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Acute refractory intestinal pseudo-obstruction in MELAS: Efficacy of prucalopride
In mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), a multisystem mitochondrial disorder, gastrointestinal involvement is frequent with dysphagia, chronic diarrhea, anorexia, abdominal pain, delayed gastric emptying, and paralytic, often intractable, ileus.1 In this article, we report a patient with chronic gastrointestinal dysmotility and acute refractory intestinal pseudo-obstruction responsive to prucalopride.
Source: Neurology - May 26, 2014 Category: Neurology Authors: Primiano, G., Plantone, D., Forte, F., Sauchelli, D., Scaldaferri, F., Gasbarrini, A., Servidei, S. Tags: CT, Mitochondrial disorders; see Genetics/Mitochondrial disorders, Muscle disease, Class IV, Mitochondrial disorders CLINICAL/SCIENTIFIC NOTES Source Type: research

Quality of Life in Liver Transplant Patients with Neurologic Complications. (P4.031)
Conclusions: Our analysis shows that neurological complications worsen the quality of life of liver transplant patients. Especially regarding perception of health, ability to function independently due to physical and mental health limitations. Pain is a limiting condition in this group. Transplant patients who suffer neurological complications should be carefully followed up to reduce the impact on quality of life, in order to promote the ultimate goal of transplant.Disclosure: Dr. Gonzalez Toledo has nothing to disclose. Dr. Calle has received personal compensation for activities with UCB Pharma. Dr. Pagani Cassara has n...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Gonzalez Toledo, M., Calle, A., Pagani Cassara, F., Tamargo, A., Thomson, A., Nadile, D., Gruz, F., Sinay, V. Tags: General Neurology III Source Type: research

Improving Assessment and Documentation of Pain Management at University of Florida - Jacksonville. (P4.290)
CONCLUSIONS:Resident education, development of standardized templates for H&P and progress notes and continuous compliance monitoring have significantly improved pain documentation and treatment.Disclosure: Dr. Shapovalov has nothing to disclose. Dr. Antonios has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Shapovalov, D., Antonios, N. Tags: Practice, Policy, and Ethics: Stroke, Critical Care, and Other Source Type: research

Helping Haiti: Addressing the Burden of Neurologic Disease (P4.292)
CONCLUSIONS: With this nationwide collaborative and interdisciplinary approach, we hope to have a dramatic impact on the perceptions and outcomes of neurologic disease and provide a continuous, but dynamic presence in Port au Prince, Haiti while training physicians, nurses, and other team members in global health perspectives.Disclosure: Dr. Santini has nothing to disclose. Dr. Alessi has received personal compensation for activities with CBS Radio, the National Football League Players Association, and Colonial Cooperative Care. Dr. Jones has nothing to disclose. Dr. Etienne has nothing to disclose. Dr. Hohler has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Santini, V., Alessi, A., Jones, E., Etienne, M., Hohler, A. Tags: Global Health and Infection Source Type: research

Treatment of Post-Influenza Vaccination Induced Acute Disseminated Encephalomyelitis (ADEM) with Plasma Exchange - A Case Report (P4.036)
DISCUSSION:Influenza vaccination has been rarely linked to ADEM. Due to a low-incidence of the disease, there are no established treatment guidelines. Our patient did not respond to steroids but showed marked radiographic improvement with PE. PE should be considered for refractory ADEM after influenza vaccination.Disclosure: Dr. Chahil has nothing to disclose. Dr. Pillainayagam has nothing to disclose. Dr. Schulz has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Chahil, M., Pillainayagam, C., Schulz, P. Tags: General Neurology III Source Type: research

Reversible Cerebral Vasoconstriction Syndrome and Fingolimod: Culprit or Innocent Bystander (P2.224)
CONCLUSIONS:Reversible cerebral vasoconstriction syndrome may be a rare complication of Fingolimod treatment and should be considered in patients with new onset thunderclap headache. The mechanism likely involves the effects of Fingolimod on S1P(3) receptors on cerebral arteries.Disclosure: Dr. Fleming has nothing to disclose. Dr. West has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Fleming, J., West, M. Tags: MS and CNS Inflammatory Disease: Treatment Safety Source Type: research

Multiple Sclerosis Exacerbation Presenting as Stress Cardiomyopathy (P6.162)
Conclusions: Stress cardiomyopathy is increasingly suspected to be neurogenic in etiology. This case not only supports this theory, but also reports multiple sclerosis to be a potential cause of neurologic dysfunction leading to this cardiac phenomenon. In addition, it fortifies the theory that bilateral medullary lesions are required for many instances of autonomic dysfunction.Disclosure: Dr. Webb has nothing to disclose. Dr. Reyna has nothing to disclose. Dr. Blair has nothing to disclose. Dr. Foreman has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Webb, T., Reyna, T., Blair, R., Foreman, R. Tags: Multiple Sclerosis Symptoms and Comorbidities Source Type: research

Intracranial Arterial Dissection (P2.013)
CONCLUSIONS:IAD represent a substantial proportion of CAD and may be a frequently underdiagnosed cause of stroke. Intraparenchymal hemorrhage seemed to occur less frequently in our series than previously reported.Study Supported by:Disclosure: Dr. Dossi has nothing to disclose. Dr. Farez has received personal compensation for activities with Merck Serono. Dr. Farez has received research support from Novartis. Dr. Arena has nothing to disclose. Dr. Pujol Lereis has nothing to disclose. Dr. Povedano has nothing to disclose. Dr. Ameriso has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Dossi, D., Farez, M., Arena, J., Pujol Lereis, V., Povedano, G., Ameriso, S. Tags: Cerebrovascular Disease and Interventional Neurology I Source Type: research

