Unintended changes in cognition, mood, and behavior arising from cell-based interventions for neurological conditions: ethical challenges.

Science.gov (United States)

Duggan, P S; Siegel, A W; Blass, D M; Bok, H; Coyle, J T; Faden, R; Finkel, J; Gearhart, J D; Greely, H T; Hillis, A; Hoke, A; Johnson, R; Johnston, M; Kahn, J; Kerr, D; King, P; Kurtzberg, J; Liao, S M; McDonald, J W; McKhann, G; Nelson, K B; Rao, M; Regenberg, A; Smith, K; Solter, D; Song, H; Sugarman, J; Traystman, R J; Vescovi, A; Yanofski, J; Young, W; Mathews, D J H

2009-05-01

The prospect of using cell-based interventions (CBIs) to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior-brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment.

PRISM: a novel research tool to assess the prevalence of pseudobulbar affect symptoms across neurological conditions.

Directory of Open Access Journals (Sweden)

Benjamin Rix Brooks

Full Text Available Pseudobulbar affect (PBA is a neurological condition characterized by involuntary, sudden, and frequent episodes of laughing and/or crying, which can be socially disabling. Although PBA occurs secondary to many neurological conditions, with an estimated United States (US prevalence of up to 2 million persons, it is thought to be under-recognized and undertreated. The PBA Registry Series (PRISM was established to provide additional PBA symptom prevalence data in a large, representative US sample of patients with neurological conditions known to be associated with PBA.Participating clinicians were asked to enroll ≥20 consenting patients with any of 6 conditions: Alzheimer's disease (AD, amyotrophic lateral sclerosis (ALS, multiple sclerosis (MS, Parkinson's disease (PD, stroke, or traumatic brain injury (TBI. Patients (or their caregivers completed the Center for Neurologic Study-Lability Scale (CNS-LS and an 11-point scale measuring impact of the neurological condition on the patient's quality of life (QOL. Presence of PBA symptoms was defined as a CNS-LS score ≥13. Demographic data and current use of antidepressant or antipsychotic medications were also recorded.PRISM enrolled 5290 patients. More than one third of patients (n = 1944; 36.7% had a CNS-LS score ≥13, suggesting PBA symptoms. The mean (SD score measuring impact of neurological condition on QOL was significantly higher (worse in patients with CNS-LS ≥13 vs <13 (6.7 [2.5] vs. 4.7 [3.1], respectively; P<0.0001 two-sample t-test. A greater percentage of patients with CNS-LS ≥13 versus <13 were using antidepressant/antipsychotic medications (53.0% vs 35.4%, respectively; P<0.0001, chi-square test.Data from PRISM, the largest clinic-based study to assess PBA symptom prevalence, showed that PBA symptoms were common among patients with diverse neurological conditions. Higher CNS-LS scores were associated with impaired QOL and greater use of antipsychotic

Plasma focus matching conditions

International Nuclear Information System (INIS)

Soliman, H.M.; Masoud, M.M.; Elkhalafawy, T.A.

1988-01-01

A snow-plough and slug models have been used to obtain the optimum matching conditions of the plasma in the focus. The dimensions of the plasma focus device are, inner electrode radius = 2 cm, outer electrode radius = 5.5 cm, and its length = 8 cm. It was found that the maximum magnetic energy of 12.26 kJ has to be delivered to plasma focus whose density is 10 19 /cm 3 at focusing time of 2.55 μs and with total external inductance of 24.2 n H. The same method is used to evaluate the optimum matching conditions for the previous coaxial discharge system which had inner electrode radius = 1.6 cm, outer electrode radius = 3.3 cm and its length = 31.5 cm. These conditions are charging voltage = 12 kV, capacity of the condenser bank = 430 μf, plasma focus density = 10 19 /cm 3 focusing time = 8 μs and total external inductance = 60.32 n H.3 fig., 2 tab

Milestone-compatible neurology resident assessments: A role for observable practice activities.

Science.gov (United States)

Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J

2015-06-02

Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

Vaccination and neurological disorders

Directory of Open Access Journals (Sweden)

Anastasia Gkampeta

2015-12-01

Full Text Available Active immunization of children has been proven very effective in elimination of life threatening complications of many infectious diseases in developed countries. However, as vaccination-preventable infectious diseases and their complications have become rare, the interest focuses on immunization-related adverse reactions. Unfortunately, fear of vaccination-related adverse effects can led to decreased vaccination coverage and subsequent epidemics of infectious diseases. This review includes reports about possible side effects following vaccinations in children with neurological disorders and also published recommendations about vaccinating children with neurological disorders. From all international published data anyone can conclude that vaccines are safer than ever before, but the challenge remains to convey this message to society.

A Randomized Controlled Trial Testing the Efficacy of the Creating Opportunities for Parent Empowerment Program for Parents of Children With Epilepsy and Other Chronic Neurological Conditions.

Science.gov (United States)

Duffy, Lisa V; Vessey, Judith A

2016-06-01

one-between, one-within multivariate analysis of variance showed that the effect of the interaction between time and group was significant for internalized behavior assessment system score only (p = .037) because the usual care group reported a significant decrease in internalizing behavior scores in their children over time. Findings from this study have significant implications for clinical practice and future research. Parents of children with neurological conditions often struggle to manage a constant feeling of uncertainty in their daily lives. Nurses possess the knowledge and expertise necessary to identify the psychosocial needs of these parents and provide education and support as needed. Future research should focus on designing interventions to meet the needs of these families and develop strategies to help improve the quality of life for both the parent and child living with a neurological condition.

The "Growing" Reality of the Neurological Complications of Global "Stem Cell Tourism".

Science.gov (United States)

Julian, Katie; Yuhasz, Nick; Hollingsworth, Ethan; Imitola, Jaime

2018-04-01

"Stem cell tourism" is defined as the unethical practice of offering unproven cellular preparations to patients suffering from various medical conditions. This phenomenon is rising in the field of neurology as patients are requesting information and opportunities for treatment with stem cells for incurable conditions such as multiple sclerosis and amyotrophic lateral sclerosis, despite their clinical research and experimental designation. Here, we review the recent trends in "stem cell tourism" in both the United States and abroad, and discuss the recent reports of neurological complications from these activities. Finally, we frame critical questions for the field of neurology regarding training in the ethical, legal, and societal issues of the global "stem cell tourism," as well as suggest strategies to alleviate this problem. Although there are ongoing legitimate clinical trials with stem cells for neurological diseases, procedures offered by "stem cell clinics" cannot be defined as clinical research. They lack the experimental and state-of-the-art framework defined by peers and the FDA that focus on human research that safeguard the protection of human subjects against economical exploitation, unwanted side effects, and futility of unproven procedures. "Stem cell tourism" ultimately exploits therapeutic hope of patients and families with incurable neurological diseases and can put in danger the legitimacy of stem cell research as a whole. We posit that an improvement in education, regulation, legislation, and involvement of authorities in global health in neurology and neurosurgery is required. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Palliative care and neurology

Science.gov (United States)

Boersma, Isabel; Miyasaki, Janis; Kutner, Jean

2014-01-01

Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. PMID:24991027

Predictors of activity and participation across neurodegenerative conditions: a comparison of people with motor neurone disease, multiple sclerosis and Parkinson's disease.

Science.gov (United States)

Morley, David; Dummett, Sarah; Kelly, Laura; Fitzpatrick, Ray; Jenkinson, Crispin

2018-02-17

Comparisons between neurological conditions have the potential to inform service providers by identifying particular areas of difficulty experienced by affected individuals. This study aimed to identify predictors of activity and participation in people with motor neurone disease (MND), people with multiple sclerosis (MS) and people with Parkinson's Disease (PD). The Oxford Participation and Activities Questionnaire (Ox-PAQ) and Medical Outcomes Study 36-Item Short Form Survey (MOS SF-36) were administered by postal survey to 386 people with a confirmed diagnosis of MND, MS or PD. Data analyses focused on stepwise regression analyses in order to identify predictors of activity and participation in the three conditions assessed. Three hundred and thirty four participants completed the survey, a response rate of 86.5%. Regression analyses identified multiple predictors of activity and participation dependent on Ox-PAQ domain and disease group, the most prominent being social and physical functioning as measured by the MOS SF-36. Results indicate that the physical and social consequences of neurological illness are of greatest relevance to people experiencing the conditions assessed. Whilst the largely inevitable physical implications of disease take hold, emphasis should be placed on the avoidance of social withdrawal and isolation, and the maintenance of social engagement should become a significant priority.

VEGF Signaling in Neurological Disorders

Directory of Open Access Journals (Sweden)

Joon W. Shim

2018-01-01

Full Text Available Vascular endothelial growth factor (VEGF is a potent growth factor playing diverse roles in vasculogenesis and angiogenesis. In the brain, VEGF mediates angiogenesis, neural migration and neuroprotection. As a permeability factor, excessive VEGF disrupts intracellular barriers, increases leakage of the choroid plexus endothelia, evokes edema, and activates the inflammatory pathway. Recently, we discovered that a heparin binding epidermal growth factor like growth factor (HB-EGF—a class of EGF receptor (EGFR family ligands—contributes to the development of hydrocephalus with subarachnoid hemorrhage through activation of VEGF signaling. The objective of this review is to entail a recent update on causes of death due to neurological disorders involving cerebrovascular and age-related neurological conditions and to understand the mechanism by which angiogenesis-dependent pathological events can be treated with VEGF antagonisms. The Global Burden of Disease study indicates that cancer and cardiovascular disease including ischemic and hemorrhagic stroke are two leading causes of death worldwide. The literature suggests that VEGF signaling in ischemic brains highlights the importance of concentration, timing, and alternate route of modulating VEGF signaling pathway. Molecular targets distinguishing two distinct pathways of VEGF signaling may provide novel therapies for the treatment of neurological disorders and for maintaining lower mortality due to these conditions.

Co-activation: its association with weakness and specific neurological pathology

Directory of Open Access Journals (Sweden)

Wiles Charles M

2006-11-01

Full Text Available Abstract Background Net agonist muscle strength is in part determined by the degree of antagonist co-activation. The level of co-activation might vary in different neurological disorders causing weakness or might vary with agonist strength. Aim This study investigated whether antagonist co-activation changed a with the degree of muscle weakness and b with the nature of the neurological lesion causing weakness. Methods Measures of isometric quadriceps and hamstrings strength were obtained. Antagonist (hamstring co-activation during knee extension was calculated as a ratio of hamstrings over quadriceps activity both during an isometric and during a functional sit to stand (STS task (using kinematics in groups of patients with extrapyramidal (n = 15, upper motor neuron (UMN (n = 12, lower motor neuron (LMN with (n = 18 or without (n = 12 sensory loss, primary muscle or neuromuscular junction disorder (n = 17 and in healthy matched controls (n = 32. Independent t-tests or Mann Witney U tests were used to compare between the groups. Correlations between variables were also investigated. Results In healthy subjects mean (SD co-activation of hamstrings during isometric knee extension was 11.8 (6.2% and during STS was 20.5 (12.9%. In patients, co-activation ranged from 7 to 17% during isometric knee extension and 15 to 25% during STS. Only the extrapyramidal group had lower co-activation levels than healthy matched controls (p Conclusion It is concluded that antagonist co-activation does not systematically vary with the site of neurological pathology when compared to healthy matched controls or, in most patient groups, with strength. The lower co-activation levels found in the extrapyramidal group require confirmation and further investigation. Co-activation may be relevant to individuals with muscle weakness. Within patient serial studies in the presence of changing muscle strength may help to understand these relationships more clearly.

Microbiota and neurologic diseases: potential effects of probiotics.

Science.gov (United States)

Umbrello, Giulia; Esposito, Susanna

2016-10-19

The microbiota colonizing the gastrointestinal tract have been associated with both gastrointestinal and extra-gastrointestinal diseases. In recent years, considerable interest has been devoted to their role in the development of neurologic diseases, as many studies have described bidirectional communication between the central nervous system and the gut, the so-called "microbiota-gut-brain axis". Considering the ability of probiotics (i.e., live non-pathogenic microorganisms) to restore the normal microbial population and produce benefits for the host, their potential effects have been investigated in the context of neurologic diseases. The main aims of this review are to analyse the relationship between the gut microbiota and brain disorders and to evaluate the current evidence for the use of probiotics in the treatment and prevention of neurologic conditions. Overall, trials involving animal models and adults have reported encouraging results, suggesting that the administration of probiotic strains may exert some prophylactic and therapeutic effects in a wide range of neurologic conditions. Studies involving children have mainly focused on autism spectrum disorder and have shown that probiotics seem to improve neuro behavioural symptoms. However, the available data are incomplete and far from conclusive. The potential usefulness of probiotics in preventing or treating neurologic diseases is becoming a topic of great interest. However, deeper studies are needed to understand which formulation, dosage and timing might represent the optimal regimen for each specific neurologic disease and what populations can benefit. Moreover, future trials should also consider the tolerability and safety of probiotics in patients with neurologic diseases.

Effectiveness of external cues to facilitate task performance in people with neurological disorders: a systematic review and meta-analysis.

Science.gov (United States)

Harrison, Stephanie L; Laver, Kate E; Ninnis, Kayla; Rowett, Cherie; Lannin, Natasha A; Crotty, Maria

2018-03-09

To examine in people with neurological disorders, which method/s of providing external cues to improve task performance are most effective. Medline, EMBASE, and PsycINFO were systematically searched. Two reviewers independently screened, extracted data, and assessed the quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Twenty six studies were included. Studies examined a wide-range of cues including visual, tactile, auditory, verbal, and multi-component cues. Cueing (any type) improved walking speed when comparing cues to no cues (mean difference (95% confidence interval): 0.08 m/s (0.06-0.10), I 2  = 68%, low quality of evidence). Remaining evidence was analysed narratively; evidence that cueing improves activity-related outcomes was inconsistent and rated as very low quality. It was not possible to determine which form of cueing may be more effective than others. Providing cues to encourage successful task performance is a core component of rehabilitation, however there is limited evidence on the type of cueing or which tasks benefit most from external cueing. Low-quality evidence suggests there may be a beneficial effect of cueing (any type) on walking speed. Sufficiently powered randomised controlled trials are needed to inform therapists of the most effective cueing strategies to improve activity performance in populations with a neurological disorder. Implications for rehabilitation Providing cues is a core component of rehabilitation and may improve successful task performance and activities in people with neurological conditions including stroke, Parkinson's disease, Alzheimer's disease, traumatic brain injury, and multiple sclerosis, but evidence is limited for most neurological conditions with much research focusing on stroke and Parkinson's disease. Therapists should consider using a range of different types of cues depending on the aims of treatment and the neurological condition. There is

Use of Lower-Limb Robotics to Enhance Practice and Participation in Individuals With Neurological Conditions.

Science.gov (United States)

Jayaraman, Arun; Burt, Sheila; Rymer, William Zev

2017-07-01

To review lower-limb technology currently available for people with neurological disorders, such as spinal cord injury, stroke, or other conditions. We focus on 3 emerging technologies: treadmill-based training devices, exoskeletons, and other wearable robots. Efficacy for these devices remains unclear, although preliminary data indicate that specific patient populations may benefit from robotic training used with more traditional physical therapy. Potential benefits include improved lower-limb function and a more typical gait trajectory. Use of these devices is limited by insufficient data, cost, and in some cases size of the machine. However, robotic technology is likely to become more prevalent as these machines are enhanced and able to produce targeted physical rehabilitation. Therapists should be aware of these technologies as they continue to advance but understand the limitations and challenges posed with therapeutic/mobility robots.

Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship

Directory of Open Access Journals (Sweden)

John W. Norbury

2016-01-01

Full Text Available Background. A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R Clerkship was found to increase students’ knowledge of PM&R; however the students’ overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective. To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting. Academic Medical Center. Participants. 73 fourth-year medical students. Methods. The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements. Student evaluations of the clerkship. Results. Statistically significant improvements were found in the students’ evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills (p≤0.05. Conclusions. This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content.

Evidence for the Importance of Vitamin D Status in Neurologic Conditions.

Science.gov (United States)

Yeshokumar, Anusha K; Saylor, Deanna; Kornberg, Michael D; Mowry, Ellen M

2015-12-01

Vitamin D status has been proposed as relevant to many neurological disorders. Data suggest that vitamin D may be important for the development of the nervous system, and it also plays a role in neuroimmunology and neuroprotection. Lower levels of circulating 25-hydroxyvitamin D have been linked with increased risk of multiple sclerosis (MS) and Alzheimer's disease (AD). While people with amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), and stroke have lower vitamin D levels than those without the diseases, it is unclear if this is because hypovitaminosis D contributes to disease risk or is a consequence of immobility and other factors caused by the disease. Lower levels of vitamin D have been associated with worse prognosis in MS, PD, ALS, and stroke, while no longitudinal studies have been performed to evaluate such an association in AD. Small pilot trials have been performed to evaluate vitamin D supplementation for some of these diseases, but there have been no phase III studies to support vitamin D supplementation in these patient populations; further, ideal levels of 25-hydroxyvitamin D are not known. Thus, while some expert panels or individuals have suggested routine testing and supplementation for patients with these neurological conditions, it is our opinion that there are currently insufficient data to support high-dose vitamin D supplementation to specifically treat or prevent these conditions.

The Neurological Significance of Abnormal Natural Killer Cell Activity in Chronic Toxigenic Mold Exposures

Directory of Open Access Journals (Sweden)

Ebere Anyanwu

2003-01-01

Full Text Available Toxigenic mold activities produce metabolites that are either broad-spectrum antibiotics or mycotoxins that are cytotoxic. Indoor environmental exposure to these toxigenic molds leads to adverse health conditions with the main outcome measure of frequent neuroimmunologic and behavioral consequences. One of the immune system disorders found in patients presenting with toxigenic mold exposure is an abnormal natural killer cell activity. This paper presents an overview of the neurological significance of abnormal natural killer cell (NKC activity in chronic toxigenic mold exposure. A comprehensive review of the literature was carried out to evaluate and assess the conditions under which the immune system could be dysfunctionally interfered with leading to abnormal NKC activity and the involvement of mycotoxins in these processes. The functions, mechanism, the factors that influence NKC activities, and the roles of mycotoxins in NKCs were cited wherever necessary. The major presentations are headache, general debilitating pains, nose bleeding, fevers with body temperatures up to 40�C (104�F, cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, vertigo/dizziness, and in some cases, seizures. Although sleep is commonly considered a restorative process that is important for the proper functioning of the immune system, it could be disturbed by mycotoxins. Most likely, mycotoxins exert some rigorous effects on the circadian rhythmic processes resulting in sleep deprivation to which an acute and transient increase in NKC activity is observed. Depression, psychological stress, tissue injuries, malignancies, carcinogenesis, chronic fatigue syndrome, and experimental allergic encephalomyelitis could be induced at very low physiological concentrations by mycotoxin-induced NKC activity. In the light of this review, it is concluded that chronic exposures to toxigenic mold could lead to abnormal NKC activity with a wide

Use of the interRAI CHESS scale to predict mortality among persons with neurological conditions in three care settings.

Science.gov (United States)

Hirdes, John P; Poss, Jeffrey W; Mitchell, Lori; Korngut, Lawrence; Heckman, George

2014-01-01

Persons with certain neurological conditions have higher mortality rates than the population without neurological conditions, but the risk factors for increased mortality within diagnostic groups are less well understood. The interRAI CHESS scale has been shown to be a strong predictor of mortality in the overall population of persons receiving health care in community and institutional settings. This study examines the performance of CHESS as a predictor of mortality among persons with 11 different neurological conditions. Survival analyses were done with interRAI assessments linked to mortality data among persons in home care (n = 359,940), complex continuing care hospitals/units (n = 88,721), and nursing homes (n = 185,309) in seven Canadian provinces/territories. CHESS was a significant predictor of mortality in all 3 care settings for the 11 neurological diagnostic groups considered after adjusting for age and sex. The distribution of CHESS scores varied between diagnostic groups and within diagnostic groups in different care settings. CHESS is a valid predictor of mortality in neurological populations in community and institutional care. It may prove useful for several clinical, administrative, policy-development, evaluation and research purposes. Because it is routinely gathered as part of normal clinical practice in jurisdictions (like Canada) that have implemented interRAI assessment instruments, CHESS can be derived without additional need for data collection.

Use of the interRAI CHESS scale to predict mortality among persons with neurological conditions in three care settings.

Directory of Open Access Journals (Sweden)

John P Hirdes

Full Text Available Persons with certain neurological conditions have higher mortality rates than the population without neurological conditions, but the risk factors for increased mortality within diagnostic groups are less well understood. The interRAI CHESS scale has been shown to be a strong predictor of mortality in the overall population of persons receiving health care in community and institutional settings. This study examines the performance of CHESS as a predictor of mortality among persons with 11 different neurological conditions.Survival analyses were done with interRAI assessments linked to mortality data among persons in home care (n = 359,940, complex continuing care hospitals/units (n = 88,721, and nursing homes (n = 185,309 in seven Canadian provinces/territories.CHESS was a significant predictor of mortality in all 3 care settings for the 11 neurological diagnostic groups considered after adjusting for age and sex. The distribution of CHESS scores varied between diagnostic groups and within diagnostic groups in different care settings.CHESS is a valid predictor of mortality in neurological populations in community and institutional care. It may prove useful for several clinical, administrative, policy-development, evaluation and research purposes. Because it is routinely gathered as part of normal clinical practice in jurisdictions (like Canada that have implemented interRAI assessment instruments, CHESS can be derived without additional need for data collection.

Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders.

Science.gov (United States)

Millman, Alexander J; Finelli, Lyn; Bramley, Anna M; Peacock, Georgina; Williams, Derek J; Arnold, Sandra R; Grijalva, Carlos G; Anderson, Evan J; McCullers, Jonathan A; Ampofo, Krow; Pavia, Andrew T; Edwards, Kathryn M; Jain, Seema

2016-06-01

To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions. Children children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses. From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age. Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders. Published by Elsevier Inc.

Abnormal transitory focus of hyperactivity revealed by gamma-angioencephalogram in patient with seizure activity. Case report

International Nuclear Information System (INIS)

Planchon, C.A.; Chimenes, H.; Perez, R.

1979-01-01

A young patient was admitted to the hospital for a neurological accident following an epileptic seizure. An important focus of hyperactivity of the frontal region was noted on the gamma-angioencephalogram, consistent with a vascular malformation or a highly vascular tumor but corresponding in fact to a focal transiroty hyperfusion, with accompanying intense neuronal activity [fr

Repetitive Transcranial Magnetic Stimulation for Clinical Applications in Neurological and Psychiatric Disorders: An Overview

Science.gov (United States)

Machado, Sergio; Arias-Carrión, Oscar; Paes, Flávia; Vieira, Renata Teles; Caixeta, Leonardo; Novaes, Felipe; Marinho, Tamires; Almada, Leonardo Ferreira; Silva, Adriana Cardoso; Nardi, Antonio Egidio

2013-01-01

Neurological and psychiatric disorders are characterized by several disabling symptoms for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A method that may modulate brain activity and be viable for use in clinical practice is repetitive transcranial magnetic stimulation (rTMS). It is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Here, we focus on the basic foundation of rTMS, the main stimulation parametters, the factors that influence individual responses to rTMS and the experimental advances of rTMS that may become a viable clinical application to treat neurological and psychiatric disorders. The findings showed that rTMS can improve some symptoms associated with these conditions and might be useful for promoting cortical plasticity in patients with neurological and psychiatric disorders. However, these changes are transient and it is premature to propose these applications as realistic therapeutic options, even though the rTMS technique has been evidenced as a potential modulator of sensorimotor integration and neuroplasticity. Functional imaging of the region of interest could highlight the capacity of rTMS to bring about plastic changes of the cortical circuitry and hint at future novel clinical interventions. Thus, we recommend that further studies clearly determine the role of rTMS in the treatment of these conditions. Finally, we must remember that however exciting the neurobiological mechanisms might be, the clinical usefulness of rTMS will be determined by its ability to provide patients with neurological and psychiatric disorders with safe, long-lasting and substantial improvements in quality of life. PMID:25610279

The practice of neurology: Looking ahead by looking back.

Science.gov (United States)

Ringel, Steven P

2015-05-19

Over the last 50 years, there have been many improvements in therapy for individuals with neurologic disorders. Simultaneously, the complexity and cost of care have increased. The delivery of neurologic services is inefficient. The needs of both patients and neurologists are not being optimally addressed. Although greater attention is on the quality, safety, and value of the care, there remains a need for fundamental redesign in the way neurologic services are provided. The future practice of neurology will likely be interdisciplinary and provide both easy access and efficient coordination of services. No matter what changes in financing of health care are adopted, focus needs to be on reducing health care costs. Patients seeking neurologic care will expect seamless, innovative, and cost-effective services and to be active participants in their care. The proposed modifications address current demands and advocate for prospective innovative solutions. The changes proposed to improve care for patients will simultaneously make the careers of neurologists more gratifying and less stressful. © 2015 American Academy of Neurology.

Child Neurology Services in Africa

Science.gov (United States)

Wilmshurst, Jo M.; Badoe, Eben; Wammanda, Robinson D.; Mallewa, Macpherson; Kakooza-Mwesige, Angelina; Venter, Andre; Newton, Charles R.

2013-01-01

The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level. PMID:22019842

Guided self-help interventions for mental health disorders in children with neurological conditions: study protocol for a pilot randomised controlled trial.

Science.gov (United States)

Bennett, Sophie; Heyman, Isobel; Coughtrey, Anna; Simmonds, Jess; Varadkar, Sophia; Stephenson, Terence; DeJong, Margaret; Shafran, Roz

2016-11-04

Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions. A pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children's Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and

Neurological condition in 42-month-old children in relation to pre- and postnatal exposure to polychlorinated biphenyls and dioxins.

NARCIS (Netherlands)

Patandin, S; Fidler, [No Value; Weisglas-Kuperus, N; Sauer, PJJ; Boersma, ER; Touwen, BCL

1998-01-01

Adverse neurological effects of exposure to PCBs have been found up to 18 months of age. Now we report on the effect of pre-and postnatal exposure to PCBs and dioxins on the neurological condition at 42 months of age. For this purpose, PCB levels were determined in cord and maternal plasma, and used

Astaxanthin as a Potential Neuroprotective Agent for Neurological Diseases

Directory of Open Access Journals (Sweden)

Haijian Wu

2015-09-01

Full Text Available Neurological diseases, which consist of acute injuries and chronic neurodegeneration, are the leading causes of human death and disability. However, the pathophysiology of these diseases have not been fully elucidated, and effective treatments are still lacking. Astaxanthin, a member of the xanthophyll group, is a red-orange carotenoid with unique cell membrane actions and diverse biological activities. More importantly, there is evidence demonstrating that astaxanthin confers neuroprotective effects in experimental models of acute injuries, chronic neurodegenerative disorders, and neurological diseases. The beneficial effects of astaxanthin are linked to its oxidative, anti-inflammatory, and anti-apoptotic characteristics. In this review, we will focus on the neuroprotective properties of astaxanthin and explore the underlying mechanisms in the setting of neurological diseases.

Neurologic emergencies in sports.

Science.gov (United States)

Williams, Vernon B

2014-12-01

Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.

Getting to value in neurological care: a roadmap for academic neurology.

Science.gov (United States)

Holloway, Robert G; Ringel, Steven P

2011-06-01

Academic neurology is undergoing transformational changes. The public investment in biomedical research and clinical care is enormous and there is a growing perception that the return on this huge investment is insufficient. Hospitals, departments, and individual neurologists should expect more scrutiny as information about their quality of care and financial relationships with industry are increasingly reported to the public. There are unprecedented changes occurring in the financing and delivery of health care and research that will have profound impact on the mission and operation of academic departments of neurology. With the passage of the Patient Protection and Affordable Care Act (PPACA) there will be increasing emphasis on research that demonstrates value and includes the patient's perspective. Here we review neurological investigations of our clinical and research enterprises that focus on quality of care and comparative effectiveness, including cost-effectiveness. By highlighting progress made and the challenges that lie ahead, we hope to create a clinical, educational, and research roadmap for academic departments of neurology to thrive in today's increasingly regulated environment. Copyright © 2011 American Neurological Association.

Education requirements for nurses working with people with complex neurological conditions: nurses' perceptions.

Science.gov (United States)

Baker, Mark

2012-01-01

Following a service evaluation methodology, this paper reports on registered nurses' (RNs) and healthcare assistants' (HCAs) perceptions about education and training requirements in order to work with people with complex neurological disabilities. A service evaluation was undertaken to meet the study aim using a non-probability, convenience method of sampling 368 nurses (n=110 RNs, n=258 HCAs) employed between October and November 2008 at one specialist hospital in south-west London in the U.K. The main results show that respondents were clear about the need to develop an education and training programme for RNs and HCAs working in this speciality area (91% of RNs and 94% of HCAs). A variety of topics were identified to be included within a work-based education and training programme, such as positively managing challenging behaviour, moving and handling, working with families. Adults with complex neurological needs have diverse needs and thus nurses working with this patient group require diverse education and training in order to deliver quality patient-focused nursing care. Copyright © 2011 Elsevier Ltd. All rights reserved.

Palliative care and neurology: time for a paradigm shift.

Science.gov (United States)

Boersma, Isabel; Miyasaki, Janis; Kutner, Jean; Kluger, Benzi

2014-08-05

Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. © 2014 American Academy of Neurology.

Neurologic complications in oncology

Directory of Open Access Journals (Sweden)

Andrea Pace

2010-06-01

Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

Guided self-help for mental health disorders in children and young people with chronic neurological conditions: A qualitative evaluation.

Science.gov (United States)

Bennett, Sophie D; Coughtrey, Anna E; Heyman, Isobel; Greally, Suzanna; Clarkson, Harriet; Bhattacharyya, Tuhina; Lewis, Corah; Varadkar, Sophia; Shafran, Roz

2018-03-09

Children with neurological conditions such as epilepsy are at high risk of developing mental health disorders. Guided self-help can be used to increase access to psychological therapies. When developing and evaluating interventions, it is important to obtain the views of service-users about their acceptability. A telephone-guided self-help intervention was used to treat common mental health difficulties in children and young people with neurological conditions. The intervention was not adapted in content to account for chronic illness. This study therefore reports on qualitative interviews with participants to determine the acceptability of the intervention. Semi-structured interviews were conducted with 27 participants (25 parents and 2 young people) who had undertaken a telephone-delivered guided self-help intervention for common mental health difficulties in the context of a paediatric neurological condition. Transcripts were analysed thematically using the framework approach. Thirteen themes were extracted, organised into three main domains, which covered: the practicalities of telephone guided self-help treatment; the outcomes of the intervention; and the extent to which adaptation was needed for chronic illness. Most families found the intervention helpful in working towards their specific goals and noticed changes for the child and/or parents and family. Participants had a positive experience of the intervention and the majority of parents found the standard intervention with individualised goals sufficient to meet the young person's mental health needs. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Wikipedia and neurological disorders.

Science.gov (United States)

Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M

2015-07-01

Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a popular free online encyclopedia used by patients and physicians to search for health-related information. The following Wikipedia articles were considered: Alzheimer's disease; Amyotrophic lateral sclerosis; Dementia; Epilepsy; Epileptic seizure; Migraine; Multiple sclerosis; Parkinson's disease; Stroke; Traumatic brain injury. We analyzed information regarding the total article views for 90 days and the rank of these articles among all those available in Wikipedia. We determined the highest search volume peaks to identify possible relation with online news headlines. No relation between incidence or prevalence of neurological disorders and the search volume for the related articles was found. Seven out of 10 neurological conditions showed relations in search volume peaks and news headlines. Six out of these seven peaks were related to news about famous people suffering from neurological disorders, especially those from showbusiness. Identification of discrepancies between disease burden and health seeking behavior on Wikipedia is useful in the planning of public health campaigns. Celebrities who publicly announce their neurological diagnosis might effectively promote awareness programs, increase public knowledge and reduce stigma related to diagnoses of neurological disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Vitamin D and Neurological Diseases: An Endocrine View

Directory of Open Access Journals (Sweden)

Carolina Di Somma

2017-11-01

Full Text Available Vitamin D system comprises hormone precursors, active metabolites, carriers, enzymes, and receptors involved in genomic and non-genomic effects. In addition to classical bone-related effects, this system has also been shown to activate multiple molecular mediators and elicit many physiological functions. In vitro and in vivo studies have, in fact, increasingly focused on the “non-calcemic” actions of vitamin D, which are associated with the maintenance of glucose homeostasis, cardiovascular morbidity, autoimmunity, inflammation, and cancer. In parallel, growing evidence has recognized that a multimodal association links vitamin D system to brain development, functions and diseases. With vitamin D deficiency reaching epidemic proportions worldwide, there is now concern that optimal levels of vitamin D in the bloodstream are also necessary to preserve the neurological development and protect the adult brain. The aim of this review is to highlight the relationship between vitamin D and neurological diseases.

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol-Surgical Treatment of Neurological Hip Flexion Contracture.

Science.gov (United States)

Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

2014-01-01

Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

An open-label multicenter study to assess the safety of dextromethorphan/quinidine in patients with pseudobulbar affect associated with a range of underlying neurological conditions.

