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Yohannes W Woldeamanuel, Adel T Andemeskel, Kwame Kyei, Meheret W Woldeamanuel, Woubishet Woldeamanuel
INTRODUCTION: Tetanus is a continued public health neuroinfectious burden in Africa; it accounts for significant proportion of lengthy intensive care unit (ICU) and hospital admissions. OBJECTIVES: This study aimed to describe the pooled case-fatality rates of adult tetanus at African hospitals along with relevant discussions and recommendations. METHODS: A systematic review using advanced search strategies employing PubMed/MEDLINE and Web of Science inclusive of gray literature handsearch was conducted for facility-based studies on adult tetanus by combining the terms "tetanus", "Africa" spanning all previous years until January 15, 2016...
September 15, 2016: Journal of the Neurological Sciences
Alejandra N Martinez, Mario T Philipp
This review addresses the role that substance P (SP) and its preferred receptor neurokinin-1 (NK1R) play in neuroinflammation associated with select bacterial, viral, parasitic, and neurodegenerative diseases of the central nervous system. The SP/NK1R complex is a key player in the interaction between the immune and nervous systems. A common effect of this interaction is inflammation. For this reason and because of the predominance in the human brain of the NK1R, its antagonists are attractive potential therapeutic agents...
2016: Journal of Neurology & Neuromedicine
Shila Azodi, Steven Jacobson
Cytokines are a heterogeneous group of glycoproteins that coordinate physiological functions. Cytokine deregulation is observed in many neurological diseases. This article reviews current research focused on human clinical trials of cytokine and anticytokine therapies in the treatment of several neurological disease including stroke, neuromuscular diseases, neuroinfectious diseases, demyelinating diseases, and neurobehavioral diseases. This research suggests that cytokine therapy applications may play an important role in offering new strategies for disease modulation and treatment...
July 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Emily C Leibovitch, Steven Jacobson
Vaccines for neuroinfectious diseases are becoming an ever-increasing global health priority, as neurologic manifestations and sequelae from existing and emerging central nervous system infections account for significant worldwide morbidity and mortality. The prevention of neurotropic infections can be achieved through globally coordinated vaccination campaigns, which have successfully eradicated nonzoonotic agents such as the variola viruses and, hopefully soon, poliovirus. This review discusses vaccines that are currently available or under development for zoonotic flaviviruses and alphaviruses, including Japanese and tick-borne encephalitis, yellow fever, West Nile, dengue, Zika, encephalitic equine viruses, and chikungunya...
July 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
Aaron F Struck, M Brandon Westover, Lance T Hall, Gina M Deck, Andrew J Cole, Eric S Rosenthal
BACKGROUND: Ictal-interictal continuum (IIC) continuous EEG (cEEG) patterns including periodic discharges and rhythmic delta activity are associated with poor outcome and in the appropriate clinical context, IIC patterns may represent "electroclinical" status epilepticus (SE). To clarify the significance of IIC patterns and their relationship to "electrographic" SE, we investigated FDG-PET imaging as a complementary metabolic biomarker of SE among patients with IIC patterns. METHODS: A single-center prospective clinical database was ascertained for patients undergoing FDG-PET during cEEG...
June 2016: Neurocritical Care
Nathalie Strazielle, Rita Creidy, Christophe Malcus, José Boucraut, Jean-François Ghersi-Egea
An emerging concept of normal brain immune surveillance proposes that recently and moderately activated central memory T lymphocytes enter the central nervous system (CNS) directly into the cerebrospinal fluid (CSF) via the choroid plexus. Within the CSF space, T cells inspect the CNS environment for cognate antigens. This gate of entry into the CNS could also prevail at the initial stage of neuroinflammatory processes. To actually demonstrate T cell migration across the choroidal epithelium forming the blood-CSF barrier, an in vitro model of the rat blood-CSF barrier was established in an "inverse" configuration that enables cell transmigration studies in the basolateral to apical, i...
2016: PloS One
Herbert I Fried, Barnett R Nathan, A Shaun Rowe, Joseph M Zabramski, Norberto Andaluz, Adarsh Bhimraj, Mary McKenna Guanci, David B Seder, Jeffrey M Singh
External ventricular drains (EVDs) are commonly placed to monitor intracranial pressure and manage acute hydrocephalus in patients with a variety of intracranial pathologies. The indications for EVD insertion and their efficacy in the management of these various conditions have been previously addressed in guidelines published by the Brain Trauma Foundation, American Heart Association and combined committees of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. While it is well recognized that placement of an EVD may be a lifesaving intervention, the benefits can be offset by procedural and catheter-related complications, such as hemorrhage along the catheter tract, catheter malposition, and CSF infection...
February 2016: Neurocritical Care
Gregory L Barkley
Accurate coding is an important function of neurologic practice. This contribution to Continuum is part of an ongoing series that presents helpful coding information along with examples related to the issue topic. Tips for diagnosis coding, Evaluation and Management coding, procedure coding, or a combination are presented, depending on which is most applicable to the subject area of the issue.
December 2015: Continuum: Lifelong Learning in Neurology
Kiran Thakur, Joseph Zunt
PURPOSE OF REVIEW: This article discusses the assessment of the patient presenting with neurologic symptoms who has lived in or traveled through tropical or subtropical regions and reviews selected nervous system infections prevalent in the tropics and subtropics, with discussion of the epidemiology, clinical features, recommended diagnostic testing, and management. RECENT FINDINGS: Increasing travel, emigration, and population growth all facilitate the global spread of tropical neurologic infections...
