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https://www.readbyqxmd.com/read/28545782/autoimmune-encephalopathy-for-psychiatrists-when-to-suspect-autoimmunity-and-what-to-do-next
#1
REVIEW
Mark Oldham
OBJECTIVE: To provide a critical review of autoimmune encephalopathy-broadly defined as neuropsychiatric features directly related to an autoimmune process-relevant for psychiatric practice. METHODS: We consulted rheumatology textbooks to define the scope of autoimmune conditions and identified recent reviews of rheumatic conditions, autoimmune vasculitis, and autoimmune encephalitis. We integrated these with primary reports to provide a clinically relevant overview of autoimmune encephalopathy...
May 2017: Psychosomatics
https://www.readbyqxmd.com/read/28544888/pre-stroke-seizures-a-nationwide-register-based-investigation
#2
Johan Zelano, David Larsson, Eva Kumlien, Signild Åsberg
PURPOSE: The relationship between cerebrovascular disease and seizures is clearly illustrated by poststroke epilepsy. Seizures can also be the first manifestation of cerebrovascular disease and case-control studies have demonstrated that seizures carry an increased risk of subsequent stroke. Thus, seizures could serve as a marker for vascular risk that merits intervention, but more data is needed before proper trials can be conducted. The occurrence of pre-stroke seizures has not been assessed on a national scale...
May 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28538440/neurologic-injury-in-adults-supported-with-veno-venous-extracorporeal-membrane-oxygenation-for-respiratory-failure-findings-from-the-extracorporeal-life-support-organization-database
#3
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Michele Di Mauro, Fabio Barili, Gijs Geskes, Enrico Vizzardi, Peter T Rycus, Raf Muellenbach, Thomas Mueller, Antonio Pesenti, Alain Combes, Giles Peek, Bjorn Frenckner, Matteo Di Nardo, Justyna Swol, Jos Maessen, Ravi R Thiagarajan
OBJECTIVES: To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING: Data reported to Extracorporeal Life Support Organization from 350 international extracorporeal membrane oxygenation centers during 1992-2015. PATIENTS: Adults (≥ 18 yr old) supported with veno-venous extracorporeal membrane oxygenation for respiratory failure...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28530152/new-onset-fixation-off-sensitivity-or-scotosensitivity-in-an-adult-male-after-bilateral-embolic-strokes-of-the-parietal-and-occipital-regions
#4
Francis G Tirol
A 50-year old male suffered new-onset clinical and subclinical seizures provoked by acute bilateral embolic strokes in the parietal and occipital regions as a complication of aortic valve replacement surgery. After successful treatment of these refractory symptomatic seizures with intravenous propofol and antiseizure medications, video-EEG recordings revealed acute and transient fixation-off sensitivity or scotosensitivity that resolved within 10 weeks.
May 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#5
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28521701/unexpected-effects-of-acetylcholine-precursors-on-pilocarpine-seizure-induced-neuronal-death
#6
Minwoo Lee, Bo Young Choi, Sang Won Suh
Choline alfoscerate (α-GPC) and Cytidine 5'-diphosphocholine (CDP-Choline) are both acetylcholine precursors and are considered to act as pro-cholinergic nootropic agents. Acetylcholine precursors have also recently found frequent use in the neurology clinic. Stroke and many types of dementia have been shown to respond favorably after treatment with these agents, not only in terms of cognitive dysfunction but also behavioral and psychological symptoms. The primary mechanisms of Acetylcholine precursors are the following: 1) Acetylcholine precursors themselves are used in the biosynthesis of acetylcholine and 2) byproducts like glycerophosphate have protective functions for neuronal phospholipids...
May 18, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28516331/burden-of-herpes-simplex-virus-encephalitis-in-the-united-states
#7
S Modi, Abhimanyu Mahajan, D Dharaiya, P Varelas, P Mitsias
Herpes simplex virus encephalitis (HSVE) is a disease of public health concern, but its burden on the healthcare of United States has not been adequately assessed recently. We aimed to define the incidence, complications and outcomes of HSVE in the recent decade by analyzing data from a nationally representative database. Healthcare Cost and Utilization Project databases were utilized to identify patients with primary discharge diagnosis of HSVE. Annual hospitalization rate was estimated and several preselected inpatient complications were identified...
