Letter re: Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies
This article, which may be widely cited, is problematic. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Zack, M., Kobau, R. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Author response: Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
We thank Papanicolaou et al. for the comment on our article,1 and agree that important issues were raised regarding thresholding methods in functional MRI (fMRI).2 However, the original estimate of the number of studies potentially affected was substantially lowered.3,4 Imprecision is part of every diagnostic test; its presence in thresholded fMRI activation maps is unlikely to lead to spurious lateralized correlations between cognitive tasks and blood oxygenation level–dependent signal, or to agreement between fMRI and other investigations. As Papanicolaou et al. note, laterality measures are likely robust to the oc...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Gloss, D., Szaflarski, J. P., Holland, S. K., Binder, J. R., Theodore, W. H. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Letter re: Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
The American Academy of Neurology (AAN) endorsement for the use of fMRI evaluation of hemispheric dominance for language in epilepsy surgery candidates1 appears as an odd and disconcerting sequel to the article by Eckland et al.,2 which reported that the clustering approach in functional MRI (fMRI) data processing may be responsible for an excessively high rate of false-positive findings. The latter report implied that up to 70% of the significant fMRI effects reported in approximately 40,000 peer-reviewed publications could represent no brain physiology facts, but type I statistical errors to the degree that they employed...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Papanicolaou, A. C., Wheless, J. W., Babajani-Feremi, A., Narayana, S., Rezaie, R., Choudhri, A., Boop, F. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
: In reference to "Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy," Dr. Papanicolaou et al. discuss whether functional MRI (fMRI) evaluation for language dominance in epilepsy surgery can be considered reliable given the high rate of false-positives inherent in fMRI data processing. In support, guideline editors Gloss et al. cite the high concordance between fMRI and amobarbital testing and explain how the method of analysis used in hemispheric language assessment has been shown to be less prone to statistical error. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Alcauskas, M., Griggs, R. C. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Bilateral ape hand deformity
A 54-year-old man with a history of alcohol abuse (>2 bottles of wine per day for 40 years) presented with 2 years of progressive weakness in all 4 limbs. Alcoholic polyneuropathy was diagnosed on clinical grounds and gabapentin was used for alcohol withdrawal.1 (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Amelot, A., Lechanoine, F., Francois, P., Terrier, L.-M. Tags: Clinical neurology examination, Peripheral neuropathy, All Spinal Cord NEUROIMAGES Source Type: research
All noble things
Connecticut knows from whales. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: George, I. C. Tags: Clinical neurology examination REFLECTIONS: NEUROLOGY AND THE HUMANITIES Source Type: research
Wrist sensor reveals sympathetic hyperactivity and hypoventilation before probable SUDEP
We report a probable sudden unexpected death in epilepsy (SUDEP) in a 20-year-old man wearing a smartwatch that recorded wrist motion via 3-axis accelerometer (ACC) and electrodermal activity (EDA). EDA reflects sympathetic activity without parasympathetic antagonism.1 The smartwatch (Empatica [Milan, Italy] Embrace, with CE Medical clearance from the European Union for seizure detection) issued an alert, received by the caregiver at 8:50 am, indicating a probable convulsive seizure. An adult trained in cardiopulmonary resuscitation (CPR) arrived at 9:05 am, found the patient pulseless, prone, face in pillow with mucus in ...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Picard, R. W., Migliorini, M., Caborni, C., Onorati, F., Regalia, G., Friedman, D., Devinsky, O. Tags: Patient safety, All Epilepsy/Seizures CLINICAL/SCIENTIFIC NOTES Source Type: research
The spectrum of mild traumatic brain injury: A review
