Utility of Routine EEG in Emergency Department and Inpatient Service
Conclusions
Routine EEG is useful in the ED, even in patients with a normal CT or MR brain image, because it helps determine clinical management or AED changes. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Rodriguez Quintana, J. H., Bueno, S. J., Zuleta-Motta, J. L., Ramos, M. F., Velez-van-Meerbeke, A., , the Neuroscience Research Group (NeuRos) Tags: Decision analysis, EEG; see Epilepsy/Seizures, Class IV, All epidemiology, EEG Research Source Type: research
Efficacy and Tolerability of Clobazam in Adults With Drug-Refractory Epilepsy
Conclusions
Clobazam is effective and safe as a long-term adjunctive therapy for adults with drug-resistant epilepsy; efficacy in off-label use is similar to that in LGS.
Classification of Evidence
This study provides Class IV evidence that clobazam is an effective treatment for adults with drug-resistant epilepsy, independent of epilepsy classification. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Jamil, A., Levinson, N., Gelfand, M., Hill, C. E., Khankhanian, P., Davis, K. A. Tags: Class IV, All Epilepsy/Seizures, Antiepileptic drugs, Generalized seizures, Partial seizures Research Source Type: research
Preventing Cardiomyopathy in DMD: A Randomized Placebo-Controlled Drug Trial
Conclusions
Combination therapy was well tolerated. Consistent with the previous prophylactic perindopril heart study, there was no evidence of group benefit after 36-month treatment.
Classification of Evidence
This study provides Class I evidence that combination perindopril-bisoprolol therapy was well tolerated but did not change decline in LVEF significantly in boys with DMD. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Bourke, J. P., Watson, G., Spinty, S., Bryant, A., Roper, H., Chadwick, T., Wood, R., McColl, E., Bushby, K., Muntoni, F., Guglieri, M., for the DMD Heart Study Group Tags: Muscle disease, Clinical trials Randomized controlled (CONSORT agreement), All Pediatric, Cardiac; see Cerebrovascular Disease/Cardiac Research Source Type: research
Facial Palsy, Radiographic and Other Workup Negative: FROWN
Conclusion
Patients with slow-onset facial palsy with negative radiographic and medical evaluations over several years may be characterized as having FROWN, an idiopathic and as yet poorly understood condition, which appears to be amenable to facial reanimation but requires further investigation as to its pathophysiology. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Greene, J. J., Sadjadi, R., Jowett, N., Hadlock, T. Tags: All Neuromuscular Disease, Cranial neuropathy Research Source Type: research
Pediatric Dystonic Storm: A Hospital-Based Study
Conclusions
Dystonic storm is a medical emergency mandating aggressive multimodal management. Supportive care, antidystonic drugs, and early elective ventilation alongside adequate sedation with benzodiazepines ameliorate complications. Relapses of dystonic storm are not uncommon. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Goswami, J. N., Roy, S., Patnaik, S. K. Tags: Dystonia, All Pediatric Research Source Type: research
Patterns of Language Impairment in Early Amyotrophic Lateral Sclerosis
Conclusions
Language impairment is characteristic of ALS at early stages of the disease and can develop independently of executive dysfunction, reflecting selective patterns of frontotemporal involvement at disease onset. Language change is therefore an important component of the frontotemporal syndrome associated with ALS. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Pinto-Grau, M., Donohoe, B., O'Connor, S., Murphy, L., Costello, E., Heverin, M., Vajda, A., Hardiman, O., Pender, N. Tags: Amyotrophic lateral sclerosis, Aphasia, Neuropsychological assessment, Executive function Research Source Type: research
Alzheimer Dementia in People Living With HIV
Conclusions
In older PLWH cognitive symptoms may represent the onset of AD: a multidisciplinary team may be needed for reaching a likely in vivo diagnosis. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Calcagno, A., Celani, L., Trunfio, M., Orofino, G., Imperiale, D., Atzori, C., Arena, V., d'Ettorre, G., Guaraldi, G., Gisslen, M., Di Perri, G. Tags: HIV, Alzheimer's disease, HIV dementia Research Source Type: research
Serial Optic Nerve Sheath Diameter via Radiographic Imaging: Correlation With ICP and Outcomes
Conclusions
Findings contribute to the utility of CT ONSD measurements as a potential indicator of increased ICP. Measurement of ONSD during serial CT brain imaging may inform clinical decisions regarding need for more invasive monitoring after neurologic injury. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: McLaughlin, D., Anderson, L., Guo, J., McNett, M. Tags: CT, Optic nerve Research Source Type: research
Impact of ICD-9 to ICD-10 Coding Transition on Prevalence Trends in Neurology
Conclusions