May 17, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28516033/the-impact-of-large-structural-brain-changes-in-chronic-stroke-patients-on-the-electric-field-caused-by-transcranial-brain-stimulation
#8
Sena Minjoli, Guilherme B Saturnino, Jakob Udby Blicher, Charlotte J Stagg, Hartwig R Siebner, André Antunes, Axel Thielscher
Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (TDCS) are two types of non-invasive transcranial brain stimulation (TBS). They are useful tools for stroke research and may be potential adjunct therapies for functional recovery. However, stroke often causes large cerebral lesions, which are commonly accompanied by a secondary enlargement of the ventricles and atrophy. These structural alterations substantially change the conductivity distribution inside the head, which may have potentially important consequences for both brain stimulation methods...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28499982/identification-of-fastkd2-compound-heterozygous-mutations-as-the-underlying-cause-of-autosomal-recessive-melas-like-syndrome
#9
Da Hye Yoo, Young-Chul Choi, Da Eun Nam, Sun Seong Choi, Ji Won Kim, Byung-Ok Choi, Ki Wha Chung
Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a condition that affects many parts of the body, particularly the brain and muscles. This study examined a Korean MELAS-like syndrome patient with seizure, stroke-like episode, and optic atrophy. Target sequencing of whole mtDNA and 73 nuclear genes identified compound heterozygous mutations p.R205X and p.L255P in the FASTKD2. Each of his unaffected parents has one of the two mutations, and both mutations were not found in 302 controls...
May 9, 2017: Mitochondrion
https://www.readbyqxmd.com/read/28499876/mr-imaging-for-accurate-prediction-of-outcome-after-perinatal-arterial-ischemic-stroke-sooner-not-necessarily-better
#10
Nienke Wagenaar, Niek E van der Aa, Floris Groenendaal, Cornelia H Verhage, Manon J N L Benders, Linda S de Vries
BACKGROUND: Involvement of the corticospinal tracts after perinatal arterial ischemic stroke (PAIS) is strongly correlated with adverse motor outcome. METHODS: Two full-term infants with PAIS, with two early MRI scans available, are reported. RESULTS: Diffusion weighted imaging (DWI)-MRI, performed within 24 h following onset of seizures and repeated 48 h later, clearly showed restricted diffusion within the middle cerebral artery territory on both MRIs, but clear patterns of signal intensity changes in the descending corticospinal tracts on the second MRI only...
April 12, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28497610/epilepsia-partialis-continua-after-an-anterior-circulation-ischaemic-stroke
#11
C Bentes, A C Franco, A R Peralta, P Viana, H Martins, C Morgado, C Casimiro, C Fonseca, R Geraldes, P Canhão, T Pinho E Melo, T Paiva, J M Ferro
BACKGROUND AND PURPOSE: Although cerebrovascular disorders are the main cause of epilepsia partialis continua (EPC) in adulthood, the frequency of EPC after stroke is unknown. The aim was to prospectively ascertain its frequency 1 year after an ischaemic stroke. METHODS: This was a prospective study of consecutive acute anterior circulation ischaemic stroke patients, previously independent, with an admission National Institutes of Health Stroke Scale score ≥4, an acute ischaemic lesion on imaging and no previous epileptic seizures...
May 12, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28489816/endothelial-tlr4-and-the-microbiome-drive-cerebral-cavernous-malformations
#12
Alan T Tang, Jaesung P Choi, Jonathan J Kotzin, Yiqing Yang, Courtney C Hong, Nicholas Hobson, Romuald Girard, Hussein A Zeineddine, Rhonda Lightle, Thomas Moore, Ying Cao, Robert Shenkar, Mei Chen, Patricia Mericko, Jisheng Yang, Li Li, Ceylan Tanes, Dmytro Kobuley, Urmo Võsa, Kevin J Whitehead, Dean Y Li, Lude Franke, Blaine Hart, Markus Schwaninger, Jorge Henao-Mejia, Leslie Morrison, Helen Kim, Issam A Awad, Xiangjian Zheng, Mark L Kahn
Cerebral cavernous malformations (CCMs) are a cause of stroke and seizure for which no effective medical therapies yet exist. CCMs arise from the loss of an adaptor complex that negatively regulates MEKK3-KLF2/4 signalling in brain endothelial cells, but upstream activators of this disease pathway have yet to be identified. Here we identify endothelial Toll-like receptor 4 (TLR4) and the gut microbiome as critical stimulants of CCM formation. Activation of TLR4 by Gram-negative bacteria or lipopolysaccharide accelerates CCM formation, and genetic or pharmacologic blockade of TLR4 signalling prevents CCM formation in mice...