Conclusions: Given the lack of objective biomarkers and the spectrum of different disorders that likely encompass mTBI, clinicians are encouraged to adopt a probabilistic, rather than definitive, diagnostic and prognostic framework. The relevance of accurately diagnosing and managing the different manifestations of mTBI becomes clear when one considers the overall incidence of the disorder (42 million people each year worldwide), and the different treatment implications for patients with a true neurodegenerative disorder (e.g., chronic traumatic encephalopathy; rare) vs potentially treatable conditions (e.g., depression or...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Mayer, A. R., Quinn, D. K., Master, C. L. Tags: Prognosis VIEWS & amp;amp; REVIEWS Source Type: research
Teaching neurology to medical students with a simplified version of team-based learning
Conclusions: sTBL served as an equivalent alternative to small group interactive seminars for imparting knowledge and teaching CR skills, and was particularly advantageous for teaching CR in the setting of a complex neurologic topic. Furthermore, students reported a strong preference for the sTBL approach, making it a promising tool for effectively teaching neurology. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Brich, J., Jost, M., Brüstle, P., Giesler, M., Rijntjes, M. Tags: Methods of education CONTEMPORARY ISSUES: INNOVATIONS IN EDUCATION Source Type: research
Jules Dejerine and the peripheral nervous system
Jules Dejerine (1849–1917) was a French neurologist who contributed to the description of numerous neurologic conditions ranging from neurovascular pathology to neuromuscular disorders. A considerable body of his research was devoted to the peripheral nervous system. In this area, the eponymous Dejerine-Sottas syndrome refers to a form of infantile hereditary neuropathy. Dejerine also contributed to the description of many other disorders of the peripheral nervous system and was even a precursor in the study of acquired neuropathies (as well as acute inflammatory neuropathies, before the first description of the Guil...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Mathis, S., Vallat, J.-M. Tags: Clinical neurology history, Peripheral neuropathy, Guillain-Barre syndrome, Chronic inflammatory demyelinating polyneuropathy HISTORICAL NEUROLOGY Source Type: research
Assessing structure and function of myelin in cervical spondylotic myelopathy: Evidence of demyelination
Purpose: To assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques. Methods: Somatosensory evoked potentials (SSEPs) and MWI were acquired in 14 patients with CSM and 18 age-matched healthy controls. MWI was performed on a 3.0T whole body magnetic resonance scanner. Myelin water fraction (MWF) was extracted for the dorsal columns and whole cord. SSEPs and MWF were also compared with conventional MRI outcomes, including T2 signal intensity, compression ratio, maximum spinal cord compression (MSCC), and maximum canal compromise (MCC). R...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Liu, H., MacMillian, E. L., Jutzeler, C. R., Ljungberg, E., MacKay, A. L., Kolind, S. H., Mädler, B., Li, D. K. B., Dvorak, M. F., Curt, A., Laule, C., Kramer, J. L. K. Tags: MRI, All Spinal Cord ARTICLE Source Type: research
The CREST-E study of creatine for Huntington disease: A randomized controlled trial
Conclusions: Our data do not support the use of creatine treatment for delaying functional decline in early manifest HD. Clinicaltrials.gov identifier: NCT00712426. Classification of evidence: This study provides Class II evidence that for patients with early symptomatic HD, creatine monohydrate is not beneficial for slowing functional decline. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Hersch, S. M., Schifitto, G., Oakes, D., Bredlau, A.-L., Meyers, C. M., Nahin, R., Rosas, H. D., For the Huntington Study Group CREST-E Investigators and Coordinators Tags: Huntington's disease, All Clinical trials, Clinical trials Randomized controlled (CONSORT agreement), Class II ARTICLE Source Type: research
Loss of phosphodiesterase 4 in Parkinson disease: Relevance to cognitive deficits
Conclusions: Our findings demonstrate loss of PDE4 expression in the striato-thalamo-cortical circuit, which is associated with deficits of spatial working memory in patients with PD. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Niccolini, F., Wilson, H., Pagano, G., Coello, C., Mehta, M. A., Searle, G. E., Gunn, R. N., Rabiner, E. A., Foltynie, T., Politis, M. Tags: MRI, PET, Volumetric MRI, Parkinson's disease/Parkinsonism, Parkinson's disease with dementia ARTICLE Source Type: research