Science.gov (United States)

Pattee, Gary L; Wymer, James P; Lomen-Hoerth, Catherine; Appel, Stanley H; Formella, Andrea E; Pope, Laura E

2014-11-01

Pseudobulbar affect (PBA) is associated with neurological disorders or injury affecting the brain, and characterized by frequent, uncontrollable episodes of crying and/or laughing that are exaggerated or unrelated to the patient's emotional state. Clinical trials establishing dextromethorphan and quinidine (DM/Q) as PBA treatment were conducted in patients with amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS). This trial evaluated DM/Q safety in patients with PBA secondary to any neurological condition affecting the brain. To evaluate the safety and tolerability of DM/Q during long-term administration to patients with PBA associated with multiple neurological conditions. Fifty-two-week open-label study of DM/Q 30/30 mg twice daily. Safety measures included adverse events (AEs), laboratory tests, electrocardiograms (ECGs), vital signs, and physical examinations. #NCT00056524. A total of 553 PBA patients with >30 different neurological conditions enrolled; 296 (53.5%) completed. The most frequently reported treatment-related AEs (TRAEs) were nausea (11.8%), dizziness (10.5%), headache (9.9%), somnolence (7.2%), fatigue (7.1%), diarrhea (6.5%), and dry mouth (5.1%). TRAEs were mostly mild/moderate, generally transient, and consistent with previous controlled trials. Serious AEs (SAEs) were reported in 126 patients (22.8%), including 47 deaths, mostly due to ALS progression and respiratory failure. No SAEs were deemed related to DM/Q treatment by investigators. ECG results suggested no clinically meaningful effect of DM/Q on myocardial repolarization. Differences in AEs across neurological disease groups appeared consistent with the known morbidity of the primary neurological conditions. Study interpretation is limited by the small size of some disease groups, the lack of a specific efficacy measure and the use of a DM/Q dose higher than the eventually approved dose. DM/Q was generally well tolerated over this 52 week trial in patients with PBA

The neurological basis of occupation.

Science.gov (United States)

Gutman, Sharon A; Schindler, Victoria P

2007-01-01

The purpose of the present paper was to survey the literature about the neurological basis of human activity and its relationship to occupation and health. Activities related to neurological function were organized into three categories: those that activate the brain's reward system; those that promote the relaxation response; and those that preserve cognitive function into old age. The results from the literature review correlating neurological evidence and activities showed that purposeful and meaningful activities could counter the effects of stress-related diseases and reduce the risk for dementia. Specifically, it was found that music, drawing, meditation, reading, arts and crafts, and home repairs, for example, can stimulate the neurogical system and enhance health and well-being, Prospective research studies are needed to examine the effects of purposeful activities on reducing stress and slowing the rate of cognitive decline.

Human endogenous retroviruses in neurologic disease.

Science.gov (United States)

Christensen, Tove

2016-01-01

Endogenous retroviruses are pathogenic - in other species than the human. Disease associations for Human Endogenous RetroViruses (HERVs) are emerging, but so far an unequivocal pathogenetic cause-effect relationship has not been established. A role for HERVs has been proposed in neurological and neuropsychiatric diseases as diverse as multiple sclerosis (MS) and schizophrenia (SCZ). Particularly for MS, many aspects of the activation and involvement of specific HERV families (HERV-H/F and HERV-W/MSRV) have been reported, both for cells in the circulation and in the central nervous system. Notably envelope genes and their gene products (Envs) appear strongly associated with the disease. For SCZ, for ALS, and for HIV-associated dementia (HAD), indications are accumulating for involvement of the HERV-K family, and also HERV-H/F and/or HERV-W. Activation is reasonably a prerequisite for causality as most HERV sequences remain quiescent in non-pathological conditions, so the importance of regulatory pathways and epigenetics involved in regulating HERV activation, derepression, and also involvement of retroviral restriction factors, is emerging. HERV-directed antiretrovirals have potential as novel therapeutic paradigms in neurologic disease, particularly in MS. The possible protective or ameliorative effects of antiretroviral therapy in MS are substantiated by reports that treatment of HIV infection may be associated with a significantly decreased risk of MS. Further studies of HERVs, their role in neurologic diseases, and their potential as therapeutic targets are essential. © 2016 APMIS. Published by John Wiley & Sons Ltd.

Introduction to Focus Issue: Rhythms and Dynamic Transitions in Neurological Disease: Modeling, Computation, and Experiment

Energy Technology Data Exchange (ETDEWEB)

Kaper, Tasso J., E-mail: tasso@bu.edu; Kramer, Mark A., E-mail: mak@bu.edu [Department of Mathematics and Statistics, Boston University, Boston, Massachusetts 02215 (United States); Rotstein, Horacio G., E-mail: horacio@njit.edu [Department of Mathematical Sciences, New Jersey Institute of Technology, Newark, New Jersey 07102 (United States)

2013-12-15

Rhythmic neuronal oscillations across a broad range of frequencies, as well as spatiotemporal phenomena, such as waves and bumps, have been observed in various areas of the brain and proposed as critical to brain function. While there is a long and distinguished history of studying rhythms in nerve cells and neuronal networks in healthy organisms, the association and analysis of rhythms to diseases are more recent developments. Indeed, it is now thought that certain aspects of diseases of the nervous system, such as epilepsy, schizophrenia, Parkinson's, and sleep disorders, are associated with transitions or disruptions of neurological rhythms. This focus issue brings together articles presenting modeling, computational, analytical, and experimental perspectives about rhythms and dynamic transitions between them that are associated to various diseases.

Introduction to Focus Issue: Rhythms and Dynamic Transitions in Neurological Disease: Modeling, Computation, and Experiment

International Nuclear Information System (INIS)

Kaper, Tasso J.; Kramer, Mark A.; Rotstein, Horacio G.

2013-01-01

Rhythmic neuronal oscillations across a broad range of frequencies, as well as spatiotemporal phenomena, such as waves and bumps, have been observed in various areas of the brain and proposed as critical to brain function. While there is a long and distinguished history of studying rhythms in nerve cells and neuronal networks in healthy organisms, the association and analysis of rhythms to diseases are more recent developments. Indeed, it is now thought that certain aspects of diseases of the nervous system, such as epilepsy, schizophrenia, Parkinson's, and sleep disorders, are associated with transitions or disruptions of neurological rhythms. This focus issue brings together articles presenting modeling, computational, analytical, and experimental perspectives about rhythms and dynamic transitions between them that are associated to various diseases

Cardiomyopathy in neurological disorders.

Science.gov (United States)

Finsterer, Josef; Stöllberger, Claudia; Wahbi, Karim

2013-01-01

According to the American Heart Association, cardiomyopathies are classified as primary (solely or predominantly confined to heart muscle), secondary (those showing pathological myocardial involvement as part of a neuromuscular disorder) and those in which cardiomyopathy is the first/predominant manifestation of a neuromuscular disorder. Cardiomyopathies may be further classified as hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or unclassified cardiomyopathy (noncompaction, Takotsubo-cardiomyopathy). This review focuses on secondary cardiomyopathies and those in which cardiomyopathy is the predominant manifestation of a myopathy. Any of them may cause neurological disease, and any of them may be a manifestation of a neurological disorder. Neurological disease most frequently caused by cardiomyopathies is ischemic stroke, followed by transitory ischemic attack, syncope, or vertigo. Neurological disease, which most frequently manifests with cardiomyopathies are the neuromuscular disorders. Most commonly associated with cardiomyopathies are muscular dystrophies, myofibrillar myopathies, congenital myopathies and metabolic myopathies. Management of neurological disease caused by cardiomyopathies is not at variance from the same neurological disorders due to other causes. Management of secondary cardiomyopathies is not different from that of cardiomyopathies due to other causes either. Patients with neuromuscular disorders require early cardiologic investigations and close follow-ups, patients with cardiomyopathies require neurological investigation and avoidance of muscle toxic medication if a neuromuscular disorder is diagnosed. Which patients with cardiomyopathy profit most from primary stroke prevention is unsolved and requires further investigations. Copyright © 2013 Elsevier Inc. All rights reserved.

Predominance of neurologic diseases in international aeromedical transportation.

Science.gov (United States)

Chen, Wan-Lin; Lin, Yu-Ming; Ma, Hong-Ping; Chiu, Wen-Ta; Tsai, Shin-Han

2009-12-01

International travel industry in Taiwan is expanding. The number of people traveling abroad was approximately 480,000 people in 1980; 2,940,000 in 1990; 7,320,000 in 2000, and in 2007, it has reached 8,960,000, which was more than one third of total population. Air medical transportation will be necessary when local medical facilities do not approximate the international standards. No previous study on epidemiology in Taiwan on patients received international medical repatriation. This is the first report to discuss the epidemiology of Taiwan's international aeromedical transportation and its focus on neurologic diseases. Retrospective analysis of all international aeromedical transports on Taiwanese patients from October 2005 to September 2007 was performed. All materials were collected from the databank of International SOS, Taipei. The data were analyzed with Microsoft Excel and SPSS v. 11.0 software (SPSS, Chicago, Ill). A total of 416 patients were transported. Excluding expatriates transported outbound and 2-stage inbound transports, the Taiwanese patient number with international aeromedical transport was 379; 51 by air ambulance and 328 commercially. There were 271 male (72%) and 108 female patients (18%). Of the 379 patients, 178 (47%) were neurologic diseases. Two hundred ninety-five (78%) patients were transported from China. Patient transports peaked in autumn by 105 (28%). Of all 33 ventilated patients, 12 (36%) were neurologic diseases. In-flight complications occurred in 10% of neurologic and 2% of nonneurologic cases. No in-flight mortality occurred in both groups. Neurologic diseases comprise most of the Taiwanese patients that requires medical transportation. With relatively suboptimal medical standard and high medical expenses in China, patients with neurologic conditions need timely and safe aeromedical transport than those with other diseases. Transport of patients with neurologic diseases, either by air ambulance or commercial flights, can

Neuronal CCL2 is upregulated during hepatic encephalopathy and contributes to microglia activation and neurological decline.

Science.gov (United States)

McMillin, Matthew; Frampton, Gabriel; Thompson, Michelle; Galindo, Cheryl; Standeford, Holly; Whittington, Eric; Alpini, Gianfranco; DeMorrow, Sharon

2014-07-10

Acute liver failure leads to systemic complications with one of the most dangerous being a decline in neurological function, termed hepatic encephalopathy. Neurological dysfunction is exacerbated by an increase of toxic metabolites in the brain that lead to neuroinflammation. Following various liver diseases, hepatic and circulating chemokines, such as chemokine ligand 2 (CCL2), are elevated, though their effects on the brain following acute liver injury and subsequent hepatic encephalopathy are unknown. CCL2 is known to activate microglia in other neuropathies, leading to a proinflammatory response. However, the effects of CCL2 on microglia activation and the pathogenesis of hepatic encephalopathy following acute liver injury remain to be determined. Hepatic encephalopathy was induced in mice via injection of azoxymethane (AOM) in the presence or absence of INCB 3284 dimesylate (INCB), a chemokine receptor 2 inhibitor, or C 021 dihydrochloride (C021), a chemokine receptor 4 inhibitor. Mice were monitored for neurological decline and time to coma (loss of all reflexes) was recorded. Tissue was collected at coma and used for real-time PCR, immunoblots, ELISA, or immunostaining analyses to assess the activation of microglia and consequences on pro-inflammatory cytokine expression. Following AOM administration, microglia activation was significantly increased in AOM-treated mice compared to controls. Concentrations of CCL2 in the liver, serum, and cortex were significantly elevated in AOM-treated mice compared to controls. Systemic administration of INCB or C021 reduced liver damage as assessed by serum liver enzyme biochemistry. Administration of INCB or C021 significantly improved the neurological outcomes of AOM-treated mice, reduced microglia activation, reduced phosphorylation of ERK1/2, and alleviated AOM-induced cytokine upregulation. These findings suggest that CCL2 is elevated systemically following acute liver injury and that CCL2 is involved in both the

Need for palliative care for neurological diseases.

Science.gov (United States)

Provinciali, Leandro; Carlini, Giulia; Tarquini, Daniela; Defanti, Carlo Alberto; Veronese, Simone; Pucci, Eugenio

2016-10-01

The new concept of palliative care supports the idea of palliation as an early approach to patients affected by disabling and life-limiting disease which focuses on the patient's quality of life along the entire course of disease. This model moves beyond the traditional concept of palliation as an approach restricted to the final stage of disease and widens the fields of intervention. There is a growing awareness of the importance of palliative care not only in oncological diseases but also in many other branches of medicine, and it appears particularly evident in the approach to many of the most frequent neurological diseases that are chronic, incurable and autonomy-impairing illnesses. The definition and implementation of palliative goals and procedures in neurology must take into account the specific features of these conditions in terms of the complexity and variability of symptoms, clinical course, disability and prognosis. The realization of an effective palliative approach to neurological diseases requires specific skills and expertise to adapt the concept of palliation to the peculiarities of these diseases; this approach should be realized through the cooperation of different services and the action of a multidisciplinary team in which the neurologist should play a central role to identify and face the patient's needs. In this view, it is paramount for the neurologist to be trained in these issues to promote the integration of palliative care in the care of neurological patients.

Maternal anxiety is related to infant neurological condition, paternal anxiety is not

NARCIS (Netherlands)

Kikkert, Hedwig K.; Middelburg, Karin J.; Hadders-Algra, Mijna

Background: Parental anxiety and stress may have consequences for infant neurological development. Aims: To study relationships between parental anxiety or well-being and infant neurological development approximately one year after birth. Study design: Longitudinal study of a birth cohort of infants

Neurologic manifestations of achondroplasia.

Science.gov (United States)

Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J

2014-01-01

Achondroplasia is the best described and most common form of the congenital short-limbed dwarfing conditions. Achondroplasia is apparent at birth and has a birth prevalence of 1 in 20000-30000 live-born infants. Achondroplasia is inherited as an autosomal dominant condition, although 80% of cases occur sporadically as new events in their families. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3). Patients with achondroplasia should be evaluated by a multidisciplinary team of clinicians including geneticists, neurologists, and orthopedists, since there are numerous bony and neurological complications. The most severe complication results from craniocervical stenosis and medullary and upper spinal cord compression, which can have devastating and even lethal sequelae during early childhood. In subsequent decades, including adolescence, spinal cord and nerve compression are more prominent. The neurological complications of achondroplasia have been recognized in adults for more than a century and are attributed to bony defects, connective tissue structures, or both. Similar neurological complications are now appreciated in infants, young children, and teenagers with achondroplasia. Defective connective tissue elements in achondroplasia frequently lead to ligamentous laxity, which can aggravate the complications associated with bony stenosis. Bony abnormalities are known to cause neurological morbidity and lead to a shortened lifespan. Neurological complications associated with achondroplasia are reviewed, including recommendations for the evaluation and management of these clinical problems. © 2014 Elsevier B.V. All rights reserved.

A focus on adolescence to reduce neurological, mental health and substance-use disability.

Science.gov (United States)

Davidson, Leslie L; Grigorenko, Elena L; Boivin, Michael J; Rapa, Elizabeth; Stein, Alan

2015-11-19

Globally, there is a crucial need to prioritize research directed at reducing neurological, mental health and substance-use disorders in adolescence, which is a pivotal age for the development of self-control and regulation. In adolescence, behaviour optimally advances towards adaptive long-term goals and suppresses conflicting maladaptive short-lived urges to balance impulsivity, exploration and defiance, while establishing effective societal participation. When self-control fails to develop, violence, injury and neurological, mental health and substance-use disorders can result, further challenging the development of self-regulation and impeding the transition to a productive adulthood. Adolescent outcomes, positive and negative, arise from both a life-course perspective and within a socioecological framework. Little is known about the emergence of self-control and regulation in adolescents in low- and middle-income countries where enormous environmental threats are more common (for example, poverty, war, local conflicts, sex trafficking and slavery, early marriage and/or pregnancy, and the absence of adequate access to education) than in high-income countries and can threaten optimal neurodevelopment. Research must develop or adapt appropriate assessments of adolescent ability and disability, social inclusion and exclusion, normative development, and neurological, mental health and substance-use disorders. Socioecological challenges in low- and middle-income countries require innovative strategies to prevent mental health, neurological and substance-use disorders and develop effective interventions for adolescents at risk, especially those already living with these disorders and the consequent disability.

Quality improvement in neurology: AAN Parkinson disease quality measures

Science.gov (United States)

Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

2010-01-01

Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

Adult neurology training during child neurology residency.

Science.gov (United States)

Schor, Nina F

2012-08-21

As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

Directory of Open Access Journals (Sweden)

Alberto Nicodemo

2014-01-01

Full Text Available Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible.

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

Science.gov (United States)

Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

2014-01-01

Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this study we report our experience on surgical treatment of adult hip flexion contracture due to neurological diseases; we have tried to outline an algorithm to choose the best treatment avoiding useless or too aggressive therapies. We present 5 cases of adult hips flexion due to neurological conditions treated following our algorithm. At 1-year-follow-up all patients had a good clinical outcome in terms of hip range of motion, pain and recovery of walking if possible. In conclusion we think that this algorithm could be a good guideline to treat these complex cases even if we need to treat more patients to confirm this theory. We believe also that postoperation physiotherapy it is useful in hip motility preservation, improvement of muscular function, and walking ability recovery when possible. PMID:24707293

Apollo’s gift: new aspects of neurologic music therapy

Science.gov (United States)

Altenmüller, Eckart; Schlaug, Gottfried

2015-01-01

Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music’s ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms. PMID:25725918

Practical approach to management of respiratory complications in neurological disorders

Directory of Open Access Journals (Sweden)

Mangera Z

2012-03-01

Full Text Available Zaheer Mangera, Kirat Panesar, Himender MakkerRespiratory Medicine, North Middlesex University Hospital, London, UKAbstract: Patients with certain neurological diseases are at increased risk of developing chest infections as well as respiratory failure due to muscular weakness. In particular, patients with certain neuromuscular disorders are at higher risk. These conditions are often associated with sleep disordered breathing. It is important to identify patients at risk of respiratory complications early in the course of their disease, although patients with neuromuscular disorders often present in the acute setting with respiratory involvement. This review of the respiratory complications of neurological disorders, with a particular focus on neuromuscular disorders, explores why this happens and looks at how to recognize, investigate, and manage these patients effectively.Keywords: respiratory failure, respiratory muscle weakness

Apollo's gift: new aspects of neurologic music therapy.

Science.gov (United States)

Altenmüller, Eckart; Schlaug, Gottfried

2015-01-01

Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms. © 2015 Elsevier B.V. All rights reserved.

Effects of music and music therapy on mood in neurological patients

Science.gov (United States)

Raglio, Alfredo; Attardo, Lapo; Gontero, Giulia; Rollino, Silvia; Groppo, Elisabetta; Granieri, Enrico

2015-01-01

Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders with a prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson’s disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy (MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on PubMed and PsycInfo databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson’s Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients. PMID:25815256

Effects of music and music therapy on mood in neurological patients.

Science.gov (United States)

Raglio, Alfredo; Attardo, Lapo; Gontero, Giulia; Rollino, Silvia; Groppo, Elisabetta; Granieri, Enrico

2015-03-22

Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders with a prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson's disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional association between depression and neurological disorders may be possible being that depressive syndromes may be considered as a risk factor for certain neurological diseases. Despite the large amount of evidence regarding the effects of music therapy (MT) and other musical interventions on different aspects of neurological disorders, no updated article reviewing outcomes such as mood, emotions, depression, activity of daily living and so on is actually available; for this reason, little is known about the effectiveness of music and MT on these important outcomes in neurological patients. The aim of this article is to provide a narrative review of the current literature on musical interventions and their effects on mood and depression in patients with neurological disorders. Searching on PubMed and PsycInfo databases, 25 studies corresponding to the inclusion criteria have been selected; 11 of them assess the effects of music or MT in Dementia, 9 explore the efficacy on patients with Stroke, and 5 regard other neurological diseases like Multiple Sclerosis, Amyotrophic Lateral Sclerosis/motor neuron disease, Chronic quadriplegia, Parkinson's Disease, and Acquired Brain dysfunctions. Selected studies are based on relational and rehabilitative music therapy approaches or concern music listening interventions. Most of the studies support the efficacy of MT and other musical interventions on mood, depressive syndromes, and quality of life on neurological patients.

Neurological abnormalities predict disability

DEFF Research Database (Denmark)

Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

2014-01-01

To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

Neurology and neurologic practice in China.

Science.gov (United States)

Shi, Fu-Dong; Jia, Jian-Ping

2011-11-29

In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions.

Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.

Science.gov (United States)

Pearl, Phillip L; McConnell, Emily R; Fernandez, Rosamary; Brooks-Kayal, Amy

2014-09-01

The optimal academic home for child neurology programs between adult neurology versus pediatric departments remains an open question. The Professors of Child Neurology, the national organization of child neurology department chairs, division chiefs, and training program directors, was surveyed to evaluate the placement of child neurology programs. Professors of Child Neurology members were surveyed regarding the placement of child neurology programs within adult neurology versus pediatric departments. Questions explored academic versus clinical lines of reporting and factors that may be advantages and disadvantages of these affiliations. Issues also addressed were the current status of board certification and number of clinics expected in academic child neurology departments. Of 120 surveys sent, 95 responses were received (79% response rate). The primary academic affiliation is in neurology in 54% of programs versus 46% in pediatrics, and the primary clinical affiliation is 45% neurology and 55% pediatrics. Advantages versus disadvantages of one's primary affiliation were similar whether the primary affiliation was in neurology or pediatrics. While 61% of respondents are presently board certified in pediatrics, only 2% of those with time-limited certification in general pediatrics plan to be recertified going forward. Typically six to eight half-day clinics per week are anticipated for child neurologists in academic departments without additional funding sources. Overall, leaders of child neurology departments and training programs would not change their affiliation if given the opportunity. Advantages and disadvantages associated with current affiliations did not change whether child neurology was located in neurology or pediatrics. Board certification by the American Board of Psychiatry and Neurology in child neurology is virtually universal, whereas pediatric board certification by the American Board of Pediatrics is being maintained by very few. Most academic

Serotonin and conditioning: focus on Pavlovian psychostimulant drug conditioning.

Science.gov (United States)

Carey, Robert J; Damianopoulos, Ernest N

2015-04-01

Serotonin containing neurons are located in nuclei deep in the brainstem and send axons throughout the central nervous system from the spinal cord to the cerebral cortex. The vast scope of these connections and interactions enable serotonin and serotonin analogs to have profound effects upon sensory/motor processes. In that conditioning represents a neuroplastic process that leads to new sensory/motor connections, it is apparent that the serotonin system has the potential for a critical role in conditioning. In this article we review the basics of conditioning as well as the serotonergic system and point up the number of non-associative ways in which manipulations of serotonin neurotransmission have an impact upon conditioning. We focus upon psychostimulant drug conditioning and review the contribution of drug stimuli in the use of serotonin drugs to investigate drug conditioning and the important impact drug stimuli can have on conditioning by introducing new sensory stimuli that can create or mask a CS. We also review the ways in which experimental manipulations of serotonin can disrupt conditioned behavioral effects but not the associative processes in conditioning. In addition, we propose the use of the recently developed memory re-consolidation model of conditioning as an approach to assess the possible role of serotonin in associative processes without the complexities of performance effects related to serotonin treatment induced alterations in sensory/motor systems. Copyright © 2014 Elsevier B.V. All rights reserved.

"I'm still me - I'm still here!" Understanding the person's sense of self in the provision of self-management support for people with progressive neurological long-term conditions.

Science.gov (United States)

Kulnik, Stefan Tino; Hollinshead, Lucinda; Jones, Fiona

2018-01-11

There is increasing interest in tailoring self-management support, but little detail is available on the relevance and impact of such approaches for people with progressive neurological conditions. The aim of this study was to draw on individuals' experiences to inform the practice of self-management support for these groups. Community rehabilitation service users were purposively recruited and took part in in-depth qualitative interviews. Interviews were audio-recorded and transcribed. Data analysis was iterative and interpretative, taking a phenomenological approach. Strategies to enhance rigor were auditability, peer review, and researcher reflexivity. The sample consisted of 10 adults (age 20-79 years) who were living with a range of progressive neurological conditions. Individuals demonstrated resourcefulness in developing practice-based self-management strategies. Beyond practical strategies, interviewees' experiences were signified by reflecting on and upholding a sense of identity and a desire for purpose against the background of losses and gains over time. Linking with this overarching theme of "Sense of self" were aspects of "My body and mind", "Time", "Space", "Relationships", and "What I do". Self-management approaches for individuals with progressive neurological conditions will benefit from incorporating ways of recognizing, articulating, and supporting the person's sense of identity and purpose. Implications for rehabilitation Self-management approaches for people with progressive neurological conditions need to take account of individuals' wishes to contribute, connect with others, and be valued as a person. Person-centred self-management support can be realized through a broader approach than solely managing disease progression. The experiences and words of people with progressive neurological conditions can be used to inform meaningful evaluation of self-management support to drive service delivery by measuring what really matters

Breastfeeding and neurological outcome at 42 months

NARCIS (Netherlands)

Patandin, S; Weisglas-Kuperus, N; Touwen, BCL; Boersma, ER

1998-01-01

This study investigated the effect of early feeding mode on the neurological condition at 42 months. For this purpose, healthy pregnant women were recruited in Groningen and Rotterdam, The Netherlands. Children were healthy and born at term. At 42 months, the children were neurologically examined by

Neurological examination in small animals

Directory of Open Access Journals (Sweden)

Viktor Paluš

2014-03-01

Full Text Available This clinical review about the neurological examination in small animals describes the basics about the first steps of investigation when dealing with neurological patients. The knowledge of how to perform the neurological examination is important however more important is how to correctly interpret these performed tests. A step-by-step approach is mandatory and examiners should master the order and the style of performing these tests. Neurological conditions can be sometimes very distressing for owners and for pets that might not be the most cooperating. The role of a veterinary surgeon, as a professional, is therefore to collect the most relevant history, to examine a patient in a professional manner and to give to owners an educated opinion about the further treatment and prognosis. However neurological examinations might look challenging for many. But it is only the clinical application of neuroanatomy and neurophysiology to an every-day situation for practicing veterinarians and it does not require any specific in-to-depth knowledge. This clinical review is aimed not only to provide the information on how to perform the neurological examination but it is also aimed to appeal on veterinarians to challenge their daily routine and to start practicing on neurologically normal patients. This is the best and only way to differentiate between the normal and abnormal in a real situation.

Historical perspective of Indian neurology.

Science.gov (United States)

Mishra, Shrikant; Trikamji, Bhavesh; Singh, Sandeep; Singh, Parampreet; Nair, Rajasekharan

2013-10-01

To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. THE HISTORY OF NEUROLOGY IN INDIA IS DIVIDED INTO TWO PERIODS: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C.) during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20(th) century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation's first allopathic medical colleges located in Madras (1835), Calcutta (1835) and Mumbai (1848). Prior to India's independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI). Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN). Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930's. Early pioneers and founders of the NSI (1951) include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991). The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in the amount of basic, clinical and epidemiological research being

Primary care perceptions of neurology and neurology services.

Science.gov (United States)

Loftus, Angela M; Wade, Carrie; McCarron, Mark O

2016-06-01

Neurophobia (fear of neural sciences) and evaluation of independent sector contracts in neurology have seldom been examined among general practitioners (GPs). A questionnaire determined GPs' perceptions of neurology compared with other medical specialties. GP experiences of neurology services with independent sector companies and the local National Health Service (NHS) were compared. Areas of potential improvement in NHS neurology services were recorded from thematic analyses. Among 76 GPs neurology was perceived to be as interesting as other medical specialties. GPs reported less knowledge, more difficulty and less confidence in neurology compared with other medical specialties. There was a preference for a local NHS neurology service (pneurology services provided better patient satisfaction. GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Has clinical activity in paediatric neurology changed in the past 11 years?

Science.gov (United States)

Martínez Menéndez, B; Escolar Escamilla, E; Pinel González, A; Cerezo García, M; Martínez Sarries, F J; Morlán Gracia, L

We believe that the demand for paediatric neurology (PN) care has increased over the past decade, and that reasons for requesting consultations have also changed. The objective of this study is to complete a registry study to profile the demand for PN care in 2013 and compare results to those from a study performed in 2002. A prospective registry of PN healthcare activities was completed at Hospital Universitario de Getafe in 2013. Results were compared with those from a prospective registry study conducted in 2002. The number of visits increased from 1,300 in 2002 to 1,982 in 2013 (a 52.46% increase), and from 32.6 visits per 1,000 children to 57.48 (a 76.32% increase). Outpatient consultations accounted for 92.2% of all PN consultations in 2013. Currently, attention deficit-hyperactivity disorder (ADHD) is the most frequent diagnosis (27.6% in 2013 vs. 8.1% in 2002). Although the percentage of headache consultations has decreased (19% in 2013 vs. 22% in 2002), headache was still the most common reason for an initial visit in 2013 (32.1%), followed by ADHD (19.1%). Epilepsy remains the most frequent diagnosis in hospitalised patients (30.3% in 2013 vs. 36.7% in 2002). PN is fundamentally an outpatient activity that has increased considerably in recent years. This increase is mainly due to neurodevelopmental disorders, especially ADHD. We might state that the role of ADHD in PN is comparable to that of dementia in general neurology. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

The Effectiveness of Singing or Playing a Wind Instrument in Improving Respiratory Function in Patients with Long-Term Neurological Conditions: A Systematic Review.

Science.gov (United States)

Ang, Kexin; Maddocks, Matthew; Xu, Huiying; Higginson, Irene J

2017-03-01

Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care. To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions. Systematic review of published randomized controlled trials and observational studies examining singing or playing wind instruments to improve respiratory function in individuals with long-term neurological conditions. Articles meeting specified inclusion criteria were identified through a search of the Medline, Embase, PsycINFO, Cochrane Library, CINAHL, Web of Science, CAIRSS for Music, WHO International Clinical Trials Registry Platform Search Portal, and AMED databases as early as 1806 through March 2015. Information on study design, clinical populations, interventions, and outcome measures was extracted and summarized using an electronic standardized coding form. Methodological quality was assessed and summarized across studies descriptively. From screening 584 references, 68 full texts were reviewed and five studies included. These concerned 109 participants. The studies were deemed of low quality, due to evidence of bias, in part due to intervention complexity. No adverse effects were reported. Overall, there was a trend toward improved respiratory function, but only one study on Parkinson's disease had significant between-group differences. The positive trend in respiratory function in people with long-term neurological conditions following singing or wind instrument therapy is of interest, and warrants further investigation. © the American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

The Role of Magnesium in Neurological Disorders

Directory of Open Access Journals (Sweden)

Anna E. Kirkland

2018-06-01

Full Text Available Magnesium is well known for its diverse actions within the human body. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. It also functions in a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity, and has been implicated in multiple neurological disorders. Due to these important functions within the nervous system, magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders. Current literature is reviewed for migraine, chronic pain, epilepsy, Alzheimer’s, Parkinson’s, and stroke, as well as the commonly comorbid conditions of anxiety and depression. Previous reviews and meta-analyses are used to set the scene for magnesium research across neurological conditions, while current research is reviewed in greater detail to update the literature and demonstrate the progress (or lack thereof in the field. There is strong data to suggest a role for magnesium in migraine and depression, and emerging data to suggest a protective effect of magnesium for chronic pain, anxiety, and stroke. More research is needed on magnesium as an adjunct treatment in epilepsy, and to further clarify its role in Alzheimer’s and Parkinson’s. Overall, the mechanistic attributes of magnesium in neurological diseases connote the macromineral as a potential target for neurological disease prevention and treatment.

Disregard of neurological impairments associated with neglected tropical diseases in Africa

Directory of Open Access Journals (Sweden)

Emmanuel Quansah

2016-06-01

Full Text Available Neglected tropical diseases (NTDs affect people in the bottom billion poorest in the world. These diseases are concentrated in rural areas, conflict zones and urban slums in Africa and other tropical areas. While the World Health Organization recognizes seventeen priority NTDs, the list of conditions present in Africa and elsewhere that are eligible to be classified as NTDs is much longer. Although NTDs are generally marginalized, their associated neurological burden has been almost completely disregarded. However, reports indicate that trichuriasis, schistosomiasis and hookworm infection, among others, cause impairments in memory and cognition, negatively affecting school attendance rates and educational performance particularly among children, as well as agricultural productivity among adults. Consequently, the neurological impairments have substantial influence on education and economic productivity, thus aggravating and perpetuating poverty in affected societies. However, inadequate research, policy and public health attention has been paid to the neurological burdens associated with NTDs. In order to appropriately address these burdens, we recommend the development of policy interventions that focus on the following areas: (i the introduction of training programs to develop the capacity of scientists and clinicians in research, diagnostic and treatment approaches (ii the establishment of competitive research grant schemes to fund cutting-edge research into these neurological impairments, and (iii the development of public health interventions to improve community awareness of the NTD-associated neurological problems, possibly enhancing disease prevention and expediting treatment.

Koumine exhibits anxiolytic properties without inducing adverse neurological effects on functional observation battery, open-field and Vogel conflict tests in rodents.

Science.gov (United States)

Chen, Chao-Jie; Zhong, Zhi-Feng; Xin, Zhi-Ming; Hong, Long-Hui; Su, Yan-Ping; Yu, Chang-Xi

2017-04-01

Koumine, an active alkaloid of neurotoxic plant Gelsemium, has been focused on its therapeutic uses, especially in central nervous system. Nevertheless, less is known about the neurological effects of koumine, which hampers its potential therapeutic exploitation. Moreover, as the anxiolytic potential of Gelsemium has raised many critical issues, its active principles on the anxiolytic and other neurological effects need to be further investigated. Here, we used functional observation battery (FOB) of mice to systematically measure the neurological effects of koumine at the effective doses, and then further confirmed its anxiolytic properties in open-field test (OFT) of mice and Vogel conflict test (VCT) of rats. Koumine exhibited anxiolytic-like activities but did not affect other autonomic, neurological and physical functions in FOB. Furthermore, koumine released anxiolytic responses and anti-punishment action in a manner similar to diazepam in OFT and VCT, respectively. The results constitutes solid set of fundamental data further demonstrating anxiolytic properties of koumine at the therapeutic doses without inducing adverse neurological effects, which supports the perspectives for the development of safe and effective koumine medicine against pathological anxiety.

