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Source: Neurology
Condition: Pain

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Total 95 results found since Jan 2013.

TIPIC syndrome
A 31-year-old woman presented with left acute cervical pain. Cervical imaging showed a large pericarotid infiltration (figure 1). A diagnosis of transient perivascular inflammation of the carotid artery (TIPIC) syndrome was made. The patient received steroids with full clinical recovery 12 days after onset. The follow-up ultrasound showed striking decrease of the perivascular infiltration, confirming the diagnosis (figure 2).
Source: Neurology - October 9, 2017 Category: Neurology Authors: Lecler, A., Obadia, M., Sadik, J.-C. Tags: Secondary headache disorders, MRI, Ultrasound, Other cerebrovascular disease/ Stroke NEUROIMAGES Source Type: research

Mystery Case: Diagnostic challenges in a young patient with hypereosinophilia
A 48-year-old woman with recent diagnosis of nonischemic cardiomyopathy and longstanding history of asthma and allergic rhinitis without additional vascular risk factors had intermittent chest pain and dyspnea for 6 weeks, treated with antibiotics and oral steroids without benefit. Subsequently, she developed bilateral leg edema, orthopnea, and chest pain, and was hospitalized twice at another institution. Transthoracic echocardiogram (TTE) demonstrated an ejection fraction (EF) of 30%. Cardiac catheterization was normal. CT of the chest showed a large pericardial effusion (~300 mL) and bilateral pleural effusions. She had...
Source: Neurology - September 25, 2017 Category: Neurology Authors: Ortiz, J. G., Douglas, P. W., Gill, C. E., Mehrotra, S., Biller, J. Tags: Stroke in young adults, Infarction RESIDENT AND FELLOW SECTION Source Type: research

Activity limitations and subjective well-being after stroke
Conclusions: Activity limitations were not associated with stroke survivors' subjective well-being after adjustment for other factors. While some predictors of well-being after stroke were identified, the determinants of well-being remained largely unexplained.
Source: Neurology - August 28, 2017 Category: Neurology Authors: Zahuranec, D. B., Skolarus, L. E., Feng, C., Freedman, V. A., Burke, J. F. Tags: Quality of life, All Cerebrovascular disease/Stroke, All Rehabilitation ARTICLE Source Type: research

Mystery Case: A case of fulminant encephalopathy in a 69-year-old woman
A 69-year-old right-handed woman was admitted to the medical intensive care unit for acute encephalopathy. Her medical history included sickle cell disease (hemoglobin sickle cell [HbSC]) with bone involvement (bilateral femoral head osteonecrosis) and rare sickle cell crises with joint pain and hemolytic anemia requiring red blood cell transfusions, sarcoidosis, diabetes, hypertension, and hypothyroidism. She never smoked cigarettes and never used recreational drugs or alcohol, and there was no history of recent travel. The patient's daughter reported that the patient was found unresponsive lying on the floor in the morni...
Source: Neurology - August 28, 2017 Category: Neurology Authors: Lamotte, G., Williams, C. Tags: MRI, Other cerebrovascular disease/ Stroke, Coma, Critical care, Embolism RESIDENT AND FELLOW SECTION Source Type: research

Response to pain
She is lying there behind a glass wall too covered in white: air too white, people too white crowded around her funeral chorus of ridiculous moves: her arm is raised and left to fall her eyes are opened and left to close her blood is food to a machine that turns it white, its sins forgiven. White coats, birds of prey! where have you taken her? my faith in you has vanished like a hunted animal you seek to give your prisoner the gift of pain so she would rise in screams above the whiteness of that stiffening bed. In vain! you absurd creatures! what can you hope to save in violence? A soul? not possible. The body alone? not p...
Source: Neurology - August 21, 2017 Category: Neurology Authors: Parvan, A. Tags: All Cerebrovascular disease/Stroke REFLECTIONS: NEUROLOGY AND THE HUMANITIES Source Type: research

