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Specialty: Neurosurgery

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Total 602 results found since Jan 2013.

Haemolytic anaemia as a complication of intravenous immunoglobulin therapy
Conclusion We confirm the literature findings of a strong association between high dose intravenous immunoglobulin therapy and haemolysis in neurology patients receiving immunoglobulin therapy.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Salam, S., Woodall, A., Gosal, D. Tags: Immunology (including allergy), Neuromuscular disease, Peripheral nerve disease ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Management of myasthenia gravis compared to national guidelines
Conclusion Management of MG patients at UHB in general comply with national guidelines. However, variations in practice were noted for once or alternate day steroid usage and also regarding reduction or withdrawal of Pyridostigmine.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Perera, P. S., Tiet, M. Y., Jacob, S. Tags: Immunology (including allergy), Neuromuscular disease, Musculoskeletal syndromes ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Optimising ivig delivery in a tertiary neurology centre
Conclusion Our project highlights the importance of a multidisciplinary approach, allowing us to implement significant changes in the unit's structure, reduce unnecessary waiting times and ensure safe administration of IVIg.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Zarkali, A., Bonifacio, G., Englezou, C., Parsons, V. V. H., Renshaw, H., Ingle, G., Manji, H., Reilly, M., Lunn, M., Carr, A. Tags: Immunology (including allergy) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Cll, a rare but treatable cause of longitudinally extensive myelitis
A 65-year-old lady presented with a 1-year history of progressive sensory and motor symptoms in the the legs, back pain, pruritus and night sweats. Neurological examination of the cranial nerves and upper limbs was unremarkable. Lower limb examination revealed mild bilateral spastic paraparesis. Cervical, axillary and inguinal lymphadenopathy was noted. Bloods showed only a mild lymphopenia. MRI revealed symmetrically diffuse nodular enhancement in the brain and longitudinally extensive transverse myelitis in the cervical and thoracic spine with leptomeningeal enhancement. CSF analysis showed a protein of 1888 mg/L, W...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Ahmed, W., Coe, J., Carroll, L., Vundavalli, S., Chevassut, T., Saha, R. Tags: Immunology (including allergy), Cranial nerves, Infection (neurology), Multiple sclerosis, Pain (neurology), Spinal cord, Radiology, Surgical diagnostic tests, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Primary t-cell cns lymphoma mimicking vasculitis
A 29 year old male presented with headache and no neurological signs. MRI brain strongly suggested an aggressive primary brain tumour in the right frontal lobe but histopathology revealed a pleomorphic lymphoid infiltrate, necrosis and vague granulomata and vasculitis was diagnosed. There was aggressive clinico-radiological progression despite two debunking surgeries, corticosteroids and cyclophosphamide. On review the following were noted: areas of necrosis and focal diffuse lymphoid infiltrate showing perivascular cuffing; the presence of granuloma formation and vascular necrosis was less certain; overwhelming predominan...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Raheem, B., Khan, H., Scolding, N., Love, S., Al-Sarraj, S., Bhangoo, R., Devereaux, S., Rooney, N., Sutak, J., Moran, N. Tags: Genetics, Immunology (including allergy), Headache (including migraine), Pain (neurology), Drugs: musculoskeletal and joint diseases, Vascularitis, Surgical oncology ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Take the bitter with the sweet
We present a unique case of paraneoplastic Sweet's syndrome associated with a primary CNS lymphoma. A 69-year old gentleman presented with pyrexia of unknown origin (PUO), Sweet's syndrome and marked neutrophilia. 3 repeated bone marrow aspirates demonstrated a myelodysplastic-like syndrome. Initial treatment with hydroxycarbamide ameliorated the PUO and skin lesions. He subsequently presented with a clinical syndrome mimicking motor neurone disease; developing dysphagia, weakness and weight loss. Videofluoroscopy demonstrated oropharyngeal dysphagia requiring gastrotomy insertion. Nerve conduction and CSF studies were unr...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Salam, S., Fardoom, P., Milahova, T. Tags: Immunology (including allergy), Epilepsy and seizures, Radiology, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Case report: pandysautonomia
We present the case of a 25 year old previously healthy female who became unwell with abdominal pain and vomiting a day after taking part in a half marathon and was found to have a pseudo-obstruction requiring laparotomy. Post surgery she developed a dry mouth and urinary retention and was consistently tachycardic with labile blood pressure. She developed one episode of parotitis which resolved with antibiotics. Family history included relatives with Addison's disease, hypothyroidism and Raynaud's phenomenon. Neurological examination was normal. There were no other findings to suggest systemic autoimmune disease. Vasculiti...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Al-Ansari, A., Rickards, C., Thomas, L., Bain, S. Tags: Genetics, Immunology (including allergy), HIV/AIDS, Pain (neurology), Hypertension, Ophthalmology, Connective tissue disease, Musculoskeletal syndromes ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Ebv meningitis as a presenting feature of gata-2 deficiency
We present the case of a 21-year old woman who presented to a district general hospital with headache and meningeal irritation and bilateral abducence nerve palsy and diagnosed with viral meningitis. Her investigation showed positive EBV serology. She represented with signs and symptoms of raised intracranial pressure and then neutropenic sepsis and was found to have persistent EBV viral load. Investigation revealed a mutation in the GATA2 gene [c. 1091_1096dup p.(Ala364_Asn365dup)] which has not been previously reported. She is awaiting haematopoetic stem cell transplant. To our knowledge there have been no previous repor...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: AlMasri, O., Housheham, E., McLean, B. Tags: Immunology (including allergy), Meningitis, Headache (including migraine), Hydrocephalus, Infection (neurology), Pain (neurology) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

