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Source: Neurology
Condition: Pain
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Total 95 results found since Jan 2013.
Glioproliferative Lesion of the Spinal Cord Derived from Intrathecal Administration of Stem Cells (P4.234)
CONCLUSIONS: Unregulated intrathecal SCT can cause devastating complications. This patient’s highly proliferative neoplasm developing from pluripotent stem cells supports the ideological shift to employ more differentiated cells in future SCT research.Disclosure: Dr. Saad has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Cagney has nothing to disclose. Dr. Chavakula has nothing to disclose. Dr. Guleria has nothing to disclose. Dr. Aizer has nothing to disclose. Dr. Ligon has nothing to disclose. Dr. Chi has nothing to disclose. Dr. Berkowitz has received royalty payments from Clinical Pathophysiology M...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Saad, M., Miller, M., Cagney, D., Chavakula, V., Guleria, I., Aizer, A., Ligon, K., Chi, J., Berkowitz, A. Tags: Neuro-oncology: Neurologic Complications of Cancer Source Type: research
Pain after Cervical Artery Dissection (P4.381)
Conclusions: Chronic pain or new pain development is frequent after spontaneous CAD. Recognition of clinical factors that predict chronic pain could help clinicians manage pain in CAD patients more effectively.Disclosure: Dr. Youn has nothing to disclose. Dr. Prabhakaran has received personal compensation for activities with the American Heart Association.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Youn, J., Prabhakaran, S. Tags: Non-Atherosclerotic Arteriopathies Source Type: research
Clinical Reasoning: A 76-year-old man with acute-onset left-sided weakness and numbness
A 76-year-old right-handed man with no known medical problems presented 2 hours after falling at work due to the acute onset of left-sided weakness and numbness. He had experienced left knee pain the previous day, but denied vertigo, headache, neck pain, chest pain, abdominal pain, or back pain. On examination, his blood pressure was 230/118 mm Hg; pulse and respiratory rate were normal. He was anxious with normal mentation, no carotid bruits, normal cardiac rate and rhythm, clear lung fields, normal cranial nerves including facial strength, weakness in his left leg (2/5 power) and arm (4/5 power), sensory loss to painful ...
Source: Neurology - April 10, 2016 Category: Neurology Authors: Renthal, W., Alberts, M., Shang, T. Tags: All Cerebrovascular disease/Stroke RESIDENT AND FELLOW SECTION Source Type: research
Clinical Reasoning: Proptosis, headache, and fever in a healthy young woman
A 23-year-old healthy woman presented to the emergency department with a week-long history of intense, pulsatile, right-sided headache, accompanied by fever, diplopia, and right eye pain and decreased visual acuity. She reported partial relief with nonsteroidal anti-inflammatory drugs.
Source: Neurology - April 17, 2016 Category: Neurology Authors: Orquera, J., Godoy, D. A., Behrouz, R., Rabinstein, A., Di Napoli, M. Tags: All Infections, Bacterial infections, All Cerebrovascular disease/Stroke, Subarachnoid hemorrhage RESIDENT AND FELLOW SECTION Source Type: research
Transient deficits after inadvertent intrathecal trigger-point injection with lidocaine
A 43-year-old woman had trigger-point injections for chronic neck pain by a traditional Chinese medicine physician. Paravertebral muscles at C5-C6 were infiltrated with lidocaine. Thirty minutes later, right-sided hemiparesis with nystagmus, dysarthria, and anisocoria developed. The patient complained of vertigo, vomited multiple times, and became somnolent. Neuroimaging revealed air in the ventricular system (figure 1) and in the dural sheath of the fifth cervical nerve root (figure 2), implying an accidental intrathecal injection and thus a possible direct effect of lidocaine. Three hours later, neurologic symptoms resol...
Source: Neurology - August 21, 2016 Category: Neurology Authors: Bereczki, D., Peto, N., Szegedi, N. Tags: All Cerebrovascular disease/Stroke, All Pain, Cerebrospinal Fluid NEUROIMAGES Source Type: research
Teaching NeuroImages: Carotid cavernous fistula in a patient with Ehlers-Danlos syndrome
A 25-year-old woman with Ehlers-Danlos syndrome type IV and history of spontaneous right petrous internal carotid artery dissection presents with severe headache, right eye pain with extraocular movements, proptosis, and chemosis of the right eye. She reported hearing her heartbeat in her right ear. CT angiogram (figure) revealed an engorged right ophthalmic vein. Subsequent digital subtraction angiography confirmed a carotid cavernous fistula along a previously dissected carotid artery.
Source: Neurology - August 28, 2016 Category: Neurology Authors: Liang, J. W., Horowitz, D. Tags: CT, Other cerebrovascular disease/ Stroke, Arteriovenous malformation, Carotid artery dissection RESIDENT AND FELLOW SECTION Source Type: research
Three-dimensional modeling of Eagle syndrome
A 63-year-old man presented with transient episodes of left-hand weakness and right-eye vision loss following a lengthy airplane trip. The patient had reported right neck pain after sleeping awkwardly on the flight. Carotid dissection, paradoxical embolism, atherosclerotic occlusion, and thrombotic occlusion were considered possible etiologies of the associated carotid occlusion. Following a period of anticoagulation, a subsequent CT angiography (figure 1, A–C) revealed findings consistent with the styloid-carotid artery, or Eagle, syndrome.1 A 3-dimensional model was subsequently created (figure 2, A and B) utilizin...
