Multisensory Hallucinatory Experiences in Migraine: A Preliminary Basis for Olfactory, Somatic-Tactile, and Gustatory Auras
This study aimed to examine the prevalence of multisensory aura experiences in migraine and their phenomenologic and clinical correlates. Methods Respondents were 729 participants with probable migraine, who completed an online study examining unusual sensory experiences. These comprised aura experiences in the auditory, visual, olfactory, somatic-tactile, and gustatory domains. Basic demographic and clinical information and migraine symptomatology were also collected. To facilitate groupwise comparisons, participants with probable migraine were divided into those with and without (visual) aura experiences. Results Endor...
Source: Neurology Clinical Practice - December 1, 2023 Category: Neurology Authors: Toh, W. L., Yolland, C. O., Li, Y., Sommer, I. E., Rossell, S. Tags: Migraine Research Article Source Type: research

Kelch-like Protein-11 Encephalitis Associated With Squamous Cell Carcinoma of Unknown Origin: A Case Report
We report a case of Kelch-like protein-11 (KLHL11) encephalitis associated with squamous cell carcinoma (SCC) of unknown origin in the neck. Methods A 70-year-old man, diagnosed with prurigo nodularis 4 months prior, presented with subacute-onset progressive dysarthria, imbalance, and diplopia. Neurologic examination revealed horizontal and downbeating nystagmus with lateral gaze, dysarthria, dysmetria, and hearing difficulties. Skin examination showed localized pruritus with excoriated ulcerations on the neck and proximal upper extremities. MRI of the brain revealed T2 hyperintensities in the pons and left cerebellum, an...
Source: Neurology Clinical Practice - November 17, 2023 Category: Neurology Authors: Hoshina, Y., Gradin, C., Germaine, S., Wold, J. Tags: MRI, All Immunology, Autoimmune diseases Clinical/Scientific Note Source Type: research

Abnormal Neurologic Findings in Patients With Sickle Cell Disease Without a History of Major Neurologic Events
Discussion Neurologic deficits are relatively common in patients with SCD, even without documented major neurologic insults. They range from peripheral and ophthalmic deficits to central and cognitive disabilities. Patients with SCD should have early regular neurologic evaluations and risk factor modification, particularly actively promoting smoking cessation. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - November 10, 2023 Category: Neurology Authors: Nawaiseh, M. B., Yassin, A. M., Al-Sabbagh, M. Q., AlNawaiseh, A., Zureigat, H., Aljbour AlMajali, D., Haddadin, R. R., El-Ghanem, M., Abu-Rub, M. Tags: Stroke in young adults, All Clinical Neurology Research Article Source Type: research

Zonisamide: A Comprehensive, Updated Review for the Clinician
Purpose of Review Zonisamide (ZNS) was first approved in the United States in 2000 for the adjunctive treatment of patients aged 16 years or older with partial (focal) seizures. Although ZNS has been proven to treat multiple seizure types, it has been largely underutilized in US clinical practice. Recent Findings Published literature demonstrated that antiseizure medications (ASMs) acting on Na+ and Ca2+ channels may add beneficial effects in many seizure types by reducing seizure frequency and leading to overall improvements. In addition, effects of ZNS may lead to clinical improvements in Parkinson disease, alcohol and ...
Source: Neurology Clinical Practice - November 10, 2023 Category: Neurology Authors: Gidal, B. E., Resnick, T., Smith, M. C., Wheless, J. W. Tags: All Epilepsy/Seizures, Antiepileptic drugs Review Source Type: research

Heart Brain Clinic: An Integrated Approach to Stroke Care
We report our experience creating a multidisciplinary Structural Heart Brain Clinic (HBC) with a focus on patients with PFO-associated stroke. Methods Demographic and clinical data were retrospectively collected for patients with PFO-associated ischemic stroke. Patients with PFO-associated stroke were divided into a standard care group and Heart Brain Clinic group for analysis. Outcome measures included time from stroke to PFO closure and number of clinic visits before decision regarding closure. Nonparametric analysis evaluated differences in median time to visit and clinical decision, while the chi square analysis compa...
Source: Neurology Clinical Practice - November 6, 2023 Category: Neurology Authors: Tariq, M. B., Qadri, S. K. S., Sharrief, A., Tulod, K., Dhoble, A., Gurung, S., Jamilla Lacap, M., Okpala, M., Manwani, B., Smalling, R. W., Gonzales, N. Tags: Stroke in young adults, Cardiac Research Article Source Type: research