May 10, 2017: Nature
https://www.readbyqxmd.com/read/28487744/atorvastatin-diltiazem-combination-induced-rhabdomyolysis-leading-to-diagnosis-of-hypothyroidism
#13
N D B Ehelepola, S M B Y Sathkumara, H M P A G S Bandara, K L R Kalupahana
Statins and hypothyroidism, independently, can rarely cause rhabdomyolysis. The combination of them especially with concurrent intake of drugs such as diltiazem increases the risk of rhabdomyolysis. Hashimoto's encephalopathy is a rare condition associated with Hashimoto's thyroiditis and some patients with that can present with a stroke like picture. An elderly male who has been on atorvastatin for three years and on diltiazem for a week presented with sudden onset inability to walk and confusion. On examination muscle tenderness was noticed and creatine kinase levels indicated rhabdomyolysis which we attributed to atorvastatin...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28479338/effects-of-experimental-traumatic-brain-injury-and-impaired-glutamate-transport-on-cortical-spreading-depression
#14
Mahshid Sadat Hosseini-Zare, Feng Gu, Ahmad Abdulla, Simon Powell, Jokūbas Žiburkus
Cortical spreading depression (CSD) is associated with traumatic brain injury (TBI), stroke, migraines, and seizures. Typically, following TBIs and other insults, neuronal excitability in and around the area of the injury is affected, with reported increases in local glutamate signaling. Astrocytic glutamate transporters are critical for precise regulation of the extracellular glutamate availability. However, it remains unclear how impaired astrocytic glutamate transport or an acute TBI affect characteristics of the CSD...
May 4, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28476510/prevalence-and-predictors-of-long-term-functional-impairment-epilepsy-mortality-and-stroke-recurrence-after-childhood-stroke-a-prospective-study-of-a-chilean-cohort
#15
Mauricio López-Espejo, Marta Hernández-Chávez
BACKGROUND: To evaluate the prevalence and predictors of long-term impairment, epilepsy, mortality, and recurrences after the first stroke in a cohort of Chilean children. METHODS: A prospective study involving 98 children who suffered a first stroke and underwent follow-up for at least 3 years in a single center. Functional outcome was measured using the modified Rankin Scale for children. We utilized multivariate logistic regression models to estimate the odds ratios (ORs) for outcomes while adjusting for age, sex, and underlying conditions (significance <...
May 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28476507/old-stroke-as-an-independent-risk-etiology-for-todd-s-paralysis
#16
Kenichiro Sato, Noritoshi Arai, Ayumi Hida, Sousuke Takeuchi
BACKGROUND: Todd's paralysis (TP) is a well-known postictal paresis in which patients present with transient weakness in their limb(s) after seizures. Although recognized as a stroke mimic in clinical practice, the pathophysiological mechanism and clinical features of TP remain unknown. Furthermore, its diagnosis can be erroneous in neurological emergency practice. We aimed to illustrate the clinical features and identify factors associated with TP. METHODS: This single-center, retrospective observational study included consecutive adult patients who presented with convulsive seizure and were referred to an urban tertiary care emergency department between August 2010 and April 2016...
