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Clinical Reasoning: A young woman with respiratory failure, hearing loss, and paraplegia
A 35-year-old woman with bipolar disorder presented to the emergency room (ER) obtunded with hypercapnic respiratory failure. Neurology was consulted because the patient had acute hearing loss and paraparesis. She was last seen normal the prior night by her ex-husband. Paramedics found her on the couch, obtunded, bradypneic, and hypoxic to 82% SpO2, blood pressure 116/79 mm Hg, heart rate 98 beats per minute, and normothermic. She awakened after 0.4 mg of naloxone administration. Home medications included oxycodone/acetaminophen for chronic pain and venlafaxine, alprazolam, and lamotrigine for bipolar disorder. O...
Source: Neurology - March 5, 2017 Category: Neurology Authors: Ntranos, A., Shoirah, H., Dhamoon, M. S., Hahn, D., Naidich, T. P., Shin, S. Tags: Stroke in young adults, MRI, Spinal cord infarction, Opiates, Infarction RESIDENT AND FELLOW SECTION Source Type: research

Neuro-Psychiatry Diseases Predisposing to Mental Status Changes in Patients with Community-Acquired Pneumonia (P1.313)
Conclusions: This study indicates that MSC is frequent in patients with CAP presenting to hospital emergency departments. The etiology of MSC is diverse, with approximately half of the cases due to neuro-psychiatric conditions. In patients presenting to the emergency department with MSC, a high index of suspicion should be maintained regarding the diagnosis of pneumonia.Disclosure: Dr. Kolikonda has nothing to disclose. Dr. Wiemken has nothing to disclose. Dr. Arnold has nothing to disclose. Dr. Nakamatsu has nothing to disclose. Dr. Raghuram has nothing to disclose. Dr. Ramirez has nothing to disclose. Dr. Peyrani has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Kolikonda, M., Wiemken, T., Arnold, F., Nakamatsu, R., Raghuram, A., Ramirez, J., Peyrani, P. Tags: Other Bacterial Infections Source Type: research

Clinical Reasoning: Acute-onset homonymous hemianopia with hyperglycemia: Seeing is believing
A 32-year-old woman with a history of bipolar disorder, polycystic ovarian syndrome, and hypertension and a 4-year history of uncontrolled type 2 diabetes mellitus (DM) presented with bifrontal headache, elevated blood sugars (>500 mg/dL), and abrupt-onset left homonymous hemianopia upon awakening. Vital signs included temperature 98.0°F, blood pressure 160/89 mm Hg, and heart rate 67 bpm. Neurologic examination showed dense left homonymous hemianopia with macular sparing and without other focal findings.
Source: Neurology - April 14, 2014 Category: Neurology Authors: Strowd, R. E., Wabnitz, A., Balakrishnan, N., Craig, J., Tegeler, C. H. Tags: Endocrine, All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research

The Role of Toll-Like Receptor 3 in Epileptogenesis (S29.002)
Conclusion:These preliminary results -in a still ongoing study- indicate a central involvement of seizure induction (epileptogenesis) by TLR3 and provide evidence for future research and possibly drug development to finally change the treatment paradigm of epilepsy from symptomatic seizure control to curable prevention of seizure development.Disclosure: Dr. Benninger has nothing to disclose. Dr. Gross has nothing to disclose. Dr. Steiner has received personal compensation for activities with Actelion and Hoffman La Roche. Dr. Offen has nothing to disclose. Dr. Okun has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Benninger, F., Gross, A., Steiner, I., Offen, D., Okun, E. Tags: Epilepsy and Clinical Neurophysiology: Inflammation, Status Epilepticus, and Genetics Source Type: research

Thoracoscopic Pulmonary Vein Isolation and Atrial Appendage Ligation (TPVIAL) versus Medical Management in Atrial Fibrillation Patients with Prior Stroke (P1.126)
CONCLUSIONS: TPVIAL may become an important therapeutic tool for reducing recurrent stroke in AF patients.Disclosure: Dr. Waters has nothing to disclose. Dr. Hedna has nothing to disclose. Dr. Khanna has nothing to disclose. Dr. Miles has nothing to disclose. Dr. Price has nothing to disclose. Dr. Schmalfuss has nothing to disclose. Dr. Robertson has nothing to disclose. Dr. Karimi has nothing to disclose. Dr. Beaver has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Waters, M., Hedna, V., Khanna, A., Miles, W., Price, C., Schmalfuss, I., Robertson, D., Karimi, A., Beaver, T. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Miscellaneous Source Type: research

The Role of Toll-Like Receptor 3 in Epileptogenesis (I1-2.001)
Conclusion:These preliminary results -in a still ongoing study- indicate a central involvement of seizure induction (epileptogenesis) by TLR3 and provide evidence for future research and possibly drug development to finally change the treatment paradigm of epilepsy from symptomatic seizure control to curable prevention of seizure development.Disclosure: Dr. Benninger has nothing to disclose. Dr. Gross has nothing to disclose. Dr. Steiner has received personal compensation for activities with Actelion and Hoffman La Roche. Dr. Offen has nothing to disclose. Dr. Okun has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Benninger, F., Gross, A., Steiner, I., Offen, D., Okun, E. Tags: Temporal Lobe Epilepsy and Febrile Seizures Data Blitz Presentations Source Type: research