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https://www.readbyqxmd.com/read/29166203/temporal-profile-of-care-following-mild-traumatic-brain-injury-predictors-of-hospital-admission-follow-up-referral-and-six-month-outcome
#1
John K Yue, Ethan A Winkler, Sourabh Sharma, Mary J Vassar, Jonathan J Ratcliff, Frederick K Korley, Seth A Seabury, Adam R Ferguson, Hester F Lingsma, Sacha Meeuws, Opeolu M Adeoye, Jonathan W Rick, Caitlin K Robinson, Siena M Duarte, Esther L Yuh, Pratik Mukherjee, Sureyya S Dikmen, Thomas W McAllister, Ramon Diaz-Arrastia, Alex B Valadka, Wayne A Gordon, David O Okonkwo, Geoffrey T Manley
OBJECTIVE: To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). METHODS: Overall, 168 adult patients with mTBI from the prospective, multicentre Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Pilot study with Glasgow Coma Scale (GCS) 13-15, no polytrauma and alive at six months were included. Predictors for hospital admission, three-month follow-up referral and six-month functional disability (Glasgow Outcome Scale-Extended (GOSE) ≤ 6) were analysed using multivariable regression...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29163745/possible-reversible-cerebral-vasoconstriction-syndrome-associated-with-eucalyptus-case-report
#2
Daniel Lapid, Mohtashim Arbaab Qureshi, Ihtesham Aatif Quresh, Mohammed Rauf Afzal, Alberto Maud, Gustavo J Rodriguez, Rakesh Khatri
Background: Reversible cerebral vasoconstrictive syndrome (RCVS) has characteristic clinical features, brain imaging and Angiographic features. The majority of RCVS cases are associated with the use of antidepressants, polysubstance abuse, and nasal decongestants. We here present a case that highlights the use of eucalyptus herbs as a possible precipitant factor for RCVS formation. Case Presentation: A 42-year-old woman presented to the emergency department with a tingling sensation on the right-hand side of her body and a two-week progressive throbbing severe holocranial headache radiating to the neck, with associated nausea, photophobia, and phonophobia...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29159426/an-initial-cost-effectiveness-analysis-of-intraoperative-magnetic-resonance-imaging-imri-in-pediatric-epilepsy-surgery
#3
Matthew F Sacino, Sean S Huang, Robert F Keating, William D Gaillard, Chima O Oluigbo
PURPOSE: Previous studies have illustrated the clinical utility of the addition of intraoperative magnetic resonance imaging (iMRI) to conventional microsurgical resection. While iMRI requires initial capital cost investment, long-term reduction in costly follow-up management and reoperation costs may prove economically efficacious. The objective of this study is to investigate the cost-effectiveness of the addition of iMRI utilization versus conventional microsurgical techniques in focal cortical dysplasia (FCD) resection in pediatric patients with medically refractory epilepsy...
November 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29159151/a-case-of-unusual-presentation-of-contrast-induced-encephalopathy-after-cerebral-angiography-using-iodixanol
#4
Jun Chul Park, Jun Hyong Ahn, In Bok Chang, Jae Keun Oh, Ji Hee Kim, Joon Ho Song
Contrast-induced encephalopathy after cerebral angiography is a rare complication and until now, only few cases have been reported. This paper reports on contras-induced encephalopathy mimicking meningoencephalitis after cerebral angiography by using iodixanol, an iso-osmolar non-ionic contrast agent. A 58-year-old woman underwent cerebral angiography for the evaluation of multiple intracranial aneurysms. A few hours later, she had persistent headache, vomiting, fever, and seizures. Brain computed tomography (CT) showed sulcal obliteration of right cerebral hemisphere and cerebrospinal fluid profile was unremarkable...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29157660/encephalitis-and-myelitis-in-tropical-countries-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#5
REVIEW
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Pravin R Amin
Tropical diseases are those that occur primarily or solely in the tropics, and as such include infectious diseases that are particularly prevalent in hot, humid conditions. The incidence of encephalitis in tropical countries is reported to be as high as 6.34/100,000/year. The term encephalitis implies inflammation of the brain and includes the presence of encephalopathy with two and more of the following features: fever, seizures and/or focal neurological findings; a cerebrospinal fluid pleocytosis; electroencephalographic findings or abnormal neuroimaging suggestive of encephalitis...
