Discordance Between Perceptions and Experience of Lumbar Puncture: A Prospective Study
The objective of this study was to prospectively investigate discordance between patient perception and tolerability of LP.
Methods
Adult patients were surveyed before and after LP regarding their perceptions and experience of LP. Physician perceptions were gathered through a web-based survey. Relative risk and Spearman correlation were used to assess the relationship between responses. Paired binomial and paired ordinal responses were compared by McNemar and paired Wilcoxon rank-sum tests.
Results
A total of 178 patients completed the surveys. About half of the patients (58%) reported anxiety pre-LP, at median 3.0 of 10...
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Umemura, Y., Khan, B., Weill, B. J., Buthorn, J. J., Skakodub, A., Ridder, A. J., Nevel, K. S., Sun, Y., Boire, A. Tags: Research Article Source Type: research
A Review of Practices Around Determination of Death by Neurologic Criteria by an Organ Procurement Organization in the WAMI Region
Discussion
Ongoing review of institutional DNC standards and adherence to those standards is an urgent unmet need. Both referring hospitals and OPOs jointly carry responsibility for preventing errors in DNC leading up to organ recovery. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Lele, A. V., Wahlster, S., Bost, I., Adorno, D., Wells, C., O'Connor, K., Greer, D., Souter, M. J. Tags: Research Article Source Type: research
Prevention of False-Positive Determinations of Death by Neurologic Criteria Requires Education, Regulation, and Revision of Hospital Policies
In a 2016 summit on interdisciplinary concerns related to determination of death by neurologic criteria (DNC), the American Academy of Neurology (AAN) and other stakeholder organizations acknowledged variability in institutional policies on determination of DNC and emphasized the importance for all determinations of DNC to be performed in accordance with accepted medical standards.1 This is imperative because false-positive determinations of death undermine the credibility of the medical profession. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Lewis, A. Tags: Editorial Source Type: research
A Message From the Editors to Our Reviewers: 2021-2022
The Editors of Neurology® Clinical Practice wish to acknowledge the individuals who have completed peer reviews for the journal over the past year and a half. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Bartolini, L., Kvam, K., Jagolino-Cole, A., Ney, J., Savage-Edwards, B. A., Tsao, J. W. Tags: Acknowledgment to Reviewers Source Type: research
Downbeat Nystagmus Is Abolished by Alcohol in Nonalcoholic Wernicke Encephalopathy
The objective was to study the effects of alcohol in nWE.
Methods
We recorded eye movements of a unique patient with nWE under controlled alcohol consumption who said his oscillopsia disappeared with a few drinks of alcohol.
Results
His DBN was markedly diminished by alcohol (by 77.4%), although he remained alert with normal saccades.
Discussion
This striking observation may be caused by the differential effect of alcohol on the perihypoglossal complex and the paramedian tract neurons, which control the level of activity in the flocculus, with opposite (inhibition and excitation, respectively) effects. The finding sugge...
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Helmchen, C., Machner, B., Gablentz, J. v. d., Sprenger, A., Zee, D. S. Tags: Nystagmus, Oscillopsia, Vertigo Cases Source Type: research
Pediatric SARS-CoV-2-Related Diplopia and Mesencephalic Abnormalities
This report expands the spectrum of pediatric COVID-19–associated neurologic symptoms and highlights a possible isolated neurologic COVID-19–related symptom. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Signa, S., Brolatti, N., Trincianti, C., Tortora, D., Saffioti, C., Di Marco, E., Acquila, M., Amadori, E., Fiorillo, C., Ricci, E., Striano, P., Castagnola, E., Vari, M. S. Tags: Cases Source Type: research
"Stretched Slinky" Sign: Another Clue to Functional Tremor
We describe a unique appearance of spiral drawings, which could add as another clinical sign for FT. Consider looping of spirals as another diagnostic clue to FT. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Fung, W. K. W., Fasano, A. Tags: Cases Source Type: research
Reversible Cerebral Vasoconstriction Syndrome in a Previously Healthy Child: A Case Report
We describe the case of a healthy boy diagnosed with reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES).
Methods
He was identified after presenting in the emergency department (ED). A review of the 5 previous cases of RCVS complicated with PRES reported in the literature was performed.
Results
A 9-year-old boy was brought to the ED for intense, throbbing headache and vomiting. Physical and neurologic examinations were normal. Brain CT and CSF examination were unremarkable, and he was discharged after symptomatic relief. Five days later, he returned to the ED for g...
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Manuel, A. R., Goncalves, C., Silva, A., Escobar, C., Manacas, R., Luis, C. Tags: Cases Source Type: research
Orthostatic Hypotension in Parkinson Disease: What Is New?