Source: Neurology - November 20, 2016 Category: Neurology Authors: Shah, K., Miller, D. J. Tags: All Headache, All Clinical Neurology, All Cerebrovascular disease/Stroke, All Education NEUROIMAGES Source Type: research
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
Teaching NeuroImages: Acute infarction of the left medial lemniscus masquerading as a peripheral neuropathy
A 58-year-old woman with hypertension and bilateral carpal tunnel syndrome presented with acute paresthesias in her right hand and foot. She had decreased sensation to vibration and pinprick in a right-sided stocking-glove distribution. MRI of the pons confirmed an acute infarction of a paramedian branch of the basilar artery in the left medial lemniscus (figure). In the posterior column pathway, sensory projections from the face, arm, and leg are somatotopically arranged medially to laterally within the medial lemniscus.1,2 Although strokes classically present with numbness, both thalamic and medial lemniscal infarcts can...
Source: Neurology - April 24, 2017 Category: Neurology Authors: Aamodt, W. W., Siegler, J. E., Elman, L. Tags: MRI, DWI, All Cerebrovascular disease/Stroke, Central pain, Infarction RESIDENT AND FELLOW SECTION Source Type: research
Zika associated Guillain-Barre syndrome in the United States (P2.327)
Conclusions:Zika can induce GBS after a brief viral illness. Neuropathy can be a mixture of demyelinating and axonal. Dysautonomia may also be present including severe dysphagia, orthostatics and retention.Zika RNA has a short detection window in serum and CSF making a diagnosis time sensitive. Serological assays using IgM and IgG cross-react with other flaviviruses making them unable to differentiate between recent Zika exposure and cross reactivity with Dengue and Chikungunya. Our pt likely had prior exposure to Dengue, being from an endemic area. Prior Dengue exposure may possibly modulate the response to Zika via antib...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Tantillo, G., Sclar, G., Vasa, C., Shin, S., Sivak, M. Tags: Zika, Chikungunya, West Nile Virus, and Other Viral Infections I Source Type: research
Limb-Shaking TIA as the Presenting Symptom of ICA Dissection (P3.269)
Conclusions:This case demonstrates limb-shaking TIA as the presenting symptom of ICA dissection. Neurologists should be aware that involuntary limb movements in the setting of ICA dissection with associated borderzone ischemia can represent limb-shaking TIA. Broadening the differential will increase appropriate diagnostic testing and proper treatment.Disclosure: Dr. LaBoy has nothing to disclose. Dr. Mannel has nothing to disclose. Dr. Silliman has received research support from Sanofi Genzyme, Biogen Idec, Bristol Myers and Novartis.
Source: Neurology - April 17, 2017 Category: Neurology Authors: LaBoy, S., Mannel, R., Silliman, S. Tags: Cerebrovascular Disease Case Reports II Source Type: research
The Vertebral Body Infarct Sign: A Case of Thoracic Spinal Cord Ischemic Stroke (P3.292)
Conclusions:While the vertebral body infarct sign is often recognized by neuro-radiologists, it is still relatively unknown to practicing neurologists. Early recognition of spinal cord infarct allows for timely evaluation for precipitating factors and initiation of secondary preventative therapies to decrease risk of further vascular events.Disclosure: Dr. Chan has nothing to disclose. Dr. Chan has nothing to disclose. Dr. Farooque has nothing to disclose. Dr. Nowak has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Chan, D., Chan, A., Farooque, P., Nowak, R. Tags: Cerebrovascular Disease Case Reports II Source Type: research
The Adult Spasticity International Registry (ASPIRE) Study: 1-Year Results (P4.034)
Conclusions:Findings demonstrate the real-world safety and effectiveness for onabotulinumtoxinA treatment in spasticity. Further analyses will explore clinical and burden outcomes and differences across etiology and presentation.Study Supported by: Allergan plcDisclosure: Dr. Francisco has received personal compensation for activities with Allergan, Ipsen, Mallinckrodt, and Merz. Dr. Francisco has received personal compensation in an editorial capacity for Journal of Rehabilitation Medicine. Dr. Francisco has received research support from Allergan, Ipsen, Mallinckrodt, Medtronic, Merz, Microtransponder, and Nexstim. Dr. B...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Francisco, G. E., Bandari, D. S., Bavikatte, G., Jost, W. H., Adams, A. M., Largent, J., Esquenazi, A. Tags: Neuro-rehabilitation: Motor Recovery and Spasticity Treatment Source Type: research
Characterization of pain and fatigue following deployment-related mild traumatic brain injury (P5.149)
Conclusions:This exploratory analysis suggests that severity of headache pain and degree of fatigue are interrelated following mTBI, and the most prominent dimensions of fatigue are general, mental and reduced activity, rather than reduced motivation.Study Supported by:National Institute of Neurological Disorders and Stroke Clinical Neuroscience ProgramDisclosure: Dr. Lewis has nothing to disclose. Dr. Knutson has nothing to disclose. Dr. Wassermann has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Lewis, J., Knutson, K., Wassermann, E. Tags: Clinical Neuro-rehabilitation Source Type: research
Identification of a novel TRPA1 mutation associated with carbamazepine-responsive cramp-fasciculation syndrome (S45.008)
Conclusions:Autosomal dominant CFS is associated with a novel mutation in the putative selectivity filter of TRPA1. These findings further clarify the functional role of human TRPA1, and underscore the importance of this ion channel as a potential therapeutic target.Study Supported by: This work was supported by the National Institute of Neurological Disorders and Stroke of the National Institute of Health (R01NS079388). MJN also receives support from the New York Stem Cell Foundation.Disclosure: Dr. Biller has nothing to disclose. Dr. Paisan-Ruiz has nothing to disclose. Dr. Gilbert has nothing to disclose. Dr. Chaouni ha...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Biller, T. M., Paisan-Ruiz, C., Gilbert, R. M., Chaouni, R., Nirenberg, M. J. Tags: Peripheral Nerve Disorders Source Type: research