Neurodegenerative and psychiatric diseases among families with amyotrophic lateral sclerosis
Conclusions: Familial aggregation of ALS and other neurodegenerative diseases implies a shared etiopathogenesis among all neurodegenerative diseases. The increased risk of psychiatric disorders among patients with ALS and their children might be attributable to nonmotor symptoms of ALS and severe stress response toward the diagnosis. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Longinetti, E., Mariosa, D., Larsson, H., Ye, W., Ingre, C., Almqvist, C., Lichtenstein, P., Piehl, F., Fang, F. Tags: Amyotrophic lateral sclerosis, All Psychiatric disorders, All Cognitive Disorders/Dementia, All epidemiology ARTICLE Source Type: research
Behavioral-variant frontotemporal dementia: Distinct phenotypes with unique functional profiles
Conclusions: This study reveals that different clinical behavioral phenotypes of bvFTD have differing profiles of functional decline and distinct patterns of associated cortical changes. These findings emphasize the importance of apathy in functional impairment, highlight the role of the right temporal region in disinhibition, and suggest that disability may be a sensitive outcome measure for treatments targeting reduction of apathy. These phenotypes could also support understanding of prognosis and clinical management. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: O'Connor, C. M., Landin-Romero, R., Clemson, L., Kaizik, C., Daveson, N., Hodges, J. R., Hsieh, S., Piguet, O., Mioshi, E. Tags: MRI, Frontotemporal dementia ARTICLE Source Type: research
Breastfeeding, ovulatory years, and risk of multiple sclerosis
Conclusions: Mothers who breastfeed longer may be at lower subsequent risk of developing multiple sclerosis. This is consistent with the other known maternal health benefits of breastfeeding and with our previous observation that women with MS who breastfeed exclusively are at lower risk of postpartum relapses. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Langer-Gould, A., Smith, J. B., Hellwig, K., Gonzales, E., Haraszti, S., Koebnick, C., Xiang, A. Tags: Multiple sclerosis, Case control studies ARTICLE Source Type: research
Mortality trends for multiple sclerosis patients in Sweden from 1968 to 2012
Conclusions: There has been a substantial improvement in mortality overall and for each specified cause of death for patients with MS compared with individuals without MS; however, large differences still remain. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Burkill, S., Montgomery, S., Hajiebrahimi, M., Hillert, J., Olsson, T., Bahmanyar, S. Tags: Multiple sclerosis, Cohort studies ARTICLE Source Type: research
Blood pressure reduction and noncontrast CT markers of intracerebral hemorrhage expansion
Conclusions: NCCT signs reliably identify ICH patients at high risk of hematoma growth. However, we found no evidence that patients with these markers specifically benefit from intensive BP reduction. Clinicaltrials.gov identifier: NCT01176565. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Morotti, A., Boulouis, G., Romero, J. M., Brouwers, H. B., Jessel, M. J., Vashkevich, A., Schwab, K., Afzal, M. R., Cassarly, C., Greenberg, S. M., Martin, R. H., Qureshi, A. I., Rosand, J., Goldstein, J. N., On behalf of ATACH-II and NETT investigators Tags: CT, All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research
Blood pressure levels post mechanical thrombectomy and outcomes in large vessel occlusion strokes
Objective: There are limited data evaluating the effect of post mechanical thrombectomy (MT) blood pressure (BP) levels on early outcomes of patients with large vessel occlusions (LVO). We sought to investigate the association of BP course following MT with early outcomes in LVO. Methods: Consecutive patients with LVO treated with MT during a 3-year period were evaluated. Hourly systolic BP (SBP) and diastolic BP (DBP) values were recorded for 24 hours following MT and maximum SBP and DBP levels were identified. LVO patients with complete reperfusion following MT were stratified in 3 groups based on post-MT achieved BP goals:
Source: Neurology - August 7, 2017 Category: Neurology Authors: Goyal, N., Tsivgoulis, G., Pandhi, A., Chang, J. J., Dillard, K., Ishfaq, M. F., Nearing, K., Choudhri, A. F., Hoit, D., Alexandrov, A. W., Arthur, A. S., Elijovich, L., Alexandrov, A. V. Tags: All Cerebrovascular disease/Stroke ARTICLE Source Type: research
Age- and sex-specific analysis of patients with embolic stroke of undetermined source
