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Clinical examination neurologist

Maria Shoaib, Jacqueline J Kraus, Muhammad T Khan
Herpes simplex virus encephalitis (HSVE) is a medical emergency associated with high mortality and morbidity. Definitive diagnosis is established by history, clinical examination, neuroimaging studies, supportive electroencephalogram (EEG) findings, and cerebrospinal fluid (CSF) analysis. We report a case of HSVE presenting as a stroke mimic in a 76-year-old female with a history of atrial fibrillation on warfarin. She was admitted to our medical intensive care unit with intermittent fever, lethargy, and new onset left-sided hemiparesis...
January 15, 2018: Curēus
Malo Le Hanneur, Andres A Maldonado, Benjamin M Howe, Michelle L Mauermann, Robert J Spinner
BACKGROUND: Several hypotheses have been proposed for the pathophysiology of suprascapular nerve (SSN) palsy, including compression, traction, and nerve inflammation. OBJECTIVE: To provide insight into the pathophysiology of isolated nontraumatic SSN palsy by performing critical reinterpretations of electrodiagnostic (EDX) studies and magnetic resonance (MR) images of patients with such diagnosis. METHODS: We retrospectively reviewed all patients referred to our institution for the past 20 yr with a diagnosis of nontraumatic isolated suprascapular neuropathy who had an upper extremity EDX study and a shoulder or brachial plexus MR scan...
February 26, 2018: Neurosurgery
Anna Sojka, Marcin Żarowski, Barbara Steinborn, Wiesław Hedzelek, Beata Wiśniewska-Spychała, Barbara Dorocka-Bobkowska
BACKGROUND: Headache is a common complaint in all age groups and is a frequent cause of medical consultations and hospitalization. OBJECTIVES: The aim of this study was to evaluate the prevalence of bite and non-bite parafunctions as well as the signs and symptoms of temporomandibular disorder (TMD) in adolescents presenting with primary headaches. MATERIAL AND METHODS: Parents of adolescents presented with headaches to the Department of Developmental Neurology within a 12-month period were asked to complete a questionnaire developed by the authors of this study...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Vanessa Siffredi, Vicki Anderson, Alissandra McIlroy, Amanda G Wood, Richard J Leventer, Megan M Spencer-Smith
OBJECTIVES: Agenesis of the corpus callosum (AgCC), characterized by developmental absence of the corpus callosum, is one of the most common congenital brain malformations. To date, there are limited data on the neuropsychological consequences of AgCC and factors that modulate different outcomes, especially in children. This study aimed to describe general intellectual, academic, executive, social and behavioral functioning in a cohort of school-aged children presenting for clinical services to a hospital and diagnosed with AgCC...
March 7, 2018: Journal of the International Neuropsychological Society: JINS
Chiara Zucchella, Angela Federico, Alice Martini, Michele Tinazzi, Michelangelo Bartolo, Stefano Tamburin
Neuropsychological testing is a key diagnostic tool for assessing people with dementia and mild cognitive impairment, but can also help in other neurological conditions such as Parkinson's disease, stroke, multiple sclerosis, traumatic brain injury and epilepsy. While cognitive screening tests offer gross information, detailed neuropsychological evaluation can provide data on different cognitive domains (visuospatial function, memory, attention, executive function, language and praxis) as well as neuropsychiatric and behavioural features...
February 22, 2018: Practical Neurology
Satish V Khadilkar, Bhagyadhan A Patel, Jamshed A Lalkaka
The expansion of the spectrum of limb girdle muscular dystrophies (LGMDs) in recent years means that neurologists need to be familiar with the clinical clues that can help with their diagnosis. The LGMDs comprise a group of genetic myopathies that manifest as chronic progressive weakness of hip and shoulder girdles. Their inheritance is either autosomal dominant (LGMD1) or autosomal recessive (LGMD2). Their prevalence varies in different regions of the world; certain ethnic groups have documented founder mutations and this knowledge can facilitate the diagnosis...
February 22, 2018: Practical Neurology
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
Steve Simpson, Ingrid van der Mei, Robyn M Lucas, Anne-Louise Ponsonby, Simon Broadley, Leigh Blizzard, Bruce Taylor
Background: Low vitamin D and/or sun exposure have been associated with increased risk of multiple sclerosis (MS) onset. However, comparatively, few studies have prospectively examined associations between these factors and clinical course. Objectives: To evaluate the association of sun exposure parameters and vitamin D levels with conversion to MS and relapse risk in a prospectively monitored cohort of 145 participants followed after a first demyelinating event up to 5-year review (AusLong Study)...