The transition from ICD-9-CM to ICD-10-CM coding affects prevalence estimates for status epilepticus and other neurologic disorders, a potential source of bias for future longitudinal neurologic studies. Studies should limit to 1 coding system or use interrupted time series models to adjust for changes in coding patterns until new neurology-specific ICD-9 to ICD-10 conversion maps can be developed. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Hamedani, A. G., Blank, L., Thibault, D. P., Willis, A. W. Tags: All Health Services Research, Coding, All epidemiology, Prevalence studies Source Type: research
Utility of MRI Enhancement Pattern in Myelopathies With Longitudinally Extensive T2 Lesions
Conclusions
Misdiagnosis of myelopathies is common. The gadolinium enhancement patterns characteristic of specific diagnoses can be identified with excellent agreement between raters educated on this topic. This study highlights the potential diagnostic utility of enhancement patterns in myelopathies with longitudinally extensive T2 lesions. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Mustafa, R., Passe, T. J., Lopez-Chiriboga, A. S., Weinshenker, B. G., Krecke, K. N., Zalewski, N. L., Diehn, F. E., Sechi, E., Mandrekar, J., Kaufmann, T. J., Morris, P. P., Pittock, S. J., Toledano, M., Lanzino, G., Aksamit, A. J., Kumar, N., Lucchinett Tags: MRI, All Spinal Cord, Transverse myelitis Research Source Type: research
Author Response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use
We thank Drs. Randhawa and Chen for their comments on our article.1 We appreciate their insightful comments regarding the possibility of delayed leukoencephalopathy in patients with acute opioid-associated amnestic syndrome.2 Our patient1 did indeed have interval follow-up at 1, 3, and 34 months after the index hospitalization. By 1 month, the patient returned to his previous cognitive baseline with no reported memory deficits. Since his hospitalization, he has not experienced any new neurologic symptoms, including headaches, vision changes, weakness, sensory changes, tremor, bradykinesia, or gait changes. No further brain...
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Holmes, B. B., Ahlbach, C., Narvid, J., Rosendale, N. Tags: The Nerve! Readers Speak Source Type: research
Reader Response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use
Reports of opioid-associated amnestic syndrome1 have increased with the rising use of opioids, particularly among young men.2 At our institution in British Columbia, which has one of the highest rates of opioid-related hospitalizations in Canada,3 we have observed at least 3 such cases in the last 4 years with similar initial imaging. All were positive for fentanyl on urine toxicology. One of these was associated with a delayed leukoencephalopathy causing akinetic mutism, which developed roughly 3 weeks after initial presentation with isolated anterograde amnesia. Diffuse delayed leukoencephalopathy was recently reported a...
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Randhawa, J., Chen, T. Tags: The Nerve! Readers Speak Source Type: research
Striking MRI Changes of Focal Cortical Dysplasia Over Time: A Case Series and Literature Review
We describe 2 cases of FCD type IIb that initially displayed inconspicuous findings on MRI, however progressed to obvious signal changes on subsequent MRI 10–17 years later. Pathologic analysis indicates that the interval changes are likely attributed to reactive astrogliosis and diffuse parenchymal rarefaction. A few case reports and case series showing similar MRI changes have been described in the literature, the majority in pediatric patients. The adult cases we present add to the scientific evidence of these changes occurring in the adult population.
Summary
Our observations lead to several clinical suggestions...
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Achiriloaie, A., Deisch, J., Boling, W., Bannout, F. Tags: MRI, Epilepsy surgery, Cortical dysplasia Review Source Type: research
Practical Considerations for Ketogenic Diet in Adults With Super-Refractory Status Epilepticus
This report describes the ketogenic diet therapy protocol implemented for the treatment of SRSE and a review of the current evidence to support clinical practice.
Summary
The control of SRSE is critical in reducing morbidity and mortality. There is emerging evidence that ketogenic diet may be a safe and effective treatment option for these patients. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Kaul, N., Laing, J., Nicolo, J.-P., Nation, J., Kwan, P., O'Brien, T. J. Tags: Nutritional, Critical care, Status epilepticus Review Source Type: research
Association Between Psychiatric Comorbidities and Mortality in Epilepsy
Conclusion
The presence of comorbid psychiatric disorders in adults with epilepsy is associated with increased mortality, highlighting the importance of identifying and treating psychiatric comorbidities in these patients. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - October 11, 2021 Category: Neurology Authors: Tao, G., Auvrez, C., Nightscales, R., Barnard, S., McCartney, L., Malpas, C. B., Perucca, P., Chen, Z., Adams, S., McIntosh, A., Ignatiadis, S., O'Brien, P., Cook, M. J., Kwan, P., Berkovic, S. F., D'Souza, W., Velakoulis, D., O'Brien, T. J. Tags: All Psychiatric disorders, All Epilepsy/Seizures, Video/ EEG use in epilepsy Research Source Type: research
