clinical and radiologic data of total disk allografting (TDA) cases were collected and analyzed to explore the correlation between neurological function improvements and imaging changes. OBJECTIVE: The aim of the study was to assess the medium-term and long-term outcome and radiographic character after TDA, and, furthermore, to explore the significance of the changes of imaging signs after the transplantation. SUMMARY OF BACKGROUND DATA: Spinal fusion may result in the adjacent segment degeneration...
November 2016: Clinical Spine Surgery
Kunal Gandhi, Dharmendra Prasad, Vinay Malhotra, Dhananjai Agrawal
Gitelman's syndrome is an autosomal recessive renal tubular disorder characterized by hypomagnesemia, hypokalemia, hypocalciuria, and metabolic alkalosis. Hypocalcemic tetany as a presentation of Gitelman's syndrome has rarely been reported in literature. We report a rare case of Gitelman's syndrome presenting with hypocalcemic tetany along with hypokalemic periodic paralysis. A 17-year-old female was admitted to our hospital with a history of perioral numbness and carpal spasms of five days duration with progressive quadriparesis developing over a period of few hours...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Steven L Clark, Emily Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: To validate a recently published algorithm for the management of category II fetal heart rate tracings , examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring and critically examine the limits of EFHRM in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
Brian H Cohen, Michael P Gaspar, Alan H Daniels, Edward Akelman, Patrick M Kane
Double crush syndrome (DCS), as it is classically defined, is a clinical condition composed of neurological dysfunction due to compressive pathology at multiple sites along a single peripheral nerve. The traditional definition of DCS is narrow in scope because many systemic pathologic processes, such as diabetes mellitus, drug-induced neuropathy, vascular disease and autoimmune neuronal damage, can have deleterious effects on nerve function. Multifocal neuropathy is a more appropriate term describing the multiple etiologies (including compressive lesions) that may synergistically contribute to nerve dysfunction and clinical symptoms...
October 14, 2016: Journal of Hand Surgery
Sebastian Frese, Jens A Petersen, Maria Ligon-Auer, Sandro Manuel Mueller, Violeta Mihaylova, Saskia M Gehrig, Veronika Kana, Elisabeth J Rushing, Evelyn Unterburger, Georg Kägi, Jean-Marc Burgunder, Marco Toigo, Hans H Jung
Huntington disease (HD) is a relentlessly progressive neurodegenerative disorder with symptoms across a wide range of neurological domains, including cognitive and motor dysfunction. There is still no causative treatment for HD but environmental factors such as passive lifestyle may modulate disease onset and progression. In humans, multidisciplinary rehabilitation has a positive impact on cognitive functions. However, a specific role for exercise as a component of an environmental enrichment effect has been difficult to demonstrate...
October 17, 2016: Journal of Neurology
Ula Khatib, Diederik van de Beek, John A Lees, Matthijs C Brouwer
OBJECTIVES: To study the diagnostic accuracy of clinical and laboratory features in the diagnosis of central nervous system (CNS) infection and bacterial meningitis. METHODS: We included consecutive adult episodes with suspected CNS infection who underwent cerebrospinal fluid (CSF) examination. The reference standard was the diagnosis classified into 5 categories: 1) CNS infection; 2) CNS inflammation without infection; 3) other neurological disorder; 4) non-neurological infection; and 5) other systemic disorder...
October 13, 2016: Journal of Infection
Andrey Karpenko, Vladimir Starodubtsev, Pavel Ignatenko, Alexander Gostev
OBJECTIVE: The aim of our study was to compare immediate and long-term results of endovascular interventions for the treatment of steno-occlusive disease of subclavian arteries (SAs) depending on the length of lesion. MATERIALS AND METHODS: Between 2010 and 2013, we performed 245 endovascular procedures to treat patients with atherosclerotic steno-occlusive disease of SAs. All patients were examined and subdivided according to the received results into 2 groups: 125 patients with stenosis of SA were included in the first group and 120 patients with occlusion of SA were included in the second group...
October 12, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Radhesh Krishna Lalam, Victor N Cassar-Pullicino, Naomi Winn
Paget disease (PD) is a common disease of bone associated with abnormal bone turnover that in turn is due to an imbalance between osteoclastic and osteoblastic activity. There is good evidence that PD is reducing in incidence, prevalence, and severity. The disease is most often asymptomatic and is usually detected incidentally on imaging examinations performed for other reasons. The features of PD are relatively specific on radiographs and computed tomography. However, the appearances on magnetic resonance imaging are subtle and nonspecific, although it has become the initial imaging choice for several clinical indications including back pain, neurologic dysfunction, and knee pain...
July 2016: Seminars in Musculoskeletal Radiology
Alon Kalron, Uri Givon, Lior Frid, Mark Dolev, Anat Achiron
Balance impairment is common in people with multiple sclerosis (PwMS) and frequently impacts quality of life by decreasing mobility and increasing the risk of falling. However, there are only scarce data examining the contribution of specific neurological functional systems on balance measures in MS. Therefore, the primary aim of our study was to examine the differences in posturography parameters and fall incidence according to the pyramidal, cerebellar and sensory systems functional systems in PwMS. The study included 342 PwMS, 211 women and mean disease duration of 8...
2016: PloS One
Georgios Tsivgoulis, Andrei V Alexandrov
PURPOSE OF REVIEW: Low cost, avoidance of irradiation, and high temporal resolution are inherent advantages of ultrasound imaging that translate into multiple clinical uses in many domains of neurology. This article presents clinical uses of ultrasound examination in cerebrovascular, neurodegenerative, and peripheral nervous system diseases. RECENT FINDINGS: Modern treatment and prevention of ischemic stroke rely on prompt diagnosis. Ultrasonography has found a place as a noninvasive screening test and bedside technique that provides estimates of the degree of stenosis as well as hemodynamic and structural information about intracranial and extracranial vessels in real time...
October 2016: Continuum: Lifelong Learning in Neurology
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
Taylor J Yaw, Nick D Jeffery, Brandon Cain, Amanda Fales-Williams, Bianca A Zaffarano
A juvenile, male crested pekin duck ( Anas platyrhynchos f dom) was presented for neurologic signs suggestive of cerebellar disease. Physical examination revealed microphthalmia, erratic head movements, and ataxia. Computed tomography scan of the head and neck regions revealed 2 full-thickness skull-bone defects within the caudal portion of the cranium. The cerebellum appeared to be ventrally compressed by a homogeneous, triangular, fluid-attenuating region (0-10 Hounsfield units). A craniectomy was performed, and a presumed peripheral cerebral cyst was removed with suction and gentle dissection...
September 2016: Journal of Avian Medicine and Surgery
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