2018: Frontiers in Neurology
Humera Manzoor, Norbert Brüggemann, Hafiz Muhammad Jafar Hussain, Tobias Bäumer, Frauke Hinrichs, Muhammad Wajid, Alexander Münchau, Sadaf Naz, Katja Lohmann
BACKGROUND: Neurological disorders comprise a large group of clinically and genetically heterogeneous disorders, many of which have a genetic cause. In addition to a detailed neurological examination, exome sequencing is being increasingly used as a complementary diagnostic tool to identify the underlying genetic cause in patients with unclear, supposedly genetically determined disorders. OBJECTIVE: To identify the genetic cause of a complex movement disorder in five consanguineous Pakistani families...
February 6, 2018: Parkinsonism & related Disorders
Tena Rosser
PURPOSE OF REVIEW: This article presents an up-to-date summary of the genetic etiology, diagnostic criteria, clinical features, and current management recommendations for the most common neurocutaneous disorders encountered in clinical adult and pediatric neurology practices. RECENT FINDINGS: The phakomatoses are a phenotypically and genetically diverse group of multisystem disorders that primarily affect the skin and central nervous system. A greater understanding of the genetic and biological underpinnings of numerous neurocutaneous disorders has led to better clinical characterization, more refined diagnostic criteria, and improved treatments in neurofibromatosis type 1, Legius syndrome, neurofibromatosis type 2, Noonan syndrome with multiple lentigines, tuberous sclerosis complex, Sturge-Weber syndrome, and incontinentia pigmenti...
February 2018: Continuum: Lifelong Learning in Neurology
Shahram Abootalebi, Mahmoud Reza Azarpazhooh, Luciano Sposato, Vladimir Hachinski
Background: The upgoing thumb sign as a subtle clinical finding of upper motor neuron involvement has been frequently reported in patients with TIAs and minor strokes. This study was designed to show the method of examination and interpretation and the interobserver/intraobserver reliability. Methods: The thumb sign was elicited in TIA/minor strokes or stroke mimics. After obtaining the participant's permission, the examinations were recorded. Two independent neurologists reviewed all patients for the possibility of an upgoing thumb sign...
December 2017: Neurology. Clinical Practice
Joshua VanDerWerf, Donna Kurowski, James Siegler, Taneeta Ganguly, Brett Cucchiara
BACKGROUND: Hematoma expansion (HE) occurs in 1/3 of ICH patients and is associated with poor outcome. Intra-hematomal hypodensity (IHH) on CT has been reported to predict HE, as has the "BRAIN" score. We sought to assess the predictive value of these markers alone and in combination. METHODS: We performed a retrospective single-center study of ICH patients with CT < 6 h from onset. Two blinded neurologists assessed IHH on initial CT. Two HE definitions were examined: > 6 ml and > 6 ml or > 33%...
February 6, 2018: Neurocritical Care
Christiane Cavalcante Feitoza, Matheus Corrêa da-Silva, Yasmim Lima Nascimento, Elaine Sobral Leite, Corintho Viana Pereira, Lucas Gomes Patrocínio
Obstructive Sleep Apnea Syndrome (OSA) is a multifactorial disease that highly alters a persons quality of life. It is characterized by the repeated interruption of breathing during sleep, due to an obstruction or the collapse of the upper airways. Since it is a multifactorial etiological disorder, it requires a thorough diagnosis and treatment with an interdisciplinary team, which comprises several professionals such as a surgical dentist, phonoaudiologist, otorhinolaryngologist, sleep doctor, neurologist and physiotherapist...
October 2017: Sleep Science
Fatih Artvinli, Şahap Erkoç, Fulya Kardeş
Introduction: The aim of this article is to provide a brief history of Turkish Neuropsychiatric Society by examining its institutional background, the milestones within its history, and the major activities undertaken by the organization during the years. Methods: Firstly, the books, journals, and articles that are related to the history of psychiatry and neurology in Turkey have been reviewed and the information that can explain the history of the society has been brought together...