HIV Infection and 90-Day Stroke Outcomes in Uganda: A Prospective Observational Cohort Study
Discussion In the modern ART era, PWH with acute stroke in Uganda present with modest stroke and are significantly less likely to die within 90 days than PWOH. This potentially reflects the protective effects of ART, enhanced health care access, and their younger age at stroke presentation. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - November 6, 2023 Category: Neurology Authors: Mbonde, A. A., Chang, J., Musubire, A. K., Okello, S., Kayanja, A., Moses, A., Butterfield, R. J., Chow, F. C., Saylor, D. R., O'Carroll, C. B., Siedner, M. Tags: Stroke in young adults, HIV, All Cerebrovascular disease/Stroke, All global neurology Research Article Source Type: research

Parakinesia Brachialis Oscitans in a Patient With a First Manifestation of Multiple Sclerosis
We describe the first case of PBO in a patient with a first manifestation of tumefactive multiple sclerosis (MS). Methods A 35-year-old man presented to the emergency department with a first episode of generalized seizure. Neurologic examination revealed left-sided spastic hemiparesis, predominantly affecting his upper limb. Brain MRI showed a tumefactive right hemisphere lesion consistent with demyelination. CSF did not document unmatched oligoclonal bands. Results Two weeks after admission and, despite being unable to voluntarily raise his left arm, the patient noticed a repeated and reproducible involuntary raise of t...
Source: Neurology Clinical Practice - November 3, 2023 Category: Neurology Authors: Salavisa, M., Mohamed, B., Allen-Philbey, K., Stennett, A. M., Campion, T., Schmierer, K. Tags: All Clinical Neurology, Multiple sclerosis Clinical/Scientific Note Source Type: research

Patient-Reported Impact of Symptoms in Spinal and Bulbar Muscular Atrophy
Discussion There are a diversity of themes that are important to patients with SBMA. These themes have a variable level of importance to the population with SBMA and represent clinically meaningful outcome measures for future therapeutic interventions. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - November 1, 2023 Category: Neurology Authors: Alqahtani, A., Kokkinis, A., Zizzi, C., Dilek, N., Fischbeck, K. H., Heatwole, C. R., Grunseich, C. Tags: All Neuromuscular Disease, Burden of disease Research Article Source Type: research

Improving Seizure Frequency Documentation and Classification
Discussion We demonstrated that by implementing an easy-to-use standardized EHR documentation tool, our documentation of critical metrics, as defined by the ELHS, improved dramatically. This shows that simple and practical interventions can substantially improve clinically meaningful documentation. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 19, 2023 Category: Neurology Authors: Nuthalapati, P., Thomas, L., Donahue, M. A., Moura, L. M. V. R., DeStefano, S., Simpson, J. R., Buchhalter, J., Fureman, B. E., Pellinen, J. Tags: All Health Services Research, Medical care, All Clinical Neurology, All Practice Management, All Epilepsy/Seizures Research Article Source Type: research

Value-Based Care and Neurology: The Shifting Paradigm
There is a growing interest noted nationally in moving from fee for service to value-based care. Health care systems are increasingly involved in various payer contracts focused on reducing the total cost of care and are forming clinically integrated networks to be more efficient with care delivery. Although these trends affect primary care significantly, the specialty services are also learning to navigate and understand the roles they will need to play in these new care models. With this "value-based care" digital collection, we hope to provide insight into the current landscape while also sharing ideas to think innovati...
Source: Neurology Clinical Practice - October 16, 2023 Category: Neurology Authors: Ahmed, A. Tags: All Clinical Neurology Special Editorial Source Type: research

