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https://www.readbyqxmd.com/read/29691835/rufinamide-add-on-therapy-for-refractory-epilepsy
#1
REVIEW
Mariangela Panebianco, Hemanshu Prabhakar, Anthony G Marson
BACKGROUND: Epilepsy is a central nervous system disorder (neurological disorder). Epileptic seizures are the result of excessive and abnormal cortical nerve cell electrical activity in the brain. Despite the development of more than 10 new antiepileptic drugs (AEDs) since the early 2000s, approximately a third of people with epilepsy remain resistant to pharmacotherapy, often requiring treatment with a combination of AEDs. In this review, we summarised the current evidence regarding rufinamide, a novel anticonvulsant medication, which, as a triazole derivative, is structurally unrelated to any other currently used anticonvulsant medication, when used as an add-on treatment for refractory epilepsy...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29689764/a-speed-based-approach-to-vestibular-rehabilitation-for-peripheral-vestibular-hypofunction-a-retrospective-chart-review
#2
Robert Alan Roller, Courtney D Hall
BACKGROUND: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during gaze stability exercises. OBJECTIVE: Examine outcomes of modified VOR X1 exercises that emphasize a speed-based approach for gaze stabilization while omitting substitution and habituation exercises...
April 18, 2018: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/29687619/understanding-jugular-venous-outflow-disturbance
#3
REVIEW
Da Zhou, Jia-Yue Ding, Jing-Yuan Ya, Li-Qun Pan, Feng Yan, Qi Yang, Yu-Chuan Ding, Xun-Ming Ji, Ran Meng
Extracranial venous abnormalities, especially jugular venous outflow disturbance, were originally viewed as nonpathological phenomena due to a lack of realization and exploration of their feature and clinical significance. The etiology and pathogenesis are still unclear, whereas a couple of causal factors have been conjectured. The clinical presentation of this condition is highly variable, ranging from insidious to symptomatic, such as headaches, dizziness, pulsatile tinnitus, visual impairment, sleep disturbance, and neck discomfort or pain...
April 23, 2018: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29686557/coronary-artery-fistula-between-the-left-anterior-descending-artery-and-pulmonary-artery
#4
Abdul Al-Douri, Ari Cedars, Dat Tran
Coronary artery fistula is a rare anomalous connection between a coronary artery and a cardiac chamber or major vessel. Here we present the case of a 36-year-old woman who presented with sharp, substernal chest pain, dyspnea, and dizziness. A fistula between her left anterior descending artery and pulmonary trunk was found. Herein, we describe our approach and review the epidemiology, pathophysiology, diagnosis, and treatment options.
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29685473/acute-pediatric-colchicine-toxicity-is-associated-with-marked-bradydysrhythmias
#5
Lamya Mubayed, Brie-Ann A Muller, Jessica L Jacobson, Howard A Hast, Hoang H Nguyen
BACKGROUND: Colchicine ingestion is rare but highly lethal. Patients usually die of multiorgan failure and cardiogenic shock. Colchicine is not only associated with depressed myocardial function but also with fatal heart rhythm disturbances, such as complete heart block, ventricular tachycardia, and asystole. While histologic changes of myocytes are well known, the mechanism by which colchicine affects cardiac impulse generation and conduction is not fully understood. CASE REPORT: We present a case of colchicine ingestion with sinus bradycardia, marked sinus arrhythmia, and first- and second-degree heart block...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29685082/peripheral-vestibular-disorders-in-children-and-adolescents-with-concussion
#6
Jacob R Brodsky, Talia N Shoshany, Sophie Lipson, Guangwei Zhou
Objective To review peripheral vestibular disorders in pediatric patients with dizziness following concussion. Study Design Case series with chart review. Setting Pediatric vestibular clinic and pediatric multidisciplinary concussion clinic at a tertiary level pediatric hospital. Subjects and Methods We retrospectively reviewed 109 patients seen for dizziness following a concussion between September 2012 and July 2015. Patients were ≤20 years of age at the time of concussion. Incidences of specific peripheral vestibular disorders were assessed along with timing of diagnosis relative to the date of injury, diagnostic test findings, and treatment interventions associated with those diagnoses...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29684032/pseudo-spontaneous-nystagmus-in-patients-with-geotropic-direction-changing-positional-nystagmus
#7
Seok Min Hong, Sung Kyun Kim, Il-Seok Park, Min Gyeong Shim
BACKGROUND: Pseudo-spontaneous nystagmus has been reported in patients with direction-changing positional nystagmus (DCPN). Recently, the concept of a "light cupula" has been introduced as a pathophysiology that can exhibit persistent geotropic DCPN. Patients with persistent DCPN could have different characteristics of nystagmus. Therefore, we investigated the pseudo-spontaneous nystagmus in patients with transient (canalolithiasis) and persistent (belong to light cupula theory) geotropic DCPN...
