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Sudden unexpected death in epilepsy patients is often misdiagnosed as sudden cardiac death
Sudden unexpected death in epilepsy patients (SUDEP) represents the second main neurologic cause of years of potential life lost, following stroke, with a cumulative lifetime risk reaching 8% for childhood-onset epilepsy.1 In light of these worrying figures, the American Academy of Neurology (AAN) has recently published practice guidelines on the risk of SUDEP. These guidelines emphasize the "considerable uncertainty"of SUDEP incidence in adults with epilepsy, currently estimated at 1.2/1,000 patient-years (95% CI 0.64–2.32).2 Difficulties in assessing the epidemiology of SUDEP are several, including large variation ...
Source: Neurology - August 28, 2017 Category: Neurology Authors: Ryvlin, P., Cascino, G. D. Tags: All Epilepsy/Seizures EDITORIALS Source Type: research

Systematic Review and Meta-Analysis of Cohort Studies Examining Effect of Anticoagulation and Risk of Cerebral Hemorrhage in patients with Cerebral Microbleeds (P2.276)
Conclusions:Results of this meta-analysis suggest that patients with CMBs started on anticoagulation after ischemic stroke are more likely to have ICH outcomes than patients without CMBs. However, the study was limited by small sample sizes based on extracted data and lack of quality prospective cohort studies meeting inclusion criteria. Further investigation is necessary to conclude increased risk of ICH in this patient population.Disclosure: Dr. Faheem has nothing to disclose. Dr. Wang has received research support from TEVA Pharmaceuticals Ltd. Dr. Gronseth has received personal compensation in an editorial capacity for...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Faheem, N., Wang, Y., Gronseth, G. Tags: Intracerebral Hemorrhage Source Type: research

A Common Data Language for Clinical Research Studies: The National Institute of Neurological Disorders and Stroke (NINDS) and American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) Cerebral Palsy Common Data Elements Version 1.0 Recommendations (P2.060)
Conclusions:The NINDS encourages use of CDEs within and beyond the neurological clinical research community in order to standardize research data collection across studies. CDEs are an evolving resource, continually updated as research progresses. CP CDEs will serve to be a useful starting point for researchers and will facilitate valuable research in the CP developmental medicine area.Study Supported by: This project was funded by HHSN271201200034C.Disclosure: Dr. Feldman has nothing to disclose. Dr. Odenkirchen has nothing to disclose. Dr. Alai has nothing to disclose. Dr. Esterlitz has nothing to disclose. Dr. Burr has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Feldman, R., Odenkirchen, J., Alai, S., Esterlitz, J., Burr, T. Tags: Research Methodologies Source Type: research

Duration of effect of abobotulinumtoxina (dysport(r)) in adult patients with upper limb spasticity (uls) post-stroke or traumatic brain injury (p4.038)
Conclusions:These data show that 24% to 37% of subjects did not require re-injection before Week 16 across multiple cycles. This longer duration to re-treatment may reduce the burden associated with frequency of injections for patients and their caregivers/families. This also highlights the needs for a tailored approach in the treatment of patients with ULS.Study Supported by:Study supported by IpsenDisclosure: Dr. Gracies has received research support from Ipsen. Dr. Brashear has received personal compensation for activities with Ipsen, Worldmeds and Revance as a consultant. Dr. Marciniak has received personal compensatio...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Gracies, J.-M., Brashear, A., Marciniak, C., Jech, R., Banach, M., Marque, P., Grandoulier, A.-S., Vilain, C., Picaut, P. Tags: Neuro-rehabilitation: Motor Recovery and Spasticity Treatment Source Type: research

Feasibility of Google Glass for Remote Resident Supervision and Evaluation (P1.039)
Conclusions:This pilot feasibility study is a first step in applying mobile telemedicine using GG for remote supervision and evaluation of neurology residents. Early experiences suggest good technical feasibility and patient acceptance. Primary outcome analysis of inter-rater agreement between in-person and remote (GG) evaluation of the NIHSS and NEX assessments is pending.Study Supported by: This study receives support from an American Academy of Neurology Education Grant, as well as from an American Board of Psychiatry and Neurology Faculty Fellowship Award.Disclosure: Dr. Carrera has nothing to disclose. Dr. Chiota-McCo...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Carrera, J., Chiota-McCollum, N., Mantri, S., Clark, W., Wang, C., Odell, V., Berthaud, J., Gunnell, B., McMurry, T., Worrall, B., Southerland, A. Tags: Graduate Medical Education Research Source Type: research