Reach of Palliative Care for Parkinson Disease: Results From a Large National Survey of Patients and Care Partners
This study's primary objective is to describe PWP's and care partners' perceptions of the extent to which their PC needs are being met. Secondary objectives are to describe their perceptions of the quality of clinical communication and their knowledge of PC. Methods PWPs and care partners (n = 12,995) who had consented to receiving surveys from the Parkinson's Foundation were emailed an electronic survey. PC was operationalized as comprising 5 key components: systematic assessment and management of (1) nonmotor symptoms, (2) PWPs' emotional and spiritual needs, (3) care partners' needs, (4) the completion of annual advanc...
Source: Neurology Clinical Practice - October 16, 2023 Category: Neurology Authors: Seshadri, S., Dini, M., Macchi, Z., Auinger, P., Norton, S. A., Holtrop, J. S., Kluger, B. M. Tags: Parkinson disease/Parkinsonism Research Article Source Type: research

Alzheimer Disease: A Life-Limiting Disease With a Burden of a Terminal Illness
Purpose of Review An estimated 6.5 million Americans live with Alzheimer dementia. Better understanding of advanced stages of Alzheimer disease (AD) and timely monitoring of its preventable complications would translate to improved survival and quality of life in this population. Recent Findings In this perspective review, we proposed shifting the narrative to recognizing AD as a chronic life-limiting illness instead of a terminal disease. In support of this view, we discussed the following: (1) the biochemical, cellular (preclinical), and clinical phases of AD; (2) survival after AD; (3) AD therapeutics and potential imp...
Source: Neurology Clinical Practice - October 16, 2023 Category: Neurology Authors: Waziry, R., Williams, O. A. Tags: Alzheimer disease Review Source Type: research

End-of-Life Discussions With Patients and Caregivers Affected By Neurogenetic Diseases
Discussion Being affected by severe neurogenetic diseases does not seem to prompt individuals to give much thought to end-of-life planning. However, patients and caregivers welcome comprehensive information and expect progressive support from trained health care professionals in having such discussions. Routine integration of these conversations into medical management through a holistic and adapted approach will benefit patients with illnesses with unfavorable long-term prognoses. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 16, 2023 Category: Neurology Authors: Anne-Claire, D., Coarelli, G., Heinzmann, A., Verdon, B., Manuella, D. L., Petit, E., Pierron, L., Levy-Soussan, M., Durr, A., Gargiulo, M., Ewenczyk, C. Tags: Huntington's disease, Spinocerebellar ataxia, Public health, All Ethics in Neurology/Legal issues, Palliative care Research Article Source Type: research

Dispatcher Stroke/TIA Recognition in Emergency Medical Call Center and Out-of-Hours Service Calls in Copenhagen, Denmark
Discussion As the first study reporting on OOHS setting dispatcher stroke/TIA recognition, we find a need for the improvement of stroke/TIA recognition both in EMCC and in OOHS. Solutions may include specific training of dispatchers, public awareness campaigns, and new technological solutions. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 16, 2023 Category: Neurology Authors: Wenstrup, J., Blomberg, S. N., Christensen, H., Folke, F., Christensen, H. C., Kruuse, C. Tags: All Health Services Research, All Cerebrovascular disease/Stroke, All epidemiology Research Article Source Type: research

Safety and Feasibility of an Emergency Department-to-Outpatient Pathway for Patients With TIA and Nondisabling Stroke
Discussion Our TIA/NDS pathway, implemented during the initial outbreak of COVID-19, seems feasible and safe, with significant positive impact on ED throughput and ED-based high-cost duplicative imaging. The safety checklist and option of virtual telehealth follow-up are novel features. Broader adoption of such pathways has important implications for value-based health care. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2023 Category: Neurology Authors: Roy, A., Sreekrishnan, A., Camargo Faye, E., Silverman, S., Zachrison, K. S., Harriott, A. M., Matiello, M., Manzano, G. S., Prasanna, M., Nedelcu, S., Singhal, A. B. Tags: All Cerebrovascular disease/Stroke Research Article Source Type: research