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Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Guideline of neuropathic pain treatment and dilemma from neurological point of view.
Authors: Yang CM, Chen NC, Shen HC, Chou CH, Yeh PS, Lin HJ, Chang CY, Cheng TJ, Lin KC Abstract Neuropathic pain is a complicated symptomatic disease as migraine in recent years. Not because the pain character differed from the nociceptive inflammatory symptoms but because of its complexity of mechanisms. Though peripheral sensitization, ectopic discharge, central sensitization, central re-organization and loss of inhibition play part of roles in mechanisms, however, based on this mechanistic treatment, the outcome still disappointed physicians and patients, exampled as central post-stroke central pain (CPSP). The...
Source: Acta Neurologica Taiwanica - December 12, 2015 Category: Neurology Tags: Acta Neurol Taiwan Source Type: research

Clinical presentation, management, and pathophysiology of neuropathic itch
Publication date: August 2018Source: The Lancet Neurology, Volume 17, Issue 8Author(s): Martin Steinhoff, Martin Schmelz, Imre Lőrinc Szabó, Anne Louise OaklanderSummaryUnlike conventional itch, neuropathic itch develops in normal skin from excess peripheral firing or dampened central inhibition of itch pathway neurons. Neuropathic itch is a symptom of the same central and peripheral nervous system disorders that cause neuropathic pain, such as sensory polyneuropathy, radiculopathy, herpes zoster, stroke, or multiple sclerosis, and lesion location affects symptoms more than aetiology. The causes of neuropathic itch are h...
Source: The Lancet Neurology - July 18, 2018 Category: Neurology Source Type: research

Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3- and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study
Conclusions: Pre-injury psychiatric and pre-injury headache/migraine symptoms are risk factors for worse functional and post-concussive outcomes at 3- and 6-months post-mTBI. mTBI patients presenting to acute care should be evaluated for psychiatric and headache/migraine history, with lower thresholds for providing TBI education/resources, surveillance, and follow-up/referrals. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01565551. Introduction Traumatic brain injury (TBI) remains a significant cause of morbidity and mortality worldwide. In 2013 ~2.8 million TBI cases were recorded an...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Light-Induced Pupillary Responses in Alzheimer's Disease
Light-Induced Pupillary Responses in Alzheimer's Disease Pratik S. Chougule1, Raymond P. Najjar1,2, Maxwell T. Finkelstein1, Nagaendran Kandiah3,4 and Dan Milea1,2,5* 1Department of Visual Neurosciences, Singapore Eye Research Institute, Singapore, Singapore 2The Ophthalmology & Visual Sciences ACP, Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore 3Department of Neurology, National Neuroscience Institute, Singapore, Singapore 4Duke-National University of Singapore (NUS), Singapore, Singapore 5Singapore National Eye Centre, Singapore, Singapore The impact of Alzhe...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Challenges of Robotic Gynecologic Surgery in Morbidly Obese Patients and How to Optimize Success
This article reviews the benefits of a minimally invasive approach in obese patients and provides a thorough guide to perioperative management of obese patients undergoing robotic gynecologic surgery. A useful set of tips and tricks to overcome many of the technical challenges in performing robotic surgery in the obese patients is included.Recent FindingsIn the USA, obesity has risen to affect 39.8% of the population, which leads to increased incidence of mortality, hypertension, diabetes, heart disease, and stroke. Moreover, obese patients are at greater risk of perioperative complications during gynecologic surgery. With...
Source: Current Pain and Headache Reports - June 30, 2019 Category: Neurology Source Type: research