Patterns of utilization of extracranial neurovascular ultrasound in patients with syncope in the context of the American Academy of Neurology (AAN) Choosing Wisely initiative. (P2.187)
Conclusions:The clinical value of ENVU in syncope evaluation is not well established. Our study demonstrated a local increase utilization of ENVU despite AAN recommendations. We suspect our observations are not unique to our institution, and encourage colleagues to review the Choosing Wisely campaign in order to implement cost – effective practices in the evaluation of syncope.Study Supported by: n/aDisclosure: Dr. Ortiz-Garcia has nothing to disclose. Dr. Bruzzone Giraldez has nothing to disclose. Dr. Andino has nothing to disclose. Dr. Sweis has nothing to disclose. Dr. Gomez has received personal compensation for ...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Ortiz-Garcia, J., Bruzzone, M., Andino, D., Sweis, R., Gomez, C., Biller, J. Tags: General Neurology: Practice Improvement and Novel Approaches to Care Source Type: research

Does Prior Use of Beta Blockers Affect Functional Outcomes Post Ischemic Stroke Endovascular Intervention? (P5.296)
Conclusions:Prior use of beta blockers did not lead to better functional outcomes (MRS ≤2) in acute ischemic stroke patients undergoing EVI. Findings should be further confirmed in larger population.Disclosure: Dr. Albadareen has nothing to disclose. Dr. Gronseth has received personal compensation in an editorial capacity for Neurology. Dr. Gronseth has received research support from the American Academy of Neurology. Dr. Mittal has nothing to disclose. Dr. Sharrock has nothing to disclose. Dr. Keshary has nothing to disclose. Dr. Abraham has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Albadareen, R., Gronseth, G., Mittal, M., Sharrock, M., Keshary, S., Abraham, M. Tags: Stroke Recovery and Rehabilitation Source Type: research

Association between Leucocyte Count and Perihematomal Edema Growth After Primary Intracerebral Hemorrhage (N8.001)
Conclusions:Higher admission leucocyte count, particularly monocyte count, is associated with PHE growth. This suggests a potential role of inflammation in modulating PHE after ICH.Study Supported by: American Academy of Neurology and American Brain Foundation Clinical Research Training FellowshipDisclosure: Dr. Gusdon has nothing to disclose. Dr. Gialdini has nothing to disclose. Dr. Baradaran has nothing to disclose. Dr. Merkler has nothing to disclose. Dr. Iadecola has received personal compensation in an editorial capacity for the Journal of Neuroscience. Dr. Navi has nothing to disclose. Dr. Gupta has nothing to discl...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Gusdon, A., Gialdini, G., Baradaran, H., Merkler, A., Iadecola, C., Navi, B., Gupta, A., Kamel, H., Murthy, S. Tags: Neuroscience in the Clinic: Novel Therapeutic Targets in Critical Care Neurology: Intracerebral and Intraventricular Hemorrhage Source Type: research

Diagnostic errors in cerebrovascular disease: What are we missing?
Diagnostic error is the "failure to establish an accurate and timely explanation of the patient's health problems or communicate that explanation to the patient," according to the Institute of Medicine of the National Academies of Sciences.1 These errors occur pervasively in all settings of our health care system, including outpatient clinics, inpatient wards, and the emergency room. Diagnostic errors harm patients and cost the health care system. Among malpractice claims between 1986 and 2010, diagnostic errors accounted for the largest number of claims.2 Diagnostic errors most often led to death and permanent injury and ...
Source: Neurology - April 10, 2017 Category: Neurology Authors: Batra, A., Henderson, G. V. Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Clinical trials Systematic review/meta analysis, Infarction, Subarachnoid hemorrhage EDITORIALS Source Type: research

Practice advisory: Recurrent stroke with patent foramen ovale (update of practice parameter): Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
Conclusions: Percutaneous PFO closure with the STARFlex device possibly does not provide a benefit in preventing stroke vs medical therapy alone (risk difference [RD] 0.13%, 95% confidence interval [CI] –2.2% to 2.0%). Percutaneous PFO closure with the AMPLATZER PFO Occluder possibly decreases the risk of recurrent stroke (RD –1.68%, 95% CI –3.18% to –0.19%), possibly increases the risk of new-onset atrial fibrillation (AF) (RD 1.64%, 95% CI 0.07%–3.2%), and is highly likely to be associated with a procedural complication risk of 3.4% (95% CI 2.3%–5%). There is insufficient evidence to d...
Source: Neurology - August 21, 2016 Category: Neurology Authors: Messe, S. R., Gronseth, G., Kent, D. M., Kizer, J. R., Homma, S., Rosterman, L., Kasner, S. E. Tags: All Cerebrovascular disease/Stroke SPECIAL ARTICLE Source Type: research

