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Neurología

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56 papers 25 to 100 followers
https://www.readbyqxmd.com/read/29084063/central-vertigo
#1
Jeong-Yoon Choi, Seung-Han Lee, Ji-Soo Kim
PURPOSE OF REVIEW: This review considers recent advances in central vertigo in terms of clinical and laboratory features and pathophysiology. RECENT FINDINGS: Strokes presenting dizziness-vertigo are more likely to be associated with a misdiagnosis in the emergency setting. The risk of future strokes after discharge is higher in patients diagnosed with peripheral vertigo than in control patients. Strokes and transient ischemic attacks account for one-quarter of acute transient vestibular syndrome...
October 27, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/19923838/seizure-semiology-an-overview-of-the-inverse-problem
#2
REVIEW
Andrea O Rossetti, Peter W Kaplan
In clinical practice, a classification of seizures based on clinical signs and symptoms leads to an improved understanding of epilepsy-related issues and therefore strongly contributes to a better patient care. The inverse problem involves inferring the anatomical brain localization of a seizure from the scalp surface EEG, a concept we apply here to correlate seizure origin with seizure semiology. The spheres of sensorium, motor features, consciousness changes and autonomic alterations during ictal and postictal manifestations are reviewed, including several subdivisions used to better categorize particular features...
2010: European Neurology
https://www.readbyqxmd.com/read/22161914/stereotypies-a-critical-appraisal-and-suggestion-of-a-clinically-useful-definition
#3
REVIEW
Mark J Edwards, Anthony E Lang, Kailash P Bhatia
The foundations of the clinical classification of movement disorders rest on the precise definition of the words used to describe the disorders. Here we argue that the current use of the term stereotypy falls well short of the precision needed for either clinical or academic use, and fails both to provide a clinically useful diagnostic category and to define a set of conditions that are linked pathophysiologically. The difficulty in defining this concept is not a new one as our review of the history of the term demonstrates...
February 2012: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/24424286/emergence-of-semiology-in-epileptic-seizures
#4
REVIEW
Patrick Chauvel, Aileen McGonigal
Semiology, the manifestation of epilepsy, is dependent upon electrical activity produced by epileptic seizures that are organized within existing neural pathways. Clinical signs evolve as the epileptic discharge spreads in both time and space. Studying the relation between these, of which the temporal component is at least as important as the spatial one, is possible using anatomo-electro-clinical correlations of stereoelectroencephalography (SEEG) data. The period of semiology production occurs with variable time lag after seizure onset and signs then emerge more or less rapidly depending on seizure type (temporal seizures generally propagating more slowly and frontal seizures more quickly)...
September 2014: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/24372328/frontal-lobe-seizures-from-clinical-semiology-to-localization
#5
Francesca Bonini, Aileen McGonigal, Agnès Trébuchon, Martine Gavaret, Fabrice Bartolomei, Bernard Giusiano, Patrick Chauvel
OBJECTIVE: Frontal lobe seizures are difficult to characterize according to semiologic and electrical features. We wished to establish whether different semiologic subgroups can be identified and whether these relate to anatomic organization. METHODS: We assessed all seizures from 54 patients with frontal lobe epilepsy that were explored with stereoelectroencephalography (SEEG) during presurgical evaluation. Semiologic features and concomitant intracerebral EEG changes were documented and quantified...
February 2014: Epilepsia
https://www.readbyqxmd.com/read/28887767/management-of-spontaneous-intracerebral-hemorrhage
#6
REVIEW
Roland Veltkamp, Jan Purrucker
PURPOSE OF REVIEW: We review the current evidence for medical and surgical treatments of spontaneous intracerebral hemorrhage (ICH). RECENT FINDINGS: Therapy with hemostatic agents (e.g. factor VIIa and tranexamic acid) if started early after bleeding onset may reduce hematoma expansion, but their clinical effectiveness has not been shown. Rapid anticoagulation reversal with prothrombin concentrates (PCC) plus vitamin K is the first choice in vitamin K antagonist-related ICH...
September 8, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/24693960/subtypes-of-post-traumatic-epilepsy-clinical-electrophysiological-and-imaging-features
#7
Puneet K Gupta, Nasreen Sayed, Kan Ding, Mark A Agostini, Paul C Van Ness, Stuart Yablon, Christopher Madden, Bruce Mickey, Raimondo D'Ambrosio, Ramon Diaz-Arrastia
Post-traumatic epilepsy (PTE) is a consequence of traumatic brain injury (TBI), occurring in 10-25% of patients with moderate to severe injuries. The development of animal models for testing antiepileptogenic therapies and validation of biomarkers to follow epileptogenesis in humans necessitates sophisticated understanding of the subtypes of PTE, which is the objective of this study. In this study, retrospective review was performed of patients with moderate to severe TBI with subsequent development of medically refractory epilepsy referred for video-electroencephalography (EEG) monitoring at a single center over a 10-year period...