Objective: To investigate whether the correlation of age and sex with the risk of recurrence and death seen in patients with previous ischemic stroke is also evident in patients with embolic stroke of undetermined source (ESUS). Methods: We pooled datasets of 11 stroke registries from Europe and America. ESUS was defined according to the Cryptogenic Stroke/ESUS International Working Group. We performed Cox regression and Kaplan-Meier product limit analyses to investigate whether age (80 years) and sex were independently associated with the risk for ischemic stroke/TIA recurrence or death. Results: Ischemic stroke/TIA rec...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Ntaios, G., Lip, G. Y. H., Vemmos, K., Koroboki, E., Manios, E., Vemmou, A., Rodriguez-Campello, A., Cuadrado-Godia, E., Roquer, J., Arnao, V., Caso, V., Paciaroni, M., Diez-Tejedor, E., Fuentes, B., Perez Lucas, J., Arauz, A., Ameriso, S. F., Pertierra, Tags: Other cerebrovascular disease/ Stroke, All Cerebrovascular disease/Stroke, Embolism ARTICLE Source Type: research
Phosphodiesterase 4: Rethinking cognition in Parkinson disease
The nosology and treatment options for cognitive impairment in Parkinson disease (PD) remains perhaps the greatest unmet clinical need.1 The reported frequency of mild cognitive impairment (MCI) in newly diagnosed PD has ranged from 22% to 43%.2,3 A proportion of those with PD-MCI progress to PD dementia (PDD), the prevalence of which is variously estimated between 24% and 31%, but is as high as 75% in longitudinal studies.4 Dementia is associated with increased disability, nursing home placement, mortality, and caregiver stress. Global cognition and executive/working memory deficits also occur in individuals at risk for P...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Jacova, C., Factor, S. A. Tags: MRI, PET, Volumetric MRI, Parkinson's disease/Parkinsonism, Parkinson's disease with dementia EDITORIALS Source Type: research
Determining the optimal target blood pressure after thrombectomy: High or low?
The management of patients with acute ischemic stroke has changed dramatically with modern mechanical thrombectomy (MT) techniques and improved patient selection using CT angiography.1 Although the benefit of early recanalization in large vessel occlusion (LVO) seems clear, the optimal periprocedural management remains uncertain. Unresolved issues include the method of analgesia and sedation, reversal and application of adjunctive periprocedural anticoagulation, glycemic control, ventilatory management, and perhaps most important, blood pressure (BP) control. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Wartenberg, K. E., Mayer, S. A. Tags: EDITORIALS Source Type: research
Age and the fuzzy edges of embolic stroke of undetermined source: Implications for trials
After an acute ischemic stroke, clinicians pursue further diagnostic assessment to identify the most plausible causes and tailor secondary prevention strategies. Available treatments with a high level of evidence for reducing recurrence stroke risk might include long-term oral anticoagulation in patients with a major-risk cardioembolic source (atrial fibrillation, prosthetic valves, etc), carotid endarterectomy in minor ischemic stroke related to moderate to severe internal carotid artery atherosclerotic stenosis, and best-practice medical management in those with lacunar stroke due to cerebral small vessel disease.1 Howev...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Charidimou, A. Tags: Stroke in young adults, All Clinical trials, All Cerebrovascular disease/Stroke, Embolism, Infarction EDITORIALS Source Type: research
The state of academic neurology departments in the United States, 2016: A national survey
Over the last decade, the United States has entered an era of national health care system reform, unprecedented in its scope and velocity. The seismic changes wrought by this process continue unabated and may have widespread effects on the academic medical enterprise throughout the country. To better understand the contemporary structure and features of academic neurology departments in this environment and to create a baseline for tracking future changes, we designed and executed a survey of department chairs in neurology nationwide in the fall of 2016, with the endorsement and support of the Association of University Pro...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Gooch, C. Tags: SPECIAL EDITORIALS Source Type: research
Teaching NeuroImages: Cerebral amyloid angiopathy-related inflammation presenting with isolated leptomeningitis
