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Specialty: Neurosurgery

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Total 602 results found since Jan 2013.

Headache in miller-fisher syndrome
A 22-year-old female presented with a three day history of headache, unsteadiness and double vision. The headache was described as being occipital, constant, radiated to the front of the head, and was exacerbated by lying down. On direct questioning, it appeared that she had an acute diarrheal illness two weeks previously. Neurological examination was remarkable for a complete external ophthalmoplegia, areflexia and ataxia. A plain CT scan of the head was normal. A lumbar puncture revealed clear cerebrospinal fluid with an opening pressure of 29 cm H2O, a protein content of 0.42g/l, WCC of 0 and RBC of 82. Nerve conduction...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Amin, R., Hughes, T. Tags: Immunology (including allergy), Cranial nerves, Headache (including migraine), Pain (neurology), Ophthalmology, Radiology, Radiology (diagnostics) Thur 21, Parallel session 5: Therapeutics Source Type: research

Characteristics of functional and organic stroke mimics
Conclusion Both functional and medical stroke mimics appear to have distinct features that could aid the diagnostic process.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Gargalas, S., David, A., Khan-Bourne, N., Shotbolt, P., Weeks, R. Tags: Long term care, Immunology (including allergy), Headache (including migraine), Pain (neurology), Stroke, Memory disorders (psychiatry) ABN abstracts 2015 ABN Annual Meeting, 10 September 2015, Institute of Education, London Source Type: research

Treatment of neurological manifestations of sjogren's syndrome
We present three cases that didn't respond to initial steroid treatment but subsequently improved with regular infusions of intravenous immunoglobulins. In all three cases, the initial anti–Ro test was negative, but became positive after 4–11 years, an important feature to recognise in clinical practice. Case one presented with painful dystonic spasms of the arm and leg, hemi-facial spasm, vertigo, diplopia with skew deviation, and trigeminal neuropathy. Several years later she developed features of systemic mixed connective tissue disease. Case two presented as a facial palsy, sensory trigeminal neuropathy, an...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Dodd, K., Pegg, E., Brown, R., Shaunak, S. Tags: Immunology (including allergy), Cranial nerves, Drugs: CNS (not psychiatric), Neuromuscular disease, Spinal cord, Ophthalmology, Connective tissue disease, Drugs: musculoskeletal and joint diseases, Musculoskeletal syndromes, Ear, nose and throat/otolaryn Source Type: research

Autoimmune retinopathy - importance of recoverin b antibodies
We present two patients with autoimmune retinopathy and their clinical progression. A 70-year-old lady was referred to the neuroimmunology clinic with progressive nyctalopia and periorbital pain to exclude the possibility of an immune-mediated retinopathy. Visual acuity was 6/18 bilaterally with peripheral visual constriction. OCT showed disruption of the photoreceptor layers. A retinal antibody screen showed positive anti-Recoverin B antibodies. In view of the paraneoplastic association of this antibody, a thorough search for an underlying tumour was performed (CT, PET) and endobronchial ultrasound guided biopsy showed hi...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Sturrock, A., Karim, A., Denniston, A., Jacob, S. Tags: Immunology (including allergy), Pain (neurology), Ophthalmology, Radiology, Surgical diagnostic tests, Radiology (diagnostics) Thur 21, Parallel session 5: Therapeutics Source Type: research

Anti-voltage gated potassium channel (vgkc) antibody positive encephalopathy
We present 3 patients with positive VGKC antibodies to emphasise the spectrum of clinic presentation and value of antibody testing. A 61 yo male presented with cognitive decline and frequent right arm stiffening, which is recognised as faciobrachial dystonic seizure. VGKC/LGI1 antibody positive. Received IVIG treatment and rapidly recovered. A 69 yo women presented with acute personality change and poor short memory following a brief syncope. MRI showed bilateral hippocampus high T2/FLAIR signal. VGKC/LGI-1 antibody was 5800. She improved with IVIG and steroid treatment. However, seizures recurred when weaning from steroid...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Kemp, M., Kimber, J., Zhang, L. Tags: Immunology (including allergy), Epilepsy and seizures, Infection (neurology), Memory disorders (psychiatry) Thur 21, Parallel session 5: Therapeutics Source Type: research

