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A man with left-sided weakness and numbness
Clinical introduction A 63-year-old right-handed man presented for evaluation of left leg stiffness and sensory change. He had a medical history of remote prostate cancer (status post resection in 2011). The patient reported that one week prior, he began noticing left leg stiffness and numbness, as well as left hand weakness and discoordination. He went to see his internist where he had a fall while the physician was testing his gait. He was sent to the emergency room (figure 1). He denied episodes of loss of consciousness, shaking, or headaches. He had no recent weight loss, night sweats, or previous falls. Question What ...
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Gheihman, G., Paradis, X. G., ONeal, M. A. Tags: EMJ Image Challenge Source Type: research

Obstructive Sleep Apnea and Positive Airway Pressure Usage in Populations with Neurological Disease
Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial upper airway obstruction during sleep, with a worldwide estimate of 936 million sufferers. Treatments of OSA include continuous positive airway pressure (CPAP), weight loss, positional therapy, oral appliances, positive upper airway pressure, oro-maxillofacial surgery, hypoglossal nerve stimulation, and bariatric surgery, and others, with CPAP being the most commonly prescribed treatment. In this review, the neurologic conditions of stroke, cognitive decline, epilepsy, and migraines will be discussed as they relate to OSA. Addition...
Source: Sleep Medicine Clinics - October 9, 2022 Category: Sleep Medicine Authors: Daniel A. Barone, Alan Z. Segal Source Type: research

High Blood Pressure and Diabetes Are Linked. Here ’ s How to Reduce Your Risk for Both
High blood pressure—also known as hypertension—and Type 2 diabetes are two of the most common medical conditions in the U.S. Unfortunately, they often occur together. Some research has found that 85% of middle-aged or older adults who have Type 2 diabetes also have hyper­tension, and both conditions elevate a person’s risk for heart disease, stroke, and kidney disease. These increased risks are significant, and in some cases grave. Researchers have found that people with Type 2 ­diabetes are up to four times more likely to develop cardiovascular disease than those who don’t have the conditio...
Source: TIME: Health - August 29, 2022 Category: Consumer Health News Authors: Markham Heid Tags: Uncategorized Disease freelance healthscienceclimate Source Type: news

The Truth About Fasting and Type 2 Diabetes
Most fad diets don’t live up to the hype, let alone serious scientific scrutiny. But intermittent fasting seems to be an exception. These plans involve going without caloric foods or drinks for an extended period of time—anywhere from 16 hours to several days—and they have become increasingly popular. Research has also found them to be effective for weight loss. Doctors often advise people with Type 2 diabetes to lose weight, which can have beneficial effects on blood glucose and insulin sensitivity, as well as on the progression of the disease. For this and other reasons, experts are actively looking at ...
Source: TIME: Health - June 16, 2022 Category: Consumer Health News Authors: Markham Heid Tags: Uncategorized Diet & Nutrition freelance healthscienceclimate Source Type: news

New Analyses Suggest Favorable Results for STELARA ® (ustekinumab) When Used as a First-Line Therapy for Bio-Naïve Patients with Moderately to Severely Active Crohn’s Disease and Ulcerative Colitis
SPRING HOUSE, PENNSYLVANIA, October 25, 2021 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced data from two new analyses of STELARA® (ustekinumab) for the treatment of adults with moderately to severely active Crohn’s disease (CD) and ulcerative colitis (UC).1,2 In a modelled analysisa focused on treatment sequencing using data from randomized controlled trials, network meta-analysis and literature, results showed patient time spent in clinical remission or response was highest when STELARA was used as a first-line advanced therapy for bio-naïve patients with moderately to severely acti...
Source: Johnson and Johnson - October 25, 2021 Category: Pharmaceuticals Tags: Innovation Source Type: news

Giant-Cell Arteritis Presenting as Isolated Bilateral CN-VI Palsies: A Rare Case Report of a 65 Year Male. (P2.378)
Conclusions:GCA is the most prevalent systemic vasculitis in the elderly. It can present with a wide variety of symptoms ranging from fatigue, headache, visual loss, and even stroke. However as noted in this case, isolated CN-VI palsy can be a very rare, early manifestation of GCA. As GCA responds well to corticosteroid therapy, prompt diagnosis and treatment is critical to prevent and/or limit neurologic sequelae. As highlighted by this case, in the event of recurrent incidents and absence of other diagnosis; GCA should be considered even if headache is absent.Disclosure: Dr. Lunagariya has nothing to disclose. Dr. Patel ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lunagariya, A., Patel, U., Kotadiya, F., Wilson, C. Tags: CNS Inflammatory Diseases and Differential Diagnosis II Source Type: research

Clinical Reasoning: Myriad manifestations of a global infectious disease
A 21-year-old right-handed Cambodian woman with no history of headache presented with 2 weeks of progressive bifrontal headache. She had no sick contacts or recent travel. She moved to the United States at age 3 years. She had no fever, nuchal rigidity, photophobia, phonophobia, nausea, or vomiting. She had a recent history of weight loss and palpitations. There was no tobacco or illicit drug use or high-risk sexual behavior. She was not pregnant and denied contraception use.
Source: Neurology - June 5, 2016 Category: Neurology Authors: Prabhu, A. M., Raghupathi, R., Dissin, J. Tags: Stroke in young adults, Vasculitis, Meningitis RESIDENT AND FELLOW SECTION Source Type: research

