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https://www.readbyqxmd.com/read/28756061/assessment-of-acute-motor-deficit-in-the-pediatric-emergency-room
#1
REVIEW
Marcio Moacyr Vasconcelos, Luciana G A Vasconcelos, Adriana Rocha Brito
OBJECTIVES: This review article aimed to present a clinical approach, emphasizing the diagnostic investigation, to children and adolescents who present in the emergency room with acute-onset muscle weakness. SOURCES: A systematic search was performed in PubMed database during April and May 2017, using the following search terms in various combinations: "acute," "weakness," "motor deficit," "flaccid paralysis," "child," "pediatric," and "emergency". The articles chosen for this review were published over the past ten years, from 1997 through 2017...
July 27, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28737956/hypophonia-as-a-sign-of-thalamus-lesion-a-case-report
#2
Claudia Rodríguez-López, Blanca Ayuso García, Sara Moreno García
Hypophonia is a neurological sign usually seen after brainstem or peripheral damage, either at the recurrent laryngeal nerve or vocal cord level. However, it has been described as a sign of supratentorial strokes in a few studies, specifically when anterior and ventral thalamic involvement is reported. In addition, it is a prominent sign of other neurological disorders such as Parkinson disease and other extrapyramidal conditions. We describe a case of hypophonia secondary to a left thalamic hemorrhage, after a careful search of other potential causes of this deficit, and we discuss the underlying neuroanatomical circuits...
August 6, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28706504/hypertrophic-olivary-degeneration-and-palatal-or-oculopalatal-tremor
#3
REVIEW
Caroline Tilikete, Virginie Desestret
Hypertrophic degeneration of the inferior olive is mainly observed in patients developing palatal tremor (PT) or oculopalatal tremor (OPT). This syndrome manifests as a synchronous tremor of the palate (PT) and/or eyes (OPT) that may also involve other muscles from the branchial arches. It is associated with hypertrophic inferior olivary degeneration that is characterized by enlarged and vacuolated neurons, increased number and size of astrocytes, severe fibrillary gliosis, and demyelination. It appears on MRI as an increased T2/FLAIR signal intensity and enlargement of the inferior olive...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28702507/brainstem-phenotype-of-cathepsin-a-related-arteriopathy-with-strokes-and-leukoencephalopathy
#4
Yun Tae Hwang, Rahul Lakshmanan, Indran Davagnanam, Andrew G B Thompson, David S Lynch, Henry Houlden, Nin Bajaj, Sofia H Eriksson, Doris-Eva Bamiou, Jason D Warren
No abstract text is available yet for this article.
August 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28647663/management-of-residual-tumor-after-limited-subtotal-resection-of-large-vestibular-schwannomas-lessons-learned-and-a-rationale-for-specialized-care
#5
William R Copeland, Matthew L Carlson, Brian A Neff, Colin L W Driscoll, Michael J Link
BACKGROUND: In an era where subtotal resection (STR) is increasingly utilized, we have encountered a growing number of patients referred to our institution with limited resection of large vestibular schwannomas (VS), at times associated with grave complications. OBJECTIVE: We highlight lessons learned in the management of large VS and provide a rationale for specialized care. METHODS: A prospectively maintained database of over 2,000 patients with VS evaluated at our institution between 2000 and 2016 was reviewed...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28620564/moyamoya-syndrome-in-a-child-with-neurofibromatosis-type-1-magnetic-resonance-imaging-as-a-tool-for-clinical-decision-making
#6
Jonathan Mayl, Hanisha Patel, Tushar Chandra
Moyamoya syndrome is a rare cerebrovasculopathy of unknown etiology which is associated with multiple risk factors. Moyamoya was first discovered in Japan and is reported to have an increased prevalence in the Japanese population. The term "Moyamoya" translates into "puff of smoke" and is named after the finding of the collateral cerebral vasculature that develops secondary to occlusion of an internal carotid artery at the entrance into the circle of Willis. This collateral vasculature characterizes the disease...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28611725/multiparameter-electromyography-analysis-of-the-masticatory-muscle-activities-in-patients-with-brainstem-stroke-at-different-head-positions
#7
Chuyao Jian, Miaoluan Wei, Jie Luo, Jiayin Lin, Wen Zeng, Weitian Huang, Rong Song
The performance of the masticatory muscle is frequently affected and presents high heterogeneity poststroke. Surface electromyography (EMG) is widely used to quantify muscle movement patterns. However, only a few studies applied EMG analysis on the research of masticatory muscle activities poststroke, and most of which used single parameter-root mean squares (RMS). The aim of this study was to fully investigate the performance of masticatory muscle at different head positions in healthy subjects and brainstem stroke patients with multiparameter EMG analysis...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28590894/hearing-characteristics-of-stroke-patients-prevalence-and-characteristics-of-hearing-impairment-and-auditory-processing-disorders-in-stroke-patients
#8
Nehzat Koohi, Deborah A Vickers, Rahul Lakshmanan, Hoskote Chandrashekar, David J Werring, Jason D Warren, Doris-Eva Bamiou
BACKGROUND: Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors...