May 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28473091/acr-appropriateness-criteria-%C3%A2-cerebrovascular%C3%A2-disease
#17
Michael B Salmela, Shabnam Mortazavi, Bharathi D Jagadeesan, Daniel F Broderick, Judah Burns, Tejaswini K Deshmukh, H Benjamin Harvey, Jenny Hoang, Christopher H Hunt, Tabassum A Kennedy, Alexander A Khalessi, William Mack, Nandini D Patel, Joel S Perlmutter, Bruno Policeni, Jason W Schroeder, Gavin Setzen, Matthew T Whitehead, Rebecca S Cornelius, Amanda S Corey
Diseases of the cerebral vasculature represent a heterogeneous group of ischemic and hemorrhagic etiologies, which often manifest clinically as an acute neurologic deficit also known as stroke or less commonly with symptoms such as headache or seizures. Stroke is the fourth leading cause of death and is a leading cause of serious long-term disability in the United States. Eighty-seven percent of strokes are ischemic, 10% are due to intracerebral hemorrhage, and 3% are secondary to subarachnoid hemorrhage. The past two decades have seen significant developments in the screening, diagnosis, and treatment of ischemic and hemorrhagic causes of stroke with advancements in CT and MRI technology and novel treatment devices and techniques...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28461213/survival-and-late-effects-after-allogeneic-hematopoietic-cell-transplantation-for-hematologic-malignancy-at-less-than-three-years-of-age
#18
Lynda M Vrooman, Heather R Millard, Ruta Brazauskas, Navneet S Majhail, Minoo Battiwalla, Mary E Flowers, Bipin N Savani, Görgün Akpek, Mahmoud Aljurf, Rajinder Bajwa, K Scott Baker, Amer Beitinjaneh, Menachem Bitan, David Buchbinder, Eric Chow, Christopher Dandoy, Andrew C Dietz, Lisa Diller, Robert Peter Gale, Shahrukh K Hashmi, Robert J Hayashi, Peiman Hematti, Rammurti T Kamble, Kimberly A Kasow, Morris Kletzel, Hillard M Lazarus, Adriana K Malone, David I Marks, Tracey A O'Brien, Richard F Olsson, Olle Ringden, Sachiko Seo, Amir Steinberg, Lolie C Yu, Anne Warwick, Bronwen Shaw, Christine Duncan
Very young children undergoing hematopoietic cell transplantation (HCT) are a unique and vulnerable population. We analyzed outcomes of 717 patients from 117 centers who survived relapse free for ≥1 year after allogeneic myeloablative HCT for hematologic malignancy at <3 years of age, between 1987 and 2012. The median follow-up was 8.3 years (range, 1.0 to 26.4 years); median age at follow-up was 9 years (range, 2 to 29 years). Ten-year overall and relapse-free survival were 87% (95% confidence interval [CI], 85% to 90%) and 84% (95% CI, 81% to 87%)...
April 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28457033/clinical-and-biochemical-characteristics-of-exertional-heat-stroke-among-paratroopers-in-agra-india
#19
Rajesh Deshwal, Dhirendra Tiwari, Raj Singh
OBJECTIVE: The purpose of this study was to assess the clinical profile, biochemical parameters and outcome in a series of 78 patients of heat stroke admitted and treated in a military hospital in India. METHODS: This was a prospective study in a military hospital. A total of 78 patients of exertional heat stroke admitted and treated over more than 2 years are reported. Cooling measures started immediately on site of occurrence, carried on during evacuation and in hospital, IV normal saline initiated, clinical symptoms and signs were noted...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28454984/cannabidiol-treatment-for-refractory-seizures-in-sturge-weber-syndrome
#20
Emma H Kaplan, Elizabeth A Offermann, Jacqueline W Sievers, Anne M Comi
BACKGROUND: Sturge-Weber syndrome results in leptomeningeal vascular malformations, medically refractory epilepsy, stroke(s), and cognitive impairments. Cannabidiol, a cannabinoid without psychoactive properties, has been demonstrated in preclinical models to possibly have anticonvulsant, antioxidant, and neuroprotective actions. METHODS: Five subjects with Sturge-Weber syndrome brain involvement and treatment-resistant epilepsy were enrolled. Motor seizure frequency, quality of life, and adverse events were recorded from the eighth week of the pretreatment period, eight weeks after starting maintenance dose (week 14), and the most recent visit...
February 22, 2017: Pediatric Neurology
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