2018: PloS One
https://www.readbyqxmd.com/read/29682354/pathology-and-treatment-of-traumatic-cervical-spine-syndrome-whiplash-injury
#8
REVIEW
Nobuhiro Tanaka, Kivanc Atesok, Kazuyoshi Nakanishi, Naosuke Kamei, Toshio Nakamae, Shinji Kotaka, Nobuo Adachi
Traumatic cervical syndrome comprises the various symptoms that occur as a result of external force such as that of a traffic accident. In 1995, the Quebec Task Force on whiplash-associated disorders (WAD) formulated the Quebec classification, with accompanying clinical practice guidelines. These guidelines were in accordance with the stated clinical isolated or combined symptoms of the syndrome: neck pain, headaches, dizziness, numbness of head or face, eye pain, vision loss, double vision, tinnitus, hearing loss, nausea, and numbness and/or weakness of extremities...
2018: Advances in Orthopedics
https://www.readbyqxmd.com/read/29682046/c1-c2-transverse-foramen-decompression-by-anterolateral-approach-as-an-alternative-treatment-in-bow-hunter-s-syndrome
#9
Serdar Çevik, Salim Katar, Hakan Hanımoǧlu
Bow hunter's syndrome (BHS) is characterized with repeating paroxysmal vertigo, nystagmus and ataxia caused by mechanical compression of the vertebral arteries. There is no definite diagnostic and treatment protocol. 26-year-old female patient admitted to the outpatient clinic with complaints of dizziness and seldom falls. Stenosis in the right vertebral artery at the level of C1 and C2 was discovered by the diagnostic modalities. In our patient, we first performed hemilaminectomy by posterior approach. But the symptoms of the patient did not recede, thus we performed decompression with the anterolateral approach by opening the foramens atlas and axis without disrupting the dynamics of the vertebrae and without the need for stabilization...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682026/prognostic-implications-of-histological-clear-cells-in-high-grade-intracranial-ependymal-tumors-a-retrospective-analysis-from-a-tertiary-care-hospital-in-pakistan
#10
Fauzan Alam Hashmi, Hamid Hussain Rai, Muhammad Faheem Khan, Muhammad Ehsan Bari
Background: Clear cell variant in ependymal tumors is rare. We aimed to compare the features and outcome of the World Health Organization (WHO) Grade 3 ependymal tumors with clear cells to the WHO Grade 3 classic anaplastic ependymoma (AE). Materials and Methods: A retrospective cohort study conducted at the Department of Neurosurgery, Aga Khan University, Pakistan, from 2003 to 2013. The medical records and radiology of patients with proven histopathology were reviewed...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29681575/sinus-standstill-in-a-patient-after-intracoronary-papaverine-administration-for-a-coronary-fractional-flow-reserve
#11
Masahiro Nauchi, Tsuyoshi Sakai, Masahiro Yamawaki, Yoshiaki Ito
A 78-year-old woman had paroxysmal atrial fibrillation and effort angina. Two months before she was admitted for a coronary angiography, she had been feeling dizzy. A Holter 24-hour electrocardiography monitor exhibited an asymptomatic episode of 2.9 seconds of RR interval. She underwent a coronary angiography, which showed intermediate stenosis in the left descending artery. Fractional flow reserve (FFR) measurement using intracoronary papaverine administration was performed. After intracoronary papaverine (12 mg) administration, pause of 4 seconds led to polymorphic ventricular tachycardia (VT), although the VT terminated spontaneously...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29680815/patient-trajectories-and-their-impact-on-mobility-social-participation-and-quality-of-life-in-patients-with-vertigo-dizziness-balance-disorders-and-osteoarthritis-mobile-tra-study-protocol-of-an-observational-practice-based-cohort-study
#12
Rebecca Kisch, Antje Bergmann, Daniela Koller, Reiner Leidl, Ulrich Mansmann, Martin Mueller, Linda Sanftenberg, Joerg Schelling, Leonie Sundmacher, Karen Voigt, Eva Grill
INTRODUCTION: Mobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several shortcomings regarding mobility sustainment of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions and deficiencies in personalising care based on patients' needs and experiences...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29680437/treatment-of-restless-legs-syndrome-willis-ekbom-disease-with-the-non-selective-ent1-ent2-inhibitor-dipyridamole-testing-the-adenosine-hypothesis
#13
Diego Garcia-Borreguero, Xavier Guitart, Celia Garcia Malo, Irene Cano-Pumarega, Juan José Granizo, Sergi Ferré
OBJECTIVES: Recent animal models of restless legs syndrome (RLS) suggest that brain iron deficiency is associated with a hypoadenosinergic state, with downregulation of adenosine A1 receptors (A1R) in the striatum and cortex. We hypothesized that an increase in extracellular adenosine induced by inhibitors of adenosine transporters, such as the non-selective ENT1/ENT2 inhibitor dipyridamole, would result in an improvement in RLS symptoms. METHODS: In a prospective two-month open-label, non-placebo controlled clinical trial, 15 untreated idiopathic RLS patients began treatment with 100 mg dipyridamole (with uptitration to 400 mg if necessary)...