December 2017: Noro Psikiyatri Arsivi
J Andersson, M Rosell, K Kockum, L Söderström, K Laurell
Purpose: To evaluate the present diagnostic guidelines of idiopathic normal pressure hydrocephalus (iNPH) in a sample from the general population. Methods: A total of 168 individuals (93 females, 75 males), mean age 75 years (range 66-92) with and without symptoms of iNPH underwent a CT-scan of the brain, a neurological examination with assessment of the triad symptoms, i.e. gait disturbances, memory impairment and urgency incontinence. The participants were then diagnosed as "unlikely", "possible" and "probable" iNPH according to the American-European and the Japanese guidelines, respectively...
June 2017: ENeurologicalSci
Patric Scheidegger, Lukas Weisskopf, Anja Hirschmüller
Issue: Lower extremity tendon injuries often occur in physically active individuals. Most ruptures not involving great force are diagnosed in patients presenting underlying tendon degenerations. This also applies to patients taking medications because of a disease. We have observed several cases of bilateral Achilles tendon ruptures in patients who have been taking cortisone for a long period. We treated a healthy colleague (neurologist) in our clinic who sustained ruptures of the Achilles tendon on the left side (2012) and the peroneus brevis tendon on left side (2015) and right side (2016) after minimal traumata...
2017: SAGE Open Medical Case Reports
Valérie Biousse, Beau B Bruce, Nancy J Newman
Although the usefulness of viewing the ocular fundus is well-recognized, ophthalmoscopy is infrequently and poorly performed by most nonophthalmologist physicians, including neurologists. Barriers to the practice of ophthalmoscopy by nonophthalmologists include not only the technical difficulty related to direct ophthalmoscopy, but also lack of adequate training and discouragement by preceptors. Recent studies have shown that digital retinal fundus photographs with electronic transmission and remote interpretation of images by an ophthalmologist are an efficient and reliable way to allow examination of the ocular fundus in patients with systemic disorders such as diabetes mellitus...
January 23, 2018: Neurology
Maren R Hov, Jo Røislien, Thomas Lindner, Erik Zakariassen, Kristi C G Bache, Volker M Solyga, David Russell, Christian G Lund
BACKGROUND: Cerebral revascularization in acute stroke requires robust diagnostic tools close to symptom onset. The quantitative National Institute of Health Stroke Scale (NIHSS) is widely used in-hospital, whereas shorter and less specific stroke scales are used in the prehospital field. This study explored the accuracy and potential clinical benefit of using NIHSS prehospitally. PATIENTS AND METHODS: Thirteen anesthesiologists trained in prehospital critical care enrolled patients with suspected acute stroke in a mobile stroke unit...
December 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
James John Marriott, Hui Chen, Randall Fransoo, Ruth Ann Marrie
BACKGROUND: Severe relapses that required treatment were important outcomes in the sentinel trials of disease-modifying therapy (DMT). Identifying such relapses in administrative data would allow comparative-effectiveness studies of DMTs to be conducted in real-world clinical settings. METHODS: All relapsing-remitting (RRMS) and secondary-progressive (SPMS) patients living in Manitoba between 1999 and 2015 were identified using a validated case definition and linkage to the Manitoba MS Clinic database...
January 2018: Multiple Sclerosis and related Disorders
Lorena Broseghini Barcelos, Flávia Saad, Carla Giacominelli, Roberta Arb Saba, Patrícia Maria de Carvalho Aguiar, Sonia Maria Azevedo Silva, Vanderci Borges, Paulo Henrique Ferreira Bertolucci, Henrique Ballalai Ferraz
OBJECTIVE: We evaluated neuropsychological tests to compare cognitive impairment between two types of multiple system atrophy: predominant parkinsonism (MSA-P) and predominant cerebellar ataxia (MSA-C). PATIENTS AND METHODS: This cross-sectional study included 14 patients diagnosed with MSA: four with MSA-C and ten with MSA-P. Presence of motor symptoms was determined by using the Unified Rating MSA Scale (URMSAS). Non-motor symptoms were evaluated by the Short Form Health Survey (SF-36), Scales for Outcomes in Parkinson's disease Autonomic (SCOPA-AUT), Hospital Anxiety and Depression Scale (HADS), and Beck Depression Inventory (BDI)...
January 2018: Clinical Neurology and Neurosurgery
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