Circular RNA: a new star in neurological diseases.

Science.gov (United States)

Li, Tao-Ran; Jia, Yan-Jie; Wang, Qun; Shao, Xiao-Qiu; Lv, Rui-Juan

2017-08-01

Circular RNAs (circRNAs) are novel endogenous non-coding RNAs characterized by the presence of a covalent bond linking the 3' and 5' ends generated by backsplicing. In this review, we summarize a number of the latest theories regarding the biogenesis, properties and functions of circRNAs. Specifically, we focus on the advancing characteristics and functions of circRNAs in the brain and neurological diseases. CircRNAs exhibit the characteristics of species conservation, abundance and tissue/developmental-stage-specific expression in the brain. We also describe the relationship between circRNAs and several neurological diseases and highlight their functions in neurological diseases.

Historical perspective of Indian neurology

Directory of Open Access Journals (Sweden)

Shrikant Mishra

2013-01-01

Full Text Available Objective: To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. Background: The history of neurology in India is divided into two periods: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C. during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20 th century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation′s first allopathic medical colleges located in Madras (1835, Calcutta (1835 and Mumbai (1848. Prior to India′s independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI. Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN. Design/Methods: Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Results: Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930′s. Early pioneers and founders of the NSI (1951 include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991. The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in

Glia-neuron interactions in neurological diseases: Testing non-cell autonomy in a dish.

Science.gov (United States)

Meyer, Kathrin; Kaspar, Brian K

2017-02-01

For the past century, research on neurological disorders has largely focused on the most prominently affected cell types - the neurons. However, with increasing knowledge of the diverse physiological functions of glial cells, their impact on these diseases has become more evident. Thus, many conditions appear to have more complex origins than initially thought. Since neurological pathologies are often sporadic with unknown etiology, animal models are difficult to create and might only reflect a small portion of patients in which a mutation in a gene has been identified. Therefore, reliable in vitro systems to studying these disorders are urgently needed. They might be a pre-requisite for improving our understanding of the disease mechanisms as well as for the development of potential new therapies. In this review, we will briefly summarize the function of different glial cell types in the healthy central nervous system (CNS) and outline their implication in the development or progression of neurological conditions. We will then describe different types of culture systems to model non-cell autonomous interactions in vitro and evaluate advantages and disadvantages. This article is part of a Special Issue entitled SI: Exploiting human neurons. Copyright © 2016 Elsevier B.V. All rights reserved.

Neurological condition in 18-month-old children perinatally exposed to polychlorinated biphenyls and dioxins

NARCIS (Netherlands)

Huisman, M; KoopmanEsseboom, C; vanderPaauw, CG; Tuinstra, LGMT; Fidler, [No Value; WeisglasKuperus, N; Sauer, PJJ; Boersma, ER; Touwen, BCL

1995-01-01

The neurological optimality of 418 Dutch children was evaluated at the age of 18 months, in order to determine whether prenatal and breast milk mediated exposure to polychlorinated biphenyls (PCBs) and dioxins affected neurological development, Half of the infants were breast-fed, the other half

Neurology as career option among postgraduate medical students

Directory of Open Access Journals (Sweden)

Namit B Gupta

2013-01-01

Full Text Available Background: In the context of inadequacy of neurology workforce in India, it is important to understand factors that post-graduate medical students consider for and against choosing neurology as their career option. Understanding these factors will help in planning strategies to encourage students to pursue a career in neurology. At present, there is a paucity of studies addressing this issue in India. Aims and Objectives: (1 To analyze factors, which post-graduate students consider for and against choosing neurology as a career specialty. (2 To access the level and quality of neurology exposure in the current MBBS and MD curricula. Materials and Methods: Statewide questionnaire based study was conducted in the state of Maharashtra for students eligible to take DM neurology entrance examination (MD Medicine and MD Pediatrics. Results: In this survey, 243 students were enrolled. Factors bringing students to neurology were - intellectual challenge and logical reasoning (72%, inspired by role model teachers (63%, better quality-of-life (51% and scope for independent practice without expensive infrastructure (48%. Factors preventing students from taking neurology were - perception that most neurological diseases are degenerative (78%, neurology is mainly an academic specialty (40%, neurophobia (43% and lack of procedures (57%. Inadequate exposure and resultant lack of self-confidence were common (31%, 70-80%. 84% of the students felt the need for a short term certification course in neurology after MD. Conclusions: To attract more students to neurology, "role model" teachers of neurology could interact and teach students extensively. Neurologists′ efforts to shed their diagnostician′s image and to shift their focus to therapeutics will help change the image of neurology. Out-patient neurology clinics should be incorporated early in the student′s career. Procedures attract students; hence, they should be made conversant with procedures and

Influence of argon on temperature modulation and neurological outcome in hypothermia treated rats following cardiac arrest.

Science.gov (United States)

Brücken, Anne; Bleilevens, Christian; Föhr, Philipp; Nolte, Kay; Rossaint, Rolf; Marx, Gernot; Fries, Michael; Derwall, Matthias

2017-08-01

Combining xenon and mild therapeutic hypothermia (MTH) after cardiac arrest (CA) confers a degree of protection that is greater than either of the two interventions alone. However, xenon is very costly which might preclude a widespread use. We investigated whether the inexpensive gas argon would enhance hypothermia induced neurologic recovery in a similar manner. Following nine minutes of CA and three minutes of cardiopulmonary resuscitation 21 male Sprague-Dawley rats were randomized to receive MTH (33°C for 6h), MTH plus argon (70% for 1h), or no treatment. A first day condition score assessed behaviour, motor activity and overall condition. A neurological deficit score (NDS) was calculated daily for seven days following the experiment before the animals were killed and the brains harvested for histopathological analysis. All animals survived. Animals that received MTH alone showed best overall neurologic function. Strikingly, this effect was abolished in the argon-augmented MTH group, where animals showed worse neurologic outcome being significant in the first day condition score and on day one to three and five in the NDS in comparison to MTH treated rats. Results were reflected by the neurohistopathological analysis. Our study demonstrates that argon augmented MTH does not improve functional recovery after CA in rats, but may even worsen neurologic function in this model. Copyright © 2017 Elsevier B.V. All rights reserved.

Neurology and the Internet: a review.

Science.gov (United States)

Moccia, Marcello; Brigo, Francesco; Tedeschi, Gioacchino; Bonavita, Simona; Lavorgna, Luigi

2018-06-01

Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.

Perinatal pharmacology: applications for neonatal neurology.

Science.gov (United States)

Smits, Anne; Allegaert, Karel

2011-11-01

The principles of clinical pharmacology also apply to neonates, but their characteristics warrant a tailored approach. We focus on aspects of both developmental pharmacokinetics (concentration/time relationship) and developmental pharmacodynamics (concentration/effect relationship) in neonates. We hereby aimed to link concepts used in clinical pharmacology with compound-specific observations (anti-epileptics, analgosedatives) in the field of neonatal neurology. Although in part anecdotal, we subsequently illustrate the relevance of developmental pharmacology in the field of neonatal neurology by a specific intervention (e.g. whole body cooling), specific clinical presentations (e.g. short and long term outcome following fetal exposure to antidepressive agents, the development of new biomarkers for fetal alcohol syndrome) and specific clinical needs (e.g. analgosedation in neonates, excitocytosis versus neuro-apoptosis/impaired synaptogenesis). Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Conservative management of idiopathic anterior atlantoaxial subluxation without neurological deficits in an 83-year-old female: A case report.

Science.gov (United States)

Marchand, Andrée-Anne; Wong, Jessica J

2014-03-01

Atlantoaxial subluxation that is not related to traumatic, congenital, or rheumatological conditions is rare and can be a diagnostic challenge. This case report details a case of anterior atlantoaxial subluxation in an 83-year-old female without history of trauma, congenital, or rheumatological conditions. She presented to the chiropractor with insidious neck pain and headaches, without neurological deficits. Radiographs revealed a widened atlantodental space (measuring 6 mm) indicating anterior atlantoaxial subluxation and potential sagittal atlantoaxial instability. Prompt detection and appropriate conservative management resulted in favourable long-term outcome at 13-months follow-up. Conservative management included education, mobilizations, soft tissue therapy, monitoring for neurological progression, and co-management with the family physician. The purpose of this case report is to heighten awareness of the clinical presentation of idiopathic anterior atlantoaxial subluxation without neurological deficits. Discussion will focus on the incidence, mechanism, clinical presentation, and conservative management of a complex case of anterior atlantoaxial subluxation.

Wikipedia and neurological disorders

NARCIS (Netherlands)

Brigo, Francesco; Igwe, Stanley C.; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, WM

2015-01-01

Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a

Overall biological activity of sensorimotor and visual brain cortex of rabbits with early neurological disorders induced by high doses of γ-radiation

International Nuclear Information System (INIS)

Silin, D.Ya.

1988-01-01

The overall bioelectrical activity of the sensorimotor and visual brain cortex of rabbits was estimated during early neurological impairment caused by 120 Gy gamma irradiation. The characteristic changes were revealed in the amplitude, form, energy spectrum and spatial biopotential synchronization. The changes in the bioelectrical activity of the brain were associated with the clinically displayed stages of the neurological process development

How integrated are neurology and palliative care services? Results of a multicentre mapping exercise.

Science.gov (United States)

van Vliet, Liesbeth M; Gao, Wei; DiFrancesco, Daniel; Crosby, Vincent; Wilcock, Andrew; Byrne, Anthony; Al-Chalabi, Ammar; Chaudhuri, K Ray; Evans, Catherine; Silber, Eli; Young, Carolyn; Malik, Farida; Quibell, Rachel; Higginson, Irene J

2016-05-10

Patients affected by progressive long-term neurological conditions might benefit from specialist palliative care involvement. However, little is known on how neurology and specialist palliative care services interact. This study aimed to map the current level of connections and integration between these services. The mapping exercise was conducted in eight centres with neurology and palliative care services in the United Kingdom. The data were provided by the respective neurology and specialist palliative care teams. Questions focused on: i) catchment and population served; ii) service provision and staffing; iii) integration and relationships. Centres varied in size of catchment areas (39-5,840 square miles) and population served (142,000-3,500,000). Neurology and specialist palliative care were often not co-terminus. Service provisions for neurology and specialist palliative care were also varied. For example, neurology services varied in the number and type of provided clinics and palliative care services in the settings they work in. Integration was most developed in Motor Neuron Disease (MND), e.g., joint meetings were often held, followed by Parkinsonism (made up of Parkinson's Disease (PD), Multiple-System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP), with integration being more developed for MSA and PSP) and least in Multiple Sclerosis (MS), e.g., most sites had no formal links. The number of neurology patients per annum receiving specialist palliative care reflected these differences in integration (range: 9-88 MND, 3-25 Parkinsonism, and 0-5 MS). This mapping exercise showed heterogeneity in service provision and integration between neurology and specialist palliative care services, which varied not only between sites but also between diseases. This highlights the need and opportunities for improved models of integration, which should be rigorously tested for effectiveness.

F-18-fluorodeoxyglucose-positron-emission tomography in neurology

International Nuclear Information System (INIS)

Fazekas, F.; Payer, F.

2002-01-01

Positron emission tomography using F-18-fluorodeoxyglucose (F-18-FDG-PET) is an ideal tool for imaging regional cerebral metabolism as glucose is the most important source of energy for neurons. Under physiologic conditions the pattern of metabolism reflects the state of cerebral activation which can be modulated by various stimuli to investigate cerebral organization. Pathologic conditions usually cause a drop in metabolism because of neuronal inactivity or loss. They can, however, also be associated with an increased rate of glucose metabolism such as in case of active epileptic foci or malignant tumors. As a consequence F-18-FDG-PET has become a valuable functional imaging modality especially for the diagnostic clarification of non-contributory or negative morphologic imaging results. Dementia, pre-surgical evaluation of epilepsy and neurooncology are currently frequent indications for referral to F-18-FDG-PET in neurology. (author)

Male sexual dysfunction and infertility associated with neurological disorders

DEFF Research Database (Denmark)

Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L

2012-01-01

Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperito...... December 2011; doi:10.1038/aja.2011.70....

Rare Neurological Complications After Sleeve Gastrectomy.

Science.gov (United States)

Tabbara, Malek; Carandina, Sergio; Bossi, Manuela; Polliand, Claude; Genser, Laurent; Barrat, Christophe

2016-12-01

Bariatric surgery is considered to be the most effective treatment of morbid obesity and improvement of obesity-related comorbidities, such as type II diabetes. However, both peripheral and central neurological complications can occur after bariatric surgery. Such complications tend to occur more frequently after bypass surgery than after sleeve gastrectomy (SG). The objective of this study was to identify the patients that presented post-operative neurological complications after undergoing SG and describe the incidence, presentation, and management of these complications. This was a retrospective study of 592 cases of SG performed between 2009 and 2014 with a special focus on patients who presented neurological complications. Of the 592 SG cases, only seven (1.18 %) patients presented neurological complications. All patients had uneventful post-operative course, but all reported feeding difficulties, accompanied by severe dysphagia, and rapid weight loss, with a mean weight loss of 35 kg (30-40 kg) 3 months after SG. All patients were readmitted owing to neurological symptoms that included paresthesia, abolition of deep tendon reflexes of the lower limbs, muscle pain, and motor and sensitive deficits in some cases. There were two cases of Wernicke's encephalopathy. All patients were treated for neuropathy secondary to vitamin B1 deficiency and had a significant improvement and/or resolution of their symptoms. Neurological complications after SG are rare and are often preceded by gastrointestinal symptoms, rapid weight loss, and lack of post-operative vitamin supplementation. Re-hospitalization and multidisciplinary team management are crucial to establish the diagnosis and initiate treatment.

Advancing Neurologic Care in the Neonatal Intensive Care Unit with a Neonatal Neurologist

Science.gov (United States)

Mulkey, Sarah B.; Swearingen, Christopher J.

2014-01-01

Neonatal neurology is a growing sub-specialty area. Given the considerable amount of neurologic problems present in the neonatal intensive care unit, a neurologist with expertise in neonates is becoming more important. We sought to evaluate the change in neurologic care in the neonatal intensive care unit at our tertiary care hospital by having a dedicated neonatal neurologist. The period post-neonatal neurologist showed a greater number of neurology consultations (Pneurology encounters per patient (Pneurology became part of the multi-disciplinary team providing focused neurologic care to newborns. PMID:23271754

Canadian Paediatric Neurology Workforce Survey and Consensus Statement.

Science.gov (United States)

Doja, Asif; Orr, Serena L; McMillan, Hugh J; Kirton, Adam; Brna, Paula; Esser, Michael; Tang-Wai, Richard; Major, Philippe; Poulin, Chantal; Prasad, Narayan; Selby, Kathryn; Weiss, Shelly K; Yeh, E Ann; Callen, David Ja

2016-05-01

Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.

Designing and implementing a longitudinal study of children with neurological, genetic or metabolic conditions: charting the territory

Directory of Open Access Journals (Sweden)

Davies Betty

2010-09-01

Full Text Available Abstract Background Children with progressive metabolic, neurological, or chromosomal conditions and their families anticipate an unknown lifespan, endure unstable and often painful symptoms, and cope with erratic emotional and spiritual crises as the condition progresses along an uncertain trajectory towards death. Much is known about the genetics and pathophysiology of these diseases, but very little has been documented about the trajectory of symptoms for children with these conditions or the associated experience of their families. A longitudinal study design will help to close this gap in knowledge. Methods/Design Charting the Territory is a longitudinal descriptive, correlational study currently underway with children 0-19 years who are diagnosed with progressive neurological, metabolic, or chromosomal conditions and their families. The purpose of the study is to determine and document the clinical progression of the condition and the associated bio-psychosocial-spiritual experiences of the parents and siblings age 7-18 years. Approximately 300 families, both newly diagnosed children and those with established conditions, are being recruited in six Canadian cities. Children and their families are being followed for a minimum of 18 months, depending on when they enroll in the study. Family data collection will continue after the child's death if the child dies during the study period. Data collection includes monthly parental assessment of the child's symptoms; an annual functional assessment of the child; and completion of established instruments every 6 months by parents to assess family functioning, marital satisfaction, health status, anxiety, depression, stress, burden, grief, spirituality, and growth, and by siblings to assess coping and health. Impact of participation on parents is assessed after 1 year and at the end of the study. Chart reviews are conducted at enrollment and at the conclusion of the study or at the time of the

Antiinflammatory and neurological activity of pyrithione and related sulfur-containing pyridine N-oxides from Persian shallot (Allium stipitatum)

DEFF Research Database (Denmark)

Krejčová, Petra; Kučerová, Petra; Stafford, Gary Ivan

2014-01-01

ETHNOPHARMACOLOGICAL RELEVANCE: Persian shallot (Allium stipitatum) is a bulbous plant native to Turkey, Iran and Central Asia. It is frequently used in folk medicine for the treatment of a variety of disorders, including inflammation and stress. Antiinflammatory and neurological activities...... of pyrithione and four related sulfur-containing pyridine N-oxides which are prominent constituents of Allium stipitatum were tested. METHODS: The antiinflammatory activity was tested by the ability of the compounds to inhibit cyclooxygenase (COX-1 and COX-2), whereas the neurological activities were evaluated...... by assessing the compounds ability to inhibit monoamine oxidase-A (MAO-A) and acetylcholinesterase (AChE). The compounds׳ affinity for the serotonin transport protein (SERT) and the GABAA-benzodiazepine receptor were also investigated. RESULTS: 2-[(Methylthio)methyldithio]pyridine N-oxide showed very high...

Impact of Organized Sports on Activity, Participation, and Quality of Life in People With Neurologic Disabilities.

Science.gov (United States)

Sahlin, K Barbara; Lexell, Jan

2015-10-01

Physical activity and exercise is the mainstay of chronic disease prevention and health maintenance for all people with and without a disability, and clear evidence exists of the benefits among various populations with neurologic disabilities. However, the potential benefits of organized sports for people with neurologic disabilities are not as well explored. In this narrative review, current evidence regarding the impact of organized sports on activity, participation, and quality of life in people with neurologic disabilities of all ages is summarized, and facilitators of and barriers to participation in sports for this population are discussed. The articles reviewed were divided into 2 sets: (1) children and adolescents and (2) adults. The subjects of almost all of the studies were persons with a spinal cord injury. Children and adolescents with a disability who engaged in sports reported self-concept scores close to those of able-bodied athletes, as well as higher levels of physical activity. Adults with a spinal cord injury who engaged in organized sports reported decreased depression and anxiety, increased life satisfaction, and increased opportunity for gainful employment compared with nonathletic persons with disabilities. General facilitators, regardless of age, were fitness, fun, health, competence, and social aspects, whereas overall barriers were lack of or inappropriate medical advice and facilities, decreased self-esteem, poor finances, dependency on others, and views held by others. The importance of this topic for further research is highlighted, and suggestions for future studies are proposed. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Modern network science of neurological disorders.

Science.gov (United States)

Stam, Cornelis J

2014-10-01

Modern network science has revealed fundamental aspects of normal brain-network organization, such as small-world and scale-free patterns, hierarchical modularity, hubs and rich clubs. The next challenge is to use this knowledge to gain a better understanding of brain disease. Recent developments in the application of network science to conditions such as Alzheimer's disease, multiple sclerosis, traumatic brain injury and epilepsy have challenged the classical concept of neurological disorders being either 'local' or 'global', and have pointed to the overload and failure of hubs as a possible final common pathway in neurological disorders.

Prevalence and Distribution of Neurological Disease in a Neurology ...

African Journals Online (AJOL)

Uche

Annals of Medical and Health Sciences Research – January 2011 – Vol. 1 N0.1. >>>63<<<. Prevalence and Distribution of Neurological Disease in a. Neurology Clinic in Enugu, Nigeria. Onwuekwe IO* and Ezeala-Adikaibe B*. *Neurology Unit, Department of Medicine,. University of Nigeria Teaching Hospital, Enugu, ...

Dysfunctional HCN ion channels in neurological diseases

Directory of Open Access Journals (Sweden)

Jacopo C. DiFrancesco

2015-03-01

Full Text Available Hyperpolarization-activated cyclic nucleotide-gated (HCN channels are expressed as four different isoforms (HCN1-4 in the heart and in the central and peripheral nervous systems. HCN channels are activated by membrane hyperpolarization at voltages close to resting membrane potentials and carry the hyperpolarization-activated current, dubbed If (funny current in heart and Ih in neurons. HCN channels contribute in several ways to neuronal activity and are responsible for many important cellular functions, including cellular excitability, generation and modulation of rhythmic activity, dendritic integration, transmission of synaptic potentials and plasticity phenomena. Because of their role, defective HCN channels are natural candidates in the search for potential causes of neurological disorders in humans. Several data, including growing evidence that some forms of epilepsy are associated with HCN mutations, support the notion of an involvement of dysfunctional HCN channels in different experimental models of the disease. Additionally, some anti-epileptic drugs are known to modify the activity of the Ih current. HCN channels are widely expressed in the peripheral nervous system and recent evidence has highlighted the importance of the HCN2 isoform in the transmission of pain. HCN channels are also present in the midbrain system, where they finely regulate the activity of dopaminergic neurons, and a potential role of these channels in the pathogenesis of Parkinson’s disease has recently emerged. The function of HCN channels is regulated by specific accessory proteins, which control the correct expression and modulation of the neuronal Ih current. Alteration of these proteins can severely interfere with the physiological channel function, potentially predisposing to pathological conditions. In this review we address the present knowledge of the association between HCN dysfunctions and neurological diseases, including clinical, genetic and

Mind-body interventions: applications in neurology.

Science.gov (United States)

Wahbeh, Helané; Elsas, Siegward-M; Oken, Barry S

2008-06-10

Half of the adults in the United States use complementary and alternative medicine with mind-body therapy being the most commonly used form. Neurology patients often turn to their physicians for insight into the effectiveness of the therapies and resources to integrate them into their care. The objective of this article is to give a clinical overview of mind-body interventions and their applications in neurology. Medline and PsychInfo were searched on mind-body therapies and neurologic disease search terms for clinical trials and reviews and published evidence was graded. Meditation, relaxation, and breathing techniques, yoga, tai chi, and qigong, hypnosis, and biofeedback are described. Mind-body therapy application to general pain, back and neck pain, carpal tunnel syndrome, headaches, fibromyalgia, multiple sclerosis, epilepsy, muscular dysfunction, stroke, aging, Parkinson disease, stroke, and attention deficit-hyperactivity disorder are reviewed. There are several conditions where the evidence for mind-body therapies is quite strong such as migraine headache. Mind-body therapies for other neurology applications have limited evidence due mostly to small clinical trials and inadequate control groups.

A holistic approach on the neurological benefits of music.

Science.gov (United States)

Jimenez-Dabdoub, Lily; Catterall, Jenn

2015-09-01

A holistic perspective on human beings allows health carers to achieve an understanding of all the physiological, psychological and social disturbances of the patient as a whole. Through this article we wish to focus on how music has holistic neurological benefits. Music-therapy interventions can be more accessible and even "self-managed" by the patient's relatives. They can reinforce social cohesion, family ties and patients' self-esteem and thus produce a better quality of life. Overall, it is important to consider the benefits that an evolutionary understanding of musical behaviour and a holistic clinical perspective of the role of music may bring for rehabilitation of a wide range of symptoms and conditions.

Magnesium/calcium related neurological disorders in the ALS focus of the Kii Peninsula

International Nuclear Information System (INIS)

Yasui, Masayuki; Yoshida, Munehito; Tamaki, Tetsuya; Taniguchi, Yasunori; Minamide, Akihito; Ota, Kiichiro; Sasajima, Kazuhisa.

1997-01-01

Current epidemiological surveys in the Western Pacific area and Kii Peninsula have suggested that low calcium(Ca), magnesium(Mg) and high aluminum(Al) and manganese(Mn) in river, soil and drinking water may be implicated in the pathogenetic process of amyotrophic lateral sclerosis(ALS) and Parkinsonism-dementia(PD). The condition of unbalanced minerals was experimentally mimicked in this study using rats. Male Wistar rats, weighing 200 g, were maintained for 90 days on the following diets: (A) standard diet, (B) low Ca diet, (C) low Ca-Mg diet, (D) low Ca-Mg diet with high Al. In the groups maintained on unbalanced mineral diets, Ca and Mg contents of the bones were lower than standard diet. On the other hand, Ca content of CNS showed higher values in the unbalanced diet groups than those in the standard diet group. This was determined by neutron activation analysis(NAA) at KUR. Also, Ca content in soft tissues of rats given unbalanced mineral diets was higher than those on standard diet. Mg content of soft tissues and spinal cord of rats was markedly lower in the low Ca-Mg plus high Al diet group than the other three groups as determined by inductively coupled plasma emission spectrometry(ICP). Six Kii cases with amyotrophic lateral sclerosis(ALS) also showed higher Ca and lower Mg contents in the CNS tissues than those of neurologically normal controls. The calcification of the spinal ligaments(CSL) has been reported in only 120 cases in the world and 28 cases of CSL in the Kii Peninsula have been found in the same foci as ALS. We analyzed Mg content of 7 spinal bones and 10 ligaments of the CSL and Ca content of 5 spinal bones compared with controls. The CSL showed lower values of Mg contents in bones and ligaments compared to controls. The Ca content in bones of CSL was significantly lower than that of controls. This suggests that the environmental factor may contribute to the pathogenesis of CSL due to low Ca and Mg intake as well as for ALS. (J.P.N.)

Cervical spinal canal narrowing and cervical neurologi-cal injuries

Directory of Open Access Journals (Sweden)

ZHANG Ling

2012-04-01

Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

Are Established Methods of Physiotherapeutic Management for Long-term Neurological Conditions Applicable to 'Orphan' Conditions such as Syringomyelia?

Science.gov (United States)

Smith, Rebecca; Jones, Gareth; Curtis, Alexandra; Murphy, Hollie; Flint, Graham

2016-03-01

Syringomyelia is a rare or 'orphan' condition with the potential to cause significant disability and detrimental effects to quality of life. Syringomyelia shares similar symptoms to those common in other long-term neurological conditions, including spinal cord injury and multiple sclerosis. In these more prevalent conditions, physiotherapy is utilized widely and is effective in optimizing physical, psychological and social parameters. Therefore, we theorized that physiotherapy might be transferable to, and beneficial to syringomyelia patients. As a paucity of literature exists in this area, we aimed to evaluate the existing uptake and perceived efficacy of physiotherapy. An exploratory, mixed methodology was selected to derive sufficient qualitative data for analysis. Specifically designed questionnaires and semi-structured interviews yielded data on uptake and perceived physiotherapy efficacy. One hundred patients from a National Health Service tertiary syringomyelia service were invited to participate. The questionnaire and interviews were completed by 49 and 20 patients, respectively. Of the small number of patients receiving physiotherapy, the majority reported beneficial effects on pain modulation and quality of life. Stretching and hydrotherapy were deemed effective for relief of pain and stiffness. Additionally, physiotherapy was reported to provide similar benefits to surgical intervention. Syringomyelia patients report physiotherapy to provide benefits for symptom management and quality of life. Such findings suggest that established rehabilitation techniques in more common conditions may be transferable to those less prevalent. Uptake of physiotherapy was limited, seemingly because of inadequate information, knowledge and resources. To address these deficiencies, further studies should be planned investigating the effectiveness of physiotherapy modalities, such as hydrotherapy, in parallel or in conjunction with surgery and/or pharmacology. Additionally

Postulated Role of Vasoactive Neuropeptide-Related Immunopathology of the Blood Brain Barrier and Virchow-Robin Spaces in the Aetiology of Neurological-Related Conditions

Directory of Open Access Journals (Sweden)

D. R. Staines

2008-01-01

Full Text Available Vasoactive neuropeptides (VNs such as pituitary adenylate cyclase-activating polypeptide (PACAP and vasoactive intestinal peptide (VIP have critical roles as neurotransmitters, vasodilators including perfusion and hypoxia regulators, as well as immune and nociception modulators. They have key roles in blood vessels in the central nervous system (CNS including maintaining functional integrity of the blood brain barrier (BBB and blood spinal barrier (BSB. VNs are potent activators of adenylate cyclase and thus also have a key role in cyclic AMP production affecting regulatory T cell and other immune functions. Virchow-Robin spaces (VRSs are perivascular compartments surrounding small vessels within the CNS and contain VNs. Autoimmunity of VNs or VN receptors may affect BBB and VRS function and, therefore, may contribute to the aetiology of neurological-related conditions including multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis. VN autoimmunity will likely affect CNS and immunological homeostasis. Various pharmacological and immunological treatments including phosphodiesterase inhibitors and plasmapheresis may be indicated.

Feasibility of ballistic strengthening exercises in neurologic rehabilitation.

Science.gov (United States)

Williams, Gavin; Clark, Ross A; Hansson, Jessica; Paterson, Kade

2014-09-01

Conventional methods for strength training in neurologic rehabilitation are not task specific for walking. Ballistic strength training was developed to improve the functional transfer of strength training; however, no research has investigated this in neurologic populations. The aim of this pilot study was to evaluate the feasibility of applying ballistic principles to conventional leg strengthening exercises in individuals with mobility limitations as a result of neurologic injuries. Eleven individuals with neurologic injuries completed seated and reclined leg press using conventional and ballistic techniques. A 2 × 2 repeated-measures analysis of variance was used to compare power measures (peak movement height and peak velocity) between exercises and conditions. Peak jump velocity and peak jump height were greater when using the ballistic jump technique rather than the conventional concentric technique (P ballistic principles was associated with increased peak height and peak velocities.

Child neurology residency: system implications of new training models.

Science.gov (United States)

Heiser, Karen

2012-02-01

From limitations on residents' duty hours, to ways in which outcomes are measured, changes to graduate medical education are sweeping the nation. In this issue of the journal, Gilbert and Greenwood present thoughtful, if somewhat disparate, opinions on ways to improve the educational experience of child neurology trainees. As the Designated Institutional Officer of a large children's hospital, I have focused my commentary on "the big picture." That is, what systemwide impact can changes in child neurology trainees' education have.

Neurology cases evaluated by the U.S. Air Force School of Aerospace Medicine 2000-2012.

Science.gov (United States)

Hesselbrock, Roger; Heaton, John

2014-05-01

Historically, neurologic conditions are a major cause for removing aviators from flying status. Early neuropsychiatry studies included psychiatric conditions along with neurologic disorders. Previously reported data specifically addressing neurologic conditions in aviators are limited. And there is little current neurology-specific data reported. A retrospective review was done on patients with diagnoses evaluated by Neurology at the U.S. Air Force School of Aerospace Medicine Aeromedical Consultation Service (ACS) between 2000 and 2012 using ACS records and databases to identify cases. Patient demographics, major diagnoses with associated International Classification of Diseases (9th rev.) codes, and aeromedical disposition recommendations were abstracted into a separate database for analysis. In total, 871 cases were identified. Patients were predominantly male (91%) with average age 34 and were predominantly pilots (69%). The top neurology-related diagnoses found in our series were headaches, head injuries, and radiculopathies. Of the cases evaluated, 570 aviators (65%) were recommended by ACS to return to flying status. Waiver authorities accepted 88% of ACS recommendations. Current patterns in neurologic conditions in the selected population of cases evaluated by the ACS were presented. Of the neurologic diagnoses seen, a novel finding was the prominence of head injuries in our series not seen in previous studies. This may be due to more stringent aeromedical standards with advances in medical practice and underscores that this issue is not just about disability but affects aircrew operational readiness. Most cases of neurologic disease evaluated by the ACS were recommended for return to flying status.

Neurological disorders in Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System.

Science.gov (United States)

Mateen, Farrah J; Carone, Marco; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Al-Saedy, Huda; Lowenstein, Daniel H; Burnham, Gilbert

2012-04-01

The United Nations High Commissioner for Refugees (UNHCR) recognizes 43.7 million forcibly displaced persons and asylum seekers due to conflict and persecution worldwide. Neurological disorders have rarely been described in displaced persons but likely pose a significant burden of disease. We describe the disease spectrum and health service utilization of Iraqi refugees and asylum seekers with neurological disorders using an information system developed by the UNHCR. Neurological disorders were actively monitored among the 7,642 UNHCR-registered Iraqi refugees and asylum seekers who received health and humanitarian assistance using a pilot, centralized, database called the Refugee Assistance Information System (RAIS) in the Kingdom of Jordan in 2010. There were 122 neurological diagnoses reported in 1,328 refugees (mean age 41 years, 49% female, 10% disabled, 43% with pending resettlement applications) in 2,659 health visits, accounting for 17% of all refugees who sought health assistance in RAIS. Referral to a neurologist occurred in 178 cases (13.4%). The most frequent ICD-10 neurological diagnoses were dorsalgia (back pain) (29.7% of individuals with neurological disorders), headache (13.1%), and epilepsy (12.6%). Approximately 1 in 20 Iraqi refugees with a neurological diagnosis self-reported a history of torture, which was higher than Iraqi refugees without a history of torture [66/1,328 versus 196/6,314, odds ratio (OR) = 1.63, 95% confidence interval (CI) 1.21-2.18]. Neurological disease affects a high proportion of Iraqi refugees, including victims of torture and the disabled. Refugees require dedicated care for treatment of neurological disease with a focus on pain disorders and epilepsy.

Association between bullous pemphigoid and neurologic diseases: a case-control study.

Science.gov (United States)

Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

2014-11-01

In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

Severe neurological complication following adjustable gastric banding.