Management of suspected encephalitis in a uk teaching hospital
Conclusions Encephalitis is difficult to confirm and eventual differential of suspected cases is wide. The rate of ITU admission and death demonstrates the vulnerabilities of this cohort. While most patients received LP, aciclovir and MRI, there remains room for improvement in timing and completeness of investigations.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Binks, S., Cooper, R., Wood, R., Martin, L. Tags: Immunology (including allergy), HIV/AIDS, Infection (neurology) Thur 21, Parallel session 5: Therapeutics Source Type: research

The management of suspected encephalitis at a regional district general hospital
Conclusions Management of suspected encephalitis varied, we need to increase awareness ABN/BIA guidance and address the delay in neurology services seeing these patients.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Llewelyn, D., Fish, M. Tags: Immunology (including allergy), HIV/AIDS, Infection (neurology) Thur 21, Parallel session 5: Therapeutics Source Type: research

The ms-smart trial in secondary progressive multiple sclerosis: a multi-arm, multi-centre trial of neuroprotection
There is currently no treatment for secondary progressive multiple sclerosis (SPMS) which determines the majority of disability in multiple sclerosis. The MS-SMART trial is a multi-arm, multi-centre, phase 2 randomised trial for patients with SPMS. A total of 440 patients with progressing SPMS will be recruited in England and Scotland and randomised to one of 4 blinded arms: amiloride 5mg bd, riluzole 50mg bd, fluoxetine 20mg bd or placebo. These agents have been chosen after an extensive systematic review which has suggested putative neuroprotective properties. Patients will be followed up for 96 weeks with outcome data c...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Chataway, J., Chandran, S., Miller, D., Giovannoni, G., Wheeler-Kingshott, C., Pavitt, S., Stallard, N., Hawkins, C., Sharrack, B., for the MS-SMART trialists Tags: Immunology (including allergy), Multiple sclerosis, Stroke, Radiology, Radiology (diagnostics) Thur 21, Parallel session 5: Therapeutics Source Type: research

The known uk cases of ataxia telangiectasia-like disorder (atld)
Ataxia telangiectasia-like disorder (ATLD) is a very rare autosomal recessive disease with only 25 patients recognised worldwide. ATLD is likened to Ataxia telangiectasia (A-T) due to an overlap of clinical presentations and cellular characteristics. The clinical hallmark of A-T and ATLD is progressive young onset cerebellar ataxia. Variably present characteristics include dysarthria, oculomotor apraxia, ocular telangiectasia, immunodeficiency, spontaneous chromosome abnormalities and a predisposition to malignancy. In contrast to A-T, ocular telangiectasia is absent. Furthermore, ATLD patients tend to have a later onset a...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Westwood, K., Ealing, J., Taylor, M., Worth, P., Nemeth, A. Tags: Genetics, Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric) ABN abstracts 2015 ABN Annual Meeting, 10 September 2015, Institute of Education, London Source Type: research

Progressive multifocal leucoencephalopathy: an atypical case
Discussion PML is caused by reactivation of the polyomavirus JC in the CNS. Reactivation typically occurs following immunosuppression e.g. HIV, haematological malignancies and drugs. Gold standard for diagnosis is brain biopsy as JC virus PCR has a sensitivity of only 80%. Treatment is through removal of the immunosuppressive agent, and immune reconstitution. PML should be considered in all patients with a suggestive clinical and radiological presentation where there is current or historical immunosuppression, should JC virus PCR be negative a tissue biopsy should be sought.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Maxwell, A., Archer, H., Cohen, N., Love, S., Cottrell, D. Tags: Immunology (including allergy), HIV/AIDS, Infection (neurology), Multiple sclerosis, Radiology, Drugs: musculoskeletal and joint diseases, Surgical diagnostic tests, Ear, nose and throat/otolaryngology Thur 21, Parallel session 5: Therapeutics Source Type: research

