Spontaneous Heparin-Induced Thrombocytopenia Presenting as Cerebral Venous Sinus Thrombosis
Spontaneous HIT syndrome should be considered in any patient presenting with unexplained thrombocytopenia and unprovoked arterial and/or venous thrombosis, including CVST. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Moores, G., Warkentin, T. E., Farooqi, M. A. M., Jevtic, S. D., Zeller, M. P., Perera, K. S. Tags: Intracerebral hemorrhage, Cerebral venous thrombosis Case Source Type: research
Dengue-Associated Postinfectious Meningoencephalomyelitis With Positive Anti-GFAP Antibody
Consider GFAP antibody–mediated disease in postinfectious meningoencephalomyelitis. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Martin, A., Brown, D. A., Wolfe, N. Tags: Autoimmune diseases, All Infections, Post-infectious, All Demyelinating disease (CNS) Case Source Type: research
Reversible Brain Atrophy After Liver Transplantation for Biliary Atresia in Childhood
Brain atrophy related to malabsorption may be reversible after adequate treatment, and MRI may be a useful tool for evaluating brain changes related to malnutrition and chronic disease in children. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Fitsiori, A., McLin, V., Toso, S., Vargas, M.-I. Tags: MRI, All Clinical Neurology, Gastrointestinal, All Pediatric Case Source Type: research
Posterior Cerebral Calcifications in Celiac Disease: Improvement With Gluten-Free Diet
A 61-year-old man presented with a 15-year history of progressive bilateral vision loss. He reported neither gastrointestinal symptoms nor epilepsy. Brain CT and MRI showed bilateral occipital and cerebellar calcifications, and diffuse posterior white matter abnormalities (Figure 1). EEG demonstrated no epileptiform abnormalities. Duodenal biopsy results confirmed celiac disease (CD) diagnosis. White matter abnormalities decreased substantially after 8 months of gluten-free diet, and vision loss progression stopped (Figure 2). CD must be suspected in case of isolated neurovisual disturbances with posterior cerebral calcifi...
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Ray, A., Lecler, A., Vignal, C., Simon, J. F., Di Donato, N., Deschamps, R. Tags: CT, MRI, Autoimmune diseases, Gastrointestinal, Visual loss Case Source Type: research
Spontaneous Heparin-Induced Thrombocytopenia Presenting as Acute Ischemic Stroke
Consider spontaneous heparin-induced thrombocytopenia in the differential diagnosis of a patient presenting with acute ischemic stroke in the setting of thrombocytopenia. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Becker, C. J., Heston, A. L., Carrera, J. F. Tags: Autoimmune diseases, All Clinical Neurology, All Cerebrovascular disease/Stroke, Infarction Case Source Type: research
The Classic Triad of Triple A (Allgrove) Syndrome
Clinicians should be aware of the importance of early diagnosis of the triad of triple A syndrome to avoid life-threatening hypocortisolism. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Kronenberg, G., Guillery, S. P. E., Harms, L., Kunte, H. Tags: Autonomic diseases, Endocrine, Clinical neurology examination, All clinical neurophysiology, All global neurology Case Source Type: research
Overlapping NMDA-R and GFAP Antibody Autoimmune Encephalitis After Nivolumab Therapy
The differential diagnosis associated with acute encephalopathy is broad; however, given the increasing frequency with which immunotherapy is being used in the treatment of cancer, consider checkpoint inhibitor-induced autoimmune encephalitis in the appropriate clinical context. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Ayala, F. A., Dougherty, S. C., Swift, W., Lapides, D. A. Tags: Autoimmune diseases, Encephalitis, Endocrine, Critical care Case Source Type: research
Recurrent Hypothalamic Dysfunction in Seropositive Neuromyelitis Optica
The presence of hypothalamic dysfunction in seropositive neuromyelitis optica may reflect disease activity and warrant intensification of immunotherapy regimen. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: McKenna, M. C., McNicholas, N., Fearon, C., Bradley, D. Tags: Endocrine, Neuroendocrinology, Critical care, Devic's syndrome, Transverse myelitis Case Source Type: research
Hyperglycemic Hyperosmolar Syndrome Presenting With Unique Craniofacial Involuntary Movements
Hyperglycemic hyperosmolar syndrome should be considered in the differential diagnosis of acute onset facial hyperkinesias. Multiple movement disorders, e.g., hemifacial spasm, blepharospasm, and oromandibular dystonias, may occur in a single patient. The early diagnosis and proper treatment of the metabolic derangements of hyperglycemic hyperosmolar state usually results in complete resolution of the induced hyperkinesias. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Girija, M. S., Yadav, R., Nalini, A., Annapureddy, J., Gupta, M., Mundlamuri, R. C., Chawla, T., Shingavi, L., Vengalil, S. Tags: Endocrine, Clinical neurology examination, Dystonia, Myoclonus, Blepharospasm Case Source Type: research