A 69-year-old woman presented with 1 month of rapid cognitive decline preceded by 1 year of very mild memory changes. Examination showed impaired attention, logopenic aphasia, anosognosia, simultagnosia, graphesthesia, and apraxia. Neuroimaging demonstrated leptomeningeal enhancement without significant parenchymal lesions or cerebral microbleeds (figure 1). A lymphocytic pleocytosis (15 nucleated cells/μL) was noted on CSF analysis. Extensive diagnostic testing was inconclusive, including flow cytometry and cytology, conventional angiography, body CT, and PET. Cerebral amyloid angiopathy–related inflammation (CAA...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Kang, P., Bucelli, R. C., Ferguson, C. J., Corbo, J. C., Kim, A. H., Day, G. S. Tags: All Clinical Neurology, All Cognitive Disorders/Dementia RESIDENT AND FELLOW SECTION Source Type: research
Teaching NeuroImages: Artery of Percheron aneurysm masquerading as ICH spot sign
A 50-year-old Japanese woman presented with left thalamic intracerebral hemorrhage (ICH). CT angiography demonstrated an ICH spot sign and intracranial vasculopathy consistent with Moyamoya disease (figure 1). Conventional angiography demonstrated that the spot sign was actually a pseudoaneurysm arising from the artery of Percheron (figure 2). Intracranial aneurysms may complicate Moyamoya disease and occur at the circle of Willis, distal peripheral arteries, or Moyamoya vessels at a ratio of 3:1:1.1 Aneurysms in thalamo-perforating arteries are rare2 and an artery of Percheron aneurysm in Moyamoya disease has not been rep...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Moughamian, A. J., Morshed, R. A., Colorado, R. A., Liner, Z., Cooke, D., Hemphill, J. C. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage RESIDENT AND FELLOW SECTION Source Type: research
Pearls & Oy-sters: An uncommon initial presentation of thyrotoxicosis
Venous thrombosis is common in patients with thyrotoxicosis, with the cerebral venous system being frequently involved. (Source: Neurology)
Source: Neurology - August 7, 2017 Category: Neurology Authors: Grewal, P. K., Villamar, M. F., Raslau, F. D., Dobbs, M. R. Tags: Stroke in young adults, Endocrine, All Cerebrovascular disease/Stroke, Cerebral venous thrombosis RESIDENT AND FELLOW SECTION Source Type: research
Clinical Reasoning: Two see or not two see--Is it really double vision?
A 57-year-old right-handed woman presented to the emergency department with complaints of double vision and intractable nausea that began abruptly 2 days earlier. Her visual symptoms were characterized as seeing overlapping or separate horizontally or diagonally displaced objects. She had no history of headaches or stroke. Her cerebrovascular risk factors included hypertension, type II diabetes, coronary artery disease, and cigarette smoking. Her medications included clopidogrel, lisinopril, paroxetine, and oxycodone. Her family history was notable for late-onset ischemic heart disease in her parents with no first-degree r...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Murphy, R. R., Al Sawaf, A., Rose, D. R., Goldstein, L. B., Smith, C. D. Tags: Clinical neurology examination, Diplopia (double vision), Visual fields, Visual processing, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research
Physical activity, but not body mass index, predicts less disability before and after stroke
Source: Neurology - July 31, 2017 Category: Neurology Tags: CORRECTIONS Source Type: research
Carotid artery web and ischemic stroke: A case-control study
Source: Neurology - July 31, 2017 Category: Neurology Tags: CORRECTIONS Source Type: research
Transplantation of spinal cord-derived neural stem cells for ALS: Analysis of phase 1 and phase 2 trials
Source: Neurology - July 31, 2017 Category: Neurology Tags: CORRECTIONS Source Type: research
Author response: Neurologists and the economics of MS treatment: Lighting candles, not cursing the darkness
Dr. Otulana, Chief Medical Officer for Mallinckrodt Pharmaceuticals, which produces H.P. Acthar Gel, claims that Acthar is cost-effective in a response to our editorial.1 To support this statement, Dr. Otulana references a study paid for by Mallinckrodt that is not a cost-effectiveness analysis.2 The cited study compares costs of health care services delivered to patients who received Acthar compared with a group that received either plasmapheresis or IV immunoglobulins (IVIg) for multiple sclerosis (MS) relapse.3 While there was a modest difference in total cost of care over 12 and 24 months after treatment between the 2 ...