May 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29676210/reduced-purposeful-head-movements-during-community-ambulation-following-unilateral-vestibular-loss
#14
Serene Sulyn Paul, Leland E Dibble, Raymond G Walther, Clough Shelton, Richard Klaus Gurgel, Mark Eric Lester
BACKGROUND: Individuals with unilateral vestibular hypofunction (UVH) alter their movement and reduce mobility to try to stabilize their gaze and avoid symptoms of dizziness and vertigo. OBJECTIVE: To determine if individuals with UVH 6 weeks after surgery demonstrate altered head and trunk kinematics during community ambulation. METHODS: A total of 15 vestibular schwannoma patients with documented postoperative unilateral vestibular loss and 9 healthy controls with symmetrical vestibulo-ocular reflexes participated in this cross-sectional study...
April 1, 2018: Neurorehabilitation and Neural Repair
https://www.readbyqxmd.com/read/29674947/health-and-social-problems-associated-with-recent-novel-psychoactive-substance-nps-use-amongst-marginalised-nightlife-and-online-users-in-six-european-countries
#15
Marie Claire Van Hout, Annemieke Benschop, Michal Bujalski, Katarzyna Dąbrowska, Zsolt Demetrovics, Katalin Felvinczi, Evelyn Hearne, Susana Henriques, Zsuzsa Kaló, Gerrit Kamphausen, Dirk Korf, Joana Paula Silva, Łukasz Wieczorek, Bernd Werse
Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland ( n  = 3023). Some respondents were unable to categorise NPS they had used. Use of ' herbal blends ' and ' synthetic cannabinoids obtained pure ' was most reported in Germany, Poland and Hungary, and use of ' branded stimulants ' and ' stimulants/empathogens/nootropics obtained pure ' was most reported in the Netherlands...
2018: International Journal of Mental Health and Addiction
https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#16
Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29669175/antidepressants-for-preventing-postnatal-depression
#17
REVIEW
Emma Molyneaux, Laurence A Telesia, Carol Henshaw, Elizabeth Boath, Eleanor Bradley, Louise M Howard
BACKGROUND: Depression is common in the postnatal period and can lead to adverse effects on the infant and wider family, in addition to the morbidity for the mother. It is not clear whether antidepressants are effective for the prevention of postnatal depression and little is known about possible adverse effects for the mother and infant, particularly during breastfeeding. This is an update of a Cochrane Review last published in 2005. OBJECTIVES: To assess the effectiveness of antidepressant medication for the prevention of postnatal depression, in comparison with any other treatment, placebo or standard care...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29668616/lung-metastases-from-intracranial-bleeding-meningioma-a-case-report
#18
Su Hu, Yaqi Zhang, Yue Sun, Yang Yu, Jia Wang, Hui Dai, Feng Sun, Chunhong Hu
RATIONALE: Meningioma is slow-growing benign neoplasm that derived from the meningothelial cells of the arachnoid mater, and it is the most common type of primary brain tumor. Although cases of extracranial metastatic meningioma have been reported previously, few cases have reported the concurrent occurrence of primary meningioma with intratumoral bleeding and lung metastases. Here we report a case of meningioma with concurrent intratumoral bleeding and lung metastases. PATIENT CONCERNS: The patient was admitted to our hospital with sudden left limb paralysis combined with complaints of headache and dizziness...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29666096/devil-is-in-the-detail
#19
John Roshan Jacob, Amal Paul, Anoop George Alex
A 15-year-old girl of Asian origin, hailing from a rural agrarian background, presented with history of multiple episodes of dizziness for 3 years. The episodes were precipitated mostly by emotional and/or physical stress and relieved on lying down, with a few episodes culminating in transient loss of consciousness. As preliminary cardiac and neurological evaluation were normal, she was being treated by the primary physician as a case of probable psychogenic syncope, supported by the consistent association of the episodes with emotional stress...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29665318/assessment-of-vestibular-function-in-patients-with-chronic-middle-ear-disease-using-the-vhit-and-vemp-test
#20
J S Sandhu, M Yung, J Parker-George, B Kearney, J Ray
It is widely accepted that middle ear pathology can cause dizziness and imbalance, however this has been a challenging area to investigate, as the bi-thermal caloric test is difficult to interpret in this cohort. Recently vestibular tests that bypass the middle ear have been developed. These are the Video Head Impulse Test (vHIT) and the Bone Conduction Vestibular Evoked Myogenic Potentials (BC-VEMPs). We have successfully carried out pre-operative vHIT and BC-VEMPs on 20 patients awaiting surgery for middle ear pathologies and have shown that complete testing can be done in less than 30 minutes...
April 17, 2018: Clinical Otolaryngology
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