June 2017: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/28567027/transient-vestibulopathy-in-wallenberg-s-syndrome-pathologic-analysis
#9
Jorge C Kattah, Ali S Saber Tehrani, Sigrun Roeber, Meena Gujrati, Sarah E Bach, David E Newman Toker, Ari M Blitz, Anja K E Horn
OBJECTIVE: To report an unusual lateral medullary stroke (LMS) associated with transient unidirectional horizontal, nystagmus, and decreased horizontal vestibulo-ocular reflex (h-VOR) gain that mimicked a peripheral vestibulopathy. MRI suggested involvement of caudal medial vestibular nucleus (MVN); however, the rapid resolution of the nystagmus and improved h-VOR gain favored transient ischemia without infarction. Decreased h-VOR gain is expected with peripheral vestibular lesions within the labyrinth or superior vestibular nerve; less frequently lateral pontine strokes involving the vestibular root entry, the vestibular fascicle, or neurons within the MVN may be responsible...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28550485/change-in-excitability-of-cortical-projection-after-modified-catheter-balloon-dilatation-therapy-in-brainstem-stroke-patients-with-dysphagia-a-prospective-controlled-study
#10
Xiaomei Wei, Fan Yu, Meng Dai, Chunqing Xie, Guifang Wan, Yujue Wang, Zulin Dou
Although the modified balloon dilatation therapy has been demonstrated to improve pharyngeal swallowing function post stroke, the underlying neural mechanisms of improvement are unknown. Our aims are (1) to investigate the effect of modified balloon dilatation on the excitability of corticobulbar projections to the submental muscle in dysphagic patients with brainstem stroke and (2) the relation between changes in excitability and pharyngeal kinematic modifications. Thirty patients with upper esophageal sphincter (UES) dysfunction due to unilateral brainstem stroke were recruited into two groups...
May 26, 2017: Dysphagia
https://www.readbyqxmd.com/read/28545782/autoimmune-encephalopathy-for-psychiatrists-when-to-suspect-autoimmunity-and-what-to-do-next
#11
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/28529059/a-review-of-human-neuroimaging-investigations-involved-with-central-autonomic-regulation-of-baroreflex-mediated-cardiovascular-control
#12
REVIEW
Derek S Kimmerly
Effective regulation of central blood volume and arterial pressure is critical for optimal cardiovascular homeostasis. Inadequate regulation of mean arterial pressure has important pathophysiological implications including syncope, end organ damage, and stroke. Such regulation requires appropriate central integration of barosensory afferents and reflex autonomic control of the heart and blood vessels. The neural pathways involved with the baroreflex include brainstem nuclei that receive modulatory input from higher brain centres...
May 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28491030/the-encephalophone-a-novel-musical-biofeedback-device-using-conscious-control-of-electroencephalogram-eeg
#13
Thomas A Deuel, Juan Pampin, Jacob Sundstrom, Felix Darvas
A novel musical instrument and biofeedback device was created using electroencephalogram (EEG) posterior dominant rhythm (PDR) or mu rhythm to control a synthesized piano, which we call the Encephalophone. Alpha-frequency (8-12 Hz) signal power from PDR in the visual cortex or from mu rhythm in the motor cortex was used to create a power scale which was then converted into a musical scale, which could be manipulated by the individual in real time. Subjects could then generate different notes of the scale by activation (event-related synchronization) or de-activation (event-related desynchronization) of the PDR or mu rhythms in visual or motor cortex, respectively...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28483068/factors-associated-with-multidimensional-aspect-of-post-stroke-fatigue-in-acute-stroke-period
#14
Hitoshi Mutai, Tomomi Furukawa, Ayumi Houri, Akihito Suzuki, Tokiji Hanihara
BACKGROUND: Post-stroke fatigue (PSF) is a frequent and distressing consequence of stroke, and can be both acute and long lasting. We aimed to investigate multidimensional aspects of acute PSF and to determine the clinical factors relevant to acute PSF. METHODS: We collected data of 101 patients admitted to the hospital for acute stroke. PSF was assessed using the Multidimensional Fatigue Inventory within 2 weeks of stroke. Measures included Mini-Mental State Examination, Hospital Anxiety and Depression Scale, and Functional Independence Measure...