Source: Neurology - July 31, 2017 Category: Neurology Authors: Bourdette, D. N. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Letter re: Neurologists and the economics of MS treatment: Lighting candles, not cursing the darkness
In their editorial, Drs. Bourdette and Whitham1 mentioned "avoiding use of repository corticotropin (Acthar gel) to treat MS relapses." Objectively considering H.P. Acthar Gel, the only Food and Drug Administration–approved noncorticosteroid therapy option for multiple sclerosis (MS) relapse, as a treatment option is in the best interest of patients. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Otulana, T. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Author response: Evolving use of seizure medications after intracerebral hemorrhage: A multicenter study
We thank Srinivasan et al. for the interest in our article.1 We agree that the use of levetiracetam is rational and stated so in the last paragraph of the article.1 Separately, Srinivasan et al. state that clinicians "appreciate the futility of using prophylactic" seizure medications. It is not clear how best to reconcile the rational and common use of levetiracetam with the potential futility of this approach. Definitive clinical trials are needed to determine whether prophylactic seizure medications alter patient outcomes and the occurrence of seizures in high-risk patients. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Naidech, A. M., Jahromi, B., Prabhakaran, S., Holl, J. L. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Letter re: Evolving use of seizure medications after intracerebral hemorrhage: A multicenter study
Naidech et al.1 concluded that increased prophylactic antiseizure drug (ASD) use in intracranial hemorrhage (ICH) between 2007 and 2012 was due to clinicians' hesitation to abandon a longstanding practice despite an established guideline.2 We offer an additional interpretation. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Srinivasan, S., Shin, H. W., Lee, J. W. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
: In response to "Evolving use of seizure medications after intracerebral hemorrhage: A multicenter study," Srinivasan et al. suggest that newer antiseizure drugs (ASD) (e.g., levetiracetam) are safer, influencing drug prescription behavior. They also report their own experience that initiation of ASD in patients with intracerebral hemorrhage has not changed in 2 cohorts 10 years apart; ASDs were more frequently discontinued prior to discharge in the recent cohort. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Karam, C., Griggs, R. C. Tags: WRITECLICK & amp;reg; EDITOR ' S CHOICE Source Type: research
Myoclonic dystonia (DYT11) responsive to insulin therapy: A case report
A 44-year-old man has been longitudinally followed for myoclonic dystonia (DYT11) due to a previously described heterozygous loss-of-function mutation involving a conserved residue in the epsilon-sarcoglycan gene (SGCE, NM_003919.2:c.1114C>T, p.Arg372Ter).1 (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Gazzina, S., Alberici, A., Padovani, A., Borroni, B. Tags: Dystonia, Myoclonus CLINICAL/SCIENTIFIC NOTES Source Type: research
A meta-analysis on progressive atrophy in intractable temporal lobe epilepsy: Time is brain?
Objective: It remains unclear whether drug-resistant temporal lobe epilepsy (TLE) is associated with cumulative brain damage, with no expert consensus and no quantitative syntheses of the available evidence. Methods: We conducted a systematic review and meta-analysis of MRI studies on progressive atrophy, searching PubMed and Ovid MEDLINE databases for cross-sectional and longitudinal quantitative MRI studies on drug-resistant TLE. Results: We screened 2,976 records and assessed eligibility of 248 full-text articles. Forty-two articles met the inclusion criteria for quantitative evaluation. We observed a predominance of ...