Science.gov (United States)

Martines, G; Musa, N; Aquilino, F; Capuano, P

2018-01-01

In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately. We report the case of a 35 years-old male patient, affected by morbid obesity, anxious-depressive syndrome and alcohol use disorder, who after adjustable gastric banding implanted in another hospital developed a severe malnutrition and neurological syndrome. The patient showed poor adherence to the follow-up and to the dietary indications and after all, we needed to place a PEG for enteral nutrition in order to resolve the malnutrition condition and the neurological syndrome. Our experience emphasizes that preoperative selection and assessment of a patient's nutritional status according to guidelines, is required to identify potential problems, and that bariatric surgeons or physicians caring for patient who have undergone bariatric surgery should be familiar with the constellation of nutritional and neurological disorder that may occur after surgery. We want to remark the importance of preoperative selection of the patients, the follow-up and the cooperation between patient and physician in order to obtain the best result and avoid severe complications.

Neurological manifestations in HIV positive patients in Tehran, Iran

Directory of Open Access Journals (Sweden)

Minoo Mohraz

2014-02-01

Full Text Available Objective: To evaluate the neurological complications among Iranian HIV-positive patients. Methods: This cross-sectional study was conducted among 428 patients diagnosed with HIV infection between 2006 and 2009 at Imam Khomeini hospital, Tehran, Iran. Demographic and clinical variables as well as laboratory tests were extracted and analyzed. Also, another 100 patients refereed to Voluntary Counseling and Testing center of the hospital were visited and evaluated for neurological complications. Results: Among the patients, neurologic manifestations were observed in 34 (7.94% patients. Twenty three percent of the patients received antiretroviral therapy. Identified causes included brain toxoplasmosis (14.7%, progressive multi-focal leuko encephalopathy (5.9%, HIV encephalopathy (5.9%, TB meningitis (5% and unknown etiologies (11.8%. Also, among 100 patients who were admitted and visited at the Voluntary Counseling and Testing center, no one was diagnosed for any neurological manifestations. Conclusions: According to our results, toxoplasmosis is the most frequent cause of neurological conditions among Iranian HIV infected patients and should be considered in any HIV/AIDS patient with neurological manifestations.

European influence on Russian neurology in the eighteenth and nineteenth centuries.

Science.gov (United States)

Shterenshis, Michael; Vaiman, Michael

2007-01-01

In this study we consider the development of clinical neurology in the eighteenth and the nineteenth centuries focusing on European influence on Russian medicine. Russian physicians readily accepted newly described clinical signs, theories, and classification of nervous diseases designed in Europe. This influence initiated neurology's separation from general medicine and its transformation into a new clinical discipline. In Russia this happened already in the 1860s, decades before the similar trend in Europe. The Russian example is nearly unknown in the general history of neurology. It illustrates the relationships between physiology and practical neurology at the moment of establishment of the new discipline. It also shows that the Russian physicians of the time readily accepted European medical knowledge putting it immediately into medical practice and education.

Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

Science.gov (United States)

Demers, Marika; Levin, Mindy F

2017-07-01

Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

Neurological Disorders in Medical Use of Cannabis: An Update.

Science.gov (United States)

Solimini, Renata; Rotolo, Maria Concetta; Pichini, Simona; Pacifici, Roberta

2017-01-01

Medical cannabis is increasingly used as a treatment or adjunct treatment with different levels of efficacy in several neurological disorders or related symptoms (such as multiple sclerosis, autism, Parkinson and Alzheimer disease, Tourette's syndrome, Huntington's disease, neuropathic pain, epilepsy, headache), as well as in other medical conditions (e.g. nausea and vomiting, glaucoma, appetite stimulation, cancer, inflammatory conditions, asthma). Nevertheless, a number of neurological adverse effects from use of medical cannabis on the short- and on the longterm have been reported, in addition to other adverse health events. It has been noticed that the use of medical cannabis can lead to a paradoxical effects depending on the amount of delta-9-tetrahydrocannabinol (THC) -like cannabinoids the preparation contain. Accordingly, some neurological disorders or symptoms (e.g. multiple sclerosis, seizures, epilepsy, headache) may be caused or exacerbated by the same treatment supposed to cure them. The current review presents an update of the neurological adverse effects resulting from the use of cannabis for medical purposes, highlighting the need to weigh the benefits and risks, when using cannabinoidbased treatments. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Neurological implications and neuropsychological considerations on folk music and dance.

Science.gov (United States)

Sironi, Vittorio A; Riva, Michele A

2015-01-01

Neurological and neuropsychological aspects of folk music and traditional dance have been poorly investigated by historical and scientific literature. Some of these performances could be indeed the manifestation of latent pathological conditions or the expression of liberation rituals. This chapter aimed at analyzing the relationships between traditional dance, folk music, and neurological and psychiatric disorders. Since ancient times, dance has been used in the individual or collective as treatment of some diseases, including epilepsy and movement disorders (dyskinesia, chorea, etc.). Dionysia in Ancient Greece, St. Vitus dance in the Middle Age, tarantism and other traditional dances of southern Italy and of non-Western countries might be credited as curative rituals of these neurological and psychiatric conditions. During the nineteenth century, dance was also used for the treatment of psychiatric patients; the relationship between dance and insanity could also be reflected in classical ballets and music of that period. Nowadays, neuropsychiatric manifestations could also be evidenced in modern dances (mass fainting at rock concerts, flash mobs); some ballroom dances are commonly used for the rehabilitation of patients suffering from neurodegenerative and psychiatric conditions. Interdisciplinary research on these subjects (ethnomusicology and cultural anthropology, clinical neurology and dynamic psychology, neuroradiology and neurophysiology, and socioneurology and neuromusicology) should be increased. © 2015 Elsevier B.V. All rights reserved.

What is the Future of Pediatric Neurology in Canada? Resident and Faculty Perceptions of Training and Workforce Issues.

Science.gov (United States)

Doja, Asif; Clarkin, Chantalle; Whiting, Sharon; Moharir, Mahendranath

2016-07-01

Pediatric neurology trainee numbers have grown considerably in Canada; recent research, however, has shown that the number of pediatric neurology graduates is outpacing the need for future pediatric neurologists. The purpose of this study was to seek the opinion of pediatric neurology program directors and trainees regarding possible solutions for this issue. Two focus groups were convened during the Canadian Neurological Sciences Federation annual congress in June 2012; one consisted of current and former program directors, and the other of current pediatric neurology trainees. Groups were asked for their perceptions regarding child neurology manpower issues in Canada as well as possible solutions. Focus groups were audio-recorded and transcribed for analysis. Theme-based qualitative analysis was used to analyze the transcripts. Major themes emerging from both focus groups included the emphasis on community pediatric neurology as a viable option for trainees, including the need for community mentors; recognizing the needs of underserviced areas; and establishing academic positions for community preceptors. The need for career mentoring and support structures during residency training was another major theme which arose. Program directors and trainees also gave examples of ways to reduce the current oversupply of trainees in Canada, including limiting the number of trainees entering programs, as well as creating a long-term vision of child neurology in Canada. A nationwide dialogue to discuss the supply and demand of manpower in academic and community pediatric neurology is essential. Career guidance options for pediatric neurology trainees across the country merit further strengthening.

Standards in Neurological Rehabilitation, June 1997

Directory of Open Access Journals (Sweden)

Michael P. Barnes

1997-01-01

neurological services. We believe that disabled individuals should have access to a regional specialist service as well as a local community service. The regional specialist service would cater for people with more complicated and severe disabilities, including spinal injury and severe brain injury. The regional centres would provide specialist expertise for wheelchairs and special seating, orthotics, continence and urological services, aids and equipment including communication aids and environmental controls, prosthetics and driving assessment. The Task Force additionally endorses the development of local and community based rehabilitation teams with clear links to the regional centre. (6 The Task Force recognizes the limited amount of rehabilitation research and encourages individuals, universities and governments to invest more in rehabilitation research. Such investment should produce benefits for disabled people and their carers and in the long term benefits for the national economy. (7 The Task Force realizes that neurological rehabilitation is poorly developed both in Europe and the world as a whole. We firmly endorse international co-operation in this field and are happy to co-operate with any international organization in order to develop such links for clinical, educational or research initiatives. (8 The Task Force encourages individual countries to produce a document summarizing their own situation with regard to these standards and to produce a timetable for action to improve their situation. The EFNS Task Force would be pleased to assist in the publication of such deliberations or to act as a focus for international education and research or for sharing of examples of good practice.

Little Albert's alleged neurological impairment: Watson, Rayner, and historical revision.

Science.gov (United States)

Digdon, Nancy; Powell, Russell A; Harris, Ben

2014-11-01

In 2012, Fridlund, Beck, Goldie, and Irons (2012) announced that "Little Albert"-the infant that Watson and Rayner used in their 1920 study of conditioned fear (Watson & Rayner, 1920)-was not the healthy child the researchers described him to be, but was neurologically impaired almost from birth. Fridlund et al. also alleged that Watson had committed serious ethical breaches in regard to this research. Our article reexamines the evidentiary bases for these claims and arrives at an alternative interpretation of Albert as a normal infant. In order to set the stage for our interpretation, we first briefly describe the historical context for the Albert study, as well as how the study has been construed and revised since 1920. We then discuss the evidentiary issues in some detail, focusing on Fridlund et al.'s analysis of the film footage of Albert, and on the context within which Watson and Rayner conducted their study. In closing, we return to historical matters to speculate about why historiographical disputes matter and what the story of neurologically impaired Albert might be telling us about the discipline of psychology today.

Cognitive, emotional, and neural benefits of musical leisure activities in aging and neurological rehabilitation: A critical review.

Science.gov (United States)

Särkämö, Teppo

2017-04-28

Music has the capacity to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and is relatively preserved in aging and dementia. Thus, music is a promising tool in the rehabilitation of aging-related neurological illnesses, such as stroke and Alzheimer disease. As the population ages and the incidence and prevalence of these illnesses rapidly increases, music-based interventions that are enjoyable and effective in the everyday care of the patients are needed. In addition to formal music therapy, musical leisure activities, such as music listening and singing, which patients can do on their own or with a caregiver, are a promising way to support psychological well-being during aging and in neurological rehabilitation. This review article provides an overview of current evidence on the cognitive, emotional, and neural effects of musical leisure activities both during normal aging and in the rehabilitation and care of stroke patients and people with dementia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Quantification In Neurology

Directory of Open Access Journals (Sweden)

Netravati M

2005-01-01

Full Text Available There is a distinct shift of emphasis in clinical neurology in the last few decades. A few years ago, it was just sufficient for a clinician to precisely record history, document signs, establish diagnosis and write prescription. In the present context, there has been a significant intrusion of scientific culture in clinical practice. Several criteria have been proposed, refined and redefined to ascertain accurate diagnosis for many neurological disorders. Introduction of the concept of impairment, disability, handicap and quality of life has added new dimension to the measurement of health and disease and neurological disorders are no exception. "Best guess" treatment modalities are no more accepted and evidence based medicine has become an integral component of medical care. Traditional treatments need validation and new therapies require vigorous trials. Thus, proper quantification in neurology has become essential, both in practice and research methodology in neurology. While this aspect is widely acknowledged, there is a limited access to a comprehensive document pertaining to measurements in neurology. This following description is a critical appraisal of various measurements and also provides certain commonly used rating scales/scores in neurological practice.

Neurologic disorders, in-hospital deaths, and years of potential life lost in the USA, 1988-2011.

Science.gov (United States)

Rosenbaum, Benjamin P; Kelly, Michael L; Kshettry, Varun R; Weil, Robert J

2014-11-01

Premature mortality is a public health concern that can be quantified as years of potential life lost (YPLL). Studying premature mortality can help guide hospital initiatives and resource allocation. We investigated the categories of neurologic and neurosurgical conditions associated with in-hospital deaths that account for the highest YPLL and their trends over time. Using the Nationwide Inpatient Sample (NIS), we calculated YPLL for patients hospitalized in the USA from 1988 to 2011. Hospitalizations were categorized by related neurologic principal diagnoses. An estimated 2,355,673 in-hospital deaths accounted for an estimated 25,598,566 YPLL. The traumatic brain injury (TBI) category accounted for the highest annual mean YPLL at 361,748 (33.9% of total neurologic YPLL). Intracerebral hemorrhage, cerebral ischemia, subarachnoid hemorrhage, and anoxic brain damage completed the group of five diagnoses with the highest YPLL. TBI accounted for 12.1% of all inflation adjusted neurologic hospital charges and 22.4% of inflation adjusted charges among neurologic deaths. The in-hospital mortality rate has been stable or decreasing for all of these diagnoses except TBI, which rose from 5.1% in 1988 to 7.8% in 2011. Using YPLL, we provide a framework to compare the burden of premature in-hospital mortality on patients with neurologic disorders, which may prove useful for informing decisions related to allocation of health resources or research funding. Considering premature mortality alone, increased efforts should be focused on TBI, particularly in and related to the hospital setting. Copyright © 2014 Elsevier Ltd. All rights reserved.

Opinion and Special Articles: Neurology education at US osteopathic medical schools.

Science.gov (United States)

Freedman, Daniel A; Albert, Dara V F

2017-12-12

Osteopathic medical schools have a longstanding tradition of training primary care physicians (PCP). Neurologic symptoms are common in the PCP's office and there is an undersupply of neurologists in the United States. It is therefore crucial for osteopathic medical students to have a strong foundation in clinical neurology. Despite the importance, a mere 6% of osteopathic medical schools have required neurology clerkships. Furthermore, exposure to neurology in medical school through required clerkships has been correlated with matching into neurology residency. As osteopathic medical schools continue to expand, it will become increasingly important to emphasize the American Academy Neurology's published guidelines for a core clerkship curriculum. Practicing neurologists should take an active role in encouraging osteopathic medical schools to adopt these guidelines. © 2017 American Academy of Neurology.

Immunization safety review: influenza vaccines and neurological complications

National Research Council Canada - National Science Library

Stratton, Kathleen R

..., unlike other vaccines. The Immunization Safety Review committee reviewed the data on influenza vaccine and neurological conditions and concluded that the evidence favored rejection of a causal relationship...

Global, regional, and national burden of neurological disorders during 1990-2015

DEFF Research Database (Denmark)

2017-01-01

BACKGROUND: Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely...... aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. METHODS: We estimated global and country......-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological...

The charming physician (El médico encantador): neurological conditions in a short story by Silvina Ocampo.

Science.gov (United States)

Delgado-García, Guillermo; Rodríguez-Návarez, Carolina; Estañol, Bruno

2017-11-01

The Argentinian author Silvina Ocampo (1903-1993) left us a vast body of works which are considered outstanding in many ways. In 1960, she published a short story, entitled "El médico encantador" (The Charming Physician), in the renowned literary magazine Sur. The central character of this piece is a family doctor named Albino Morgan, who had a secret truth: in any house he visited, all variety of disease also entered. He brought with him the viruses he disseminated. The narrator of this short story-one of his patients-describes four of Morgan's diseases. These imaginary neurological conditions allowed Ocampo to explore improbable situations in everyday life.

NEUROLOGICAL DIFFERENCES BETWEEN 9-YEAR-OLD CHILDREN FED BREAST-MILK OR FORMULA-MILK AS BABIES

NARCIS (Netherlands)

LANTING, CI; FIDLER, [No Value; HUISMAN, M; TOUWEN, BCL; BOERSMA, ER

1994-01-01

The presence of minor neurological dysfunction is associated with behavioural and cognitive development at school age. We have previously shown a relation between minor neurological dysfunction and perinatal disorders, especially abnormal neonatal neurological condition. We have now investigated the

Neurology in Asia.

Science.gov (United States)

Tan, Chong-Tin

2015-02-10

Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.

Boxers--computed tomography, EEG, and neurological evaluation

International Nuclear Information System (INIS)

Ross, R.J.; Cole, M.; Thompson, J.S.; Kim, K.H.

1983-01-01

During the last three years, 40 ex-boxers were examined to determine the effects of boxing in regard to their neurological status and the computed tomographic (CT) appearance of the brain. Thirty-eight of these patients had a CT scan of the brain, and 24 had a complete neurological examination including an EEG. The results demonstrate a significant relationship between the number of bouts fought and CT changes indicating cerebral atrophy. Positive neurological findings were not significantly correlated with the number of bouts. Electroencephalographic abnormalities were significantly correlated with the number of bouts fought. Computed tomography and EEG of the brain should be considered as part of a regular neurological examination for active boxers and, if possible, before and after each match, to detect not only the effects of acute life-threatening brain trauma such as subdural hematomas and brain hemorrhages, but the more subtle and debilitating long-term changes of cerebral atrophy

Why neurology? Factors which influence career choice in neurology.

Science.gov (United States)

Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V

2016-01-01

To evaluate the factors which influence the decision to pursue a career in neurology. An anonymous survey was developed using a Likert scale to rate responses. The survey was sent to adult and child neurology faculty, residents and fellows, as well as medical students applying for neurology. Descriptive statistics were used to analyse the factors of influence. Respondents were subsequently categorized into pre-neurology trainees, neurology trainees, child neurologists and adult neurologists, and differences between the groups were analysed using Pearson's chi-square test. One hundred and thirty-three anonymous responses were received. The respondents were neurologists across all levels of training and practice. Across all respondents, the most common factor of high importance was intellectual content of specialty, challenging diagnostic problems, type of patient encountered and interest in helping people. Responses were similar across the groups; however, the earliest trainees cited interest in helping people as most important, while those in neurology training and beyond cite intellectual content of the specialty as most important. As trainees transition from their earliest levels of clinical experience into working as residents and faculty, there is a shift in the cited important factors. Lifestyle and financial factors seem to be the least motivating across all groups. Encouragement from peers, mentors, faculty and practicing physicians is considered high influences in a smaller number of neurologists. This may present an opportunity for practicing neurologists to make connections with medical students early in their education in an effort to encourage and mentor candidates.

What do Flaubert, Dostoevsky and Machado de Assis have in common with neurology?

Science.gov (United States)

Vitturi, Bruno Kusznir; Sanvito, Wilson Luiz

2017-12-01

The Frenchman Gustave Flaubert, the Russian Fyodor Dostoevsky and the Brazilian Machado de Assis are known for their immeasurable contributions to literature. However, what most people do not know is that all three authors suffered from epilepsy and were affected by their neurological condition in different ways. We offer a short description of how epilepsy influenced their lives, how they dealt with it and how their neurological condition was present in their novels and correspondence. Their lives are excellent examples of how intimately neurology can be entwined in art and history, and provide an important perspective on patients with epilepsy.

Neurology referrals to a liaison psychiatry service.

LENUS (Irish Health Repository)

Fitzgerald, P

2012-02-03

The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

Radiopharmaceutical Stem Cell Tracking for Neurological Diseases

Directory of Open Access Journals (Sweden)

Paulo Henrique Rosado-de-Castro

2014-01-01

Full Text Available Although neurological ailments continue to be some of the main causes of disease burden in the world, current therapies such as pharmacological agents have limited potential in the restoration of neural functions. Cell therapies, firstly applied to treat different hematological diseases, are now being investigated in preclinical and clinical studies for neurological illnesses. However, the potential applications and mechanisms for such treatments are still poorly comprehended and are the focus of permanent research. In this setting, noninvasive in vivo imaging allows better understanding of several aspects of stem cell therapies. Amongst the various methods available, radioisotope cell labeling has become one of the most promising since it permits tracking of cells after injection by different routes to investigate their biodistribution. A significant increase in the number of studies utilizing this method has occurred in the last years. Here, we review the different radiopharmaceuticals, imaging techniques, and findings of the preclinical and clinical reports published up to now. Moreover, we discuss the limitations and future applications of radioisotope cell labeling in the field of cell transplantation for neurological diseases.

Late sequelae of a non-optimal neonatal neurological condition in ERPs at the age of 11-13 years.

Science.gov (United States)

De Sonneville, L M; Visser, S L; Njiokiktjien, C

1989-06-01

In a longitudinal study a selective attention task was administered to 11-13-year-old children. During this task (employing a combined filter and selective-set paradigm), event-related brain potentials were recorded to study timing and morphology of early and late selection processes. Task performance was prospectively and retrospectively related to neurological optimality at birth and to flash-evoked potential correlates that were registered at the age of five. The results provided evidence that even after 13 years neonatal neurological suboptimality was reflected in task performance, both in reaction time and in electrophysiological data. Task load interacted with group classification according to optimality to the disadvantage of suboptimals. This implied that load demands differentiated between groups. The event-related brain potentials revealed the existence of a negative shift associated with memory load (search-related negativity) at Fz and Cz, and a positive deflection at Pz (P3b) associated with target detection. Cortical activity, expressed in terms of these deflections, appeared to be less pronounced for the suboptimal group.

[Neurology! Adieau? (Part 2)].

Science.gov (United States)

Szirmai, Imre

2010-05-30

The education of neurologists is debilitated worldwide. University professors are engaged in teaching, research and patient-care. This triple challenge is very demanding, and results in permanent insecurity of University employees. To compensate for the insufficient clinical training, some institutes in the USA employ academic staff members exclusively for teaching. The formation of new subspecialties hinders the education and training of general neurologists. At present, four generations of medical doctors are working together in hospitals. The two older generations educate the younger neurologists who have been brought up in the world of limitless network of sterile information. Therefore their manual skills at the bedside and their knowledge of emergency treatment are deficient. Demographics of medical doctors changed drastically. Twice as many women are working in neurology and psychiatry than men. Integrity of neurology is threatened by: (1) Separation of the cerebrovascular diseases from general neurology. Development of "stroke units" was facilitated by the better reimbursement for treatment and by the interest of the pharmaceutical companies. Healthcare politics promoted the split of neurology into two parts. The independent status of "stroke departments" will reduce the rest of clinical neurology to outpatient service. (2) The main argumentation to segregate the rare neurological diseases was that their research will provide benefit for the diseases with high prevalence. This argumentation serves territorial ambitions. The separation of rare diseases interferes with the teaching of differential diagnostics in neurological training. The traditional pragmatic neurology can not be retrieved. The faculty of neurology could retain its integrity by the improvement of diagnostic methods and the ever more effective drugs. Nevertheless, even the progression of neurological sciences induces dissociation of clinical neurology. Neurology shall suffer fragmentation if

Survey highlights the need to expand offerings of introductory pharmacy practice experiences in psychiatry and neurology: Benefits and example experiences.

Science.gov (United States)

Bostwick, Jolene R; Leung, Gillian P; Smith, Tawny L; Ahmed, Uzma; Bainbridge, Jacquelyn L; Peyronnet, Jean-Xavier

2018-01-01

Introductory pharmacy practice experiences (IPPEs) are 1 requirement schools and colleges of pharmacy must fulfill to meet accreditation standards. The purpose of this manuscript is to report existing IPPEs in psychiatry and neurology across the United States. Two separate electronic surveys were administered to individual College of Psychiatric and Neurologic Pharmacists members with board certification in psychiatric pharmacy with an academic affiliation and academic institutions in the 2014-15 academic year to assess the neuropsychiatric curriculum in pharmacy programs. Results focusing on IPPEs were summarized using descriptive statistics. Academic institutional data reveal only 37.3% offered IPPEs in psychiatry, and 6.7% offered neurology. The number of available IPPEs is low even if a program offered an available rotation. The majority of College of Psychiatric and Neurologic Pharmacists member respondents (69.9%) did not offer IPPEs in psychiatry in the 2014-15 academic year, and none offered an IPPE in neurology. More than half of individual respondents feel their institution should increase IPPEs in psychiatry and neurology in order to enhance their curriculum. To expand IPPE availability, pharmacy programs should increase early exposure of pharmacy students to patients with psychiatric and neurologic conditions. Longitudinal experiences may allow students to engage in hands-on experiences, which may impact future career aspirations and reduce stigma. Current example IPPEs at the authors' institutions are included to stimulate discussion and action among readers on how IPPEs in these practice areas may be developed. Implementation of IPPEs in psychiatry and neurology is needed for students to gain experience working with these patients.

Neurology in a globalizing world: World Congress of Neurology, Vienna, 2013.

Science.gov (United States)

Hachinski, Vladimir

2013-06-11

The World Congress of Neurology (figure 1) theme "Neurology in a Globalizing World" acknowledges that science and increasingly medicine and neurology are becoming globalized. The best way to manage change is to shape it. It is becoming increasingly clear that brain diseases, particularly stroke and dementia, are projected to rise at a rate that could overwhelm our clinics and hospitals. Hence a new emphasis on prevention and the need to work across disciplines beyond our traditional roles. Neurologists are the guardians of the brain and need to take the lead role in advancing new approaches in stemming the tide of neurologic diseases.

Neurological complications following liver transplant: a pictorial review of radiological and clinical findings

Energy Technology Data Exchange (ETDEWEB)

Lee, Young Kyung; Shin, Ji Hoon; Kim, Sang Joon; Lee, Deok Hee; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2005-07-15

Neurological complications are a rare but important and significant source of information about morbidity and mortality in liver transplant patients. Based on the clinical and radiological findings of 21 patients, neurological complications were categorized into five main groups; focal hemorrhagic or occlusive complications (n=11); diffuse hypoxic-ischemic injury (n=3); hypertensive encephalopathy (n=1); central pontine or extra-pontine myelinolysis (n=4); and infection (n=2). Neurological manifestations varied according to the location of the lesion, although seizures were the most common manifestation. In this pictorial review, we illustrate the radiological findings, focusing on MR and CT images, of a spectrum of neurological complications following liver transplants, as well as their clinical correlations.

Neurological complications following liver transplant: a pictorial review of radiological and clinical findings

International Nuclear Information System (INIS)

Lee, Young Kyung; Shin, Ji Hoon; Kim, Sang Joon; Lee, Deok Hee; Lee, Ho Kyu; Choi, Choong Gon; Suh, Dae Chul

2005-01-01

Neurological complications are a rare but important and significant source of information about morbidity and mortality in liver transplant patients. Based on the clinical and radiological findings of 21 patients, neurological complications were categorized into five main groups; focal hemorrhagic or occlusive complications (n=11); diffuse hypoxic-ischemic injury (n=3); hypertensive encephalopathy (n=1); central pontine or extra-pontine myelinolysis (n=4); and infection (n=2). Neurological manifestations varied according to the location of the lesion, although seizures were the most common manifestation. In this pictorial review, we illustrate the radiological findings, focusing on MR and CT images, of a spectrum of neurological complications following liver transplants, as well as their clinical correlations

Neurological symptoms in patients with biopsy proven celiac disease.

Science.gov (United States)

Bürk, Katrin; Farecki, Marie-Louise; Lamprecht, Georg; Roth, Guenter; Decker, Patrice; Weller, Michael; Rammensee, Hans-Georg; Oertel, Wolfang

2009-12-15

In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet. (c) 2009 Movement Disorder Society.

The charming physician (El médico encantador: neurological conditions in a short story by Silvina Ocampo

Directory of Open Access Journals (Sweden)

Guillermo Delgado-García

Full Text Available ABSTRACT The Argentinian author Silvina Ocampo (1903-1993 left us a vast body of works which are considered outstanding in many ways. In 1960, she published a short story, entitled “El médico encantador" (The Charming Physician, in the renowned literary magazine Sur. The central character of this piece is a family doctor named Albino Morgan, who had a secret truth: in any house he visited, all variety of disease also entered. He brought with him the viruses he disseminated. The narrator of this short story—one of his patients—describes four of Morgan's diseases. These imaginary neurological conditions allowed Ocampo to explore improbable situations in everyday life.

What do Flaubert, Dostoevsky and Machado de Assis have in common with neurology?

Directory of Open Access Journals (Sweden)

Bruno Kusznir Vitturi

Full Text Available ABSTRACT The Frenchman Gustave Flaubert, the Russian Fyodor Dostoevsky and the Brazilian Machado de Assis are known for their immeasurable contributions to literature. However, what most people do not know is that all three authors suffered from epilepsy and were affected by their neurological condition in different ways. We offer a short description of how epilepsy influenced their lives, how they dealt with it and how their neurological condition was present in their novels and correspondence. Their lives are excellent examples of how intimately neurology can be entwined in art and history, and provide an important perspective on patients with epilepsy.

Thyroid-related neurological disorders and complications in children.

Science.gov (United States)

Nandi-Munshi, Debika; Taplin, Craig E

2015-04-01

Thyroid hormones exert critical roles throughout the body and play an important and permissive role in neuroendocrine, neurological, and neuromuscular function. We performed a PubMed search through June 2014 with search terms including "hypothyroidism," "hyperthyroidism," "neurological complications," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy." Relevant publications reviewed included case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials. The neurological outcomes of congenital hypothyroidism were reviewed, along with the clinical features of associated neuromuscular syndromes of both hypothyroidism and hyperthyroidism, including other autoimmune conditions. Evidence for, and pathophysiological controversies surrounding, Hashimoto encephalopathy was also reviewed. The establishment of widespread newborn screening programs has been highly successful in attenuating or preventing early and irreversible neurological harm resulting from congenital thyroid hormone deficiency, but some children continue to display neuromuscular, sensory, and cognitive defects in later life. Acquired disorders of thyroid function such as Hashimoto thyroiditis and Graves' disease are associated with a spectrum of central nervous system and/or neuromuscular dysfunction. However, considerable variation in clinical phenotype is described, and much of our knowledge of the role of thyroid disease in childhood neurological disorders is derived from adult case series. Early and aggressive normalization of thyroxine levels in newborn infants with congenital hypothyroidism is important in minimizing neurological sequelae, but maternal thyroid hormone sources are also critically important to the early developing brain. A spectrum of neurological disorders has been reported in older children with acquired thyroid disease, but the frequency with which these occur remains poorly defined in the literature, and

Neurology at the bedside

DEFF Research Database (Denmark)

Kondziella, Daniel; Waldemar, Gunhild

This updated and expanded new edition takes neurology trainees by the hand and guides them through the whole patient encounter - from an efficient neurological history and bedside examination through to differential diagnosis, diagnostic procedures and treatment. At each step the expert authors......, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training....... Medical students, general practitioners and others with an interest in neurology will also find invaluable information here....

A Comparison of the Visual Attention Patterns of People with Aphasia and Adults without Neurological Conditions for Camera-Engaged and Task-Engaged Visual Scenes

Science.gov (United States)

Thiessen, Amber; Beukelman, David; Hux, Karen; Longenecker, Maria

2016-01-01

Purpose: The purpose of the study was to compare the visual attention patterns of adults with aphasia and adults without neurological conditions when viewing visual scenes with 2 types of engagement. Method: Eye-tracking technology was used to measure the visual attention patterns of 10 adults with aphasia and 10 adults without neurological…

Solving the puzzle of neurological diseases: an interview with Huda Zoghbi

Directory of Open Access Journals (Sweden)

Huda Y. Zoghbi

2017-05-01

Full Text Available Huda Zoghbi's achievements in the field of neurology are internationally acclaimed. She is best known for elucidating the genetic basis of two complex neurological disorders, spinocerebellar ataxia type 1 and Rett syndrome, and has been honored with many prizes, including The Shaw Prize in Life Science and Medicine in 2016 and the 2017 Breakthrough Prize for Life Sciences. A diligent and creative research scientist at the bench, a respected lab mentor and founding Director of the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, her inspiration has always been the burning need to help patients faced with devastating neurological problems. Her pursuit of the mechanisms mediating spinocerebellar ataxia and Rett syndrome has been dogged, requiring 30 years of focused effort. As highlighted in this interview, her work is now paying dividends by starting to reveal potential therapeutic targets for these intractable and complex disorders.

PET molecular imaging in stem cell therapy for neurological diseases

Energy Technology Data Exchange (ETDEWEB)

Wang, Jiachuan; Zhang, Hong [Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Nuclear Medicine, Hangzhou, Zhejiang (China); Zhejiang University, Medical PET Center, Hangzhou (China); Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou (China); Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou (China); Tian, Mei [University of Texas, M.D. Anderson Cancer Center, Department of Experimental Diagnostic Imaging, Houston, TX (United States)

2011-10-15

Human neurological diseases such as Alzheimer's disease, Parkinson's disease, Huntington's disease, spinal cord injury and multiple sclerosis are caused by loss of different types of neurons and glial cells in the brain and spinal cord. At present, there are no effective therapies against these disorders. Discovery of the therapeutic potential of stem cells offers new strategies for the treatment of neurological diseases. Direct assessment of stem cells' survival, interaction with the host and impact on neuronal functions after transplantation requires advanced in vivo imaging techniques. Positron emission tomography (PET) is a potential molecular imaging modality to evaluate the viability and function of transplanted tissue or stem cells in the nervous system. This review focuses on PET molecular imaging in stem cell therapy for neurological diseases. (orig.)

Neurological outcome of patients with cryopyrin-associated periodic syndrome (CAPS).

Science.gov (United States)

Mamoudjy, Nafissa; Maurey, Hélène; Marie, Isabelle; Koné-Paut, Isabelle; Deiva, Kumaran

2017-02-14

To assess the neurological involvement and outcome, including school and professional performances, of adults and children with cryopyrin-associated periodic syndrome (CAPS). In this observational study, patients with genetically proven CAPS and followed in the national referral centre for autoinflammatory diseases at Bicêtre hospital were assessed. Neurological manifestations, CSF data and MRI results at diagnosis and during follow-up were analyzed. Twenty-four patients (15 adults and 9 children at diagnosis) with CAPS were included. The median age at disease onset was 0 year (birth) [range 0-14], the median age at diagnosis was 20 years [range 0-53] and the mean duration of follow-up was 10.4 ± 2 years. Neurological involvement at diagnosis, mostly headaches and hearing loss, was noted in 17 patients (71%). Two patients of the same family had abnormal brain MRI. A439V mutation is frequently associated with a non-neurological phenotype while R260W mutation tends to be associated with neurological involvement. Eleven adult patients (61%) and 3 children (50%) underwent school difficulties. Neurological involvement is frequent in patients with CAPS and the majority of patients presented difficulties in school performances with consequences in the professional outcome during adulthood. Further studies in larger cohorts of children with CAPS focusing in intellectual efficiency and school performances are necessary.

