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Specialty: Neurosurgery

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Total 602 results found since Jan 2013.

Characterising aggressive multiple sclerosis
Conclusions AMS was identified in 4–14% of patients, depending on the definition used. Although there was a relative preponderance of men and primary progressive MS presenting with AMS, the majority of patients were still women and those with relapsing-onset MS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Menon, S., Shirani, A., Zhao, Y., Oger, J., Traboulsee, A., Freedman, M. S., Tremlett, H. Tags: Editor's choice, Immunology (including allergy), Multiple sclerosis Source Type: research

Changes to anti-JCV antibody levels in a Swedish national MS cohort
Conclusions Treatment initiation with NAT may lead to a slight decrease in anti-JCV and anti-VZV antibody levels, suggestive of a mild suppressive effect of NAT on antibody levels. Our findings in five cases of PML demonstrate that the onset of PML can be accompanied by increasing anti-JCV antibodies in serum. Monitoring of anti-JCV antibody levels could potentially be used as a tool for prediction or earlier diagnosis of PML during NAT treatment for MS. Further studies are warranted.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Warnke, C., Ramanujam, R., Plavina, T., Bergstrom, T., Goelz, S., Subramanyam, M., Kockum, I., Rahbar, A., Kieseier, B. C., Holmen, C., Olsson, T., Hillert, J., Fogdell-Hahn, A. Tags: Open access, Immunology (including allergy), Infection (neurology), Multiple sclerosis Source Type: research

Atypical Bickerstaff brainstem encephalitis: ataxic hypersomnolence without ophthalmoplegia
Conclusions Ophthalmoplegia can be absent or incomplete in BBE, and the absence of this clinical feature should not exclude BBE from the clinicians’ differential. Such cases of incomplete BBE could be defined as ‘ataxic hypersomnolence without ophthalmoplegia’.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Wakerley, B. R., Soon, D., Chan, Y.-C., Yuki, N. Tags: Immunology (including allergy), Cranial nerves, Drugs: CNS (not psychiatric), Infection (neurology), Sleep disorders (neurology), Ophthalmology, Sleep disorders Neuro-inflammation Source Type: research

The connection between ruptured cerebral aneurysms and odontogenic bacteria
Conclusions This is the first report showing evidence that dental infection could be a part of pathophysiology in intracranial aneurysm disease.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Pyysalo, M. J., Pyysalo, L. M., Pessi, T., Karhunen, P. J., Ohman, J. E. Tags: Immunology (including allergy) Cerebrovascular disease Source Type: research

Tremor in inflammatory neuropathies
Conclusion Tremor in inflammatory neuropathies is common, adds to disability and yet does not often respond to treatment of the underlying neuropathy. When present, tremor severity is associated with F wave latency.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Saifee, T. A., Schwingenschuh, P., Reilly, M. M., Lunn, M. P. T., Katschnig, P., Kassavetis, P., Parees, I., Manji, H., Bhatia, K., Rothwell, J. C., Edwards, M. J. Tags: Genetics, Immunology (including allergy), Multiple sclerosis, Neuromuscular disease, Peripheral nerve disease Movement disorders Source Type: research

Neurogenic paradoxical breathing
A 53-year-old man rapidly developed quadriplegia and tachypnoea (figure 1). Electrophysiologic studies showed demyelinating features consistent with Guillain-Barré syndrome. He required a tracheostomy and gastrostomy. Paradoxical breathing, also known as thoracoabdominal asynchrony, was seen (see online video). Normally during inspiration, the abdomen and chest expand in a synchronised fashion. During inspiration a downward movement of diaphragm pushes the abdominal contents out as the ribs are lifted and moved out, causing both chest and abdomen to rise. With diaphragmatic paralysis, the diaphragm moves up rather t...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Wijdicks, E. F. M. Tags: Immunology (including allergy), Drugs: CNS (not psychiatric), Multiple sclerosis, Neuromuscular disease, Peripheral nerve disease, Musculoskeletal syndromes Neurological pictures Source Type: research