August 15, 2014: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27260293/lesional-cerebellar-epilepsy-a-review-of-the-evidence
#8
REVIEW
Niels A Foit, Vera van Velthoven, Reinhard Schulz, Ingmar Blümcke, Horst Urbach, Friedrich G Woermann, Christian G Bien
Classical teaching in epileptology localizes the origins of focal seizures solely in the cerebral cortex, with only inhibitory effects attributed to subcortical structures. However, electrophysiological and neuroimaging studies over the last decades now provide evidence for an initiation of epileptic seizures within subcortical structures. Intrinsic epileptogenicity of hypothalamic hamartoma has already been established in recognition of subcortical epilepsy, whereas a seizure-generating impact of dysplastic cerebellar lesions remains to be clarified...
January 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29059119/early-management-of-acute-cerebrovascular-accident
#9
Jody Manners, Alexis Steinberg, Lori Shutter
PURPOSE OF REVIEW: Stroke is common and often presents as a neurologic emergency that requires rapid evaluation and treatment to minimize debilitation. Recent advances in therapy expanded time windows for intra-arterial thrombectomy in ischemic stroke, and surgical interventions for clot evacuation in large intracranial hemorrhage have recently proven feasible. This review discusses recent data regarding new therapeutic options in both ischemic and hemorrhagic stroke, notably in scenarios in which therapy was previously limited to supportive care...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28987436/ischemic-stroke-advances-in-diagnosis-and-management
#10
REVIEW
Courtney R Cassella, Andy Jagoda
Acute ischemic stroke carries the risk of morbidity and mortality. Since the advent of intravenous thrombolysis, there have been improvements in stroke care and functional outcomes. Studies of populations once excluded from thrombolysis have begun to elucidate candidates who might benefit and thus should be engaged in the process of shared decision-making. Imaging is evolving to better target the ischemic penumbra salvageable with prompt reperfusion. Availability and use of computed tomography angiography identifies large-vessel occlusions, and new-generation endovascular therapy devices are improving outcomes in these patients...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28987433/cerebral-venous-thrombosis-a-challenging-neurologic-diagnosis
#11
REVIEW
Brit Long, Alex Koyfman, Michael S Runyon
Headache is a common emergency department chief complaint. Although most are benign, emergency physicians must rapidly identify and manage the uncommon, sometimes subtle, presentation of headache from a life-threatening cause. Cerebral venous thrombosis imparts significant morbidity and mortality, and can be a challenging diagnosis. It most commonly occurs in those under 50 years of age with thrombosis of the cerebral veins/sinuses. Diagnosis is frequently delayed. The disease can present with 1 or more clinical syndromes, including intracranial hypertension with headaches, focal neurologic deficits, seizures, and encephalopathy...
November 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28168537/hyperkinetic-movement-disorder-emergencies
#12
REVIEW
Giovanni Cossu, Carlo Colosimo
A movement disorder emergency has been defined by Fahn and Frucht as "any neurological disorder evolving acutely or subacutely, in which the clinical presentation is dominated by a primary movement disorder, and in which failure to accurately diagnose and manage the patient may result in significant morbidity or even mortality." In this review, we discuss the most common situations in which hyperkinetic movement disorders, including chorea, ballism, dystonia, myoclonus, tics, as well as psychogenic disorders, can present as emergencies...
January 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/25908090/status-epilepticus-in-adults
#13
REVIEW
John P Betjemann, Daniel H Lowenstein
Status epilepticus is a common neurological emergency with considerable associated health-care costs, morbidity, and mortality. The definition of status epilepticus as a prolonged seizure or a series of seizures with incomplete return to baseline is under reconsideration in an effort to establish a more practical definition to guide management. Clinical research has focused on early seizure termination in the prehospital setting. The approach of early escalation to anaesthetic agents for refractory generalised convulsive status epilepticus, rather than additional trials of second-line anti-epileptic drugs, to avoid neuronal injury and pharmaco-resistance associated with prolonged seizures is gaining momentum...