Materials Characterisation of Glass/epoxy Composites - Focusing on Process Conditions

DEFF Research Database (Denmark)

Jakobsen, Johnny; Lyckegaard, Anders; Jensen, Erik Appel

2013-01-01

Predicting the behaviour of fibre reinforced polymer composites taking the process conditions into account involves advanced modelling techniques and an extensive materials characterisation. The materials characterisation of a chopped strand mat glass/epoxy composite has been the focus...

Preputial calculus in a neurologically-impaired child.

Science.gov (United States)

Spataru, R I; Iozsa, D A; Ivanov, M

2015-02-01

Preputial calculi are rarely encountered in childhood. A 5-year-old boy with symptoms of chronic balanoposthitis. A preputial stone was documented and removed at circumcision. Uneventful postoperative recovery. In children, association between phimosis and neurologic impairment represent predisposing condition for preputial stone formation.

Education Research: Neurology resident education

Science.gov (United States)

Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

2016-01-01

Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

Music Education and Medicine: Music and the Neurology of Time.

Science.gov (United States)

Wilson, Frank R.

1991-01-01

Explores how the body's biological clock affects the way musicians practice and perform. Delineates questions concerning this phenomenon. Discusses the implications for music teaching and focuses on areas for collaborative research between neurology researchers and music educators. (NL)

Neurology Research in Saudi Arabia: Urgent call for action.

Science.gov (United States)

Algahtani, Hussein; Shirah, Bader; Boker, Faisal; Algamdi, Albaraa; Alkahtani, Abdulah

2017-08-01

Research activities in Saudi Arabia are promoted at the governmental and institutional levels. However, the output and quality of research conducted in the field of neurology has not yet been measured quantitatively. This study therefore aimed to analyse neurology-related publications from Saudi Arabia. This study was conducted in January 2016. A systematic search using the PubMed ® search engine (National Library of Medicine, Bethesda, Maryland, USA) was conducted to identify all neurology-related articles published from Saudi Arabia between January 1996 and December 2015. A total of 1,292 neurology-related publications were identified. Neurology research increased linearly with time, with most publications originating from Riyadh (67%) and the university sector (≈47%). However, most neurology-related articles were published in journals which had an impact factor of Saudi Arabia has increased substantially over the last 20 years. However, as most articles were published in low-impact journals, the quality of research remains inadequate and should be improved. It is important that an official research culture be established in both governmental and private universities as well as colleges and health institutions in Saudi Arabia. The formation of clinical academic departments staffed by research experts is recommended to ensure the quality of neurology research output.

Optimizing Neurologically Intact Survival from Sudden Cardiac Arrest: A Call to Action

Directory of Open Access Journals (Sweden)

Jeffrey M. Goodloe

2014-11-01

Full Text Available The U.S. national out-of-hospital and in-hospital cardiac arrest survival rates, although improving recently, have remained suboptimal despite the collective efforts of individuals, communities, and professional societies. Only until very recently, and still with inconsistency, has focus been placed specifically on survival with pre-arrest neurologic function. The reality of current approaches to sudden cardiac arrest is that they are often lacking an integrative, multi-disciplinary approach, and without deserved funding and outcome analysis. In this manuscript, a multidisciplinary group of authors propose practice, process, technology, and policy initiatives to improve cardiac arrest survival with a focus on neurologic function. [West J Emerg Med. 2014;15(7:-0.

Impact of the Journal of Child Neurology: 2002 data.

Science.gov (United States)

Brumback, Roger A

2003-11-01

The Journal of Child Neurology (JCN) began in 1986 as a quarterly publication focused on child neurology and the related clinical pediatric neuroscience areas of pediatric neurosurgery, child psychiatry, pediatric neuroradiology, and developmental and behavioral pediatrics. As submitted material increased, JCN expanded in publication frequency and now appears monthly. Article quality has always been high and many articles have been frequently cited. Over the years, the ratings produced for the ISI Journal Citation Reports have identified JCN as a high-ranking pediatric journal based upon the impact factor value. Currently (year 2002 figures), JCN (with its impact factor of 1.338) ranks 24th out of 68 pediatric journals.

Dance for the rehabilitation of balance and gait in adults with neurological conditions other than Parkinson's disease: A systematic review

Directory of Open Access Journals (Sweden)

Kara K. Patterson

2018-03-01

Full Text Available Purpose: To conduct a systematic review that examined the effect of dance interventions on balance, gait and functional mobility outcomes in adults with neurological conditions other than Parkinson's disease. Methods: A systematic search of relevant databases was conducted. Data extraction and methodological appraisal were performed by two independent authors. Results: Nine studies were included (4 pre-post studies with no control group, 3 case reports, and 2 controlled studies and results of the methodological quality assessment ranged from poor to good. Study groups included stroke, multiple sclerosis, spinal cord injury, and Huntington's disease. Dance interventions varied in frequency, type and duration, and only 1 study reported intensity. Study dropout rates ranged from 20–44%, and 88–100% of dance classes were attended. Only 3 studies mentioned adverse events, of which there were none. A summary of results revealed significant changes in spatiotemporal gait parameters, Berg Balance Scale scores, Timed Up and Go test and six-minute walk test that were similar to or greater than those previously reported in a review of dance for individuals with Parkinson's disease. Conclusions: There is emerging evidence to support the use of dance as a feasible intervention for adults with neurological conditions. Further investigation of the effects of dance with randomized controlled trials using larger sample sizes and better reporting of the intervention, participant tolerance, and adverse events is warranted. Keyword: Rehabilitation

Acute postoperative neurological deterioration associated with surgery for ruptured intracranial aneurysm: incidence, predictors, and outcomes.

Science.gov (United States)

Mahaney, Kelly B; Todd, Michael M; Bayman, Emine O; Torner, James C

2012-06-01

Subarachnoid hemorrhage (SAH) results in significant morbidity and mortality, even among patients who reach medical attention in good neurological condition. Many patients have neurological decline in the perioperative period, which contributes to long-term outcomes. The focus of this study is to characterize the incidence of, characteristics predictive of, and outcomes associated with acute postoperative neurological deterioration in patients undergoing surgery for ruptured intracranial aneurysm. The Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) was a multicenter randomized clinical trial that enrolled 1001 patients and assesssed the efficacy of hypothermia as neuroprotection during surgery to secure a ruptured intracranial aneurysm. All patients had a radiographically confirmed SAH, were classified as World Federation of Neurosurgical Societies (WFNS) Grade I-III immediately prior to surgery, and underwent surgery to secure the ruptured aneurysm within 14 days of SAH. Neurological assessment with the National Institutes of Health Stroke Scale (NIHSS) was performed preoperatively, at 24 and 72 hours postoperatively, and at time of discharge. The primary outcome variable was a dichotomized scoring based on an IHAST version of the Glasgow Outcome Scale (GOS) in which a score of 1 represents a good outcome and a score > 1 a poor outcome, as assessed at 90-days' follow-up. Data from IHAST were analyzed for occurrence of a postoperative neurological deterioration. Preoperative and intraoperative variables were assessed for associations with occurrence of postoperative neurological deterioration. Differences in baseline, intraoperative, and postoperative variables and in outcomes between patients with and without postoperative neurological deterioration were compared with Fisher exact tests. The Wilcoxon rank-sum test was used to compare variables reported as means. Multiple logistic regression was used to adjust for covariates associated with occurrence

History of Neurology in China

Institute of Scientific and Technical Information of China (English)

Wang Xinde

2000-01-01

@@In 1921, the first independent department of neurology was established in Beijing. Before 1949, all over China only 12 professional doctors lectured neurology in medical colleges. Only 30 medically trained personnel were engaged in the neurological departments. The neurological departments contained roughly 200 beds. The thesis on stroke was written by Zhang Shanlei and published in 1922. Author discussed the cerebral stroke on basis of Chinese traditional medicine and European medicine. The first Textbook of Neurology in China was written by Professor Cheng Yu-lin and was published in 1939. In 1952, the Chinese Society of Neurology and Psychiatry of Chinese Medical Association was established. In 1955, the first issue of the Chinese Journal of Neurology and Psychiatry was published.

Burden and cost of neurological diseases: a European North-South comparison.

Science.gov (United States)

Raggi, A; Leonardi, M

2015-07-01

To address the relationship between years lived with a disability (YLDs), prevalence and cost of neurological diseases, and to test whether there is a European North-South gradient for national health expenditure, disability, costs and prevalence of neurological diseases. Information on costs, prevalence and YLDs referred to 2010 were taken from the Study on the Cost of Disorders of the Brain and from the Global Burden of Disease study; data on health expenditure were taken from OECD reports. Selected conditions were as follows: brain tumours, stroke, dementia, Parkinson's disease, epilepsy, multiple sclerosis, migraine and tension-type headache; selected countries were from North (Denmark, Finland, Norway, Sweden) and South (Greece, Italy, Portugal, Spain) Europe. The association between the variables for each condition was tested using Spearman's correlation; Wilcoxon signed ranks test was used to test North-South Europe differences. Correlations were largely non-significant (except for stroke). YLDs and cost were generally lower in South-European countries, and prevalence was lower in North-European countries, but no significant differences were found. Health expenditure, YLDs, costs and prevalence of neurological conditions were generally not correlated across the eight countries. A clear North-South gradient was found for health expenditures, and partially for YLDs, costs and diseases' prevalence. We hypothesized that this is a consequence of the expansion of morbidity of neurological conditions connected to ageing, that health and welfare systems of selected countries were not prepared to face. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-chain polyunsaturated fatty acids and neurological developmental outcome at 18 months in healthy term infants

NARCIS (Netherlands)

Bouwstra, H; Dijck-Brouwer, DAJ; Boehm, G; Boersma, ER; Muskiet, FAJ; Hadders-Algra, M

Aim: Previously, we found a beneficial effect of 2 mo supplementation of infant formula with long-chain polyunsaturated fatty acids (LC-PUFA) on neurological condition at 3 mo in healthy term infants. The aim of the present follow-up study was to evaluate whether the effect on neurological condition

Wearable accelerometry-based technology capable of assessing functional activities in neurological populations in community settings: a systematic review.

Science.gov (United States)

Steins, Dax; Dawes, Helen; Esser, Patrick; Collett, Johnny

2014-03-13

Integrating rehabilitation services through wearable systems has the potential to accurately assess the type, intensity, duration, and quality of movement necessary for procuring key outcome measures. This review aims to explore wearable accelerometry-based technology (ABT) capable of assessing mobility-related functional activities intended for rehabilitation purposes in community settings for neurological populations. In this review, we focus on the accuracy of ABT-based methods, types of outcome measures, and the implementation of ABT in non-clinical settings for rehabilitation purposes. Cochrane, PubMed, Web of Knowledge, EMBASE, and IEEE Xplore. The search strategy covered three main areas, namely wearable technology, rehabilitation, and setting. Potentially relevant studies were categorized as systems either evaluating methods or outcome parameters. Methodological qualities of studies were assessed by two customized checklists, depending on their categorization and rated independently by three blinded reviewers. Twelve studies involving ABT met the eligibility criteria, of which three studies were identified as having implemented ABT for rehabilitation purposes in non-clinical settings. From the twelve studies, seven studies achieved high methodological quality scores. These studies were not only capable of assessing the type, quantity, and quality measures of functional activities, but could also distinguish healthy from non-healthy subjects and/or address disease severity levels. While many studies support ABT's potential for telerehabilitation, few actually utilized it to assess mobility-related functional activities outside laboratory settings. To generate more appropriate outcome measures, there is a clear need to translate research findings and novel methods into practice.

International issues: Obtaining an adult neurology residency position in the United States: an overview.

Science.gov (United States)

Jordan, Justin T; Sellner, Johann; Struhal, Walter; Schneider, Logan; Mayans, David

2014-04-08

Around the world, there are marked differences in neurology training, including training duration and degree of specialization. In the United States, adult neurology residency is composed of 1 year of internal medicine training (preliminary year) and 3 years of neurology-specific training. Child neurology, which is not the focus of this article, is 2 years of pediatrics and 3 years of neurology training. The route to adult neurology residency training in the United States is standardized and is similar to most other US specialties. Whereas US medical graduates often receive stepwise guidance from their medical school regarding application for residency training, international graduates often enter this complex process with little or no such assistance. Despite this discrepancy, about 10%-15% of residency positions in the United States are filled by international medical graduates.(1,2) In adult neurology specifically, 35% of matched positions were filled by international graduates in 2013, 75% of whom were not US citizens.(1) In an effort to provide a preliminary understanding of the application process and related terminology (table 1) and thereby encourage international residency applicants, we describe the steps necessary to apply for neurology residency in the United States.

Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo.

Science.gov (United States)

Mukendi, Deby; Lilo Kalo, Jean-Roger; Mpanya, Alain; Minikulu, Luigi; Kayembe, Tharcisse; Lutumba, Pascal; Barbé, Barbara; Gillet, Philippe; Jacobs, Jan; Van Loen, Harry; Yansouni, Cédric P; Chappuis, François; Ravinetto, Raffaella; Verdonck, Kristien; Boelaert, Marleen; Winkler, Andrea S; Bottieau, Emmanuel

2017-11-01

There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3-6 months after discharge. No neuroimaging was available. Severe headache (199, 56.7%), gait/walking disorders (97, 27.6%), epileptic seizure (87, 24.8%), and focal neurological deficit (86, 24.5%) were the predominant presentations, often in combination. Infections of the CNS were documented in 63 (17.9%) patients and mainly included bacterial meningitis and unspecified meningoencephalitis (33, 9.4%), second-stage human African trypanosomiasis (10, 2.8%), and human immunodeficiency virus (HIV)-related neurological disorders (10, 2.8%). Other focal/systemic infections with neurological manifestations were diagnosed in an additional 60 (17.1%) cases. The leading noncommunicable conditions were epilepsy (61, 17.3%), psychiatric disorders (56, 16.0%), and cerebrovascular accident (23, 6.6%). Overall fatality rate was 8.2% (29/351), but up to 23.8% for CNS infections. Sequelae were observed in 76 (21.6%) patients. Clinical presentations and etiologies of neurological disorders were very diverse in this rural Central African setting and caused considerable mortality and morbidity.

A review of e-textiles in neurological rehabilitation: How close are we?

Science.gov (United States)

McLaren, Ruth; Joseph, Frances; Baguley, Craig; Taylor, Denise

2016-06-21

Textiles able to perform electronic functions are known as e-textiles, and are poised to revolutionise the manner in which rehabilitation and assistive technology is provided. With numerous reports in mainstream media of the possibilities and promise of e-textiles it is timely to review research work in this area related to neurological rehabilitation.This paper provides a review based on a systematic search conducted using EBSCO- Health, Scopus, AMED, PEDro and ProQuest databases, complemented by articles sourced from reference lists. Articles were included if the e-textile technology described had the potential for use in neurological rehabilitation and had been trialled on human participants. A total of 108 records were identified and screened, with 20 meeting the broad review inclusion criteria. Nineteen user trials of healthy people and one pilot study with stroke participants have been reported.The review identifies two areas of research focus; motion sensing, and the measurement of, or stimulation of, muscle activity. In terms of motion sensing, E-textiles appear able to reliably measure gross movement and whether an individual has achieved a predetermined movement pattern. However, the technology still remains somewhat cumbersome and lacking in resolution at present. The measurement of muscle activity and the provision of functional electrical stimulation via e-textiles is in the initial stages of development but shows potential for e-textile expansion into assistive technologies.The review identified a lack of high quality clinical evidence and, in some cases, a lack of practicality for clinical application. These issues may be overcome by engagement of clinicians in e-textile research and using their expertise to develop products that augment and enhance neurological rehabilitation practice.

Neurological development of children born to mothers after kidney transplantation.

Science.gov (United States)

Schreiber-Zamora, Joanna; Szpotanska-Sikorska, Monika; Drozdowska-Szymczak, Agnieszka; Czaplinska, Natalia; Pietrzak, Bronisława; Wielgos, Miroslaw; Kociszewska-Najman, Bozena

2017-12-03

Pregnancies after kidney transplantation are at high risk of complications such as preterm birth and foetal growth restriction. Until now, the impact of these factors on neurological development of children born to transplant mothers has not been established. A comparison of neurological examinations performed in 36 children of kidney transplant women (study group) and 36 children born to healthy mothers (control group). The children from both groups were born at a similar gestational age and in the similar time period from 12/1996 to 09/2012. Neurological examinations were performed from 07/2010 to 11/2013. Each examination was adjusted to the patient's age and performed after the neonatal period. Three years later children were re-consulted, if they presented neurological deviations or were less than 12 months old at the time of the first examination. Normal neurological development was found in 86% of children in both groups (p = .999). Mild neurological deviations were observed in four (11%) children born to kidney transplant mothers and in five (14%) children born to healthy mothers (p = .999). Moderate deviations were diagnosed in one premature child born to transplant mother, whose pregnancy was complicated with a severe preeclampsia and foetal growth restriction. In the study population, no severe neurological disorders were found. Almost all (8/10) children with neurological deviations were born prematurely in good general conditions. The neurological deviations observed in the first year of life were mild and transient. In children over 1 year of age, deviations were more pronounced and continued to maintain. The neurological development of children of kidney transplant women is similar to that of the general population and possible deviations seem to be the result of intrauterine hypotrophy and prematurity. Therefore, in clinical practice, it is necessary to plan post-transplant pregnancies especially in women at high risk of these complications.

Neurology Research in Saudi Arabia : Urgent call for action

Directory of Open Access Journals (Sweden)

Hussein Algahtani

2017-08-01

Full Text Available Objectives: Research activities in Saudi Arabia are promoted at the governmental and institutional levels. However, the output and quality of research conducted in the field of neurology has not yet been measured quantitatively. This study therefore aimed to analyse neurology-related publications from Saudi Arabia. Methods: This study was conducted in January 2016. A systematic search using the PubMed® search engine (National Library of Medicine, Bethesda, Maryland, USA was conducted to identify all neurology-related articles published from Saudi Arabia between January 1996 and December 2015. Results: A total of 1,292 neurologyrelated publications were identified. Neurology research increased linearly with time, with most publications originating from Riyadh (67% and the university sector (≈47%. However, most neurology-related articles were published in journals which had an impact factor of <1 (55%. Conclusion: Neurology research in Saudi Arabia has increased substantially over the last 20 years. However, as most articles were published in low-impact journals, the quality of research remains inadequate and should be improved. It is important that an official research culture be established in both governmental and private universities as well as colleges and health institutions in Saudi Arabia. The formation of clinical academic departments staffed by research experts is recommended to ensure the quality of neurology research output.

Neurologic complications of vaccinations.

Science.gov (United States)

Miravalle, Augusto A; Schreiner, Teri

2014-01-01

This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

How integrated are neurology and palliative care services? Results of a multicentre mapping exercise.

NARCIS (Netherlands)

Vliet, L.M. van; Gao, W.; DiFrancesco, D.; Crosby, V.; Wilcock, A.; Byrne, A.; Al-Chalabi, A.; Chaudhuri, K.R.; Evans, C.; Silber, E.; Young, C.; Malik, F.; Quibell, R.; Higginson, I.J.

2016-01-01

Background: Patients affected by progressive long-term neurological conditions might benefit from specialist palliative care involvement. However, little is known on how neurology and specialist palliative care services interact. This study aimed to map the current level of connections and

Comparison of Rehabilitation Outcomes for Long Term Neurological Conditions: A Cohort Analysis of the Australian Rehabilitation Outcomes Centre Dataset for Adults of Working Age.

Directory of Open Access Journals (Sweden)

Lynne Turner-Stokes

Full Text Available To describe and compare outcomes from in-patient rehabilitation (IPR in working-aged adults across different groups of long-term neurological conditions, as defined by the UK National Service Framework.Analysis of a large Australian prospectively collected dataset for completed IPR episodes (n = 28,596 from 2003-2012.De-identified data for adults (16-65 years with specified neurological impairment codes were extracted, cleaned and divided into 'Sudden-onset' conditions: (Stroke (n = 12527, brain injury (n = 7565, spinal cord injury (SCI (n = 3753, Guillain-Barré syndrome (GBS (n = 805 and 'Progressive/stable' conditions (Progressive (n = 3750 and Cerebral palsy (n = 196. Key outcomes included Functional Independence Measure (FIM scores, length of stay (LOS, and discharge destination.Mean LOS ranged from 21-57 days with significant group differences in gender, source of admission and discharge destination. All six groups showed significant change (p<0.001 between admission and discharge that was likely to be clinically important across a range of items. Significant between-group differences were observed for FIM Motor and Cognitive change scores (Kruskal-Wallis p<0.001, and item-by-item analysis confirmed distinct patterns for each of the six groups. SCI and GBS patients were generally at the ceiling of the cognitive subscale. The 'Progressive/stable' conditions made smaller improvements in FIM score than the 'Sudden-onset conditions', but also had shorter LOS.All groups made gains in independence during admission, although pattern of change varied between conditions, and ceiling effects were observed in the FIM-cognitive subscale. Relative cost-efficiency between groups can only be indirectly inferred. Limitations of the current dataset are discussed, together with opportunities for expansion and further development.

Neurological diseases and bullous pemphigoid: A case-control study in Iranian patients.

Science.gov (United States)

Daneshpazhooh, Maryam; Khorassani, Javad; Balighi, Kamran; Ghandi, Narges; Mahmoudi, Hamidreza; Tohidinik, Hamidreza; Hamzelou, Shahin; Chams-Davatchi, Cheyda

2017-01-01

Neurological diseases are important co-morbidities found in association with bullous pemphigoid. Various neurological conditions (stroke, Parkinson's disease, dementia, epilepsy and multiple sclerosis) have been reported as associations of this bullous disease; whether these are significant has not been definitely proved. However, the presence of neurological conditions is a predictor of poorer prognosis. Our aim was to examine the association of bullous pemphigoid and neurological diseases in Iranian bullous pemphigoid patients. The medical records of one hundred and sixty consecutive bullous pemphigoid patients who presented to the Autoimmune Bullous Diseases Research Center, Tehran, Iran, from 2006 to 2011 were examined for evidence of any neurological disease. The control group comprised of 317 age- and sex-matched subjects. Neurological diseases were seen in 42 (26.4%) patients with bullous pemphigoid and in 29 (9.1%) controls (odds ratio: 3.53 (2.1-5.9), P< 0.001). Comparing cases to controls, stroke was seen in 17.5% versus 4.1%, odds ratio 4.96 (2.49-9.88); dementia in 5.6% versus 1.9%, odds ratio 3.09 (1.08-8.84); Parkinson's disease in 2.5% versus 2.2%, odds ratio 1.14 (0.33-3.94); epilepsy in 2.5% versus 0.6%, odds ratio 4.04 (0.73-22.3); and multiple sclerosis in 0 versus 0.3% odds ratio 1.00 (0.98-1.01). The main limitations of our study were referral bias, retrospective design and a rather low sample size. Neurological diseases in general, and stroke and dementia in particular, were significantly associated with bullous pemphigoid in our study.

Rhythmic auditory cueing to improve walking in patients with neurological conditions other than Parkinson's disease--what is the evidence?

Science.gov (United States)

Wittwer, Joanne E; Webster, Kate E; Hill, Keith

2013-01-01

To investigate whether synchronising over-ground walking to rhythmic auditory cues improves temporal and spatial gait measures in adults with neurological clinical conditions other than Parkinson's disease. A search was performed in June 2011 using the computerised databases AGELINE, AMED, AMI, CINAHL, Current Contents, EMBASE, MEDLINE, PsycINFO and PUBMED, and extended using hand-searching of relevant journals and article reference lists. Methodological quality was independently assessed by two reviewers. A best evidence synthesis was applied to rate levels of evidence. Fourteen studies, four of which were randomized controlled trials (RCTs), met the inclusion criteria. Patient groups included those with stroke (six studies); Huntington's disease and spinal cord injury (two studies each); traumatic brain injury, dementia, multiple sclerosis and normal pressure hydrocephalus (one study each). The best evidence synthesis found moderate evidence of improved velocity and stride length of people with stroke following gait training with rhythmic music. Insufficient evidence was found for other included neurological disorders due to low study numbers and poor methodological quality of some studies. Synchronising walking to rhythmic auditory cues can result in short-term improvement in gait measures of people with stroke. Further high quality studies are needed before recommendations for clinical practice can be made.

Adult Hip Flexion Contracture due to Neurological Disease: A New Treatment Protocol—Surgical Treatment of Neurological Hip Flexion Contracture

OpenAIRE

Nicodemo, Alberto; Arrigoni, Chiara; Bersano, Andrea; Massè, Alessandro

2014-01-01

Congenital, traumatic, or extrinsic causes can lead people to paraplegia; some of these are potentially; reversible and others are not. Paraplegia can couse hip flexion contracture and, consequently, pressure sores, scoliosis, and hyperlordosis; lumbar and groin pain are strictly correlated. Scientific literature contains many studies about children hip flexion related to neurological diseases, mainly caused by cerebral palsy; only few papers focus on this complication in adults. In this stu...

The menagerie of neurology

Science.gov (United States)

Beh, Shin C.; Frohman, Teresa; Frohman, Elliot M.

2014-01-01

Summary Neurology is a field known for “eponymophilia.” While eponym use has been a controversial issue in medicine, animal-related metaphoric descriptions continue to flourish in neurologic practice, particularly with the advent of neuroimaging. To provide practicing and trainee neurologists with a useful reference for all these colorful eponyms, we performed a literature review and summarized the various animal eponyms in the practice of neurology (and their etiologic implications) to date. We believe that the ability to recognize animal-like attributes in clinical neurology and neuroradiology may be attributed to a visual phenomenon known as pareidolia. We propose that animal eponyms are a useful method of recognizing clinical and radiologic patterns that aid in the diagnostic process and therefore are effective aidesmémoire and communicative tools that enliven and improve the practice of neurology. PMID:29473555

A hyperacute neurology team - transforming emergency neurological care.

Science.gov (United States)

Nitkunan, Arani; MacDonald, Bridget K; Boodhoo, Ajay; Tomkins, Andrew; Smyth, Caitlin; Southam, Medina; Schon, Fred

2017-07-01

We present the results of an 18-month study of a new model of how to care for emergency neurological admissions. We have established a hyperacute neurology team at a single district general hospital. Key features are a senior acute neurology nurse coordinator, an exclusively consultant-delivered service, acute epilepsy nurses, an acute neurophysiology service supported by neuroradiology and acute physicians and based within the acute medical admissions unit. Key improvements are a major increase in the number of patients seen, the speed with which they are seen and the percentage seen on acute medical unit before going to the general wards. We have shown a reduced length of stay and readmission rates for patients with epilepsy. Epilepsy accounted for 30% of all referrals. The cost implications of running this service are modest. We feel that this model is worthy of widespread consideration. © Royal College of Physicians 2017. All rights reserved.

Neurologic Outcomes After Low-Volume, Ultrasound-Guided Interscalene Block and Ambulatory Shoulder Surgery.

Science.gov (United States)

Rajpal, Gaurav; Winger, Daniel G; Cortazzo, Megan; Kentor, Michael L; Orebaugh, Steven L

2016-01-01

Postoperative neurologic symptoms after interscalene block and shoulder surgery have been reported to be relatively frequent. Reports of such symptoms after ultrasound-guided block have been variable. We evaluated 300 patients for neurologic symptoms after low-volume, ultrasound-guided interscalene block and arthroscopic shoulder surgery. Patients underwent ultrasound-guided interscalene block with 16 to 20 mL of 0.5% bupivacaine or a mix of 0.2% bupivacaine/1.2% mepivacaine solution, followed by propofol/ketamine sedation for ambulatory arthroscopic shoulder surgery. Patients were called at 10 days for evaluation of neurologic symptoms, and those with persistent symptoms were called again at 30 days, at which point neurologic evaluation was initiated. Details of patient demographics and block characteristics were collected to assess any association with persistent neurologic symptoms. Six of 300 patients reported symptoms at 10 days (2%), with one of these patients having persistent symptoms at 30 days (0.3%). This was significantly lower than rates of neurologic symptoms reported in preultrasound investigations with focused neurologic follow-up and similar to other studies performed in the ultrasound era. There was a modest correlation between the number of needle redirections during the block procedure and the presence of postoperative neurologic symptoms. Ultrasound guidance of interscalene block with 16- to 20-mL volumes of local anesthetic solution results in a lower frequency of postoperative neurologic symptoms at 10 and 30 days as compared with investigations in the preultrasound period.

Dielectrophoretic focusing integrated pulsed laser activated cell sorting

Science.gov (United States)

Zhu, Xiongfeng; Kung, Yu-Chun; Wu, Ting-Hsiang; Teitell, Michael A.; Chiou, Pei-Yu

2017-08-01

We present a pulsed laser activated cell sorter (PLACS) integrated with novel sheathless size-independent dielectrophoretic (DEP) focusing. Microfluidic fluorescence activated cell sorting (μFACS) systems aim to provide a fully enclosed environment for sterile cell sorting and integration with upstream and downstream microfluidic modules. Among them, PLACS has shown a great potential in achieving comparable performance to commercial aerosol-based FACS (>90% purity at 25,000 cells sec-1). However conventional sheath flow focusing method suffers a severe sample dilution issue. Here we demonstrate a novel dielectrophoresis-integrated pulsed laser activated cell sorter (DEP-PLACS). It consists of a microfluidic channel with 3D electrodes laid out to provide a tunnel-shaped electric field profile along a 4cmlong channel for sheathlessly focusing microparticles/cells into a single stream in high-speed microfluidic flows. All focused particles pass through the fluorescence detection zone along the same streamline regardless of their sizes and types. Upon detection of target fluorescent particles, a nanosecond laser pulse is triggered and focused in a neighboring channel to generate a rapidly expanding cavitation bubble for precise sorting. DEP-PLACS has achieved a sorting purity of 91% for polystyrene beads at a throughput of 1,500 particle/sec.

The impact of tackle football injuries on the American healthcare system with a neurological focus.

Directory of Open Access Journals (Sweden)

Michael J McGinity

Full Text Available Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public.Using the National Emergency Department Sample (NEDS and the National Inpatient Sample (NIS, the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013.The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI. Patient demographics, length of hospital stay (LOS, cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed.A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days. 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2. Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion.Injuries related to

The impact of tackle football injuries on the American healthcare system with a neurological focus.

Science.gov (United States)

McGinity, Michael J; Grandhi, Ramesh; Michalek, Joel E; Rodriguez, Jesse S; Trevino, Aron M; McGinity, Ashley C; Seifi, Ali

2018-01-01

Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013. The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED) and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI). Patient demographics, length of hospital stay (LOS), cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed. A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days). 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2). Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion. Injuries related to tackle

Fetal endoscopic myelomeningocele closure preserves segmental neurological function

NARCIS (Netherlands)

Verbeek, Renate J.; Heep, Axel; Maurits, Natalia M.; Cremer, Reinhold; Hoving, Eelco W.; Brouwer, Oebele F.; Van der Hoeven, Johannes H.; Sival, Deborah A.

AIM:   Our aim was to compare the effect of prenatal endoscopic with postnatal myelomeningocele closure (fetally operated spina bifida aperta [fSBA]) versus neonatally operated spina bifida aperta [nSBA]) on segmental neurological leg condition. METHOD:   Between 2003 and 2009, the fetal surgical

William Shakespeare's neurology.

Science.gov (United States)

Paciaroni, Maurizio; Bogousslavsky, Julien

2013-01-01

Many of Shakespeare's plays contain characters who appear to be afflicted by neurological or psychiatric disorders. Shakespeare, in his descriptive analysis of his protagonists, was contributing to the understanding of these disorders. In fact, Charcot frequently used Shakespearean references in his neurological teaching sessions, stressing how acute objective insight is essential to achieving expert clinical diagnosis. Charcot found in Shakespeare the same rigorous observational techniques for which he himself became famous. This chapter describes many of Shakespearean characters suffering from varied neurological disorders, including Parkinsonism, epilepsy, sleeping disturbances, dementia, headache, prion disease, and paralyses. © 2013 Elsevier B.V. All rights reserved.

Integrating palliative care into neurology services: what do the professionals say?

NARCIS (Netherlands)

Hepgul, N.; Gao, W.; Evans, C.J.; Jackson, D.; Vliet, L.M. van; Byrne, A.; Crosby, V.; Groves, K.E.; Lindsay, F.; Higginson, I.J.

2017-01-01

Objectives: Evaluations of new services for palliative care in non-cancer conditions are few. OPTCARE Neuro is a multicentre trial evaluating the effectiveness of short-term integrated palliative care (SIPC) for progressive long-term neurological conditions. Here, we present survey results

On the focusing conditions in time-reversed acoustics, seismic interferometry, and Marchenko imaging

NARCIS (Netherlands)

Wapenaar, C.P.A.; Van der Neut, J.R.; Thorbecke, J.W.; Vasconcelos, I.; Van Manen, D.J.; Ravasi, M.

2014-01-01

Despite the close links between the fields of time-reversed acoustics, seismic interferometry and Marchenko imaging, a number of subtle differences exist. This paper reviews the various focusing conditions of these methods, the causality/acausality aspects of the corresponding focusing wavefields,

Supply and demand analysis of the current and future US neurology workforce.