Preserved Cognition After Right Hemispherectomy
Consider the potential for the perseveration of cognitive function after complete right hemispherectomy in a previously healthy adult. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Bowren, M., Tranel, D., Boes, A. D. Tags: MRI, All Neuropsychology/Behavior, All Cerebrovascular disease/Stroke, Neuropsychological assessment Case Source Type: research
GAD65 Antibody-Associated Neurologic Disease Presenting With Hemiparkinsonism at Onset
In the correct context, GAD65 antibody-associated neurologic disease should be included in the differential diagnosis for parkinsonism, even hemiparkinsonism, especially in the setting of an acute-to-subacute presentation and the emergence of more prototypic features such as appendicular and truncal muscle stiffness and cerebellar ataxia. Prompt recognition of the condition is critical because early immunotherapy may confer a better prognosis. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Patel, R. A., Joyce, J., Witek, N., Afshari, M. Tags: Autoimmune diseases, All Clinical Neurology, Gait disorders/ataxia, Parkinson's disease/Parkinsonism, Stiff person syndrome Case Source Type: research
Administration of Recombinant Tissue Plasminogen Activator for Sulcal Artery Syndrome
The use of rtPA can result in clinical improvement in symptoms from spinal cord infarction. Spinal cord infarction is a rare type of ischemic stroke and often an elusive diagnosis. The study of recombinant tissue plasminogen activator (rtPA) in spinal cord infarction has been limited due to the rarity of this condition. Here, we present the case of an adult man with spinal cord infarction in a sulcal artery distribution who clinically improved following rtPA administration. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Lawson, E. C., Hu, R., Silver, M., Greene, J. G. Tags: All Cerebrovascular disease/Stroke, All Spinal Cord, Spinal cord infarction, Infarction Case Source Type: research
Strategies to Improve Clinician-Patient Communication Experiences for Patients With Neurologic Conditions
Increasing research supports that effective clinician communication with patients and families leads to improved patient outcomes, higher patient satisfaction, and improved clinician experiences. As a result, patient- and family-centered communication is the focus of a 2020 American Academy of Neurology quality measure and part of neurology residency training milestones. Clinicians across training levels can implement strategies for improving patient- and family-centered communication, including optimizing the communication environment, using verbal and nonverbal skills, focusing on the patient's agenda, practicing active ...
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Armstrong, M. J., Weisbrod, N. J., Bylund, C. L. Tags: Medical care, All Clinical Neurology, Other Education, Professional conduct and ethics Commentary Source Type: research
Health Care Disparities Add Insult to Spinal Cord Injury
This article should serve as a realization of these inequities and as a call to action to improve the equity of rehabilitation services in this population to improve outcomes. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Escalon, M. X., Houtrow, A., Skelton, F., Verduzco-Gutierrez, M. Tags: Spinal cord trauma; see Trauma/spinal cord trauma, Spinal cord trauma, Inclusion, Diversity, Equity, Anti-racism, and Social Justice (IDEAS), Bias, prejudice, discrimination, Health disparities Commentary Source Type: research
Lessons Learned From an Integrated Neurology Diversity, Equity, and Inclusion Curriculum
The University of California San Francisco Neurology Department incorporated a formal diversity, equity, and inclusion curriculum into the residency education in 2015. During that time, we have learned a number of lessons that can be useful to other institutions planning similar initiatives including the following: (1) training should be led by a multidisciplinary team with experienced educators, (2) sustainability of the curriculum requires broad departmental buy-in from leadership to junior faculty to the residents themselves, (3) the curriculum needs to balance training on fundamental topics with flexibility to change i...
Source: Neurology Clinical Practice - December 13, 2021 Category: Neurology Authors: Anderson, N., Josephson, S. A., Rosendale, N. Tags: All Clinical Neurology, Underserved populations, Inclusion, Diversity, Equity, Anti-racism, and Social Justice (IDEAS), All Education Commentary Source Type: research