Digging deeper
Conclusion This case involved input from multiple clinical specialties and highlights the collaboration needed to diagnose and manage such a rare organism. The case highlights unusual pathogens that may cause opportunistic infection in the immunocompromised host and the importance of a thorough occupational history.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Witherick, J., Bovill, B., Dong, A., Albur, M., Bosnell, R. Tags: Genetics, Immunology (including allergy), Headache (including migraine), Neuroimaging, Pain (neurology), Radiology, Surgical diagnostic tests, Ear, nose and throat/otolaryngology Thur 21, Parallel session 5: Therapeutics Source Type: research

LPS INDUCES AGGREGATION OF {alpha}-SYNUCLEIN IN MONOCYTES
It is well recognised that Parkinson's disease (PD) is associated with gastrointestinal problems appearing before onset of motor symptoms. An important role for the enteric nervous system (ENS) has been suggested. We hypothesize that inflammatory responses are involved in the onset and progression of PD, with a pivotal role for monocytes/macrophages in the gut. We show that lipopolysaccharide (LPS) can induce the expression and aggregation of monomeric α-synuclein in a human monocyte cell line (MM6). 24 Hours stimulation with LPS resulted in 3-6.5-fold increase in monomeric α-synuclein (determined by Western bl...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Koopman, H., Jackson, S., Anichtchik, O., Carroll, C. Tags: Immunology (including allergy), Drugs: CNS (not psychiatric), Parkinson's disease Thur 21, Parallel session 5: Therapeutics Source Type: research

Parkinson's disease and spirituality
A limited literature suggests that people with Parkinson's disease have reduced religious beliefs, practices and experiences, compared to normal healthy controls. But we reasoned these results may be confounded by reduced mobility and social isolation associated with Parkinson's disease. So, we recruited a cohort of 42 Parkinson's patients and 39 controls with chronic respiratory disease, non-neurological autoimmune disease or rheumatological problems. Each subject was examined twice, 12 months apart and assessed on validated scales of handicap and impairment, with spirituality measured by the modified Brief Multidimension...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Coles, A., Redfern, C. Tags: Immunology (including allergy), Drugs: CNS (not psychiatric), Parkinson's disease Thur 21, Parallel session 5: Therapeutics Source Type: research

Alemtuzumab improves 3-year quality of life in care-ms ii
In the 2-year, phase 3 CARE–MS II study (NCT00548405) of relapsing-remitting multiple sclerosis (RRMS) patients with inadequate efficacy response to prior therapy, alemtuzumab demonstrated superior efficacy and quality-of-life (QoL) improvements versus subcutaneous interferon beta-1a, with manageable safety. Here, QoL outcomes are examined in alemtuzumab-treated patients at Year 3 in an ongoing extension study (NCT00930553). 393 of 435 alemtuzumab 12 mg-treated patients entered the extension study; 80 received as-needed alemtuzumab retreatment during Year 3. Mean Functional Assessment of multiple sclerosis total...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Coles, A., Giovannoni, G., Moreau, T., Havrdova, E., Margolin, D., Kasten, L., Singer, B. Tags: Immunology (including allergy), Multiple sclerosis Thur 21, Parallel session 5: Therapeutics Source Type: research

Season of glandular fever as a risk factor for multiple sclerosis
Conclusions Glandular fever in winter as opposed to summer does not appear to be associated with a greater risk of developing MS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Downham, C., Visser, E., Vickers, M., Counsell, C. Tags: Immunology (including allergy), Multiple sclerosis Thur 21, Parallel session 5: Therapeutics Source Type: research