A thirst for rarity? an interesting case of hypopituitarism
A previously healthy 69-year-old short statured woman presented with a 4-month history of increased thirst, polyuria, nausea, vomiting, 2-stone weight loss and nocturnal visual hallucinations. Neurological examination was normal, however she had difficulty standing due to postural hypotension with a supine blood pressure of 98/64 mm Hg. Investigations revealed hypopituitarism with secondary hypoadrenalism (baseline cortisol of 45 nmol/l) and hypothyroidism. Neuroimaging showed leptomeningeal enhancement and an infundibular mass lesion, which on biopsy demonstrated a benign non-Langerhan cell histiocytic prol...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Edwards, M., Johnston, J. Tags: Immunology (including allergy), Hypertension, Ophthalmology, Radiology, Surgical diagnostic tests ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Peripheral neuropathy associated with whipple's disease
Whipple's Disease (WD) is a chronic multisystem infectious disease caused by the bacterium Tropheryma Whipplei. Neurological manifestations typically involve cognitive impairment and deranged ocular movement with ophthalmoplegia or oculomasticatory myorhythmia. A fifty-five year old Caucasian presented with visual disturbance, patchy lower limb weakness and dysthesia with intermittent abdominal pain and weight loss progressing over several months. He was diagnosed with bilateral uveitis and an axonal motor sensory peripheral neuropathy confirmed with neurophysiology. Blood tests for common metabolic, inflammatory and infec...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Kumar, G., Mohamed, M., Redmond, I., Harikrishnan, S. Tags: Immunology (including allergy), Cranial nerves, Pain (neurology), Ophthalmology, Memory disorders (psychiatry), Radiology, Surgical diagnostic tests ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

What do diagnostic tests tell us in central nervous system vasculitis?
Conclusion Cerebral angiography and biopsy were performed together in only a minority of published cases of PCNSV. When both were performed, conflicting results from each gold-standard test were much more likely than agreement. The diagnostic criteria for PCNSV require revision in order to classify it correctly and to exclude mimics.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: McVerry, F., Muir, K., McCarron, M. Tags: Immunology (including allergy), Neuroimaging, Radiology, Vascularitis, Surgical diagnostic tests, Radiology (diagnostics) ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Tibialis anterior muscle biopsy - a patient reported outcome study
Conclusions This small patient reported outcome study suggests that percutaneous tibialis anterior muscle biopsy is safe and well tolerated.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Lilleker, J., Woodall, A., Roberts, M., Chinoy, H. Tags: Drugs: CNS (not psychiatric), Neuromuscular disease, Pain (neurology), Radiology, Surgical diagnostic tests, Ear, nose and throat/otolaryngology, Trauma, Injury ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

Characterisation of uk anti-hmgcr+ antibody associated myositis
Conclusion The relationship between anti-HMGCR positivity, HLA-DRB1*11 and statin exposure confirms observations made in other international cohorts. Work is on going to characterise symptomatology, disease association and treatment response.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Murphy, S., Lilleker, J., Rothwell, S., Betteridge, Z., McHugh, N., Roberts, M., Lamb, J., Cooper, R., Chinoy, H. Tags: Immunology (including allergy), Muscle disease, Neuromuscular disease, Musculoskeletal syndromes ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

What influences false positive achr antibody results?
This study looked into the samples tested during this period to identify any false positive rates. For the purpose of the study, false positive was defined as lack of response to autoimmune myasthenia treatments (and the absence of other clinical or neurophysiological features of MG), or tests requested in error when there was no clinical suspicion of myasthenia. 696 samples were tested for AChR from 582 patients. 280 patients (48.1%) were reported to have positive AChR antibodies. 27 of these were considered to be false positive. We analysed the clinical details of these patients and have identified factors like other aut...
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Sadalage, G., Torane, P., Karim, A., Jacob, S. Tags: Immunology (including allergy), Drugs: CNS (not psychiatric), Neuromuscular disease ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research

A prospective clinical and immunological study of late onset myasthenia gravis
Conclusion Further evaluation of clinical data and immunological investigations (antibodies and T regulatory cell function and T-cell repertoire) will provide useful information and possibly an explanation for this increase in late-onset myasthenia gravis.
Source: Journal of Neurology, Neurosurgery and Psychiatry - November 14, 2016 Category: Neurosurgery Authors: Sadalage, G., Jacob, S., Hilton-Jones, D., Buckley, C., Vincent, A., Maddison, P. Tags: Immunology (including allergy), Neuromuscular disease, Ophthalmology ABN Annual Meeting, 17-19 May 2016, The Brighton Centre, Brighton Source Type: research