Practice advisory: Etanercept for poststroke disability: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
Conclusions: For patients with poststroke disability, the evidence is insufficient to support or refute a benefit of etanercept for the treatment of poststroke disability. Recommendations: Clinicians should counsel patients considering etanercept for treatment of poststroke disability that the evidence is insufficient to determine the treatment's effectiveness and that it may be associated with adverse outcomes and high cost (Level U).
Source: Neurology - June 5, 2016 Category: Neurology Authors: Gronseth, G. S., Messe, S. R. Tags: All Cerebrovascular disease/Stroke, All Rehabilitation SPECIAL ARTICLE Source Type: research

Longer Door to Needle Times When Fellows Administer Tissue Plasminogen Activator via Telemedicine (P2.359)
Conclusions: DTN was longer over TM than in our ED. While our findings imply that NFVs may have taken a longer time to administer IV tPA, further studies are needed to determine what are the causative factors and how to address them.Disclosure: Dr. Jagolino has nothing to disclose. Dr. Bozorgui has nothing to disclose. Dr. Cossey has nothing to disclose. Dr. Ankrom has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Irani has nothing to disclose. Dr. Vahidy has nothing to disclose. Dr. Savitz has received research support from NIH T32 grant. Dr. Wu has received personal compensation for activities with Genentech.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Jagolino, A., Bozorgui, S., Cossey, T., Ankrom, C., Patel, J., Irani, M., Vahidy, F., Savitz, S., Wu, T.-C. Tags: Education Research: Graduate Medical Education Source Type: research

Kinematic and Kinetic Outcome of Robot Assisted Neurorehabilitation in Chronic Moderate-to-Severe Hemiparetic Stroke (P3.298)
Conclusions: RT+TTT was not significantly different from RT alone, suggesting that TTT did not interfere with motor learning conferred by RT. Study Supported by: American Academy of Neurology (AAN) and the VA Department of Research and Development VA Merit Award B6935RDisclosure: Dr. Iqbal has nothing to disclose. Dr. Conroy has nothing to disclose. Dr. Roy has nothing to disclose. Dr. Bever has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Iqbal, T., Conroy, S., Roy, A., Bever, C. Tags: Neurorehabilitation Source Type: research

A Mobile Application for Predicting 90-day Outcomes after IV Thrombolysis in Ischemic Stroke (P3.069)
CONCLUSIONS: We evaluated the ability of our score to predict 90-day outcomes and developed an iOS application based on results. Our mobile application brings a unique opportunity to optimize rT-PA treatment decisions for acute ischemic stroke patients.Disclosure: Dr. Nystrom has nothing to disclose. Dr. Asuzu has nothing to disclose. Dr. Amin has nothing to disclose. Dr. Schindler has nothing to disclose. Dr. Wira has nothing to disclose. Dr. Greer has received personal compensation in an editorial capacity for Seminars in Neurology. Dr. Chi has nothing to disclose. Dr. Halliday has nothing to disclose. Dr. Sheth has rece...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Nystrom, K., Asuzu, D., Amin, H., Schindler, J., Wira, C., Greer, D., Chi, N. F., Halliday, J., Sheth, K. Tags: Cerebrovascular Disease and Interventional Neurology: Ischemic Stroke Outcome Source Type: research

Comparison of On-hour vs Off-hour Patient Cohorts at a Primary Stroke Center: Onset-To-Treatment Duration and Clinical Outcomes after IV Thrombolysis (S21.005)
CONCLUSIONS: We found no significant differences in OTT durations, stroke severity, or stroke outcomes between patients whose symptoms originated during on-hours vs off-hours. This represents progress in emergency response, recognition and acute stroke care delivered by our Emergency Department staff and acute stroke team on a 24 hour basis and likely reflects nationwide efforts to provide consistent care for acute stroke patients.Disclosure: Dr. Nystrom has nothing to disclose. Dr. Asuzu has nothing to disclose. Dr. Amin has nothing to disclose. Dr. Schindler has nothing to disclose. Dr. Wira has nothing to disclose. Dr. ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Nystrom, K., Asuzu, D., Amin, H., Schindler, J., Wira, C., Greer, D., Chi, N. F., Halliday, J., Sheth, K. Tags: Cerebrovascular Disease and Interventional Neurology: Prehospital and Acute Ischemic Stroke Treatment Source Type: research

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