Science.gov (United States)

Dall, Timothy M; Storm, Michael V; Chakrabarti, Ritashree; Drogan, Oksana; Keran, Christopher M; Donofrio, Peter D; Henderson, Victor W; Kaminski, Henry J; Stevens, James C; Vidic, Thomas R

2013-07-30

This study estimates current and projects future neurologist supply and demand under alternative scenarios nationally and by state from 2012 through 2025. A microsimulation supply model simulates likely career choices of individual neurologists, taking into account the number of new neurologists trained each year and changing demographics of the neurology workforce. A microsimulation demand model simulates utilization of neurology services for each individual in a representative sample of the population in each state and for the United States as a whole. Demand projections reflect increased prevalence of neurologic conditions associated with population growth and aging, and expanded coverage under health care reform. The estimated active supply of 16,366 neurologists in 2012 is projected to increase to 18,060 by 2025. Long wait times for patients to see a neurologist, difficulty hiring new neurologists, and large numbers of neurologists who do not accept new Medicaid patients are consistent with a current national shortfall of neurologists. Demand for neurologists is projected to increase from ∼18,180 in 2012 (11% shortfall) to 21,440 by 2025 (19% shortfall). This includes an increased demand of 520 full-time equivalent neurologists starting in 2014 from expanded medical insurance coverage associated with the Patient Protection and Affordable Care Act. In the absence of efforts to increase the number of neurology professionals and retain the existing workforce, current national and geographic shortfalls of neurologists are likely to worsen, exacerbating long wait times and reducing access to care for Medicaid beneficiaries. Current geographic differences in adequacy of supply likely will persist into the future.

Hypnosis as therapy for functional neurologic disorders.

Science.gov (United States)

Deeley, Q

2016-01-01

Suggestion in hypnosis has been applied to the treatment of functional neurologic symptoms since the earliest descriptions of hypnosis in the 19th century. Suggestion in this sense refers to an intentional communication of beliefs or ideas, whether verbally or nonverbally, to produce subjectively convincing changes in experience and behavior. The recognition of suggestion as a psychologic process with therapeutic applications was closely linked to the derivation of hypnosis from earlier healing practices. Animal magnetism, the immediate precursor of hypnosis, arrived at a psychologic concept of suggestion along with other ideas and practices which were then incorporated into hypnosis. Before then, other forms of magnetism and ritual healing practices such as exorcism involved unintentionally suggestive verbal and nonverbal stimuli. We consider the derivation of hypnosis from these practices not only to illustrate the range of suggestive processes, but also the consistency with which suggestion has been applied to the production and removal of dissociative and functional neurologic symptoms over many centuries. Nineteenth-century practitioners treated functional symptoms with induction of hypnosis per se; imperative suggestions, or commands for specific effects; "medical clairvoyance" in hypnotic trance, in which patients diagnosed their own condition and predicted the time and manner of their recovery; and suggestion without prior hypnosis, known as "fascination" or "psychotherapeutics." Modern treatments largely involve different types of imperative suggestion with or without hypnosis. However, the therapeutic application of suggestion in hypnosis to functional and other symptoms waned in the first half of the 20th century under the separate pressures of behaviorism and psychoanalysis. In recent decades suggestion in hypnosis has been more widely applied to treating functional neurologic symptoms. Suggestion is typically applied within the context of other

[Neurologic vigor of term newborns according to the type of delivery and obstetric maneuvers].

Science.gov (United States)

Riesgo, Rudimar dos Santos; Ohlweiler, Lygia; Winckler, Maria Isabel Bragatti; Ranzan, Josiane; Riesgo, Itamar Dos Santos; Rotta, Newra Tellechea

2009-06-01

to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic

Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

Science.gov (United States)

Faulkner, L.R.; Juul, D.; Pascuzzi, R.M.; Aminoff, M.J.; Crumrine, P.K.; DeKosky, S.T.; Jozefowicz, R.F.; Massey, J.M.; Pirzada, N.; Tilton, A.

2010-01-01

Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era. PMID:20855855

Neurological sequelae of bacterial meningitis

NARCIS (Netherlands)

Lucas, Marjolein J.; Brouwer, Matthijs C.; van de Beek, Diederik

2016-01-01

We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive

Neurological Consequences of Obesity

Science.gov (United States)

O’Brien, Phillipe D.; Hinder, Lucy M.; Callaghan, Brian C.; Feldman, Eva L.

2017-01-01

Obesity, primarily a consequence of poor dietary choices and an increased sedentary lifestyle, has become a global pandemic that brings with it enormous medical, social, and economic challenges. Not only does obesity increase the risk of cardiovascular disease and certain cancers, but it is also recognized as a key driver of other metabolic syndrome (MetS) components. These components include insulin resistance, hyperglycemia with prediabetes or type 2 diabetes, dyslipidemia, and hypertension, and are underlying contributors to systemic metabolic dysfunction. More recently, obesity and diet-induced metabolic dysfunction have been identified as risk factors for the development of a wide variety of neurological disorders in both the central and peripheral nervous systems. An abundance of literature has shown that obesity is associated with mild cognitive impairment and altered hippocampal structure and function, and there is a robust correlation between obesity and Alzheimer’s type dementia. Similarly, many reports show that both the autonomic and somatic components of the peripheral nervous system are impacted by obesity. The autonomic nervous system, under control of the hypothalamus, displays altered catabolic and anabolic processes in obese individuals attributed to sympathetic-parasympathetic imbalances. A close association also exists between obesity and polyneuropathy, a complication most commonly found in prediabetic and diabetic patients, and is likely secondary to a combination of obesity-induced dyslipidemia with hyperglycemia. This review will outline the pathophysiological development of obesity and dyslipidemia, discuss the adverse impact of these conditions on the nervous system, and provide evidence for lipotoxicity and metabolic inflammation as the drivers underlying the neurological consequences of obesity. In addition, this review will examine the benefits of lifestyle and surgical interventions in obesity-induced neurological disorders. PMID

Outcomes from a US military neurology and traumatic brain injury telemedicine program.

Science.gov (United States)

Yurkiewicz, Ilana R; Lappan, Charles M; Neely, Edward T; Hesselbrock, Roger R; Girard, Philip D; Alphonso, Aimee L; Tsao, Jack W

2012-09-18

This study evaluated usage of the Army Knowledge Online (AKO) Telemedicine Consultation Program for neurology and traumatic brain injury (TBI) cases in remote overseas areas with limited access to subspecialists. We performed a descriptive analysis of quantity of consults, response times, sites where consults originated, military branches that benefitted, anatomic locations of problems, and diagnoses. This was a retrospective analysis that searched electronic databases for neurology consults from October 2006 to December 2010 and TBI consults from March 2008 to December 2010. A total of 508 consults were received for neurology, and 131 consults involved TBI. For the most part, quantity of consults increased over the years. Meanwhile, response times decreased, with a mean response time of 8 hours, 14 minutes for neurology consults and 2 hours, 44 minutes for TBI consults. Most neurology consults originated in Iraq (67.59%) followed by Afghanistan (16.84%), whereas TBI consults mainly originated from Afghanistan (40.87%) followed by Iraq (33.91%). The most common consultant diagnoses were headaches, including migraines (52.1%), for neurology cases and mild TBI/concussion (52.3%) for TBI cases. In the majority of cases, consultants recommended in-theater management. After receipt of consultant's recommendation, 84 known neurology evacuations were facilitated, and 3 known neurology evacuations were prevented. E-mail-based neurology and TBI subspecialty teleconsultation is a viable method for overseas providers in remote locations to receive expert recommendations for a range of neurologic conditions. These recommendations can facilitate medically necessary patient evacuations or prevent evacuations for which on-site care is preferable.

[Neurology and literature].

Science.gov (United States)

Iniesta, I

2010-10-01

Literature complements medical literature in the academic and clinical development of neurologists. The present article explores the contributions of writers of fiction on neurology. Literary works of fiction with particular reference to neurology. A symbiosis between writers of fiction and doctors has been well recognised. From Shakespeare to Cervantes by way of Dickens and Cela to writer - physicians such as Anton Chekhov or António Lobo Antunes have contributed through their medically informed literature to the better understanding of neurology. Some writers like Dostoevsky, Machado de Assis and Margiad Evans have written about their own experiences with disease thus bringing new insights to medicine. Furthermore, some neurological disorders have been largely based on literary descriptions. For instance, Dostoevsky's epilepsy has been retrospectively analysed by famous neurologists including Freud, Alajouanine or Gastaut, whilst his writings and biography have prompted others like Waxman and Geschwind to describe typical behavioural changes in temporal lobe epilepsy, finding their source of inspiration in Dostoevsky. Likewise, Cirignotta et al have named an unusual type of seizure after the Russian novelist. Inspired by Lewis Carroll, Todd introduced the term Alice in Wonderland Syndrome to refer to visual distortions generally associated with migraine. Writers of fiction offer a humanised perception of disease by contributing new insights into the clinical history, informing about the subjective experience of the illness and helping to eradicate the stigma associated to neurological disorders.

Patient-reported financial barriers to adherence to treatment in neurology

Directory of Open Access Journals (Sweden)

Moura LMVR

2016-11-01

Full Text Available Lidia MVR Moura,1 Eli L Schwamm,1 Valdery Moura Junior,1 Michael P Seitz,1 Daniel B Hoch,1 John Hsu,2,3 Lee H Schwamm1 1Department of Neurology, 2Mongan Institute for Health Policy, Massachusetts General Hospital, 3Department of Medicine and Department of Health Care Policy, Harvard Medical School, Boston, MA, USA Objective: Many effective medical therapies are available for treating neurological diseases, but these therapies tend to be expensive and adherence is critical to their effectiveness. We used patient-reported data to examine the frequency and determinants of financial barriers to medication adherence among individuals treated for neurological disorders. Patients and methods: Patients completed cross-sectional surveys on iPads as part of routine outpatient care in a neurology clinic. Survey responses from a 3-month period were collected and merged with administrative sources of demographic and clinical information (eg, insurance type. We explored the association between patient characteristics and patient-reported failure to refill prescription medication due to cost in the previous 12 months, termed here as “nonadherence”. Results: The population studied comprised 6075 adults who were presented between July and September 2015 for outpatient neurology appointments. The mean age of participants was 56 (standard deviation: 18 years, and 1613 (54% were females. The patients who participated in the surveys (2992, 49% were comparable to nonparticipants with respect to gender and ethnicity but more often identified English as their preferred language (94% vs 6%, p<0.01. Among respondents, 9.8% (n=265 reported nonadherence that varied by condition. These patients were more frequently Hispanic (16.7% vs 9.8% white, p=0.01, living alone (13.9% vs 8.9% cohabitating, p<0.01, and preferred a language other than English (15.3% vs 9.4%, p=0.02. Conclusion: Overall, the magnitude of financial barriers to medication adherence appears to vary

A prospective study of risk factors for neurological complications in childhood bacterial meningitis.

Science.gov (United States)

Namani, Sadie; Milenković, Zvonko; Koci, Bulëza

2013-01-01

To prospectively analyze the prognostic factors for neurological complications of childhood bacterial meningitis. This prospective study enrolled 77 children from 1 month until 16 years of age, treated for bacterial meningitis during the period of January 1, 2009 through December 31, 2010. 16 relevant predictors were chosen to analyze their association with the incidence of neurological complications. p-values 5,000 cells/mm(3), pleocytosis > 5,000 cells/mm(3) after 48 hours, CSF/blood glucose ratio 48 hours, presence of comorbidity, and primary focus of infection were not associated with increased risk for the development of neurological complications. Age < 12 months and severity of clinical presentation at admission were identified as the strongest predictors of neurological complications and may be of value in selecting patients for more intensive care and treatment. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

THE KETOGENIC DIET AS A TREATMENT PARADIGM FOR DIVERSE NEUROLOGICAL DISORDERS

Directory of Open Access Journals (Sweden)

Jong Min Rho

2012-04-01

Full Text Available Dietary and metabolic therapies have been attempted in a wide variety of neurological diseases, including epilepsy, headache, neurotrauma, Alzheimer disease, Parkinson disease, sleep disorders, brain cancer, autism, pain, and multiple sclerosis. The impetus for using various diets to treat – or at least ameliorate symptoms of – these disorders stems from both a lack of effectiveness of pharmacological therapies, and also the intrinsic appeal of implementing a more natural treatment. The enormous spectrum of pathophysiological mechanisms underlying the aforementioned diseases would suggest a degree of complexity that cannot be impacted universally by any single dietary treatment. Yet, it is conceivable that alterations in certain dietary constituents could affect the course and impact the outcome of these brain disorders. Further, it is possible that a final common neurometabolic pathway might be influenced by a variety of dietary interventions. The most notable example of a dietary treatment with proven efficacy against a neurological condition is the high-fat, low-carbohydrate ketogenic diet (KD used in patients with medically intractable epilepsy. While the mechanisms through which the KD works remain unclear, there is now compelling evidence that its efficacy is likely related to the normalization of aberrant energy metabolism. The concept that many neurological conditions are linked pathophysiologically to energy dysregulation could well provide a common research and experimental therapeutics platform, from which the course of several neurological diseases could be favorably influenced by dietary means. Here we provide an overview of studies using the KD in a wide panoply of neurologic disorders in which neuroprotection is an essential component.

A century of Dutch neurology.

Science.gov (United States)

Koehler, P J; Bruyn, G W; Moffie, D

1998-12-01

The Netherlands Society of Neurology evolved from the Society of Psychiatry founded in 1871. The name was changed into Netherlands Society of Psychiatry and Neurology (NSPN) in 1897. In the same year, the word neurology was also added to the name of the journal. The Society steadily blossomed, but in 1909 the first signs of dissatisfaction occurred: the Amsterdam Neurologists Society was founded. A few split-offs would follow. The number of members of the NSPN increased from 205 in 1920 to 585 in 1960. In the early 1960s, the Society was reorganised and would consist of two sections, one for psychiatry and one for neurology. However, this would not last, as a full separation was established in 1974. For several reasons, the name of the journal was changed four times until it assumed its present name in 1974. The 100th volume of CNN was not published, as expected. in 1996, but in 1998, because of two skipped publication years, one during WWII and another in the 1970s. During the last decades of the nineteenth century, teaching of neurology was mostly given within the frame of psychiatry, following the German tradition of 'brainpsychiatry' (organic or biologic psychiatry). The first official chair of psychiatry was founded at Utrecht, 1893 (Winkler). In Amsterdam, private teachers such as Delprat taught 'electro-therapy and nervous diseases' since the 1880s. The first extraordinary chair of neurology and electrotherapy was founded for his successor, Wertheim Salomonson in 1899. The first university clinic for psychiatry and neurology started at the Amsterdam Municipal University, when Winkler became professor of psychiatry and neurology in Amsterdam in 1896. Around the turn of the century, chairs of psychiatry and neurology were also founded in Groningen and Leiden. Separate chairs for neurology and psychiatry appeared in Amsterdam in 1923 and in Utrecht in 1936. Following an initiative of Brouwer, the first neurological university clinic opened its doors in

Trends in neurology fellowship training

Institute of Scientific and Technical Information of China (English)

Jordan S.A. Williams; Trent S. Hodgson; Fernando D. Goldenberg; Rimas V. Lukas

2017-01-01

Aim:Aneed for Neurologists exists in the USA.The majority of Neurology residency graduates go on to additional subspecialty training. Methods: Data from the Accreditation Council for Graduate Medical Education from 2001-2014 and the United Council for Neurologic Subspecialties from was analyzed for trends in the number of Neurology subspecialty training programs and their composition. Results: There has been an overall trend of growth in the number of accredited Neurology subspecialty training programs and fellows. These trends vary between specific subspecialties. Conclusion: The authors provide an overview of the contemporary state of Neurology subspecialty training in the USA. A clearer understanding of subspecialty training allows for anticipation of workforce surpluses and deficits.

The Anxiety Level of Caregivers of Neurological Patients with Dysphagia.

Science.gov (United States)

Serel Arslan, Selen; Demir, Numan; Karaduman, A Ayşe

2017-08-01

We aimed to investigate anxiety level of caregivers of neurological patients with dysphagia, and the relationship of patient-related factors to anxiety level of dysphagia caregivers. A total of 103 adult neurological patients with dysphagia (study group), 30 without dysphagia (control group), and their primary caregivers were included. Types of feeding, condition of dependency in eating and drinking, dysphagia duration, and history of previous dysphagia treatment were recorded for study group. In study group, the Turkish version of the Eating Assessment Tool-10 (T-EAT-10) was used to determine dysphagia symptom severity. Penetration and aspiration severity was determined with the penetration-aspiration scale (PAS). The Spielberger State-Trait Anxiety Inventory (STAI) that has two subscales including state anxiety (S-STAI) and trait anxiety (T-STAI) was used to determine anxiety level of caregivers. There was no difference between groups in terms of age, gender, weight, and height. The mean S-STAI was 42.56 ± 10.10 for the study group and 29.20 ± 6.64 for the control group (p dysphagia treatment (p = 0.01, r = 0.25). No correlation was found between STAI (in terms of both S-STAI and T-STAI) and T-EAT-10, PAS, types of feeding, condition of dependency in eating and drinking, dysphagia duration (p > 0.05). Caregivers of neurological patients with dysphagia have greater anxiety level than caregivers of neurological patients without dysphagia.

Therapeutic hypothermia brings favorable neurologic outcomes in children with near drowning.

Science.gov (United States)

Chen, Ming-Chun; Chu, Chia-Hsiang; Cheng, Ching-Feng; Lin, Jun-Song; Chen, Jui-Hsia; Chang, Yu-Hsun

2016-01-01

A 1-year-10-month-old boy was admitted to our pediatric intensive care unit due to near drowning with pulmonary edema. A conventional ventilator with 100% oxygen supplementation was used initially, but was shifted to high frequency oscillatory ventilation as his oxygen saturation was around 84-88%. Therapeutic hypothermia was applied due to hypoxic ischemic encephalopathy with severe acidosis. His respiratory condition improved and he was extubated successfully on the 6 th hospital day. The patient had no obvious neurological defects and he was discharged in a stable condition after 17 days of hospitalization. Our case report demonstrates the advantages of therapeutic hypothermia on survival and neurological outcomes in treating pediatric near drowning patients.

Activation analysis in a multitechnique study of trace element imbalances in age-related neurological diseases

International Nuclear Information System (INIS)

Ehmann, W.D.; Ding, X.X.; Khare, S.S.; Lovell, M.A.; Ni, B.F.; Tandon, L.; Vance, D.E.; Wenstrup, D.E.

1993-01-01

It has been suggested that several age-related neurological diseases such as Alzheimer's disease and amyotrophic lateral sclerosis may be related to environmental toxins. Bulk sample multielemental analyses by INAA alone are not adequate to define the role of trace elements in these diseases. A multitechnique approach has been developed that incorporates 14 MeV, instrumental reactor, radiochemical, and pre-irradiation chemical neutron activation analysis, together with laser microprobe mass spectrometry. The analytical scheme is able to provide bulk or protein normalized elemental concentrations, as well as microstructural, cellular, and subcellular localization information. (author) 21 refs.; 3 figs.; 3 tabs

Phrenic nerve deficits and neurological immunopathology associated with acute West Nile virus infection in mice and hamsters.

Science.gov (United States)

Zukor, Katherine; Wang, Hong; Hurst, Brett L; Siddharthan, Venkatraman; Van Wettere, Arnaud; Pilowsky, Paul M; Morrey, John D

2017-04-01

Neurological respiratory deficits are serious outcomes of West Nile virus (WNV) disease. WNV patients requiring intubation have a poor prognosis. We previously reported that WNV-infected rodents also appear to have respiratory deficits when assessed by whole-body plethysmography and diaphragmatic electromyography. The purpose of this study was to determine if the nature of the respiratory deficits in WNV-infected rodents is neurological and if deficits are due to a disorder of brainstem respiratory centers, cervical spinal cord (CSC) phrenic motor neuron (PMN) circuitry, or both. We recorded phrenic nerve (PN) activity and found that in WNV-infected mice, PN amplitude is reduced, corroborating a neurological basis for respiratory deficits. These results were associated with a reduction in CSC motor neuron number. We found no dramatic deficits, however, in brainstem-mediated breathing rhythm generation or responses to hypercapnia. PN frequency and pattern parameters were normal, and all PN parameters changed appropriately upon a CO 2 challenge. Histological analysis revealed generalized microglia activation, astrocyte reactivity, T cell and neutrophil infiltration, and mild histopathologic lesions in both the brainstem and CSC, but none of these were tightly correlated with PN function. Similar results in PN activity, brainstem function, motor neuron number, and histopathology were seen in WNV-infected hamsters, except that histopathologic lesions were more severe. Taken together, the results suggest that respiratory deficits in acute WNV infection are primarily due to a lower motor neuron disorder affecting PMNs and the PN rather than a brainstem disorder. Future efforts should focus on markers of neuronal dysfunction, axonal degeneration, and myelination.

History of pediatric neurology in Poland.

Science.gov (United States)

Steinborn, Barbara; Józwiak, Sergiusz

2010-02-01

This review presents the past and the present of pediatric neurology in Poland. Pediatric neurology has its roots in Polish general neurology represented by many outstanding scientists. The founder of Polish school of neurology at the end of 19th century was Edward Flatau, known as the author of Flatau's law. The most famous Polish neurologist was Joseph Babiński, recognized for the first description of pathological plantar reflex. First Polish publication related to child neurology was Brudziński's report on a new meningeal symptom (the flexion of lower limbs during passive neck flexion with pain in neck). Contemporary child neurology in Poland was created by Professor Zofia Majewska after the Second World War. Now 10 academic centers of child neurology exist in Poland fulfilling educational, scientific, and therapeutic roles. Polish Society of Child Neurology was established in 1991 and now there are about 580 members, including 300 child neurologists.

Synaesthesia, the arts and creativity: a neurological connection.

Science.gov (United States)

Mulvenna, Catherine M

2007-01-01

For over 100 years the link between synaesthesia and the arts has attracted controversy. This has been spurred by the production of auditory, literary and visual art by famous individuals who report experiences synonymous with the neurological condition. Impressive protagonists in this discussion include Arthur Rimbaud, Charles Baudelaire, Vasily Kandinsky, Vladimir Nabokov, Alexander Scriabin, Olivier Messiaen and David Hockney. Interdisciplinary debates have concerned whether synaesthesia can actively contribute to an artist's ability, whether it is a driving force or a mere idiosyncratic quirk and whether, fundamentally, it is a distinct idiopathic condition or an unusual metaphorical description of normal perception. Recent psychological and neuroscientific evidence offers a new level to the debate. Coherent patterns of a neural basis of synaesthesia have been confirmed with high spatial resolution brain imaging techniques and the link with the arts is transpiring to be more than superficial or coincidental. Moreover, the neural distinction of the synaesthete brain may prove to be a window into a neural basis of creative cognition, and therefore conducive to the expression of creativity in various media.

African Journal of Neurological Sciences

African Journals Online (AJOL)

African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

Neurology and international organizations.

Science.gov (United States)

Mateen, Farrah J

2013-07-23

A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas.

The Effects of External Focus of Attention on Shoulder Muscle Activities during Forehand Drive in Table Tennis

Directory of Open Access Journals (Sweden)

Mohammad Reza Hatami

2016-06-01

Full Text Available Objective: The aim of this study was to evaluate the impact of the external focus of attention on the rotator cuff muscle activity for the timely hit forehand drive by table tennis players. Methods: Twelve professional table tennis players with mean age of 26.5 years voluntarily participated in this study. The electrical activities of the muscles of the shoulder girdle using M.A 300 machine and bipolar electrodes surface under two conditions .First with external focus of attention and then without such attention were recorded, first without any guidance blows forehand drive was carried out by subjects (without focus. Then such subject was asked to focus their attention on the area marked for the ball landing (external focus of attention.      Muscle activities in both preparation and tapping phases were analyzed the three –dimensional (200 Hz, Vicon, with four camera series T motion analysis system was used to obtain the data. Data was analyzed by running reported measures ANOVA at a significance level of p0.05 but the different between the intensity of muscle activity was meaningful. This suggests that there is a mutual influence between the two attention factors and muscles (p=0.03, that is, orientation can have a significant effect on the severity of muscle contraction. Intensities of muscle contraction in the preparation and tapping were different (p<0.05. Conclusion: On the forehand drive technique, the anterior deltoid muscle has the most activity. The type of focus and attention had a significant impact on the change of activity of muscles relative to each other, and the greatest impact is on the reduction of activity of the infraspinatus muscle. This type of focus delays fatigue and results in an increase in the efficiency of neuromuscular in the activities of skills.

Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders.

Science.gov (United States)

Nowinski, W L; Chua, B C

2013-06-01

Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way.

Nanotechnology based diagnostics for neurological disorders

Energy Technology Data Exchange (ETDEWEB)

Kurek, Nicholas S; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

2012-07-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Nanotechnology based diagnostics for neurological disorders

Energy Technology Data Exchange (ETDEWEB)

Kurek, Nicholas S.; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

2012-07-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

Nanotechnology based diagnostics for neurological disorders

International Nuclear Information System (INIS)

Kurek, Nicholas S.; Chandra, Sathees B.

2012-01-01

Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

THE NEUROLOGICAL FACE OF CELIAC DISEASE.

Science.gov (United States)

Işikay, Sedat; Kocamaz, Halil

2015-01-01

Several neurological disorders have also been widely described in celiac disease patients. The aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature. This prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed. In neurological evaluation, totally 40 (13. 5%) of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations. It is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

The popularity of neurology in Spain: An analysis of specialty selection.

Science.gov (United States)

Curbelo, J; Romeo, J M; Galván-Román, J M; Vega-Villar, J; Martinez-Lapiscina, E H; Jiménez-Fonseca, P; Villacampa, T; Sánchez-Lasheras, F; Fernández-Somoano, A; Baladrón, J

2017-12-23

Neurology is one of the medical specialties offered each year to residency training candidates. This project analyses the data associated with candidates choosing neurology residency programmes in recent years. Data related to specialty selection were obtained from official reports by the Spanish Ministry of Health, Social Services, and Equality. Information was collected on several characteristics of teaching centres: availability of stroke units, endovascular intervention, national reference clinics for neurology, specific on-call shifts for neurology residents, and links with medical schools or national research networks. The median selection list position of candidates selecting neurology training has been higher year on year; neurology was among the 4 most popular residency programmes in 2016. Potential residents were mainly female, Spanish, and had good academic results. The median number of hospitals with higher numbers of beds, endovascular intervention, stroke units, and national reference clinics for neurology is significantly lower. This is also true when centers are analysed by presence of specific on-call shifts for neurology residents and association with medical schools or national research networks. The centres selected by candidates with the highest median selection list position in 2012-2016 were the Clínico San Carlos, 12 de Octubre, and Vall d'Hebron university hospitals. Neurology has gradually improved in residency selection choices and is now one of the 4 most popular options. Potential residents prefer larger centres which are more demanding in terms of patient care and which perform more research activity. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

The Pan-American Federation of Neurological Societies (PAFNS): A New Regional Organization.

Science.gov (United States)

Medina, Marco T; Román, Gustavo C

2016-07-15

The Pan-American Federation of Neurological Societies (PAFNS) was created on 15 November 2011 during the 20th World Congress of Neurology in Marrakech by virtue of the "Declaration of Morocco" signed by the WFN Latin American delegates and ratified on 5 March 2012 by delegates attending the 13th Pan-American Congress of Neurology in La Paz, Bolivia. On 20 March 2013 delegates attending the 65th Annual Meeting of the American Academy of Neurology in San Diego, California, USA, gave formal approval to the PAFNS Constitution. The neurological societies from the following countries have approved and signed the constitution as founding members and active ordinary members: Argentina, Brazil, Bolivia, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, Uruguay, and Venezuela. The Ibero-American Stroke Society (SIECV), the Commission on Latin American Affairs of the International League Against Epilepsy (ILAE) and the World Sleep Society have requested the status of Associate Members. The WFN and the American Academy of Neurology provided seed grants for the creation of the Pan-American Federation of Neurological Societies. PAFNS represents a major step for the improvement of regional neurological care, education and research. Copyright © 2016 Elsevier B.V. All rights reserved.

Neurology of foreign language aptitude

Directory of Open Access Journals (Sweden)

Adriana Biedroń

2015-01-01

Full Text Available This state-of-the art paper focuses on the poorly explored issue of foreign language aptitude, attempting to present the latest developments in this field and reconceptualizations of the construct from the perspective of neuroscience. In accordance with this goal, it first discusses general directions in neurolinguistic research on foreign language aptitude, starting with the earliest attempts to define the neurological substrate for talent, sources of difficulties in the neurolinguistic research on foreign language aptitude and modern research methods. This is followed by the discussion of the research on the phonology of foreign language aptitude with emphasis on functional and structural studies as well as their consequences for the knowledge of the concept. The subsequent section presents the studies which focus on lexical and morphosyntactic aspects of foreign language aptitude. The paper ends with a discussion of the limitations of contemporary research, the future directions of such research and selec ed methodological issues.

Hippocrates: the forefather of neurology.

Science.gov (United States)

Breitenfeld, T; Jurasic, M J; Breitenfeld, D

2014-09-01

Hippocrates is one of the most influential medical doctors of all times. He started observing and experimenting in times of mysticism and magic. He carried a holistic and humanitarian approach to the patient with examination as the principal approach-inspection, palpation and auscultation are still the most important tools in diagnosing algorithms of today. He had immense experience with the human body most likely due to numerous wound treatments he had performed; some even believe he performed autopsies despite the negative trend at the time. Hippocrates identified the brain as the analyst of the outside world, the interpreter of consciousness and the center of intelligence and willpower. Interestingly, Hippocrates was aware of many valid concepts in neurology; his treatise On the Sacred Disease was the most important for understanding neurology and epilepsy. His other ideas pioneered modern day neurology mentioning neurological diseases like apoplexy, spondylitis, hemiplegia, and paraplegia. Today, 10 % of neurological Pubmed and 7 % of neuroscience Scopus reviews mention Corpus Hippocraticum as one of the sources. Therefore, Hippocrates may be considered as the forefather of neurology.

Improving clinical cognitive testing: report of the AAN Behavioral Neurology Section Workgroup.

Science.gov (United States)

Daffner, Kirk R; Gale, Seth A; Barrett, A M; Boeve, Bradley F; Chatterjee, Anjan; Coslett, H Branch; D'Esposito, Mark; Finney, Glen R; Gitelman, Darren R; Hart, John J; Lerner, Alan J; Meador, Kimford J; Pietras, Alison C; Voeller, Kytja S; Kaufer, Daniel I

2015-09-08

To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. © 2015 American Academy of Neurology.

Neurology at the bedside

DEFF Research Database (Denmark)

Kondziella, Daniel; Waldemar, Gunhild

, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training...

[German neurology and neurologists during the Third Reich: the aftermath].

Science.gov (United States)

Martin, M; Fangerau, H; Karenberg, A

2016-08-01

The article discusses the consequences for neurology as a discipline which resulted from neurologists' participation in the crimes committed under National Socialism (NS). Chronologically, the current literature distinguishes mainly four overlapping stages: (1) a first phase was characterized by legal persecution and "denazification", which was also the time of the Nuremberg doctors' trial in which no neurologists were on trial. A detailed documentation of the trial for the German medical profession was published by Alexander Mitscherlich. (2) In the subsequent practice of wide amnestying and reintegration of former Nazi followers during the 1950s, neurologists were no exception as its elite continued in their positions. The year 1953 was the year of the Lisbon scandal, when chiefly Dutch representatives protested against the participation of Julius Hallervorden in the International Congress of Neurology. The newly founded societies, the German Society for Neurology (Deutsche Gesellschaft für Neurologie, DGN) and the German Society for Psychiatry and Neurology (Deutsche Gesellschaft für Psychiatrie und Neurologie, DGPN), unanimously supported their member. (3) The next period was characterized by a nascent criticism of the prevailing attitude of covering up the crimes committed by physicians during the Nazi period. The discovery of incriminating brain sections at various Max Planck Institutes brought neurology to the focus of the debate. (4) Since the 1980s and 1990s historians (of medicine) have been systematically examining medicine's Nazi past in a professional way, which resulted in a noticeable increase of knowledge. Additionally, a new generation of scholars provoked a change of mind insofar as they recognized medicine's responsibility for the crimes committed between 1933 and 1945. We expect that future historical research will further elucidate the history of neurology during the NS regime and have consequences for our current understanding of research

THE NEUROLOGICAL FACE OF CELIAC DISEASE

Directory of Open Access Journals (Sweden)

Sedat IŞIKAY

2015-09-01

Full Text Available BackgroundSeveral neurological disorders have also been widely described in celiac disease patients.ObjectiveThe aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature.MethodsThis prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed.ResultsIn neurological evaluation, totally 40 (13. 5% of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations.ConclusionIt is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

X-ray diagnostics of neurological manifestations of cervical osteochondrosis and their importance in planning rehabilitation activities

International Nuclear Information System (INIS)

Mikhajlov, A.N.; Abel'skaya, I.S.; Smychek, V.B.

2009-01-01

We examined 500 patients with neurological manifestations of cervical osteochondrosis. It was found that each method of osteochondrosis visualization has its designation. Complex radial visualization of the cervical spine increases the quality of diagnosis: gives the chance to evaluate more precisely expressiveness of its degenerate-dystrophic changes, to establish their importance at medical planning of rehabilitation actions, and also to predict neurological complications. Distribution of patients on clinic-rehabilitation groups allows developing of an effective rehabilitation system of sick and disabled with neurological manifestations of cervical spine osteochondrosis that would not only improve the health of affected, but also have significant socio-economic effect. (authors)

Pediatric neurological syndromes and inborn errors of purine metabolism.