June 2015: Lancet Neurology
https://www.readbyqxmd.com/read/26376969/myasthenia-gravis-subgroup-classification-and-therapeutic-strategies
#14
REVIEW
Nils Erik Gilhus, Jan J Verschuuren
Myasthenia gravis is an autoimmune disease that is characterised by muscle weakness and fatigue, is B-cell mediated, and is associated with antibodies directed against the acetylcholine receptor, muscle-specific kinase (MUSK), lipoprotein-related protein 4 (LRP4), or agrin in the postsynaptic membrane at the neuromuscular junction. Patients with myasthenia gravis should be classified into subgroups to help with therapeutic decisions and prognosis. Subgroups based on serum antibodies and clinical features include early-onset, late-onset, thymoma, MUSK, LRP4, antibody-negative, and ocular forms of myasthenia gravis...
October 2015: Lancet Neurology
https://www.readbyqxmd.com/read/24695995/the-history-of-examination-of-reflexes
#15
REVIEW
Christopher J Boes
In the late 1800s, Wilhelm Erb, Joseph Babinski, William Gowers, and others helped develop the neurologic examination as we know it today. Erb was one of the first to emphasize a detailed and systematic neurologic exam and was co-discoverer of the muscle stretch reflex, Gowers began studying the knee jerk shortly after it was described, and Babinski focused on finding reliable signs that could differentiate organic from hysterical paralysis. These physicians and others emphasized the bedside examination of reflexes, which have been an important part of the neurologic examination ever since...
December 2014: Journal of Neurology
https://www.readbyqxmd.com/read/28820187/cerebral-venous-thrombosis
#16
REVIEW
Suzanne M Silvis, Diana Aguiar de Sousa, José M Ferro, Jonathan M Coutinho
Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults. Data from large international registries published in the past two decades have greatly improved our knowledge about the epidemiology, clinical manifestations and prognosis of CVT. The presentation of symptoms is highly variable in this disease, and can range from a patient seen at the clinic with a 1-month history of headache, to a comatose patient admitted to the emergency room. Consequently, the diagnosis of CVT is often delayed or overlooked...
August 18, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27276234/intensive-blood-pressure-lowering-in-patients-with-acute-cerebral-hemorrhage
#17
RANDOMIZED CONTROLLED TRIAL
Adnan I Qureshi, Yuko Y Palesch, William G Barsan, Daniel F Hanley, Chung Y Hsu, Renee L Martin, Claudia S Moy, Robert Silbergleit, Thorsten Steiner, Jose I Suarez, Kazunori Toyoda, Yongjun Wang, Haruko Yamamoto, Byung-Woo Yoon
BACKGROUND: Limited data are available to guide the choice of a target for the systolic blood-pressure level when treating acute hypertensive response in patients with intracerebral hemorrhage. METHODS: We randomly assigned eligible participants with intracerebral hemorrhage (volume, <60 cm(3)) and a Glasgow Coma Scale (GCS) score of 5 or more (on a scale from 3 to 15, with lower scores indicating worse condition) to a systolic blood-pressure target of 110 to 139 mm Hg (intensive treatment) or a target of 140 to 179 mm Hg (standard treatment) in order to test the superiority of intensive reduction of systolic blood pressure to standard reduction; intravenous nicardipine to lower blood pressure was administered within 4...
September 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27563928/adult-status-epilepticus-a-review-of-the-prehospital-and-emergency-department-management
#18
REVIEW
Michael Billington, Osama R Kandalaft, Imoigele P Aisiku
Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents...
August 23, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28754355/managing-patients-with-transient-ischemic-attack
#19
REVIEW
Jonathan A Edlow
No abstract text is available yet for this article.
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28747453/serum-matrix-metalloproteinase-9-levels-and-prognosis-of-acute-ischemic-stroke
#20
RANDOMIZED CONTROLLED TRIAL
Chongke Zhong, Jingyuan Yang, Tan Xu, Tian Xu, Yanbo Peng, Aili Wang, Jinchao Wang, Hao Peng, Qunwei Li, Zhong Ju, Deqin Geng, Yonghong Zhang, Jiang He
OBJECTIVE: To examine the association between serum matrix metalloproteinases-9 (MMP-9) levels and prognosis of acute ischemic stroke. METHODS: We measured serum MMP-9 levels in 3,186 participants (2,008 men and 1,178 women) from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). Study outcome data on death, major disability (modified Rankin Scale score ≥3), and vascular disease were collected at 3 months after stroke onset. RESULTS: During 3 months of follow-up, 767 participants (24...
August 22, 2017: Neurology
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