Purpose of the Review
Orthostatic hypotension (OH) is the primary manifestation of cardiovascular autonomic dysfunction in Parkinson disease (PD) and can be a prodromal feature of the disease. We review the recent progress in the field of autonomic dysfunction in PD.
Recent Findings
Individuals with isolated neurogenic OH should be followed up frequently because they may evolve into PD, dementia with Lewy bodies, or multiple system atrophy. The prevalence of OH in PD increases with disease stages, but the role of levodopa remains unclear. Measurement of supine and standing heart rate and blood pressure allows for accurate...
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Lamotte, G., Lenka, A. Tags: Innovations in Neurologic Practice Source Type: research
A Standardized Approach to Treatment Over Objection in Patients Lacking Decision-Making Capacity Secondary to Neurologic Disease
We describe the application of the standardized Rubin/Prager approach as a checklist to the case of a 50-year-old woman with a large frontal lobe meningioma, who lacked capacity as a result of the meningioma, but refused surgery. This approach may be applied to similar ethical dilemmas of treatment over objection in patients lacking capacity as a result of neurologic disease. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Ader, J., Otten, M. L., Critchfield, A., Prager, K. M. Tags: Commentary Source Type: research
Virtual Charcot-Marie-Tooth Examination Score: A Validated Virtual Evaluation for People With Charcot-Marie-Tooth Disease
Discussion
Statistical analyses demonstrated that the vCMTES was reproducible and reliable as a clinical outcome assessment for CMT. Further studies are needed to test responsiveness to change and progression in different subtypes. The vCMTES also offers the potential to reach diverse populations that do not have access to CMT centers. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Prada, V., Laura, M., Zuccarino, R., Reilly, M. M., Shy, M. E. Tags: Research Article Source Type: research
Online vs Face-to-Face Administration of Impulse Control Disorder Questionnaires in Parkinson Disease: Does Method Matter?
Discussion
The results highlight the importance of social context/setting and the need for sensitivity and discretion when screening for ICD symptoms. Although a higher level of symptom endorsement does not necessarily imply a greater level of accuracy, more work is needed to determine which method of administration is most accurate for clinical and research practice. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Scott, B. M., Eisinger, R. S., Sankar, R., Benge, J. F., Hilsabeck, R. C., Okun, M. S., Gunduz, A., Bowers, D. Tags: Research Article Source Type: research
Clinicopathologic Correlations of Jaw Tremor in a Longitudinal Aging Study
Discussion
The presence of either jaw tremor in isolation or associated with nonparkinsonian tremor does not portend a neurodegenerative diagnosis. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2022 Category: Neurology Authors: Aslam, S., Zhang, N., Adler, C. H., Beach, T. G., Driver-Dunckley, E., Mehta, S. H., Shill, H. Tags: Research Article Source Type: research
Need to Revise Frascati Criteria for HIV-Associated Neurocognitive Disorders to Improve Relevance for Diverse Global Populations
Worldwide, cognitive impairment is a frequent complication of HIV, and few treatments are available. Existing diagnostic criteria for cognitive disorders associated with HIV have limited diagnostic accuracy, hampering biomarker and therapeutic development. Furthermore, these criteria are not linked to clinically meaningful outcomes, limiting utility in clinical settings. Limitations in diagnostic accuracy are most pronounced in resource-limited settings where the burden of HIV is greatest, largely because of heavy reliance on neuropsychological testing with limited cross-cultural validity. Accurate and clinically meaningfu...
Source: Neurology Clinical Practice - August 9, 2022 Category: Neurology Authors: Meyer, A.-C. L. Tags: Commentary Source Type: research
Paroxysmal Nonepileptic Events in Children: A Video Gallery and a Guide for Differential Diagnosis
Purpose of Review
Paroxysmal nonepileptic events (PNEEs) are a heterogenous group of time-limited events, characterized by changes in motor or behavioral activity beginning abruptly and ending in a short time. Owing to their manifestation, these conditions can clinically simulate seizures.
Recent Findings
These episodes belong to different categories, including syncopal events, psychiatric disorders, and movement disorders. PNEEs are a common cause of diagnostic mistakes and families' concerns, and the risk of useless and sometimes even injurious treatment is considerable. The high frequency of these manifestations in cli...
Source: Neurology Clinical Practice - August 9, 2022 Category: Neurology Authors: Lagorio, I., Brunelli, L., Striano, P. Tags: EEG; see Epilepsy/Seizures, All Epilepsy/Seizures, Epilepsy semiology, Video/ EEG use in epilepsy, Nonepileptic seizures Review Source Type: research