Science.gov (United States)

Camici, Marcella; Micheli, Vanna; Ipata, Piero Luigi; Tozzi, Maria Grazia

2010-02-01

This review is devised to gather the presently known inborn errors of purine metabolism that manifest neurological pediatric syndromes. The aim is to draw a comprehensive picture of these rare diseases, characterized by unexpected and often devastating neurological symptoms. Although investigated for many years, most purine metabolism disorders associated to psychomotor dysfunctions still hide the molecular link between the metabolic derangement and the neurological manifestations. This basically indicates that many of the actual functions of nucleosides and nucleotides in the development and function of several organs, in particular central nervous system, are still unknown. Both superactivity and deficiency of phosphoribosylpyrophosphate synthetase cause hereditary disorders characterized, in most cases, by neurological impairments. The deficiency of adenylosuccinate lyase and 5-amino-4-imidazolecarboxamide ribotide transformylase/IMP cyclohydrolase, both belonging to the de novo purine synthesis pathway, is also associated to severe neurological manifestations. Among catabolic enzymes, hyperactivity of ectosolic 5'-nucleotidase, as well as deficiency of purine nucleoside phosphorylase and adenosine deaminase also lead to syndromes affecting the central nervous system. The most severe pathologies are associated to the deficiency of the salvage pathway enzymes hypoxanthine-guanine phosphoribosyltransferase and deoxyguanosine kinase: the former due to an unexplained adverse effect exerted on the development and/or differentiation of dopaminergic neurons, the latter due to a clear impairment of mitochondrial functions. The assessment of hypo- or hyperuricemic conditions is suggestive of purine enzyme dysfunctions, but most disorders of purine metabolism may escape the clinical investigation because they are not associated to these metabolic derangements. This review may represent a starting point stimulating both scientists and physicians involved in the study of

Neurology of cardiopulmonary resuscitation.

Science.gov (United States)

Mulder, M; Geocadin, R G

2017-01-01

This chapter aims to provide an up-to-date review of the science and clinical practice pertaining to neurologic injury after successful cardiopulmonary resuscitation. The past two decades have seen a major shift in the science and practice of cardiopulmonary resuscitation, with a major emphasis on postresuscitation neurologic care. This chapter provides a nuanced and thoughtful historic and bench-to-bedside overview of the neurologic aspects of cardiopulmonary resuscitation. A particular emphasis is made on the anatomy and pathophysiology of hypoxic-ischemic encephalopathy, up-to-date management of survivors of cardiopulmonary resuscitation, and a careful discussion on neurologic outcome prediction. Guidance to practice evidence-based clinical care when able and thoughtful, pragmatic suggestions for care where evidence is lacking are also provided. This chapter serves as both a useful clinical guide and an updated, thorough, and state-of-the-art reference on the topic for advanced students and experienced practitioners in the field. © 2017 Elsevier B.V. All rights reserved.

The relationship between the First World War and neurology: 100 years of "Shell Shock".

Science.gov (United States)

Pedroso, José Luiz; Linden, Stefanie C; Barsottini, Orlando G; Maranhão, Péricles; Lees, Andrew J

2017-05-01

The First World War was a global war, beginning on 28 July 1914, until 11 November 1918. Soon after the beginning of the war, there was an "epidemic" of neurological conversion symptoms. Soldiers on both sides started to present in large numbers with neurological symptoms, such as dizziness, tremor, paraplegia, tinnitus, amnesia, weakness, headache and mutism of psychosomatic origin. This condition was known as shell shock, or "war neurosis". Because medically unexplained symptoms remain a major challenge, and considering the close relationship of symptoms described in shell shock with clinical neurology, we should study their history in order to improve future care.

Neuromodulation of lower limb motor control in restorative neurology

OpenAIRE

Minassian, Karen; Hofstoetter, Ursula; Tansey, Keith; Mayr, Winfried

2012-01-01

One consequence of central nervous system injury or disease is the impairment of neural control of movement, resulting in spasticity and paralysis. To enhance recovery, restorative neurology procedures modify altered, yet preserved nervous system function. This review focuses on functional electrical stimulation (FES) and spinal cord stimulation (SCS) that utilize remaining capabilities of the distal apparatus of spinal cord, peripheral nerves and muscles in upper motor neuron dysfunctions. F...

Neurological Signs and Symptoms in Fibromyalgia

Science.gov (United States)

Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.

2009-01-01

Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM. PMID:19714636

Neurologic signs and symptoms in fibromyalgia.

Science.gov (United States)

Watson, Nathaniel F; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G

2009-09-01

To determine the type and frequency of neurologic signs and symptoms in individuals with fibromyalgia (FM). Persons with FM (n = 166) and pain-free controls (n = 66) underwent systematic neurologic examination by a neurologist blinded to disease status. Neurologic symptoms lasting at least 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurologic symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Age- and sex-adjusted estimates revealed that compared with the control group, the FM group had significantly more neurologic abnormalities in multiple categories, including greater dysfunction in cranial nerves IX and X (42% versus 8%) and more sensory (65% versus 25%), motor (33% versus 3%), and gait (28% versus 7%) abnormalities. Similarly, the FM group had significantly more neurologic symptoms than the control group in 27 of 29 categories, with the greatest differences observed for photophobia (70% versus 6%), poor balance (63% versus 4%), and weakness (58% versus 2%) and tingling (54% versus 4%) in the arms or legs. Poor balance or coordination, tingling or weakness in the arms or legs, and numbness in any part of the body correlated with appropriate neurologic examination findings in the FM group. This blinded, controlled study demonstrated neurologic physical examination findings in persons with FM. The FM group had more neurologic symptoms than did the controls, with moderate correlation between symptoms and signs. These findings have implications for the medical evaluation of patients with FM.

Blood Lead Level in Children with Neurological Disorders.

Science.gov (United States)

Parhoudeh, Marzieh; Inaloo, Soroor; Zahmatkeshan, Mozhgan; Seratishirazi, Zahra; Haghbin, Saeedeh

2018-01-01

We aimed to investigate the blood lead level (BLL) in children with neurologic disorders of unknown causes and compare with normal children. In this prospective case-control study, 68 patients aged 1 to 18 yr with neurologic disorders of unknown causes, were referred to pediatric neurology clinics and wards, Shiraz, Iran selected during a 12 months period from Sep 2013. They were compared with 1:1 ratio, age, and sex-matched healthy children. BLL was checked from all participants using 3 cc heparinized venous blood sample. Level of ≥5 mcg/dl was considered toxic dose. Totally, 136 children (68 cases and 68 controls) with mean ages of 5.20±4.12 and 4.18±3.86 yr, respectively, were enrolled. Mean BLL was higher in case group than in controls but the difference was not significant ( P =0.84), though they were less than toxic levels in both. In addition, the difference in mean BLLs was not significant in terms of living place, sex, and age. Totally, 17.7% of the study sample had BLL ≥5 mcg/dl. The frequency of BLL ≥5 mcg/dl was significantly higher in case group ( P =0.024) with an odds ratio 2.9 times higher (95% CI: 1.066-7.60). Strategies in public health must focus on practicing primary and secondary preventions of lead exposure in children.

Nanotechnology in neurology: Genesis, current status, and future prospects

Directory of Open Access Journals (Sweden)

Paurush Ambesh

2015-01-01

Full Text Available Nanotechnology is a promising, novel field of technological development. There is great potential in research and clinical applications for neurological diseases. Here we chronicle the inception of nanotechnology, discuss its integration with neurology, and highlight the challenges in current application. Some of the problems involving practical use of neuronanotechnology are direct biological toxicity, visualization of the nanodevice, and the short life expectancy of nanomachinery. Neuron cell therapy is an upcoming field for the treatment of challenging problems in neurology. Peptide nanofibers based on amphiphilic molecules have been developed that can autoregulate their structure depending on the conditions of the surrounding milieu. Such frameworks are promising for serving as drug delivery systems or communication bridges between damaged neurons. For common disabling diseases such as Alzheimer′s disease (AD, Parkinson′s disease (PD, amyotrophic lateral sclerosis (ALS, and multiple sclerosis (MS, recent developments have seen revolutionary nanotech-based novelties, which are discussed here in detail. Bioimaging integrated with nanoneuromedicine has opened up new doors for cancer and infection therapeutics.

Tank Focus Area pretreatment activities

International Nuclear Information System (INIS)

McGinnis, C.P.; Welch, T.D.; Manke, K.L.

1997-01-01

Plans call for the high-level wastes to be retrieved from the tanks and immobilized in a stable waste form suitable for long-term isolation. Chemistry and chemical engineering operations are required to retrieve the wastes, to condition the wastes for subsequent steps, and to reduce the costs of the waste management enterprise. Pretreatment includes those processes between retrieval and immobilization, and includes preparation of suitable feed material for immobilization and separations to partition the waste into streams that yield lower life-cycle costs. Some of the technologies being developed by the Tank Focus Area (TFA) to process these wastes are described. These technologies fall roughly into three areas: (1) solid/liquid separation (SLS), (2) sludge pretreatment, and (3) supernate pretreatment

The Optimal Conditions for Form-Focused Instruction: Method, Target Complexity, and Types of Knowledge

Science.gov (United States)

Kim, Jeong-eun

2012-01-01

This dissertation investigates optimal conditions for form-focused instruction (FFI) by considering effects of internal (i.e., timing and types of FFI) and external (i.e., complexity and familiarity) variables of FFI when it is offered within a primarily meaning-focused context of adult second language (L2) learning. Ninety-two Korean-speaking…

Current neurology

International Nuclear Information System (INIS)

Appel, S.H.

1988-01-01

The topics covered in this book include: Duchenne muscular dystrophy: DNA diagnosis in practice; Central nervous system magnetic resonance imaging; and Magnetic resonance spectroscopy of neurologic diseases

Neurological aspects of eclampsia

Directory of Open Access Journals (Sweden)

Jovanović Dejana

2003-01-01

Full Text Available The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn’t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.

Mercy killing in neurology: The beginnings of neurology on screen (II).

Science.gov (United States)

Wijdicks, Eelco F M; Karenberg, Axel

2016-09-20

The history of Neurocinema includes neuroethics, and this theme was first used in 2 films released in the 1940s in both Germany and the United States. Ich Klage An (I Accuse) is about "terminal" multiple sclerosis in a young woman and the decision to determine one's own fate. The protagonist anticipates becoming "deaf, blind, and idiotic" and asks her husband to administer a toxic drug dose, which he does. The film disturbingly suggests that the diagnosis of multiple sclerosis is tantamount to a death sentence. Ich Klage An (1941) played during the medical murders era ("Aktion T-4" program) but has few references to National Socialism, except for judges with Nazi emblems on their robes making a brief Nazi salute and a jury chamber with a bust of Hitler. Party leadership agreed that the film made a deep impression, but the intended effect on the viewing public is largely unknown. An Act of Murder (1948) involves another young woman with an inoperable brain tumor. When her condition worsens during a trip, her husband deliberately crashes the car, killing her but surviving himself. A subsequent trial finds that she died of an overdose rather than the crash. The trial judge dismisses the murder charge, but the film argues the morals of mercy killing. These films came out during the Nazi euthanasia program and founding of the Euthanasia Society of America in 1938. The choice of neurologic disease by these filmmakers and scriptwriters to defend euthanasia is remarkable. © 2016 American Academy of Neurology.

K-Cl cotransporters, cell volume homeostasis, and neurological disease.

Science.gov (United States)

Kahle, Kristopher T; Khanna, Arjun R; Alper, Seth L; Adragna, Norma C; Lauf, Peter K; Sun, Dandan; Delpire, Eric

2015-08-01

K(+)-Cl(-) cotransporters (KCCs) were originally characterized as regulators of red blood cell (RBC) volume. Since then, four distinct KCCs have been cloned, and their importance for volume regulation has been demonstrated in other cell types. Genetic models of certain KCCs, such as KCC3, and their inhibitory WNK-STE20/SPS1-related proline/alanine-rich kinase (SPAK) serine-threonine kinases, have demonstrated the evolutionary necessity of these molecules for nervous system cell volume regulation, structure, and function, and their involvement in neurological disease. The recent characterization of a swelling-activated dephosphorylation mechanism that potently stimulates the KCCs has pinpointed a potentially druggable switch of KCC activity. An improved understanding of WNK/SPAK-mediated KCC cell volume regulation in the nervous system might reveal novel avenues for the treatment of multiple neurological diseases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neurological manifestations of Chikungunya and Zika infections

Directory of Open Access Journals (Sweden)

Talys J. Pinheiro

Full Text Available ABSTRACT The epidemics of Chikungunya virus (CHIKV and Zika virus (ZIKV infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others. The diagnosis is based on clinical, epidemiological, and laboratory criteria. The most common symptoms of ZIKV infection are skin rash (mostly maculopapular, fever, arthralgia, myalgia, headache, and conjunctivitis. Some epidemics that have recently occurred in French Polynesia and Brazil, reported the most severe conditions, with involvement of the nervous system (Guillain-Barré syndrome, transverse myelitis, microcephaly and meningitis. The treatment for ZIKV and CHIKV infections are symptomatic and the management for neurological complications depends on the type of affliction. Intravenous immunoglobulin, plasmapheresis, and corticosteroid pulse therapy are options.

Severe neurological impairment: legal aspects of decisions to reduce care.

Science.gov (United States)

Beresford, H R

1984-05-01

Decisions to reduce care for patients with severe neurological impairment may raise legal questions. The laws of most states now authorize physicians to stop care for those who have suffered irreversible cessation of all functions of the brain ("brain death"). Where state law is not explicit, it is nevertheless probably lawful to regard brain death as death for legal purposes so long as currently accepted criteria are satisfied. Several courts have ruled that it is lawful to reduce care for patients in vegetative states, but have prescribed differing standards and procedures for implementing such decisions. The issue of whether parents can authorize physicians to reduce care for neurologically impaired children is the focus of current litigation. Implicit in this litigation is the question of how severe neurological impairment must be before parents and physicians may lawfully agree to reduce care. For severely impaired but not vegetative adults, there is some legal authority to justify certain decisions to reduce care. The issue of whether withholding feeding from a severely demented patient with life-threatening medical problems constitutes criminal behavior is now being considered by a state supreme court.

Affective disorders in neurological diseases

DEFF Research Database (Denmark)

Nilsson, F M; Kessing, L V; Sørensen, T M

2003-01-01

OBJECTIVE: To investigate the temporal relationships between a range of neurological diseases and affective disorders. METHOD: Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two...... of affective disorder was lower than the incidence in the control groups. CONCLUSION: In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases)....

[The problem of suicide in neurologic rehabilitation].

Science.gov (United States)

Kallert, T W

1994-05-01

Associations between somatic as well as, in particular, neurological diseases and suicidal acts are outlined, with studies of different diseases having shown that they represent only one factor in motivating the suicidal act. Biographical predispositions and stressful variables from the current social situation are always added. Depressive and organic brain syndromes that can often be found during neurological rehabilitation are discussed in their significance as risk factors for suicidal behavior, also seeking to identify distinct phases of the rehabilitation process afflicted with high suicide risk. An active and carefully directed approach to exploration as well as grasping the psychopathological symptomatology are fundamental elements in the assessment of suicide risk. In this respect, observations of the patient's behaviour and information obtained from relatives are of special importance in neurological rehabilitation clinics. The "presuicidal syndrome" (Ringel) continues to be of high clinical value in assessing the psychodynamics of the individual patient in his development towards the suicidal act. Reflections of suicidal tendencies in countertransference reactions and the communication pathology of suicidal behaviour are more recent aspects that enrich the assessment of suicide risk. Therapeutic management of suicidal patients can firstly be characterized by the principle of specific diagnosis and treatment of the underlying disease; this means that optimum medical care even has a suicide-preventive function. The other principle considers the establishment of a therapeutical relationship as a must, and some critical points in the personal contact with suicidal patients are dealt with in some detail. Especially in neurological rehabilitation clinics, custodial aspects must not be neglected.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurological complication in HIV patients

Science.gov (United States)

Ritarwan, K.

2018-03-01

Human Immunodeficiency Virus (HIV) is neurotropic and immunotropic, making themassive destruction of both systems. Although their amount has been reduced, there is still neurological presentations and complications of HIV remain common in the era of combination antiretroviral therapy (cART). Neurological opportunistic infections (OI) occur in advanced HIV diseases such as primary cerebral lymphoma, cryptococcal meningitis, cerebral toxoplasmosis, and progressive multifocal encephalopathy. Neurological problem directly related to HIV appear at any stage in the progress of HIV disease, from AIDS-associated dementia to the aseptic meningitis of primary HIV infection observed in subjects with an immune deficiency. The replication of peripheral HIV viral is able to be controlled in the era of effective antiretroviral therapy. Non-HIV-related neurological disease such as stroke increased important as the HIV population ages.

Minds on replay: musical hallucinations and their relationship to neurological disease.

Science.gov (United States)

Golden, Erin C; Josephs, Keith A

2015-12-01

The phenomenon of musical hallucinations, in which individuals perceive music in the absence of an external auditory stimulus, has been described sparingly in the literature through small case reports and series. Musical hallucinations have been linked to multiple associated conditions, including psychiatric and neurologic disease, brain lesions, drug effect, and hearing impairment. This study aimed to review the demographics of subjects with musical hallucinations and to determine the prevalence of neurological disorders, particularly neurodegenerative disease. Through the Mayo medical record, 393 subjects with musical hallucinations were identified and divided into five categories based on comorbid conditions that have been associated with musical hallucinations: neurological, psychiatric, structural, drug effect and not otherwise classifiable. Variables, including hearing impairment and the presence of visual and other auditory hallucinations, were evaluated independently in all five groups. The mean age at onset of the hallucinations was 56 years, ranging from 18 to 98 years, and 65.4% of the subjects were female. Neurological disease and focal brain lesions were found in 25% and 9% of the total subjects, respectively. Sixty-five subjects were identified with a neurodegenerative disorder, with the Lewy body disorders being the most common. Visual hallucinations were more common in the group with neurological disease compared to the psychiatric, structural, and not otherwise classifiable groups (P < 0.001), whereas auditory hallucinations were more common in the psychiatric group compared to all other groups (P < 0.001). Structural lesions associated with musical hallucinations involved both hemispheres with a preference towards the left, and all but two included the temporal lobe. Hearing impairment was common, particularly in the not otherwise classifiable category where 67.2% had documented hearing impairment, more than in any other group (P < 0.001). Those

Music-based interventions in neurological rehabilitation.

Science.gov (United States)

Sihvonen, Aleksi J; Särkämö, Teppo; Leo, Vera; Tervaniemi, Mari; Altenmüller, Eckart; Soinila, Seppo

2017-08-01

During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis. Music-based interventions can affect divergent functions such as motor performance, speech, or cognition in these patient groups. However, the psychological effects and neurobiological mechanisms underlying the effects of music interventions are likely to share common neural systems for reward, arousal, affect regulation, learning, and activity-driven plasticity. Although further controlled studies are needed to establish the efficacy of music in neurological recovery, music-based interventions are emerging as promising rehabilitation strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

The neurological legacy of John Russell Reynolds (1828-1896).

Science.gov (United States)

Eadie, M J

2007-04-01

Sir John Russell Reynolds was an eminent and highly influential physician in the Victorian era who held the Presidencies of the Royal College of Physicians of London, and of the British Medical Association. He was the protégée of the great experimental physiologist, Marshall Hall, who discovered the reflex arc, and succeeded to Hall's clinical practice in London. Reynolds' thought and clinical activities linked the emerging British neurology of the first half of the 19th century with its blossoming, particularly in London, from 1860 onwards. In his writings Reynolds was the first English author to apply the approach to classification of neurological disorders that is still often used, though now in modified form. He was also the first to enunciate the notion of positive and negative symptoms arising from neurological disease and to suggest their pathogenesis, and was arguably the originator of the influential concept that an idiopathic disease, epilepsy, existed, one to be distinguished from 'epileptiform' seizures due to brain pathology.

Neurologic sequelae associated with foscarnet therapy.

Science.gov (United States)

Lor, E; Liu, Y Q

1994-09-01

To report three cases of possible foscarnet-induced neurologic sequelae. We report two cases of seizures and one case of hand cramping and finger paresthesia after starting foscarnet therapy with no evidence of predisposing risk factors, such as serum laboratory abnormalities, renal dysfunction, or known central nervous system (CNS) involvement. All three patients had stable laboratory values during therapy and when the neurologic adverse effects occurred. All patients were receiving appropriate dosages of foscarnet. The incidence of seizures in AIDS patients was reviewed. A history of CNS lesions, infections, and/or AIDS per se may increase the risk of a neurologic adverse effect while receiving foscarnet therapy. Acute ionized hypocalcemia may cause these neurologic adverse effects. Ionized hypocalcemia is transitory, is related to the rate of foscarnet infusion, and may not be reflected as a change in total serum calcium concentration. Foscarnet probably contributed to the neurologic adverse effects reported here. Foscarnet may need to be administered at a slower rate than is recommended by the manufacturer. Electrolytes must be monitored closely; however, a neurologic adverse effect may not be foreseen.

Neurological Disorders in Adult Celiac Disease

Directory of Open Access Journals (Sweden)

Hugh J Freeman

2008-01-01

Full Text Available Celiac disease may initially present as a neurological disorder. Alternatively, celiac disease may be complicated by neurological changes. With impaired nutrient absorption, different deficiency syndromes may occur and these may be manifested clinically with neurological changes. However, in patients with deficiency syndromes, extensive involvement of the small intestine with celiac disease is often evident. There are a number of reports of celiac disease associated with neuropathy, ataxia, dementia and seizure disorder. In these reports, there is no clear relationship with nutrient deficiency and a precise mechanism for the neurological changes has not been defined. A small number of patients have been reported to have responded to vitamin E administration, but most do not. In some, gluten antibodies have also been described, especially in those with ataxia, but a consistent response to a gluten-free diet has not been defined. Screening for celiac disease should be considered in patients with unexplained neurological disorders, including ataxia and dementia. Further studies are needed, however, to determine if a gluten-free diet will lead to improvement in the associated neurological disorder.

Neurological manifestations of dengue viral infection

Directory of Open Access Journals (Sweden)

Carod-Artal FJ

2014-10-01

Full Text Available Francisco Javier Carod-Artal1,21Neurology Department, Raigmore hospital, Inverness, UK; 2Universitat Internacional de Catalunya (UIC, Barcelona, Spain Abstract: Dengue is the most common mosquito-borne viral infection worldwide. There is increased evidence for dengue virus neurotropism, and neurological manifestations could make part of the clinical picture of dengue virus infection in at least 0.5%–7.4% of symptomatic cases. Neurological complications have been classified into dengue virus encephalopathy, dengue virus encephalitis, immune-mediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain–Barré syndrome, neuritis brachialis, acute cerebellitis, and others, neuromuscular complications (hypokalemic paralysis, transient benign muscle dysfunction and myositis, and dengue-associated stroke. Common neuro-ophthalmic complications are maculopathy and retinal vasculopathy. Pathogenic mechanisms include systemic complications and metabolic disturbances resulting in encephalopathy, direct effect of the virus provoking encephalitis, and postinfectious immune mechanisms causing immune-mediated syndromes. Dengue viruses should be considered as a cause of neurological disorders in endemic regions. Standardized case definitions for specific neurological complications are still needed. Keywords: encephalitis, encephalopathy, dengue fever, neurological complications

Neurological and Sleep Disturbances in Bronchiectasis

Directory of Open Access Journals (Sweden)

Chun Seng Phua

2017-11-01

Full Text Available Bronchiectasis unrelated to cystic fibrosis is a chronic lung disease that is increasingly recognised worldwide. While other common chronic lung conditions such as chronic obstructive lung disease have been associated with cardiovascular disease, there is a paucity of data on the relationship between bronchiectasis and cardiovascular risks such as stroke and sleep disturbance. Furthermore, it is unclear whether other neuropsychological aspects are affected, such as cognition, cerebral infection, anxiety and depression. In this review, we aim to highlight neurological and sleep issues in relation to bronchiectasis and their importance to patient care.

Pediatric neurology training in Canada: current status and future directions.

Science.gov (United States)

Doja, Asif

2012-05-01

Child neurology training in Canada has changed considerably over time, with increasing requirements for standardized teaching of the fundamentals of child neurology and the CanMEDS competencies. We sought to determine the current status of child neurology training in Canada as well future directions for training. A web-based survey was sent to program directors (PD's) of active pediatric neurology training programs. General questions about the programs were asked, as well as about success at the Royal College of Physicians and Surgeons of Canada (RCPSC) exam, breakdown of rotations, views on CanMEDS roles and questions on the future of pediatric neurology. 9/9 PD's completed the survey. 96.5% of all trainees successfully passed their RCPSC exam from 2001-2006. Breakdowns of the number and type of rotations for each year of training were provided. All CanMEDS roles were deemed to be important by PD's and programs have developed unique strategies to teach and assess these roles.92.6% of trainees chose to go into academic practice, with the most popular subspecialty being epilepsy. All PD's favour joint training sessions particularly for neurogenetics and neuromuscular disease. Overall, PD's suggest recruitment for future child neurologists at the medical student level but are divided as to whether we are currently training too few or too many child neurologists. This survey provides a view of the current state of pediatric neurology training in Canada and suggestions for further development of post-graduate training. In particular, attention should be given to joint educational programs as well as urgently assessing the manpower needs of child neurologists.

Oxidative stress and neurological disorders in relation to blood lead levels in children.

Science.gov (United States)

Ahamed, M; Fareed, Mohd; Kumar, A; Siddiqui, W A; Siddiqui, M K J

2008-01-01

Oxidative stress plays a pivotal role in the pathogenesis of neurological disorders. Free radical generation appears to be the mode of lead toxicity. We evaluated the effects of blood lead levels on oxidative stress parameters in children suffering from neurological disorders. Thirty children (aged 3-12 years) with neurological disorders (cerebral palsy [n = 12], seizures [n = 11], and encephalopathy [n = 7]) were recruited in the study group. Sixty healthy children (aged 3-12 years) from similar socio-economic environments and not suffering from any chronic disease were taken as the controls. Blood lead levels and oxidant/antioxidant status were determined. Mean blood lead level was significantly higher while delta-aminolevulinic acid dehydratase (delta-ALAD) activity, a biomarker for lead exposure, was significantly lower in the study group as compared to the control group (P children with neurological disorders. Lead-induced oxidative stress as an underlying mechanism for neurological diseases in children warranted further investigation.

Music therapy in neurological rehabilitation settings

OpenAIRE

Elżbieta Galińska

2015-01-01

The neurologic music therapy is a new scope of music therapy. Its techniques deal with dysfunctions resulting from diseases of the human nervous system. Music can be used as an alternative modality to access functions unavailable through non-musical stimulus. Processes in the brain activated by the influence of music can be generalized and transferred to non-musical functions. Therefore, in clinical practice, the translation of non-musical therapeutic exercises into analogous, isomorphic ...

Dysphagia and cerebrovascular accident: relationship between severity degree and level of neurological impairment.

Science.gov (United States)

Itaquy, Roberta Baldino; Favero, Samara Regina; Ribeiro, Marlise de Castro; Barea, Liselotte Menke; Almeida, Sheila Tamanini de; Mancopes, Renata

2011-12-01

The aim of this case study was to verify the occurrence of dysphagia in acute ischemic stroke within 48 hours after the onset of the first symptoms, in order to establish a possible relationship between the level of neurologic impairment and the severity degree of dysphagia. After emergency hospital admission, three patients underwent neurological clinical evaluation (general physical examination, neurological examination, and application of the National Institute of Health Stroke Scale - NIHSS), and clinical assessment of swallowing using the Protocolo Fonoaudiológico de Avaliação do Risco para Disfagia (PARD--Speech-Language Pathology Protocol for Risk Evaluation for Dysphagia). One of the patients presented functional swallowing (NIHSS score 11), while the other two had mild and moderate oropharyngeal dysphagia (NIHSS scores 15 and 19, respectively). The service flow and the delay on the patients' search for medical care determined the small sample. The findings corroborate literature data regarding the severity of the neurological condition and the manifestation of dysphagia.

ESPEN guideline clinical nutrition in neurology.

Science.gov (United States)

Burgos, Rosa; Bretón, Irene; Cereda, Emanuele; Desport, Jean Claude; Dziewas, Rainer; Genton, Laurence; Gomes, Filomena; Jésus, Pierre; Leischker, Andreas; Muscaritoli, Maurizio; Poulia, Kalliopi-Anna; Preiser, Jean Charles; Van der Marck, Marjolein; Wirth, Rainer; Singer, Pierre; Bischoff, Stephan C

2018-02-01

Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs. The present evidence- and consensus-based guideline addresses clinical questions on best medical nutrition therapy in patients with neurological diseases. Among them, management of oropharyngeal dysphagia plays a pivotal role. The guideline has been written by a multidisciplinary team and offers 88 recommendations for use in clinical practice for amyotrophic lateral sclerosis, Parkinson's disease, stroke and multiple sclerosis. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Perception of pediatric neurology among non-neurologists.

Science.gov (United States)

Jan, Mohammed M S

2004-01-01

Pediatric neurology is considered a relatively new and evolving subspecialty. In Saudi Arabia, neurologic disorders in children are common, and the demand for trained pediatric neurologists is strong. The aim was to study the perception of the pediatric neurology specialty among practicing generalists and their referral practices. Attendees of a symposium on pediatric epilepsy comprehensive review for the generalist were included. A structured 25-item questionnaire was designed to examine their demographics, training, practice, and referral patterns. One hundred nineteen participants attended the symposium, and 90 (76%) questionnaires were returned. Attendees' ages were 22 to 70 years (mean 32 years), with 65.5% female physicians. There were 32% consultants, 51% trainees, and 17% students. Most physicians (67%) were practicing general pediatrics. Only 36% received a structured pediatric neurology rotation during training. Children with neurologic complaints constituted 28.5% of those seen in their practice, and they referred 32.5% of them to pediatric neurology. Only 32% were moderately or highly confident in making the diagnosis or providing the appropriate treatment. Those who received a structured pediatric neurology rotation felt more comfortable in their management (P = .03). Many physicians (38.5%) had no direct access to a pediatric neurologist for referrals. To conclude, pediatric neurologic disorders are common in daily practice. Most generalists did not receive a structured neurology rotation during their training and were not highly confident in diagnosing and treating these children. Given the limited number of pediatric neurologists, I highly recommend that generalists receive appropriate neurologic training.

I-123 Iofetamine SPECT scan in children with neurological disorders

International Nuclear Information System (INIS)

Flamini, J.R.; Konkol, R.J.; Wells, R.G.; Sty, J.R.

1990-01-01

I-123 Iofetamine (IMP) single photon emission computed tomography (SPECT) imaging of the brain in 42 patients (ages 14 days to 23 years) was compared with other localizing studies in children with neurological diseases. All had an EEG and at least one imaging study of the brain (computed tomography (CT) or magnetic resonance imaging (MRI), or both). Seventy-eight percent of the patients had an EEG within 24-72 hours of the IMP-SPECT scan. Thirty-five (83%) had a history of seizures, and the remainder had other neurological conditions without a history of seizures. In most cases, a normal EEG reading with normal CT or MRI result predicted a normal SPECT study. When the EEG was abnormal the majority of the IMP-SPECT scans were abnormal and localized the abnormality to the same region. A comparison with CT and MRI showed that structural abnormalities involving the cortex were usually well demonstrated with IMP-SPECT imaging. Structural lesions confined to the white matter were generally not detectable with IMP-SPECT. In a few cases, SPECT scans revealed abnormalities in deep brain areas not identified by EEG. IMP-SPECT imaging is a valuable technique for the detection and localization of abnormal cerebral metabolic activity in children with seizure disorders. A correlation with CT or MRI is essential for proper interpretation of abnormalities detected with IMP SPECT imaging

Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the Guideline Development Subcommittee of the American Academy of Neurology.

Science.gov (United States)

Koppel, Barbara S; Brust, John C M; Fife, Terry; Bronstein, Jeff; Youssof, Sarah; Gronseth, Gary; Gloss, David

2014-04-29

To determine the efficacy of medical marijuana in several neurologic conditions. We performed a systematic review of medical marijuana (1948-November 2013) to address treatment of symptoms of multiple sclerosis (MS), epilepsy, and movement disorders. We graded the studies according to the American Academy of Neurology classification scheme for therapeutic articles. Thirty-four studies met inclusion criteria; 8 were rated as Class I. The following were studied in patients with MS: (1) Spasticity: oral cannabis extract (OCE) is effective, and nabiximols and tetrahydrocannabinol (THC) are probably effective, for reducing patient-centered measures; it is possible both OCE and THC are effective for reducing both patient-centered and objective measures at 1 year. (2) Central pain or painful spasms (including spasticity-related pain, excluding neuropathic pain): OCE is effective; THC and nabiximols are probably effective. (3) Urinary dysfunction: nabiximols is probably effective for reducing bladder voids/day; THC and OCE are probably ineffective for reducing bladder complaints. (4) Tremor: THC and OCE are probably ineffective; nabiximols is possibly ineffective. (5) Other neurologic conditions: OCE is probably ineffective for treating levodopa-induced dyskinesias in patients with Parkinson disease. Oral cannabinoids are of unknown efficacy in non-chorea-related symptoms of Huntington disease, Tourette syndrome, cervical dystonia, and epilepsy. The risks and benefits of medical marijuana should be weighed carefully. Risk of serious adverse psychopathologic effects was nearly 1%. Comparative effectiveness of medical marijuana vs other therapies is unknown for these indications.