Spinal cord and cranial Bing-Neel Syndrome complicated by cerebral ischemia: A case report
Waldenström's macroglobulinemia (WM) is a B-cell malignancy characterized by lymphoplasmacytic lymphoma (LPL) within the bone marrow and an IgM monoclonal gammopathy in the blood. Symptoms may include weakness or fatigue, anorexia and weight loss, bleeding from the gums and nose, headache, blurred vision, peripheral neuropathy, and even stroke from hyperviscosity. The direct infiltration of the central nervous system (CNS), either as a diffuse leptomeningeal form or tumoral form is an exceedingly rare complication of WM, recognized as Bing-Neel Syndrome (BNS) [1].
Source: Journal of the Neurological Sciences - April 24, 2016 Category: Neurology Authors: Alejandro Vargas, Karan S. Dixit, John G. Quigley, Fernando D. Testai Tags: Letter to the Editor Source Type: research

5 Scary Symptoms That Are Usually Harmless
SPECIAL FROM Next Avenue By Linda Melone After 50, aches, pains and the occasional muscle twinge become a fact of life. But some symptoms that may seem frightening or serious turn out to be far less than they appear. While you should always see a doctor if you experience something out of the ordinary, these signs generally are more smoke than fire: A Bloody Nose Nosebleeds can be particularly frightening due to the suddenness in which they occur and the sometimes large amount of blood involved. “People worry that it’s internal bleeding, but almost every time it’s not,” says Dr. Carlo Reyes, emergency room...
Source: Healthy Living - The Huffington Post - February 5, 2015 Category: Consumer Health News Source Type: news

A stroke of bad luck.
Abstract Giant cell arteritis is a common cause of headache in patients aged more than 50 years. It is an easy diagnosis to make if classical features, ie temporal headache, jaw claudication, visual symptoms, systemic symptoms of fever or weight loss with high erythrocyte sedimentation rate and anemia, are present. However, it may present atypically and stroke can be the presenting feature. A high index of suspicion is needed in atypical presentations such as stroke. Once a diagnosis is suspected it is imperative to start high dose steroids to prevent visual and neurological complications. PMID: 25468861 [PubMed - in process]
Source: Clinical Medicine - December 1, 2014 Category: Journals (General) Authors: Nagasayi S, White S, Joshi Y Tags: Clin Med Source Type: research

Antiphospholipid syndrome: an important differential diagnosis for culture-negative endocarditis
Sometimes the initial diagnosis proves secondary to an illness that is diagnosed later. This was the case when a 37-year-old woman presented to the hospital with sudden-onset persistent left-sided weakness. While she reported pain in the right maxilla, lethargy, and malaise in the month prior to presentation, she denied headache, sensory change, visual disturbances, fever, chills or weight loss. Hypertension was her only cardiovascular risk factor, but she took no regular medications. She had no history of stroke, ischemic heart disease, deep vein thrombosis, pulmonary embolism, or miscarriage, and she had no family histor...
Source: The American Journal of Medicine - November 26, 2014 Category: Journals (General) Authors: Louis W. Wang, Baptiste Noël, Elodie Descloux, David W. Baron Source Type: research

Adult onset methylphenidate induced dyskinesia after stroke
Methylphenidate is a stimulant medication that is commonly used to treat attention-deficit/hyperactivity disorder (ADHD). It is also used as adjuvant therapy for improving disability after stroke. Recently, Moreau et al. reported that methylphenidate improved gait hypokinesia and freezing in patients with advanced Parkinson's disease (PD) . The most common side effects of methylphenidate are; insomnia, anorexia, weight loss, abdominal pain, headache, irritability, anxiety, tachycardia, hypertension, and motor tics. Dyskinesia as a side effect of methylphenidate is rare, and only a few cases have been reported . Most of th...
Source: Parkinsonism and Related Disorders - April 14, 2014 Category: Neurology Authors: Jeong Yeon Kim, Jong Sam Baik Tags: Letters to the Editor Source Type: research

The Rhino Without It's Sugar (P2.324)
We present a case of a non-diabetic patient with stroke like symptoms that was determined to be due to mucormycosis invading the sphenoid sinus.A 64 year old female was admitted for slurred speech and right-sided weakness. She was brought to the ER after being found unresponsive. Family members stated she had been experiencing difficulty speaking, and mild right facial weakness. She has been complaining of headaches for the past seven months and 15 pound weight loss. On admission, temperature was 98.4°F, BP 122/77, PR 78, and RR 18. Exam was significant for right-sided facial asymmetry/droop, expressive aphasia, and sl...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Kahlon, J., Gahley, H., Sonpal, N., Graham, R. Tags: Fungi, Parasites, and Other Pathogens Source Type: research

Acute Stroke in Young Women Taking Phentermine (P01.249)
CONCLUSIONS: We present here two patients with mild underlying cerebrovascular risk factors who presented with acute stroke after taking diet pills containing phentermine. The public should be aware of the possible association between stroke and phentermine. More long-term outcomes research is necessary to understand the safety of phentermine-containing diet pills. Patients with cerebrovascular risk factors should be cautious about using Phentermine containing diet pills.Disclosure: Dr. Smit has nothing to disclose. Dr. Cutting has received personal compensation for activities with F1000. Dr. Conners has nothing to disclos...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Smit, L., Cutting, S., Conners, J., Lee, V., Song, S. Tags: P01 Cerebrovascular Disease I Source Type: research