Source: Neurology - July 31, 2017 Category: Neurology Authors: Caciagli, L., Bernasconi, A., Wiebe, S., Koepp, M. J., Bernasconi, N., Bernhardt, B. C. Tags: MRI, Volumetric MRI use in epilepsy VIEWS & amp;amp; REVIEWS Source Type: research
When sleep-related hypermotor epilepsy (SHE) met Charles Darwin and Francis Galton
Sleep-related hypermotor epilepsy (SHE) is characterized by short-lasting seizures patterned by repetitive and stereotyped motor events in the same person. In autosomal dominant SHE, genetic factors play a well-known key role. In The Expression of Emotions in Man and Animals, Charles Darwin quotes a plausible example of SHE illustrated by his cousin Sir Francis Galton: "the gentleman...lay fast asleep on his back in bed, raising his right arm slowly in front of his face, up to his forehead, and then dropping it with a jerk, so that the wrist fell heavily on the bridge of his nose. The trick did not occur every night, ...
Source: Neurology - July 31, 2017 Category: Neurology Authors: Parrino, L., Pavesi, G. Tags: Clinical neurology history, Parasomnias, Epilepsy semiology, Partial seizures, All Genetics HISTORICAL NEUROLOGY Source Type: research
Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016
Conclusions: Burnout is common in neurology residents and fellows. Lack of work–life balance and lack of meaning in work were associated with reduced career satisfaction and increased risk of burnout. These results should inform approaches to reduce burnout and promote career satisfaction and well-being in US neurology trainees. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Levin, K. H., Shanafelt, T. D., Keran, C. M., Busis, N. A., Foster, L. A., Molano, J. R. V., O'Donovan, C. A., Ratliff, J. B., Schwarz, H. B., Sloan, J. A., Cascino, T. L. Tags: ARTICLE Source Type: research
Peripheral neuropathy in HIV-infected and uninfected patients in Rakai, Uganda
Objective: To determine the prevalence, risk factors, and functional impairment associated with peripheral neuropathy in a prospective cohort of adults in rural Uganda. Methods: Eight hundred participants (400 HIV– and 400 antiretroviral-naive HIV+) in the Rakai Community Cohort Study underwent detailed neurologic evaluations including assessment of neuropathy symptoms, functional measures (Patient Assessment of Own Functioning Inventory and Karnofsky Performance Status scores), and neurologic evaluation by a trained medical officer. Neuropathy was defined as ≥1 subjective symptom and ≥1 sign of neuropathy on ...
Source: Neurology - July 31, 2017 Category: Neurology Authors: Saylor, D., Nakigozi, G., Nakasujja, N., Robertson, K., Gray, R. H., Wawer, M. J., Sacktor, N. Tags: HIV, Peripheral neuropathy, Cohort studies, Prevalence studies ARTICLE Source Type: research
Sural nerve injury in familial amyloid polyneuropathy: MR neurography vs clinicopathologic tools
Objective: To detect and quantify lesions of the small-caliber sural nerve (SN) in symptomatic and asymptomatic transthyretin familial amyloid polyneuropathy (TTR-FAP) by high-resolution magnetic resonance neurography (MRN) in correlation with electrophysiologic and histopathologic findings. Methods: Twenty-five patients with TTR-FAP, 10 asymptomatic carriers of the mutated transthyretin gene (mutTTR), and 35 age- and sex-matched healthy controls were prospectively included in this cross-sectional case-control study. All participants underwent 3T MRN with high-structural resolution (fat-saturated, T2-weighted, and double-...