November 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29157096/complementary-and-alternative-medicine-the-mozart-effect-on-childhood-epilepsy-a-systematic-review
#6
Dana E Brackney, Jessica L Brooks
This systematic review examines the effectiveness of Mozart's music in decreasing seizures in children with epilepsy (Mozart Effect) using the Johns Hopkins Nursing Evidence-Based Practice rating scale(©). A search for articles with "Mozart Effect," "child*," and "epilepsy" was conducted in CINAHL Complete, Science Direct, Cochrane, and PubMed databases. Eight studies were selected based on the exclusion and inclusion criteria after removal of duplicates ( n = 17) and others ( n = 46). Studies included were English language, peer reviewed, published between April 2010 and February 2017, and available in full text with an abstract...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/29155706/comprehensive-endovascular-and-open-surgical-management-of-cerebral-arteriovenous-malformations
#7
Robert C Rennert, Jeffrey A Steinberg, Vincent J Cheung, David R Santiago-Dieppa, Jeffrey Scott Pannell, Alexander A Khalessi
Arteriovenious malformations (AVMs) are associated with significant morbidity and mortality, and have a rupture risk of ~3% per year. Treatment of AVMs must be tailored specifically to the lesion, with surgical resection being the gold standard for small, accessible lesions. Pre-operative embolization of AVMs can reduce nidal blood flow and remove high-risk AVM features such as intranidal or venous aneurysms, thereby simplifying a challenging neurosurgical procedure. Herein, we describe our approach for the staged endovascular embolization and open resection of AVMs, and highlight the advantages of having a comprehensively trained neurovascular surgeon leading a multi-disciplinary clinical team...
October 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29155063/technical-note-robotic-guided-bi-hippocampal-and-bi-parahippocampal-depth-placement-for-responsive-neurostimulation-in-bitemporal-lobe-epilepsy
#8
Pratik Rohatgi, Ryan J Jafrani, Nicholas J Brandmeir, Frank G Gilliam, Tiffany L Fisher, Michael D Sather
BACKGROUND: Patients with bitemporal lobe epilepsy are generally not considered for surgical resection. Fortunately, responsive neurostimulation proves another avenue for the management of this challenging disease process. In conjunction with our epileptologist, we consider responsive neurostimulation for patients who have clinical features of temporal lobe epilepsy without clear localization on imaging and stereo-EEG. METHODS: Here we describe our technique for implanting a responsive neurostimulator (NeuroPace, NeuroPace Inc...
November 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29152734/access-to-diagnostic-and-therapeutic-facilities-for-psychogenic-nonepileptic-seizures-an-international-survey-by-the-ilae-pnes-task-force-2nd-revision
#9
Coraline Hingray, Wissam El-Hage, Rod Duncan, David Gigineishvili, Kousuke Kanemoto, W Curt LaFrance, Alejandro de Marinis, Ravi Paul, Chrisma Pretorius, José F Téllez Zenteno, Hannah Wiseman, Markus Reuber
OBJECTIVE: Studies from a small number of countries suggest that patients with psychogenic nonepileptic seizures (PNES) have limited access to diagnostic and treatment services. The PNES Task Force of the International League Against Epilepsy (ILAE) carried out 2 surveys to explore the diagnosis and treatment of PNES around the world. METHODS: A short survey (8 questions) was sent to all 114 chapters of the ILAE. A longer survey (36 questions) was completed by healthcare professionals who see patients with seizures...
November 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/29143207/contribution-of-eeg-in-transient-neurological-deficits
#10
Pierre Lozeron, Nadine Carole Tcheumeni, Sahar Turki, Hélène Amiel, Elodie Meppiel, Sana Masmoudi, Caroline Roos, Isabelle Crassard, Patrick Plaisance, Houria Benbetka, Jean-Pierre Guichard, Emmanuel Houdart, Hélène Baudoin, Nathalie Kubis
Identification of stroke mimics and 'chameleons' among transient neurological deficits (TND) is critical. Diagnostic workup consists of a brain imaging study, for a vascular disease or a brain tumour and EEG, for epileptiform discharges. The precise role of EEG in this diagnostic workup has, however, never been clearly delineated. However, this could be crucial in cases of atypical or incomplete presentation with consequences on disease management and treatment. We analysed the EEG patterns on 95 consecutive patients referred for an EEG within 7 days of a TND with diagnostic uncertainty...
November 15, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29139014/the-ictal-interictal-continuum-to-treat-or-not-to-treat-and-how
#11
Clio Rubinos, Alexandra S Reynolds, Jan Claassen
Continuous electroencephalography (cEEG) monitoring is becoming increasingly used in neurologic and non-neurologic intensive care units (ICUs). Non-convulsive seizures (NCSz) and periodic discharges (PDs) are commonly seen in critically ill patients. Some of these PD patterns, also known as the ictal-interictal continuum (IIC), are associated with an increased risk of seizures and poor outcome. However, we do not fully understand the significance of these periodic patterns and the decision of how aggressively to treat remains controversial...
November 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29138603/fatal-collapse-due-to-autonomic-dysreflexia-during-manual-self-evacuation-of-bowel-in-a-tetraplegic-patient-living-alone-lessons-to-learn
#12
Subramanian Vaidyanathan, Bakul M Soni, Paul Mansour, Tun Oo
Background: To identify areas for improvement, the National Health Service in England mandates the review of case reports of patients who have died, which should be translated into improved care for other patients. Case report: A 49-year-old Caucasian man sustained C-7 tetraplegia in a motorcycle accident in 1992. In 2009, he developed seizures and collapsed in the lavatory on a number of occasions during manual self-evacuation of his bowel. A 24-hour electrocardiogram recording at that time showed sinus rhythm with a maximum heart rate of 97 and a minimum of 39 beats per minute; there were no significant arrhythmias that could have contributed to his episodes of collapse...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#13
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29134517/subcutaneous-ketamine-for-postoperative-pain-relief-in-rwanda-a-randomized-clinical-trial
#14
Calen Sacevich, Benjamin Semakuba, William P McKay, Shefali Thakore, Theogene Twagirumugabe, John Nyiligira
PURPOSE: Postoperative pain control is often inadequate in low-income countries such as Rwanda, prompting the search for an inexpensive improvement. A randomized controlled trial was conducted to study the use of subcutaneous ketamine for the management of postoperative pain in patients undergoing major surgery in Kigali, Rwanda. METHODS: Fifty-nine patients undergoing major abdominal, head and neck, plastic, or gynecological surgeries were studied. In addition to standard care, patients received five subcutaneous injections of ketamine 1 mg·kg(-1) (ketamine group, n = 30) or normal saline (placebo group, n = 29) during the postoperative period...