Restless Limbs Syndrome (RLS) Presenting as Hemisyndrome: A Case of Dejerine-Roussy Syndrome Responsive to Dopamine Agonists (P5.266)
CONCLUSION: Recognition of RLS as a hemisyndrome may offer new treatments for patients with chronic dysesthetic pain, paresthesia, and insomnia as illustrated in this case of DRS. RLS affects 10% of the population and DRS is seen in 10% after thalamic stroke. Pain associated with RLS may be contributing to chronic, persistent pain in patients with certain CNS lesions and may be treatable with Dopamine Agonists.Disclosure: Dr. Dickoff has received personal compensation for activities with UCB Pharma and Teva pharmaceuticals as a speaker.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Dickoff, D. Tags: Movement Disorders: Sleep and Movement Disorders and Miscellaneous Diagnoses Source Type: research

Stroke Awareness Among Community Residents in Chicago (P7.135)
CONCLUSIONS:Despite significant efforts made to increase public awareness about stroke, moderate deficits still exist. Future educational programs should consider targeted outreach to younger populations who may live with stroke survivors and minority populations at higher risk for stroke. In addition, financial barriers to calling EMS should be tackled at public policy level.Disclosure: Dr. Mathew has nothing to disclose. Dr. O’Neill has nothing to disclose. Dr. Beckstrom has nothing to disclose. Dr. Giles has nothing to disclose. Dr. Aggarwal has nothing to disclose. Dr. Prabhakaran has received personal compensati...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Mathew, S., O'Neill, K., Beckstrom, H., Giles, F., Aggarwal, N., Prabhakaran, S. Tags: Cerebrovascular Disease and Interventional Neurology: Barriers and Opportunities in Acute Stroke Treatment Source Type: research

Use of Veterans Specific Activity Questionnaire VSAQ to Estimate Exercise Tolerance in Ambulatory Amyotrophic Lateral Sclerosis (ambALS) Patients (P2.071)
CONCLUSIONS:VSAQ is a practical tool to estimate exercise capacity of ambALS and may be used for safe exercise prescription.Disclosure: Dr. Sanjak has nothing to disclose. Dr. Headen has nothing to disclose. Dr. Barrett has nothing to disclose. Dr. Holsten has nothing to disclose. Dr. Langford has nothing to disclose. Dr. Bravver has received research support from Biogen Idec, Avanier, Cytokinetics Pharmaceuticals, Neuraltus Pharmaceuticals, GlaxoSmithKline Inc., the National Institute of Neurological Disorders and Stroke, and the Clinical Research Consortium. Dr. Bockenek has nothing to disclose. Dr. Desai has received pe...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Sanjak, M., Headen, J., Barrett, K., Holsten, S., Langford, V., Bravver, E., Bockenek, W., Desai, U., Story, J. S., Lindblom, S. C., Paccico, T., Brooks, B. Tags: ALS: Genetics and Outcomes Source Type: research

Recurrent Intra-Luminal Aortic Thrombus And Ischemic Stroke In A Patient With Essential Thrombocythemia (P6.262)
CONCLUSIONS: This case highlights the importance of recognizing essential thrombocythemia as an entity that can lead to devastating complications, including acute coronary syndrome and either arterial and venous thrombosis. Early recognition and effective cytoreductive therapy are cornerstones to the prevention of recurrent embolism. This case demonstrates that Intra-luminal thrombus may resolve and reappear, and can vary greatly in its clinical consequences.Disclosure: Dr. Vela-Duarte has nothing to disclose. Dr. Flaster has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Vela-Duarte, D., Flaster, M. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

An Unusual Cause of Altered Mental Status: Recurrent Cerebral Air Embolism from Atrial-Esophageal Fistula (P2.119)
Conclusion:The incidence of stroke secondary to air emboli is rare but a known complication of AEF's. Review of literature showed no reports of recurrent air embolism following successful treatment with HBO and repair of AEF. It is important to consider air embolism in any patient with a history of AEF, regardless of prior treatment.Disclosure: Dr. Ahmed has nothing to disclose. Dr. Myers has nothing to disclose. Dr. Kim has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ahmed, I., Myers, T., Kim, J. Tags: Cerebrovascular Disease and Interventional Neurology: Behavioral, Cognitive, and Miscellaneous Source Type: research

Patient Registry of Outcomes in Spasticity (PROS) Care World (P3.050)
Conclusion: Findings suggest dosing differences for commonly treated patterns of UMN dysfunction and improved Ashworth and pain scores. This robust database can guide clinicians in the management of patients with spasticity.Disclosure: Dr. Esquenazi has nothing to disclose. Dr. Mayer has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Esquenazi, A., Mayer, N., Lee, S. Tags: Neural Repair and Neuro-rehabilitation: Clinical Source Type: research

Vitreous Hemorrhage as a Complication of IV-tPA Therapy in a Patient with Acute Stroke (P4.227)
CONCLUSIONS: To our knowledge, this is the first case report of vitreous hemorrhage following acute stroke therapy with IV-tPA. This underscores the risk of intraocular hemorrhage in patients with retinal neovascularization that could occur with other retinal vascular disorders such as diabetic retinopathy. The decision to proceed with IV-tPA in the presence of retinal neovascularization should be made on a case-by-case basis and further discussion with the patient.Disclosure: Dr. Shah has nothing to disclose. Dr. Verstraeten has nothing to disclose. Dr. Wright has nothing to disclose. Dr. Rana has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Shah, L., Verstraeten, T., Wright, D., Rana, S. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke Thrombolysis Source Type: research

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