Source: Neurology - July 31, 2017 Category: Neurology Authors: Kollmer, J., Sahm, F., Hegenbart, U., Purrucker, J. C., Kimmich, C., Schönland, S. O., Hund, E., Heiland, S., Hayes, J. M., Kristen, A. V., Röcken, C., Pham, M., Bendszus, M., Weiler, M. Tags: MRI, Peripheral neuropathy ARTICLE Source Type: research
Occipital headaches and neuroimaging in children
Conclusions: Children with occipital headache are more likely to undergo neuroimaging. In the absence of concerning features on the history and in the setting of a normal neurologic examination, neuroimaging can be deferred in most pediatric patients when occipital pain is present. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Bear, J. J., Gelfand, A. A., Goadsby, P. J., Bass, N. Tags: Secondary headache disorders, Pediatric headache, Diagnostic test assessment, All Imaging, Risk factors in epidemiology ARTICLE Source Type: research
Comorbid pain and migraine chronicity: The Chronic Migraine Epidemiology and Outcomes Study
Objective: To identify patterns of noncephalic pain comorbidity in people with episodic migraine (EM;
Source: Neurology - July 31, 2017 Category: Neurology Authors: Scher, A. I., Buse, D. C., Fanning, K. M., Kelly, A. M., Franznick, D. A., Adams, A. M., Lipton, R. B. Tags: Migraine, All Pain, Clinical trials Observational study (Cohort, Case control), All epidemiology ARTICLE Source Type: research
Type 2 diabetes, glucose, insulin, BMI, and ischemic stroke subtypes: Mendelian randomization study
Conclusions: This study provides support that T2D may be causally associated with large artery stroke. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Larsson, S. C., Scott, R. A., Traylor, M., Langenberg, C. C., Hindy, G., Melander, O., Orho-Melander, M., Seshadri, S., Wareham, N. J., Markus, H. S., For the METASTROKE Collaboration and NINDS Stroke Genetics Network (SiGN) Tags: Risk factors in epidemiology, Infarction ARTICLE Source Type: research
Poor sleep is associated with CSF biomarkers of amyloid pathology in cognitively normal adults
Conclusions: Self-report of poor sleep was associated with greater AD-related pathology in cognitively healthy adults at risk for AD. Effective strategies exist for improving sleep; therefore sleep health may be a tractable target for early intervention to attenuate AD pathogenesis. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Sprecher, K. E., Koscik, R. L., Carlsson, C. M., Zetterberg, H., Blennow, K., Okonkwo, O. C., Sager, M. A., Asthana, S., Johnson, S. C., Benca, R. M., Bendlin, B. B. Tags: All Sleep Disorders, Alzheimer's disease, Cerebrospinal Fluid, Cohort studies, Risk factors in epidemiology ARTICLE Source Type: research
Prospective clinical and DaT-SPECT imaging in premotor LRRK2 G2019S-associated Parkinson disease
Conclusions: Semiquantitative DaT-SPECT could be used to predict early conversion to PD in asymptomatic carriers of the LRRK2 G2019S mutation. Rate of conversion to PD at 4 years in this cohort aged ~64 years was 12%. The slope of DaT binding decline on DaT-SPECT imaging seems to be similar across different stages of the premotor period. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Sierra, M., Martinez-Rodriguez, I., Sanchez-Juan, P., Gonzalez-Aramburu, I., Jimenez-Alonso, M., Sanchez-Rodriguez, A., Berciano, J., Banzo, I., Infante, J. Tags: SPECT, Parkinson's disease/Parkinsonism, Cohort studies, Natural history studies (prognosis) ARTICLE Source Type: research
Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study
Conclusion: Single-dose MP intake met all noninferiority efficacy and safety outcome measures in comparison to dispersible levodopa/benserazide. Clinical effects of high-dose MP were similar to levodopa alone at the same dose, with a more favorable tolerability profile. ClinicalTrials.gov identifier: NCT02680977. (Source: Neurology)
Source: Neurology - July 31, 2017 Category: Neurology Authors: Cilia, R., Laguna, J., Cassani, E., Cereda, E., Pozzi, N. G., Isaias, I. U., Contin, M., Barichella, M., Pezzoli, G. Tags: Parkinson's disease/Parkinsonism, Clinical trials Randomized controlled (CONSORT agreement), Class II ARTICLE Source Type: research
Severity assessment in maximally treated ICH patients: The max-ICH score
Objective: As common prognostication models in intracerebral hemorrhage (ICH) are developed variably including patients with early (
Source: Neurology - July 31, 2017 Category: Neurology Authors: Sembill, J. A., Gerner, S. T., Volbers, B., Bobinger, T., Lücking, H., Kloska, S. P., Schwab, S., Huttner, H. B., Kuramatsu, J. B. Tags: Other cerebrovascular disease/ Stroke, Prognosis, All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research