November 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#15
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29131576/pharmacological-characterization-of-3h-atpca-as-a-substrate-for-studying-the-functional-role-of-the-betaine-gaba-transporter-1-and-the-creatine-transporter
#16
Anas Al-Khawaja, Anne S Haugaard, Ales Marek, Rebekka Löffler, Louise Thiesen, Monica Santiveri, Maria Damgaard, Christoffer Bundgaard, Bente Frølund, Petrine Wellendorph
The betaine/γ-aminobutyric acid (GABA) transporter 1 (BGT1) is one of the four GABA transporters (GATs) involved in the termination of GABAergic neurotransmission. Although suggested to be implicated in seizure management, the exact functional importance of BGT1 in the brain is still elusive. This is partly owing to the lack of potent and selective pharmacological tool compounds that can be used to probe its function. We previously reported the identification of 2-amino-1,4,5,6-tetrahydropyrimidine-5-carboxylic acid (ATPCA), a selective substrate for BGT1 over GAT1/GAT3, but also an agonist for GABAA receptors...
November 13, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29129776/glucagon-like-peptide-1-glp-1-and-neurotransmitters-signaling-in-epilepsy-an-insight-review
#17
REVIEW
Prashant Koshal, Sumit Jamwal, Puneet Kumar
Epilepsy is one of the most prevalent neurological disorder affecting more than 50 million people worldwide. Numerous studies have suggested that an imbalance in glutamatergic (excitatory) and GABAergic (inhibitory) neurotransmitter system is one of the dominating pathophysiological mechanisms underlying the occurrence and progression of seizures. Further, this alteration in GABAergic and glutamatergic system disrupts the delicate balance of other neurotransmitters system in the brain. Emerging strides have documented the protective role of GLP-1 signaling on altered neurotransmitters signaling in Epilepsy and associated co-morbidities...
November 9, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29129567/seizure-care-in-the-emergency-department-identifying-and-bridging-the-gaps-a-study-of-care-and-outcomes-from-644-seizure-presentations
#18
Jennifer Williams, Jack Doherty, Chiara Di Blasi, Dimitri Mabarak, Una Kennedy, Colin P Doherty
Care for seizures in an emergency department setting can be variable, and there are disparities in access to onward specialist referral. The purpose of this study was to evaluate the utilization and implementation of an evidence-based seizure care pathway in a busy urban tertiary referral center. A total of 644 seizure presentations over two time points were examined. Initial pathway utilization rates were low at 26.2% but increased to 61.6% after environmental barriers had been addressed. We found that patients placed on the care pathway had higher rates of neurological examination, documentation of safety and legal guidelines as regards driving, and lower rates of seizure readmission...
November 9, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29128371/assessments-of-neurocognitive-and-behavioral-function-in-the-mucopolysaccharidoses
#19
REVIEW
Elsa G Shapiro, Maria L Escolar, Kathleen A Delaney, John J Mitchell
The mucopolysaccharidoses (MPS) are a group of rare, inherited lysosomal storage disorders in which accumulation of glycosaminoglycans (GAGs) leads to progressive tissue and organ dysfunction. In addition to a variety of somatic signs and symptoms, patients with rapidly progressing MPS I (Hurler), II, III, and VII can present with significant neurological manifestations, including impaired cognitive abilities, difficulties in language and speech, behavioral abnormalities, sleep problems, and/or seizures. Neurological symptoms have a substantial impact on the quality of life of MPS patients and their families...
September 15, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29127858/telephonic-review-for-outpatients-with-epilepsy-a-prospective-randomized-parallel-group-study
#20
Kunal Bahrani, Mamta Bhushan Singh, Rohit Bhatia, Kameshwar Prasad, Deepti Vibha, Garima Shukla, Sreenivas Vishnubhatla, Victor Patterson
PURPOSE: Our objective was to assess how telephonic review of outpatients with stable epilepsy compared with conventional face-to-face clinic management. METHODS: We constructed a randomized parallel group study of suitable patients attending our Epilepsy Clinic and compared telephonic review with conventional clinic visit based management. Primary outcomes were the percentage of patients with breakthrough seizures and total number of breakthrough seizures. We also compared cost, patient satisfaction and numbers defaulting...
November 7, 2017: Seizure: the Journal of the British Epilepsy Association
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