December 2015: Continuum: Lifelong Learning in Neurology
Michael D Geschwind
PURPOSE OF REVIEW: This article presents an update on the clinical aspects of human prion disease, including the wide spectrum of their presentations. RECENT FINDINGS: Prion diseases, a group of disorders caused by abnormally shaped proteins called prions, occur in sporadic (Jakob-Creutzfeldt disease), genetic (genetic Jakob-Creutzfeldt disease, Gerstmann-Sträussler-Scheinker syndrome, and fatal familial insomnia), and acquired (kuru, variant Jakob-Creutzfeldt disease, and iatrogenic Jakob-Creutzfeldt disease) forms...
December 2015: Continuum: Lifelong Learning in Neurology
Sarah McGlasson, Alexa Jury, Andrew Jackson, David Hunt
Type I interferon is an essential component of the brain's innate immune defence, conferring protection against viral infection. Recently, dysregulation of the type I interferon pathway has been implicated in the pathogenesis of a spectrum of neuroinfectious and neuroinflammatory disorders. Underactivity of the type I interferon response is associated with a predisposition to herpes simplex encephalitis. Conversely, a group of 'interferonopathic' disorders, characterized by severe neuroinflammation and overactivity of type I interferon, has been described...
September 2015: Nature Reviews. Neurology
Paulo Emílio Corrêa Leite, Mariana Rodrigues Pereira, José Mauro Granjeiro
Nanostructured materials are widely used in many applications of industry and biomedical fields. Nanoparticles emerges as potential pharmacological carriers that can be applied in the regenerative medicine, diagnosis and drug delivery. Different types of nanoparticles exhibit ability to cross the brain blood barrier (BBB) and accumulate in several brain areas. Then, efforts have been done to develop safer nanocarrier systems to treat disorders of central nervous system (CNS). However, several in vitro and in vivo studies demonstrated that nanoparticles of different materials exhibit a wide range of neurotoxic effects inducing neuroinflammation and cognitive impairment...
October 2015: Toxicology in Vitro: An International Journal Published in Association with BIBRA
A Spreer, R Nau
Cerebrospinal fluid analysis is of prime importance to establish an early diagnosis of central nervous system infections. Beside the basic diagnostics containing CSF white cell count, lactate concentration and protein analysis, the targeted search for agents of bacterial, viral or fungal CNS infectious diseases is essential. Decisive methods are bacterial and fungal staining techniques, microbiological culture methods, nucleic acid amplification and antigen detection methods or indirect identification of pathogens by serologic testings including the determination of pathogen-specific intrathecal immunoglobulin synthesis...
February 2015: Fortschritte der Neurologie-Psychiatrie
Felicia C Chow, Brian S Schwartz, S Andrew Josephson
No abstract text is available yet for this article.
January 6, 2015: Neurology
Avindra Nath
No abstract text is available yet for this article.
February 2015: JAMA Neurology
Anthony Noto, Evie Marcolini
Neurocritical care aims to improve outcomes in patients with life-threatening neurologic illness. The scope of neurocritical care extends beyond the more commonly encountered and important field of cerebrovascular disease, as described previously. This article focuses on neuromuscular, neuroinfectious, and neuroimmunologic conditions that are significant causes of morbidity and mortality in the acutely neurologically ill patient. As understanding continues to increase regarding the physiology of these conditions and the best treatment, rapid identification, triage, and treatment of these patients in the emergency department is paramount...
November 2014: Emergency Medicine Clinics of North America
G Buchholz, S Ormanns, H-W Pfister, U Koedel, M Klein
BACKGROUND AND PURPOSE: Studies on the impact of infectious diseases affecting the nervous system are sparse. METHODS: All patients with neuroinfectious diseases (NIDs) who were treated at our Department of Neurology from 2005 until 2009 were retrospectively analyzed. RESULTS: Patients with NIDs required treatment at the intensive care unit in 34.8%. The mortality rate of patients with NIDs was significantly higher than that of other inpatients with neurological diseases (5...
December 2014: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
H L Kirsch, K T Thakur, G L Birbeck
International travelers commonly contract infections while abroad, many of which are primary neurological diseases or have potential neurological sequelae. The implications of these neuroinfectious diseases extend beyond the individual, since returning travelers may contribute to the spread of infection in novel areas. In this review, we discuss signs, symptoms, treatments, and prophylaxes for these infections, as well as emerging trends with regard to neuroinfectious diseases of the returning traveler.
November 5, 2013: Current Infectious Disease Reports
Lucas Schirmer, Veit Rothhammer, Bernhard Hemmer, Thomas Korn
OBJECTIVE: To investigate the expression of CD161 (KLRB1) and CCR6 on human γδ T cells in blood and cerebrospinal fluid (CSF) of patients with a clinically isolated syndrome (CIS) and multiple sclerosis (MS) in relapse. DESIGN: Flow cytometry analysis of CD161 and CCR6 expression and intracellular cytokine staining for interleukin 17 and interferon-γ on human γδ T cells in blood and CSF samples. SETTING: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, a tertiary referral center...
March 1, 2013: JAMA Neurology
Joseph R Berger, Allen J Aksamit, David B Clifford, Larry Davis, Igor J Koralnik, James J Sejvar, Russell Bartt, Eugene O Major, Avindra Nath
OBJECTIVE: To establish criteria for the diagnosis of progressive multifocal leukoencephalopathy (PML). METHODS: We reviewed available literature to identify various diagnostic criteria employed. Several search strategies employing the terms "progressive multifocal leukoencephalopathy" with or without "JC virus" were performed with PubMed, SCOPUS, and EMBASE search engines. The articles were reviewed by a committee of individuals with expertise in the disorder in order to determine the most useful applicable criteria...
April 9, 2013: Neurology
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