April 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/28461834/vertebral-artery-dissection-a-contemporary-perspective
#15
Cristina Tiu, Elena Terecoasa, Nicolae Grecu, Raluca Nistor, Smaranda Frangu, Florina Antochi
Arterial dissections are among the most frequent causes of stroke in young adults. Usually they are associated with trauma, but as the modern imaging tools are evolving, more dissections are being diagnosed and more etiologies are being described. Vertebral artery dissections (VADs) have the distinct particularity that they can cause ischemic stroke (in the brainstem, cerebellum or even the spinal cord), but also subarachnoid hemorrhage, when the dissection occurs in the intracranial segment of the vertebral artery...
June 2016: Mædica
https://www.readbyqxmd.com/read/28413710/combination-of-standard-axial-and-thin-section-coronal-diffusion-weighted-imaging-facilitates-the-diagnosis-of-brainstem-infarction
#16
Philippe Felfeli, Holger Wenz, Mansour Al-Zghloul, Christoph Groden, Alex Förster
BACKGROUND AND PURPOSE: Although diffusion-weighted imaging (DWI) is a very sensitive technique for the detection of small ischemic lesions in the human brain, in particular in the brainstem it may fail to demonstrate acute ischemic infarction. In this study, we sought to evaluate the value of additional thin-section coronal DWI for the detection of brainstem infarction. METHODS: In 155 consecutive patients (median age 69 [interquartile range, IQR 57-78] years, 95 [61...
April 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28337694/the-posterior-fossa-and-foreign-accent-syndrome-report-of-two-new-cases-and-review-of-the-literature
#17
Stefanie Keulen, Peter Mariën, Kim van Dun, Roelien Bastiaanse, Mario Manto, Jo Verhoeven
Foreign accent syndrome is a rare motor speech disorder that causes patients to speak their language with a non-native accent. In the neurogenic condition, the disorder develops after lesions in the language dominant hemisphere, often affecting Broca's area, the insula, the supplementary motor area and the primary motor cortex. Here, we present two new cases of FAS after posterior fossa lesions. The first case is a 44-year-old, right-handed, Dutch-speaking man who suffered motor speech disturbances and a left hemiplegia after a pontine infarction...
March 23, 2017: Cerebellum
https://www.readbyqxmd.com/read/28324264/reverse-locked-in-syndrome
#18
Pooja Raibagkar, Ram V Chavali, Tamara B Kaplan, Jennifer A Kim, Meaghan V Nitka, Sherry H-Y Chou, Brian L Edlow
BACKGROUND: Basilar artery occlusion can cause locked-in syndrome, which is characterized by quadriplegia, anarthria, and limited communication via eye movements. Here, we describe an uncommon stroke syndrome associated with endovascular recanalization of the top of the basilar artery: "reverse locked-in syndrome." METHODS: We report the case of a patient with atypical neurological deficits caused by acute ischemic stroke of the midbrain tegmentum. We perform neuroanatomic localization of the patient's infarcts by mapping the magnetic resonance imaging (MRI) data onto a brainstem atlas...
August 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28320635/safety-and-efficacy-of-multipotent-adult-progenitor-cells-in-acute-ischaemic-stroke-masters-a-randomised-double-blind-placebo-controlled-phase-2-trial
#19
RANDOMIZED CONTROLLED TRIAL
David C Hess, Lawrence R Wechsler, Wayne M Clark, Sean I Savitz, Gary A Ford, David Chiu, Dileep R Yavagal, Ken Uchino, David S Liebeskind, Alexander P Auchus, Souvik Sen, Cathy A Sila, Jeffrey D Vest, Robert W Mays
BACKGROUND: Multipotent adult progenitor cells are a bone marrow-derived, allogeneic, cell therapy product that modulates the immune system, and represents a promising therapy for acute stroke. We aimed to identify the highest, well-tolerated, and safest single dose of multipotent adult progenitor cells, and if they were efficacious as a treatment for stroke recovery. METHODS: We did a phase 2, randomised, double-blind, placebo-controlled, dose-escalation trial of intravenous multipotent adult progenitor cells in 33 centres in the UK and the USA...
May 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28314977/isolated-vestibular-syndromes-due-to-brainstem-and-cerebellar-lesions
#20
Sung-Hee Kim, Hyo Jung Kim, Ji-Soo Kim
Dizziness/vertigo is the most common symptoms of posterior circulation strokes. Isolated vestibular symptoms and signs without other neurologic deficits have been found in infarctions involving the brainstem and cerebellum. In the brainstem, infarctions responsible for isolated vestibular syndrome are usually restricted to the dorsal portion that contains the vestibular nucleus and the nucleus prepositus hypoglossi. Cerebellar lesions confined to the flocculus, tonsil, and nodulus also produce isolated vertigo and imbalance...
March 17, 2017: Journal of Neurology
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