Neuromyelitis Optica and Herpes Simplex Virus 2: A Viral Trigger for Aquaporin-4 Autoimmunity?
We present a case of myeloradiculitis associated with aquaporin-4 antibody and concomitant herpes simplex virus 2 infection. (Source: The Neurologist)
Source: The Neurologist - May 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Neuroinvasive Listeriosis: Could Petechial Hemorrhages be a Diagnostic Clue?
Conclusions:
We point out the importance of nonconventional magnetic resonance imaging techniques in the diagnosis, as we detected petechial hemorrhages in the brain parenchyma in all cases, which can be a diagnostic clue. (Source: The Neurologist)
Source: The Neurologist - May 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Rheumatoid Meningitis: A Case Review
Conclusions:
Cerebrospinal fluid findings for RM are nonspecific, typically lymphocytic pleocytosis; however, they can be neutrophilic, as in this case. Magnetic resonance imaging findings consist of leptomeningeal and pachymeningeal enhancement but can also involve the parenchyma. The diagnosis is typically confirmed with meningeal biopsy. Treatment involves high-dose corticosteroids or immunomodulatory therapy, or both. Long-term follow-up with radiologic surveillance typically ranges from improvement to resolution. (Source: The Neurologist)
Source: The Neurologist - May 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Stroke Severity Affects Timing: Time From Stroke Code Activation to Initial Imaging is Longer in Patients With Milder Strokes
Optimizing the time it takes to get a potential stroke patient to imaging is essential in a rapid stroke response. At our hospital, door-to-imaging time is comprised of 2 time periods: the time before a stroke is recognized, followed by the period after the stroke code is called during which the stroke team assesses and brings the patient to the computed tomography scanner. To control for delays due to triage, we isolated the time period after a potential stroke has been recognized, as few studies have examined the biases of stroke code responders. This “code-to-imaging time” (CIT) encompassed the time from stroke code...
Source: The Neurologist - May 1, 2018 Category: Neurology Tags: Original Articles Source Type: research
Analysis of Risk Factors in Patients With Peripheral Vertigo or Central Vertigo
This study was aimed to determine risk factors for central vertigo (CV) in patients with isolated vertigo accompanied by hearing loss or not.
Patients and Methods:
Patients with CV or peripheral vertigo (PV) who were admitted to our hospital between January 2014 and July 2016 were retrospectively reviewed. All patients underwent thorough physical examination with detailed medical histories recorded, including smoking, hypertension, diabetes, cardiovascular disease, and stroke history. Logistic regression estimated odds ratio (OR) of the risk factors.
Results:
Eighty-seven patients were enrolled into the study, includ...
Source: The Neurologist - May 1, 2018 Category: Neurology Tags: Original Articles Source Type: research
Acute Basilar Artery Occlusion: Does Recanalization Improve Clinical Outcome? A Critically Appraised Topic
Conclusions:
IVT is the standard of care for BAO patients presenting within 4.5 hours of symptom onset, whereas recanalization is associated with better outcomes regardless of how recanalization is achieved. Randomized controlled trials comparing IVT plus endovascular treatment versus IVT in the treatment of acute BAO are needed to provide evidence-based management guidance. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Critically Appraised Topics Source Type: research
Frequency of and Factors Associated With Obstructive Sleep Apnea and Periodic Limb Movements in Stroke and TIA Patients
Conclusions:
A significant number of stroke and TIA patients who underwent PSG have PLMs and moderate-severe OSA. Stroke and TIA patients with atrial fibrillation are more likely to have moderate-severe OSA and may benefit from PSG evaluation. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Original Article Source Type: research
Magnesium Sulfate Treatment Correlates With Improved Neurological Function in Posterior Reversible Encephalopathy Syndrome (PRES): Report of a Case
We describe a case of nonresolving PRES where use of magnesium sulfate led to improvement in neurological function and eventual recovery. Our case highlights the need for a randomized controlled trial to test the efficacy of magnesium in PRES. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Admission Systolic Blood Pressure Predicts the Number of Blood Pressure Medications at Discharge in Patients With Primary Intracerebral Hemorrhage
Background:
Control of systolic blood pressure (SBP) after primary intracerebral hemorrhage improves outcomes. Factors determining the number of blood pressure medications (BPM) required for goal SBP (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Original Article Source Type: research
Autoimmune Encephalitis With Multiple Autoantibodies: A Diagnostic and Therapeutic Challenge
Conclusions:
Multiple autoantibodies may be detected in patients with AE. When antibodies targeting intracellular and cell-surface antigens are detected together, investigation and treatment of syndromes associated with intracellular antibodies should be prioritized, acknowledging the link between these antibodies and irreversible neuronal injury. In paraneoplastic cases, prognosis may be tied to early detection and treatment of the underlying malignancy. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Diagnostic Evaluation in Primary CNS Lymphoma
The diagnosis of primary central nervous system lymphoma (PCNSL) may be fraught with difficulty. After initial imaging reveals enhancing intracranial mass lesions steroids are often initiated. This leads to a decreased diagnostic yield of tumor biopsies which may be associated with delay in treatment initiation. We review a case of PCNSL treated with a very brief steroid course. Initial nondiagnostic biopsy histopathology is juxtaposed against subsequent diagnostic pathology. Imaging before and after steroids is presented, as is imaging after tumor regrowth in a noncontiguous location. Elements in the clinical history and ...
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Valproate-induced Hyperammonemic Encephalopathy Presenting as Catatonia
We present the case of a 21-year-old woman presenting with catatonia as a manifestation of hyperammonemic encephalopathy that resolved with the normalization of ammonia and suspension of valproate. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Case Report/Case Series Source Type: research
Association Between the Apolipoprotein E Gene Polymorphism and Atherosclerotic Middle Cerebral Artery Stenosis
Conclusions:
This present study indicated that the hypertension (ie, systolic blood pressure and pulse pressure) and the ApoEε4/ε4 genotype may be associated with the occurrence of MCA stenosis in the ischemic stroke Chinese patients. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Original Articles Source Type: research
Continuous Intravenous Valproate as Abortive Therapy for Pediatric Status Migrainosus
This study describes the use of continuous intravenous valproate as an abortive therapy for pediatric status migrainosus.
Background:
Intravenous valproate as a bolus dose has been shown to be an effective abortive therapy for status migrainosus in children; however, Valproate’s pharmacokinetic profile suggests that it would be safer and more therapeutic as a continuous infusion. This dosing strategy results in less serum concentration fluctuations, more consistent therapeutic effects, and less adverse effects.
Methods:
A retrospective chart review between August 2009 and August 2012 identified 83 patients who had ...
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Original Articles Source Type: research
Preventive Antibiotics for Poststroke Infection in Patients With Acute Stroke: A Systematic Review and Meta-analysis
Conclusions:
Preventive antibiotics significantly reduced the incidence of algorithm-defined infection in patients with acute stroke, but did not decrease the mortality or improve the proportion of good outcome. Future research should aim to identify the group of stroke patients who will benefit most from antibiotic prophylaxis. (Source: The Neurologist)
Source: The Neurologist - March 1, 2018 Category: Neurology Tags: Review Article Source Type: research