Teaching NeuroImages: Takayasu arteritis: Neuroimaging progression after immunosuppressant treatment
A 29-year-old woman presented with a 2-year history of heel pain, constitutional symptoms, and increased acute phase reactants. CT and magnetic resonance (MR) angiography revealed a thickening of aortic walls and a thread-like appearance of bilateral subclavian and common carotid arteries. The findings were consistent with Takayasu arteritis (TA)1 and the patient was prescribed methylprednisolone, followed by azathioprine. Follow-up MR angiography, 6 years later, showed an important improvement with only a mild luminal narrowing of both common carotid arteries (figures 1 and 2, A and B). TA is a large-artery inflammatory d...
Source: Neurology - May 15, 2017 Category: Neurology Authors: Martinez Rodriguez, L., Caminal Montero, L., Pena Suarez, J., Garcia-Cabo Fernandez, C., Calleja Puerta, S. Tags: MRI, Vasculitis, All Cerebrovascular disease/Stroke 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

Increase in Rate of Utilization of Withdrawal of Care in Acute Ischemic Stroke in USA (P1.209)
Conclusions:We found a considerable increase in rate of withdrawal of care with aggressive treatment, which may be due to disease severity and/or patient/family preference. Prognostic models and clinical experience for severe stroke patients may be biased by frequent withdrawal of care, leading to errors in prognostication with significant consequences including premature withdrawal of care, suboptimal outcomes and higher risk of short-term mortalityStudy Supported by: NADisclosure: Dr. Adil has nothing to disclose. Dr. Zweifler has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Adil, M., Zweifler, R. Tags: Pain and Palliative Care Source Type: research

Early Palliative Care Consultation Decreases Length of Stay in Severe Stroke Patients (P1.211)
Conclusions:Early PCC in severe stroke patients decreased hospital LOS by 3 days. This may be due to prompt clarification of goals of care and hastened discharge to hospice. Advanced age, poor pre-stroke functional status, and severe post-stroke deficits and disability warrant early PCC. In addition to decreasing LOS, further study is needed to determine whether early PCC also limits futile tests, procedures, and iatrogenic complications. Ultimately, timely identification of PCC candidates may produce higher satisfaction and decreased hospital costs.Disclosure: Dr. Schloss has nothing to disclose. Dr. Tversky has nothing t...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Schloss, E. R., Tversky, S., Katz, J. M., Wright, P. Tags: Pain and Palliative Care Source Type: research

Do patients with thalamic pain have a specific somatosensory phenotype? (P1.222)
Conclusions:The somatosensory phenotype of the CPSP patients was characterized by reduced sensation for vibration and light touch on the affected side. These patients showed mechanical hyperalgesia and more pronounced hypoesthesia, but no temperature perception abnormalities, compared to the control patients. Our results do not support the view that a specific dysfunction of the spinothalamic tract is involved in the pathogenesis of thalamic CPSP.Disclosure: Dr. Papadopoulou has nothing to disclose. Dr. Magon has nothing to disclose. Dr. Gaetano has received personal compensation for activities with Novartis Pharmaceutical...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Papadopoulou, A., Magon, S., Gaetano, L., Jaeger, Y., Kappos, L., Sprenger, T. Tags: Pain and Palliative Care 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

Effect of early use of AbobotulinumtoxinA (Dysport(R)) after stroke on spasticity progression: first results of a pilot study (P4.032)
Conclusions:Median time between first injection (administered in patients 2–12 weeks post-stroke, MAS ≥2) and appearance of reinjection criteria (signs of symptomatic spasticity) was statistically significantly longer with aboBoNT-A compared with placebo. Safety profile was consistent with the known profile of aboBoNT-A.Study Supported by:Study supported by IpsenDisclosure: Dr. Rosales has received personal compensation for activities with Ipsen and Pfizer as a scientific advisory board member and consultant. Dr. Goh has received personal compensation for activities with Sanofi Genzyme as a moderator. Dr. Kumthorn...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Rosales, R., Goh, K. J., Kumthornthip, W., Mazlan, M., Latif, L. A., De Los Santos, M. M., Chotiyarnwong, C., Tanvijit, P., Balcaitiene, J., Maisonobe, P., Kong, K.-H. Tags: Neuro-rehabilitation: Motor Recovery and Spasticity Treatment Source Type: research

Understanding race-ethnic disparities in hospital arrival after stroke symptom onset (P3.259)
Conclusions:Limited knowledge of stroke symptoms may partially explain disparity between race-ethnic groups in hospital arrival.Disclosure: Dr. Springer has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Springer, M. Tags: Cerebrovascular Disease Epidemiology 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