Does suppression of VEGF alone lead to clinical recovery in POEMS syndrome?
POEMS syndrome (Crow-Fukase syndrome) is a multisystem disorder characterised by polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes. Vascular endothelial growth factor (VEGF) is significantly elevated in serum and used as a good biomarker for diagnosis and disease activity.1 VEGF is a potent, multifunctional cytokine that induces angiogenesis and microvascular hyperpermeability. In POEMS syndrome, VEGF is mainly produced by plasma cells in bone lesions and lymph nodes. In the circulation, excess VEGF is mainly stored in platelets and released during platelet aggregation leading to markedly increased l...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 13, 2013 Category: Neurosurgery Authors: Arimura, K. Tags: Genetics, Immunology (including allergy), Neuromuscular disease, Neurooncology, Peripheral nerve disease, CNS cancer Editorial commentaries Source Type: research

Rituximab for tumefactive demyelination refractory to corticosteroids and plasma exchange
Case history A 38-year-old woman with no significant past medical history presented with a generalised tonic–clonic seizure. The patient was afebrile and general physical and neurological examinations were normal. MRI of the brain revealed an irregular mass in the right temporal lobe with T2-weighted and fluid-attenuated inversion recovery (FLAIR) signal hyperintensity and heterogeneous enhancement after the administration of gadolinium (figure 1A–D). Laboratory investigations included normal blood count, liver enzymes, serum creatinine, angiotensin converting enzyme and erythrocyte sedimentation rate (ESR). Se...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 13, 2013 Category: Neurosurgery Authors: Sempere, A. P., Feliu-Rey, E., Sanchez-Perez, R., Nieto-Navarro, J. Tags: Immunology (including allergy), HIV/AIDS, Cranial nerves, Drugs: CNS (not psychiatric), Epilepsy and seizures, Headache (including migraine), Multiple sclerosis, Neurooncology, Pain (neurology), CNS cancer, Ophthalmology, Radiology, Surgical diagnostic te Source Type: research

Ambiguous effects of anti-VEGF monoclonal antibody (bevacizumab) for POEMS syndrome
Conclusions Both our experience and the literature suggest ambiguous effects of bevacizumab; inhibition of VEGF alone may be insufficient because multiple cytokines are upregulated, or aberrant neo-vascularization may have already fully developed in the advanced stage of POEMS syndrome.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 13, 2013 Category: Neurosurgery Authors: Sekiguchi, Y., Misawa, S., Shibuya, K., Nasu, S., Mitsuma, S., Iwai, Y., Beppu, M., Sawai, S., Ito, S., Hirano, S., Nakaseko, C., Kuwabara, S. Tags: Genetics, Immunology (including allergy), Neuromuscular disease, Peripheral nerve disease Source Type: research

Herpes encephalitis complicated by cerebral haemorrhage
Case report A 46-year-old, previously well, right-handed man presented with a 1 week history of headache, vomiting and confusion. On examination his temperature was 38.3°C, Glasgow Coma Scale score was 14/15 (E4V4M6) and he was severely expressively dysphasic. There was no limb weakness. Initial blood tests, including C reactive protein, were normal. Cranial CT revealed a hypodense area in the left anteromedial temporal lobe (figure 1). Microscopy of CSF from a lumbar puncture showed a pleocytosis (390x106/ml, lymphocytes 95%), with no organism. On a working diagnosis of herpes simplex virus (HSV) encephalitis, em...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 13, 2013 Category: Neurosurgery Authors: Lo, W. B., Wilcock, D. J., Carey, M., Albanese, E. Tags: Immunology (including allergy), HIV/AIDS, Coma and raised intracranial pressure, Epilepsy and seizures, Headache (including migraine), Infection (neurology), Pain (neurology) Neurological pictures Source Type: research

Ultra-high-field MR imaging in multiple sclerosis
In multiple sclerosis (MS), MRI is the most important paraclinical tool used to inform diagnosis and for monitoring disease evolution, either natural or modified by treatment. The increased availability of ultra-high-field magnets (7 Tesla or higher) gives rise to questions about the main benefits of and challenges for their use in patients with MS. The main advantages of ultra-high-field MRI are the improved signal-to-noise ratio, greater chemical shift dispersion, and improved contrast due to magnetic susceptibility variations, which lead to increased sensitivity to the heterogeneous pathological substrates of the diseas...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 10, 2013 Category: Neurosurgery Authors: Filippi, M., Evangelou, N., Kangarlu, A., Inglese, M., Mainero, C., Horsfield, M. A., Rocca, M. A. Tags: Immunology (including allergy), Multiple sclerosis Source Type: research

Onset of secondary progressive phase and long-term evolution of multiple sclerosis
Conclusions The onset of SP MS is the dominant determinant of long-term prognosis, and its prevention is the most important target measure for treatment. Baseline clinical features of early relapse frequency and age at onset can be used to select groups at higher risk of developing severe disability based on the probability of their disease becoming progressive within a defined time period.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 10, 2013 Category: Neurosurgery Authors: Scalfari, A., Neuhaus, A., Daumer, M., Muraro, P. A., Ebers, G. C. Tags: JNNP Patients' choice, Immunology (including allergy), Multiple sclerosis Source Type: research

Incidence and prevalence of multiple sclerosis in the UK 1990-2010: a descriptive study in the General Practice Research Database
Conclusions We estimate that 126 669 people were living with MS in the UK in 2010 (203.4 per 100 000 population) and that 6003 new cases were diagnosed that year (9.64 per 100 000/year). There is an increasing population living longer with MS, which has important implications for resource allocation for MS in the UK.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 10, 2013 Category: Neurosurgery Authors: Mackenzie, I. S., Morant, S. V., Bloomfield, G. A., MacDonald, T. M., O'Riordan, J. Tags: Open access, Immunology (including allergy), Multiple sclerosis Source Type: research

A new headache during late pregnancy: consider the nasal mucosa as a 'point' of reference
New-onset severe headache in late pregnancy is concerning for several potentially catastrophic neurologic conditions including cerebral vein thrombosis, cerebral haemorrhage and reversible cerebral vasoconstriction syndrome. There is always a question of the use of brain MRI in the pregnant patient with new-onset headache, especially in women with normal neurologic examinations. A case of new-onset pregnancy-related headache is presented in which the aetiology was diagnosed solely from findings on neuroimaging. Case: A 36-week pregnant, 31-year-old woman, presented with a 5-day history of severe right-sided headaches. She ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 10, 2013 Category: Neurosurgery Authors: Rozen, T. D. Tags: Immunology (including allergy), Headache (including migraine), Pain (neurology), Radiology, Radiology (diagnostics) Neurological pictures Source Type: research

When patient opinion and clinical science are implacably opposed: the view from an MS specialist
Some years ago, just after starting as a consultant, a patient with an established diagnosis of multiple sclerosis (MS) asked me to prescribe Diet Coca-Cola for her. I was taken aback by the unusual nature of the request, and had to ask why. It turned out that she had watched a Channel 4 documentary programme on television the previous evening, in which a lady called Cari Loder had presented a proposal for a regime of treatment that appeared to benefit her MS. The combination was vitamin B12, a somewhat out-of-fashion antidepressant called Lofepramine, and L-phenylalanine in generous quantity. The latter, the TV commentary...
Source: Journal of Neurology, Neurosurgery and Psychiatry - January 17, 2014 Category: Neurosurgery Authors: Mumford, C. J. Tags: Immunology (including allergy), Multiple sclerosis, Radiology, Drugs: musculoskeletal and joint diseases, Radiology (diagnostics) Editorial commentaries Source Type: research