Sparring And Neurological Function In Professional Boxers

Directory of Open Access Journals (Sweden)

John W Stiller

2014-07-01

Full Text Available AbstractDespite increased interest regarding the potentially long-term negative impact of chronic traumatic brain injury (CTBI, limited research had been conducted regarding such injuries and neurological outcomes in real world settings. To increase understanding regarding the relationship between sparring (e.g., number of years actively training for professional boxing and neurological functioning, professional boxers (n = 237 who competed in Maryland between 2003 to 2008 completed measures regarding sparring exposure (Cumulative Sparring Index; CSI and performance on tests of cognition (Symbol Digit Modalities Test; SDMT and balance (Sharpened Romberg Test; SRT. Measures were completed prior to boxing matches. Higher scores on the CSI (increased sparring exposure were associated with poorer performance on both tests of cognition (SDMT and balance (SRT. A threshold effect was noted regarding performance on the SDMT, with those reporting CSI values greater than about 150 experiencing a decline in cognition. A history of frequent and/or intense sparring may pose a significant risk for developing boxing associated neurological sequelae. Implementing administration of clinically meaningful tests before bouts, such as the CSI, SDMT, and/or the SRT, as well as documentation of results into the boxer’s physicals or medical profiles may be an important step for improving boxing safety.

Association of neurological diseases with metabolic syndrome among out-patients

International Nuclear Information System (INIS)

Ueno, Satoshi; Furiya, Yoshiko; Sugie, Kazuma; Kawahara, Makoto; Kataoka, Hiroshi; Saito, Kozue; Kiriyama, Takao; Kinoshita, Satoko; Hirano, Makito

2007-01-01

Metabolic syndrome (MetS) is highly prevalent in Japan; however, most previous surveys have studied only adults able to engage fully in normal daily activities, after excluding persons with diseases or disabilities. Recently, lifestyle-related risk factors have been strongly linked to a number of major diseases. In particular, the incidence of atherosclerotic vascular diseases associated with MetS has increased markedly, and this trend is projected to continue. We focused on the prevalence of MetS among out-patients with neurological diseases. The subjects for this hospital-based study were 713 out-patients with various neurological diseases (329 men, mean age 65.2±14.5 yr, age range 40-78 yr, and 384 women, mean age 64.6±15.3 yr, age range 40-88 yr) who presented at the Department of Neurology, Nara Medical University Hospital. A total of 120 patients had cerebral infarction, 102 Parkinson's disease, 32 spinal spondylosis, 30 headache, 32 myositis, and the rest various other neurological diseases. MetS was diagnosed according to the criteria proposed by The Japanese Society of Internal Medicine in 2005. The cutoff values for waist circumference (WC) were greater than 85 cm in men and 90 cm in women. A diagnosis of MetS additionally required two or more of the following: a serum triglyceride level (TG) of at least 150 mg/dl and/or a high-density lipoprotein cholesterol level (HDL-C) of less than 40 mg/dl; a blood pressure (BP) of greater than 130/85; or a fasting plasma glucose level (FPG) of greater than 110 mg/dl. Visceral fat accumulation was measured by abdominal CT scanning (N2system, K.K., Japan). WC positively correlated with visceral fat area as determined by CT scanning. WC also positively correlated with TG in both sexes and fasting blood sugar (FBS) in women, but negatively correlated with HDL-C in both sexes. The mean prevalence of MetS among subjects 40 to 70 years of age was 25.1% in men and 12.6% in women. To assess the incidence of MetS in the

High prevalence of long-term cardiovascular, neurological and psychosocial morbidity after treatment for craniopharyngioma

NARCIS (Netherlands)

Pereira, Alberto M.; Schmid, Eva M.; Schutte, Pieter J.; Voormolen, Joan H. C.; Biermasz, Nienke R.; van Thiel, Sjoerd W.; Corssmit, Eleonora P. M.; Smit, Jan W. A.; Roelfsema, Ferdinand; Romijn, Johannes A.

2005-01-01

The treatment of craniopharyngiomas is associated with long-term morbidity. To assess the long-term functional outcome and mortality rates after treatment for craniopharyngiomas, we audited our data with special focus on cardiovascular, neurological and psychosocial morbidity. Between 1965 and 2002,

Neurologic abnormalities in murderers.

Science.gov (United States)

Blake, P Y; Pincus, J H; Buckner, C

1995-09-01

Thirty-one individuals awaiting trial or sentencing for murder or undergoing an appeal process requested a neurologic examination through legal counsel. We attempted in each instance to obtain EEG, MRI or CT, and neuropsychological testing. Neurologic examination revealed evidence of "frontal" dysfunction in 20 (64.5%). There were symptoms or some other evidence of temporal lobe abnormality in nine (29%). We made a specific neurologic diagnosis in 20 individuals (64.5%), including borderline or full mental retardation (9) and cerebral palsy (2), among others. Neuropsychological testing revealed abnormalities in all subjects tested. There were EEG abnormalities in eight of the 20 subjects tested, consisting mainly of bilateral sharp waves with slowing. There were MRI or CT abnormalities in nine of the 19 subjects tested, consisting primarily of atrophy and white matter changes. Psychiatric diagnoses included paranoid schizophrenia (8), dissociative disorder (4), and depression (9). Virtually all subjects had paranoid ideas and misunderstood social situations. There was a documented history of profound, protracted physical abuse in 26 (83.8%) and of sexual abuse in 10 (32.3%). It is likely that prolonged, severe physical abuse, paranoia, and neurologic brain dysfunction interact to form the matrix of violent behavior.

Residency Training: The need for an integrated diversity curriculum for neurology residency.

Science.gov (United States)

Rosendale, Nicole; Josephson, S Andrew

2017-12-12

Providing culturally responsive care to an increasingly multicultural population is essential and requires formal cultural humility training for residents. We sought to understand the current prevalence and need for this type of training within neurology programs and to pilot an integrated curriculum locally. We surveyed via email all program directors of academic neurology programs nationally regarding the prevalence of and need for formal cultural responsiveness training. Forty-seven program directors (36%) responded to the survey. The majority of respondents did not have a formalized diversity curriculum in their program (65%), but most (85%) believed that training in cultural responsiveness was important. We developed locally an integrated diversity curriculum as a proof of concept. The curriculum covered topics of diversity in language, religion, sexual orientation, gender identity/expression, and socioeconomic status designed to focus on the needs of the local community. Program evaluation included a pre and post survey of the learner attitudes toward cultural diversity. There is an unmet need for cultural responsiveness training within neurology residencies, and integrating this curriculum is both feasible and efficacious. When adapted to address cultural issues of the local community, this curriculum can be generalizable to both academic and community organizations. © 2017 American Academy of Neurology.

Further delineation of the MECP2 duplication syndrome phenotype in 59 French male patients, with a particular focus on morphological and neurological features.

Science.gov (United States)

Miguet, Marguerite; Faivre, Laurence; Amiel, Jeanne; Nizon, Mathilde; Touraine, Renaud; Prieur, Fabienne; Pasquier, Laurent; Lefebvre, Mathilde; Thevenon, Julien; Dubourg, Christèle; Julia, Sophie; Sarret, Catherine; Remerand, Ganaëlle; Francannet, Christine; Laffargue, Fanny; Boespflug-Tanguy, Odile; David, Albert; Isidor, Bertrand; Vigneron, Jacqueline; Leheup, Bruno; Lambert, Laetitia; Philippe, Christophe; Béri-Dexheimer, Mylène; Cuisset, Jean-Marie; Andrieux, Joris; Plessis, Ghislaine; Toutain, Annick; Guibaud, Laurent; Cormier-Daire, Valérie; Rio, Marlene; Bonnefont, Jean-Paul; Echenne, Bernard; Journel, Hubert; Burglen, Lydie; Chantot-Bastaraud, Sandrine; Bienvenu, Thierry; Baumann, Clarisse; Perrin, Laurence; Drunat, Séverine; Jouk, Pierre-Simon; Dieterich, Klaus; Devillard, Françoise; Lacombe, Didier; Philip, Nicole; Sigaudy, Sabine; Moncla, Anne; Missirian, Chantal; Badens, Catherine; Perreton, Nathalie; Thauvin-Robinet, Christel; AChro-Puce, Réseau; Pedespan, Jean-Michel; Rooryck, Caroline; Goizet, Cyril; Vincent-Delorme, Catherine; Duban-Bedu, Bénédicte; Bahi-Buisson, Nadia; Afenjar, Alexandra; Maincent, Kim; Héron, Delphine; Alessandri, Jean-Luc; Martin-Coignard, Dominique; Lesca, Gaëtan; Rossi, Massimiliano; Raynaud, Martine; Callier, Patrick; Mosca-Boidron, Anne-Laure; Marle, Nathalie; Coutton, Charles; Satre, Véronique; Caignec, Cédric Le; Malan, Valérie; Romana, Serge; Keren, Boris; Tabet, Anne-Claude; Kremer, Valérie; Scheidecker, Sophie; Vigouroux, Adeline; Lackmy-Port-Lis, Marilyn; Sanlaville, Damien; Till, Marianne; Carneiro, Maryline; Gilbert-Dussardier, Brigitte; Willems, Marjolaine; Van Esch, Hilde; Portes, Vincent Des; El Chehadeh, Salima

2018-04-04

The Xq28 duplication involving the MECP2 gene ( MECP2 duplication) has been mainly described in male patients with severe developmental delay (DD) associated with spasticity, stereotypic movements and recurrent infections. Nevertheless, only a few series have been published. We aimed to better describe the phenotype of this condition, with a focus on morphological and neurological features. Through a national collaborative study, we report a large French series of 59 affected males with interstitial MECP2 duplication. Most of the patients (93%) shared similar facial features, which evolved with age (midface hypoplasia, narrow and prominent nasal bridge, thick lower lip, large prominent ears), thick hair, livedo of the limbs, tapered fingers, small feet and vasomotor troubles. Early hypotonia and global DD were constant, with 21% of patients unable to walk. In patients able to stand, lower limbs weakness and spasticity led to a singular standing habitus: flexion of the knees, broad-based stance with pseudo-ataxic gait. Scoliosis was frequent (53%), such as divergent strabismus (76%) and hypermetropia (54%), stereotypic movements (89%), without obvious social withdrawal and decreased pain sensitivity (78%). Most of the patients did not develop expressive language, 35% saying few words. Epilepsy was frequent (59%), with a mean onset around 7.4 years of age, and often (62%) drug-resistant. Other medical issues were frequent: constipation (78%), and recurrent infections (89%), mainly lung. We delineate the clinical phenotype of MECP2 duplication syndrome in a large series of 59 males. Pulmonary hypertension appeared as a cause of early death in these patients, advocating its screening early in life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Caring for Patients With Intractable Neurological Diseases

Directory of Open Access Journals (Sweden)

Masako Nagase

2014-08-01

Full Text Available This is a qualitative descriptive study examining nurses’ attitudes about caring for patients with intractable neurological diseases, with a focus on dedication and conflicts. Semistructured interviews were conducted on 11 nurses with more than 5 years of clinical experience in addition to more than 3 years of experience in neurology wards. Senior nursing officers from each hospital selected the participants. In general, these nurses expressed distress over the inevitable progression of disease. Nurses talked about the “basis of dedication,” “conflicts with dedication,” “reorganization for maintaining dedication,” and “the reason for the change from conflict to commitment.” “Reorganization for maintaining dedication” meant that nurses were able to handle the prospect of rededicating themselves to their patients. Furthermore, “the reason for the change from conflict to commitment” referred to events that changed nurses’ outlooks on nursing care, their pride as nurses, or their learning experiences. They felt dedicated and conflicted both simultaneously and separately. While committing to their patients’ physical care, nurses were empowered to think positively and treat patients with dignity in spite of the care taking much time and effort, as well as entailing considerable risk.

A controlled study of team-based learning for undergraduate clinical neurology education

Directory of Open Access Journals (Sweden)

Umapathi Thirugnanam

2011-10-01

Full Text Available Abstract Background Team-based learning (TBL, a new active learning method, has not been reported for neurology education. We aimed to determine if TBL was more effective than passive learning (PL in improving knowledge outcomes in two key neurology topics - neurological localization and neurological emergencies. Methods We conducted a modified crossover study during a nine-week internal medicine posting involving 49 third-year medical undergraduates, using TBL as the active intervention, compared against self-reading as a PL control, for teaching the two topics. Primary outcome was the mean percentage change in test scores immediately after (post-test 1 and 48 hours after TBL (post-test 2, compared to a baseline pre-test. Student engagement was the secondary outcome. Results Mean percentage change in scores was greater in the TBL versus the PL group in post-test 1 (8.8% vs 4.3%, p = 0.023 and post-test 2 (11.4% vs 3.4%, p = 0.001. After adjustment for gender and second year examination grades, mean percentage change in scores remained greater in the TBL versus the PL group for post-test 1 (10.3% vs 5.8%, mean difference 4.5%,95% CI 0.7 - 8.3%, p = 0.021 and post-test 2 (13.0% vs 4.9%, mean difference 8.1%,95% CI 3.7 - 12.5%, p = 0.001, indicating further score improvement 48 hours post-TBL. Academically weaker students, identified by poorer examination grades, showed a greater increase in scores with TBL versus strong students (p Conclusions Compared to PL, TBL showed greater improvement in knowledge scores, with continued improvement up to 48 hours later. This effect is larger in academically weaker students. TBL is an effective method for improving knowledge in neurological localization and neurological emergencies in undergraduates.

Significant interaction of hypertension and homocysteine on neurological severity in first-ever ischemic stroke patients.

Science.gov (United States)

Fan, Ying-Li; Zhan, Rui; Dong, Yi-Fei; Huang, Lei; Ji, Xi-Xin; Lu, Peng; Liu, Jian; Li, Ping; Cheng, Xiao-Shu

2018-04-03

It is not known whether combination of hypertension and high homocysteine (HHcy) impacts on stroke-related neurological severity. Our aim was to determine whether there is an interaction of hypertension and HHcy on neurological severity in first-ever ischemic stroke patients. We analyzed neurological severity among 189 consecutive first-ever ischemic stroke patients with or without hypertension or HHcy. Hypertension (odds ratio [OR]: 8.086, 95% confidence interval [CI]: 3.596-18.181, P < .001) and total homocysteine (OR: 1.403, 95% CI: 1.247-1.579, P < .001) were independently associated with neurological severity. In receiver-operating characteristic analysis, total homocysteine was a significant predictor of neurological severity (area under curve: 0.794; P < .001). A multiplicative interaction of hypertension and HHcy on more severe neurological severity was revealed by binary logistic regression (OR: 13.154, 95% CI: 5.293-32.691, P < .001). Analysis further identified a more than multiplicative interaction of hypertension and HHcy on neurological severity compared with patients without each condition (OR: 50.600, 95% CI: 14.775-173.285, P < .001). Interaction effect measured on an additive scale showed that 76.4% patients with moderate/severe neurological severity were attributed to interaction of hypertension and HHcy. Significant interaction of hypertension and HHcy on neurological severity was found on multiplicative and additive scale in first-ever Chinese ischemic stroke patients. Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.

Chapter 50: history of tropical neurology.

Science.gov (United States)

Ogunniyi, Adesola

2010-01-01

Tropical neurology began less than two centuries ago. Consumption of dietary toxins predominated at the beginning and gave birth to the geographic entity. The story moved from lathyrism through Jamaican neuropathy to cassava-induced epidemic neuropathy, which was contrasted with Konzo, also associated with cassava. Other tropical diseases enumerated with chronological details include: Chaga's diseases, kwashiorkor, Madras type of motor neuron disease, atlanto-axial dislocation, Burkitt's lymphoma and Kuru, associated with cannibalism among the Fore linguistic group in New Guinea. More recent documentation includes the Cuban neuropathy in 1991 with an epidemic of visual loss and neuropathy, Anaphe venata entomophagy in Nigeria presenting as seasonal ataxia, and neurological aspects of the human immunodeficiency virus infection complete the picture. With time, professional associations were formed and the pioneers were given prominence. The World Federation of Neurology featured Geographic Neurology as a theme in 1977 and Tropical Neurology was given prominence at its 1989 meeting in New Delhi, India. The situation remains unchanged with regards to rare diseases like Meniere's, multiple sclerosis, hereditary disorders. However, with westernization and continued urbanization, changing disease patterns are being observed and tropical neurology may depart from dietary toxins to more western world-type disorders.

Review: Psychological Factors Affecting Rehabilitation of Neurologic Patients

Directory of Open Access Journals (Sweden)

Mahshid Foroughan

2001-01-01

Full Text Available Psychological factors imply their negative effects on neurologic patients in two ways. Directly, through pathogenic processes of central nervous system, and indirectly, through maladaptive reactions toward disability. Depression: is a common finding in many neurologic diseases and may interfere with rehabilitation process. Correcting patient's attitude toward disability, reducing environmental stresses and potentiating social support network along with antidepressant drugs often help these patients remain in rehabilitation program. Chronic fatigue: decreases the activity levels of patients and the possibility for them to achieve set goals of rehabilitation in proper times. Support, reassurance and sometimes antidepressant drugs may help. Conversion reactions: often accompany chronic illnesses and disabilities and make evaluation and diagnosis difficult. Application of behavioral Techniques may lead to better results. Altered self image: is a prominent feature in patients with spinal cord injury. Counseling and Free discussion on altered self image and sexual problems are essential and other forms of sexual expression must be taught to these patients. Chronic pain: is a disabling condition. Usually physical findings are minor and it seems psychological factors play a more important role in causing it. Antidepressant drugs are effective in most cases. Intensive physical and occupational therapy must be avoided. Excessive emotionality: is a consequence of executive dysfunction arising from frontal lobe injury and mostly seen in stroke, brain injured, and demented patients, Impulsivity and disinhibition may lead to aggressive behavior and socially inappropriate forms of sexual expression. Judicious administration of psychotherapy drugs, behavioral techniques and short-term hospitalization may be helpful. Altered cognition: is a common feature of many pathological conditions of brain. Attention deficit, slowed information processing, disturbed

Neurological manifestations of Ehlers-Danlos syndrome(s): A review

Science.gov (United States)

Castori, Marco; C. Voermans, Nicol

2014-01-01

The term “Ehlers-Danlos syndrome” (EDS) groups together an increasing number of heritable connective tissue disorders mainly featuring joint hypermobility and related complications, dermal dysplasia with abnormal skin texture and repair, and variable range of the hollow organ and vascular dysfunctions. Although the nervous system is not considered a primary target of the underlying molecular defect, recently, increasing attention has been posed on neurological manifestations of EDSs, such as musculoskeletal pain, fatigue, headache, muscle weakness and paresthesias. Here, a comprehensive overview of neurological findings of these conditions is presented primarily intended for the clinical neurologist. Features are organized under various subheadings, including pain, fatigue, headache, stroke and cerebrovascular disease, brain and spine structural anomalies, epilepsy, muscular findings, neuropathy and developmental features. The emerging picture defines a wide spectrum of neurological manifestations that are unexpectedly common and potentially disabling. Their evaluation and correct interpretation by the clinical neurologist is crucial for avoiding superfluous investigations, wrong therapies, and inappropriate referral. A set of basic tools for patient’s recognition is offered for raising awareness among neurologists on this underdiagnosed group of hereditary disorders. PMID:25632331

Child Neurology Education for Pediatric Residents.

Science.gov (United States)

Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

2017-03-01

The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

[Neurological disorders in patients with hypoparathyroidism].

Science.gov (United States)

Roztoczyńska, Dorota; Kroczka, Sławomir; Kumorowicz-Czoch, Małgorzata; Dolezal-Ołtarzewska, Katarzyna; Kacińsk, Marek; Starzyk, Jerzy

2010-01-01

The term hypoparathyroidism refers to a group of disorders in which a relative or absolute deficiency of PTH leads to hypocalcemia and hyperphosphatemia. Was to evaluate clinical symptoms in patients with hypoparathyroidism during normocalcemic period and to try to establish its etiology (electrolyte imbalance, organic central nervous system lesions, coincidence of tetany and epilepsy). The analysis included a group of 14 patients with hypoparathyroidism: 3 boys and 11 girls, aged from 12 months to 31 years (median 16.11 years), with duration of the disease 12 months to 26 years (median 10.9 years). In all the patients, the diagnosis was confirmed based on history, physical examination, results of biochemical and hormonal laboratory tests, radiological and neurological examinations. All the patients were followed by endocrinology specialists. Low phosphorus diet, calcium, magnesium, active vitamin D supplementation and management of other endocrine disorders were employed. In 9 patients, pseudo-hypoparathyrodism was diagnosed; of this number, in 8 children, type Ia Albright syndrome was confirmed. Five patients were diagnosed as true hypoparathyroidism, two girls in this group were found to have autoimmune hypoparathyroidism as a component of the autoimmune polyglandular syndrome type 1, 2 others were diagnosed in infancy as congenital hypoparathyroidism and 1 girl had true hypoparathyroidism as a component of Kearns-Sayre syndrome. Five patients were referred to neurological department with epilepsy suspicion. In the medical history, 9 patients had generalized epileptic seizures, moreover, 1 girl manifested absence attack and balance disturbances. In 3 patients, EEG demonstrated changes typical of generalized seizure activity. In 5 patients on anti-epileptic management, additional calcium and active vitamin D treatment was initiated, allowing for achieving seizure remission. CT of the head and pituitary gland showed calcification foci in the central nervous system

Ketogenic diet and childhood neurological disorders other than epilepsy: an overview.

Science.gov (United States)

Verrotti, Alberto; Iapadre, Giulia; Pisano, Simone; Coppola, Giangennaro

2017-05-01

In the last years, ketogenic diet (KD) has been experimentally utilized in various childhood neurologic disorders such as mitochondriopathies, alternating hemiplegia of childhood (AHC), brain tumors, migraine, and autism spectrum disorder (ASD). The aim of this review is to analyze how KD can target these different medical conditions, highlighting possible mechanisms involved. Areas covered: We have conducted an analysis on literature concerning KD use in mitochondriopathies, AHC, brain tumors, migraine, and ASD. Expert commentary: The role of KD in reducing seizure activity in some mitochondriopathies and its efficacy in pyruvate dehydrogenase deficiency is known. Recently, few cases suggest the potentiality of KD in decreasing paroxysmal activity in children affected by AHC. A few data support its potential use as co-adjuvant and alternative therapeutic option for brain cancer, while any beneficial effect of KD on migraine remains unclear. KD could improve cognitive and social skills in a subset of children with ASD.

Approaching neurological diseases to reduce mobility limitations in older persons.

Science.gov (United States)

Lauretani, Fulvio; Ceda, Gian Paolo; Pelliccioni, Pio; Ruffini, Livia; Nardelli, Anna; Cherubini, Antonio; Maggio, Marcello

2014-01-01

The rapidly increasing elderly population poses a major challenge for future health-care systems. Neurological diseases in older persons are particularly common and coexist with other clinical conditions. This is not surprising given that, for example, even patients with Alzheimer Disease (AD) could have relevant extrapyramidal signs at the moment of the diagnosis with motor signs having more negative prognostic value. Longitudinal studies conducted on Parkinson Disease (PD) showed that, after 20 years, dementia is not only present in almost all survivors but is also the main factor influencing nursing home admission. Recently, it has been reported the importance of Comprehensive Geriatric Assessment (CGA: comprehensive evaluation of cognition, depressive symptoms, mobility and functional assessment) as a tool reducing morbidity in frail older patients admitted to any acute hospital unit. The CGA should be considered as a technological device, for physicians who take care of older persons affected by overlapping neurological diseases. CGA is an extraordinary and cost effective instrument even in patients with advanced neurological diseases where allows to collect valuable information for an effective plan of management.

Use of focused ultrasonication in activity-based profiling of deubiquitinating enzymes in tissue.

Science.gov (United States)

Nanduri, Bindu; Shack, Leslie A; Rai, Aswathy N; Epperson, William B; Baumgartner, Wes; Schmidt, Ty B; Edelmann, Mariola J

2016-12-15

To develop a reproducible tissue lysis method that retains enzyme function for activity-based protein profiling, we compared four different methods to obtain protein extracts from bovine lung tissue: focused ultrasonication, standard sonication, mortar & pestle method, and homogenization combined with standard sonication. Focused ultrasonication and mortar & pestle methods were sufficiently effective for activity-based profiling of deubiquitinases in tissue, and focused ultrasonication also had the fastest processing time. We used focused-ultrasonicator for subsequent activity-based proteomic analysis of deubiquitinases to test the compatibility of this method in sample preparation for activity-based chemical proteomics. Copyright © 2016 Elsevier Inc. All rights reserved.

Neurocritical care education during neurology residency

Science.gov (United States)

Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

2012-01-01

Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

Dextromethorphan: An update on its utility for neurological and neuropsychiatric disorders.

Science.gov (United States)

Nguyen, Linda; Thomas, Kelan L; Lucke-Wold, Brandon P; Cavendish, John Z; Crowe, Molly S; Matsumoto, Rae R

2016-03-01

Dextromethorphan (DM) is a commonly used antitussive and is currently the only FDA-approved pharmaceutical treatment for pseudobulbar affect. Its safety profile and diverse pharmacologic actions in the central nervous system have stimulated new interest for repurposing it. Numerous preclinical investigations and many open-label or blinded clinical studies have demonstrated its beneficial effects across a variety of neurological and psychiatric disorders. However, the optimal dose and safety of chronic dosing are not fully known. This review summarizes the preclinical and clinical effects of DM and its putative mechanisms of action, focusing on depression, stroke, traumatic brain injury, seizure, pain, methotrexate neurotoxicity, Parkinson's disease and autism. Moreover, we offer suggestions for future research with DM to advance the treatment for these and other neurological and psychiatric disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

Dengue: a new challenge for neurology

Directory of Open Access Journals (Sweden)

Marzia Puccioni-Sohler

2012-11-01

Full Text Available Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world’s population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial.

Limiting exercise inhibits neuronal recovery from neurological disorders

Directory of Open Access Journals (Sweden)

Stefan S Anthony

2017-01-01

Full Text Available Patients who are bedridden often suffer from muscular atrophy due to reduced daily activities and can become depressed. However, patients who undergo physical therapy sometimes demonstrate positive benefits including a reduction of stressful and depressed behavior. Regenerative medicine has seen improvements in two stem cell-based therapies for central nervous system disorders. One therapy is through the transfer of exogenous stem cells. The other therapy is a more natural method and focuses on the increasing endogenous neurogenesis and restoring the neurological impairments. This study overviews how immobilization-induced disuse atrophy affects neurogenesis in rats, specifically hypothesizing that immobilization diminishes circulating trophic factor levels, like vascular endothelial growth factors or brain-derived neurotrophic factor, which in turn limits neurogenesis. This hypothesis requires the classification of the stem cell microenvironment by probing growth factors in addition to other stress-related proteins that correlate with exercise-induced neurogenesis. There is research examining the effects of increased exercise on neurogenesis while limiting exercise, which better demonstrates the pathological states of immobile stroke patients, remains relatively unexplored. To examine the effects of immobilization on neurogenesis quantitative measurements of movements, 5-bromo-2deoxyuridine labeling of proliferative cells, biochemical assays of serum, cerebrospinal fluid and neurological levels of trophic factors, growth factors, and stress-related proteins will indicate levels of neurogenesis. In further research, studies are needed to show how in vivo stimulation, or lack thereof, affects stem cell microenvironments to advance treatment procedures for strengthening neurogenesis in bedridden patients. This paper is a review article. Referred literature in this paper has been listed in the references section. The datasets supporting the

Interobserver variability of the neurological optimality score

NARCIS (Netherlands)

Monincx, W. M.; Smolders-de Haas, H.; Bonsel, G. J.; Zondervan, H. A.

1999-01-01

To assess the interobserver reliability of the neurological optimality score. The neurological optimality score of 21 full term healthy, neurologically normal newborn infants was determined by two well trained observers. The interclass correlation coefficient was 0.31. Kappa for optimality (score of

The applications of pharmacogenomics to neurological disorders.

Science.gov (United States)

Gilman, C; McSweeney, C; Mao, Y

2014-01-01

The most common neurological disorders, including neurodegenerative diseases and psychiatric disorders, have received recent attention with regards to pharmacogenomics and personalized medicine. Here, we will focus on a neglected neurodegenerative disorder, cerebral ischemic stroke (CIS), and highlight recent advances in two disorders, Parkinson's disease (PD) and Alzheimer's diseases (AD), that possess both similar and distinct mechanisms in regards to potential therapeutic targets. In the first part of this review, we will focus primarily on mechanisms that are somewhat specific to each disorder which are involved in neurodegeneration (i.e., protease pathways, calcium homeostasis, reactive oxygen species regulation, DNA repair mechanisms, neurogenesis regulation, mitochondrial function, etc.). In the second part of this review, we will discuss the applications of the genome-wide technology on pharmacogenomics of mental illnesses including schizophrenia (SCZ), autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), and obsessive compulsive disorder (OCD).

Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

Science.gov (United States)

Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-10-23

To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

Neurological complications following bariatric surgery

Directory of Open Access Journals (Sweden)

Yara Dadalti Fragoso

2012-09-01

Full Text Available OBJECTIVE: It was to report on Brazilian cases of neurological complications from bariatric surgery. The literature on the subject is scarce. METHOD: Cases attended by neurologists in eight different Brazilian cities were collected and described in the present study. RESULTS: Twenty-six cases were collected in this study. Axonal polyneuropathy was the most frequent neurological complication, but cases of central demyelination, Wernicke syndrome, optical neuritis, radiculits, meralgia paresthetica and compressive neuropathies were also identified. Twenty-one patients (80% had partial or no recovery from the neurological signs and symptoms. CONCLUSION: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications that should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Neurologic disorder and criminal responsibility.

Science.gov (United States)

Yaffe, Gideon

2013-01-01

Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other. © 2013 Elsevier B.V. All rights reserved.

The Risk of Neurological Dysfunctions after Deep Hypothermic Circulatory Arrest with Retrograde Cerebral Perfusion.

Science.gov (United States)

Gatti, Giuseppe; Benussi, Bernardo; Currò, Placido; Forti, Gabriella; Rauber, Elisabetta; Minati, Alessandro; Gabrielli, Marco; Tognolli, Umberto; Sinagra, Gianfranco; Pappalardo, Aniello

2017-12-01

Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia. Surgery of the thoracic aorta was performed in 95.9% of these RCP patients; in 92 cases there was an aortic arch involvement. Outcomes were reviewed retrospectively. The focus was on postoperative neurological dysfunctions. There were 33 (9.6%) in-hospital deaths. Thirty-one (9%) patients had permanent neurological dysfunctions and 66 (19.1%) transitory neurological dysfunctions alone. Age older than 74 years (odds ratio [OR], 1.88, P = .023), surgery for acute aortic dissection (OR, 2.57; P = .0009), and DHCA time longer than 25 minutes (OR, 2.44; P = .0021) were predictors of neurological dysfunctions. The 10-year nonparametric estimate of freedom from all-cause death was 61.8% (95% confidence interval, 57.8%-65.8%). Permanent postoperative neurological dysfunctions were risk factors for cardiac or cerebrovascular death (hazard ratio, 2.6; P = .039) even after an adjusted survival analysis (P RCP, in addition to deep hypothermia, combines with a low risk of neurological dysfunctions provided that DHCA length is 25 minutes or less. Permanent postoperative neurological dysfunctions are predictors of poor late survival. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Managing fatigue in patients with Parkinson's disease: a patient-focused perspective

Directory of Open Access Journals (Sweden)

Ridder A

2016-07-01

Full Text Available Andrew Ridder,1 Kelvin L Chou,1,2 1Department of Neurology, 2Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA Abstract: Fatigue, experienced as a significantly diminished energy level or an increased perception of effort disproportionate to attempted activities or general activity level, is being increasingly recognized as a common and disabling problem in patients with Parkinson’s disease. There are no commonly accepted criteria to diagnose fatigue in Parkinson’s disease and there is limited evidence regarding treatment of this symptom. This article reviews the current knowledge surrounding fatigue in Parkinson’s disease, including symptoms, epidemiology, diagnosis, and treatment, with a focus on the patient’s perspective. Keywords: Parkinson’s disease, fatigue, diagnosis, treatment

[German neurology and neurologists during the Third Reich: Preconditions and general framework before and after 1933].

Science.gov (United States)

Martin, M; Karenberg, A; Fangerau, H

2016-08-01

This article focuses on the institutional development of neurology in Germany up to the rise to power of the National Socialists and the radical sociopolitical changes after 1933. A wide range of scattered secondary literature was assessed and evaluated. Additionally, some original sources are literally quoted and interpreted according to the context. Since the end of the nineteenth century a complicated process of separation from internal medicine and psychiatry led to the formation of a self-conscious discipline of neurology. The first generation of German neurologists succeeded in founding the German Journal for Neurology ("Deutsche Zeitschrift für Nervenheilkunde") in 1890 and their own neurological association, the Society of German Neurologists ("Gesellschaft Deutscher Nervenärzte", GDN) in 1907. On an international scale, however, the institutional implementation of neurology with only a small number of chairs and few neurology departments remained more than modest. The ambitions for autonomy ended 2 years after the change of power in 1933. Regulatory interventions by the government and psychiatric interests led to the fusion of the GDN with the psychiatric specialist society, the new association being called the Society of German Neurologists and Psychiatrists ("Gesellschaft Deutscher Neurologen und Psychiater", GDNP) in 1935. In this group psychiatrists dominated the discourse. The expulsion, imprisonment and murder of physicians declared as non-Aryan or Jewish along with the forced consolidation ("Gleichschaltung") at the universities prompted profound changes in medical and academic life. It remains an ongoing challenge of neurological historical research to measure the impact of this upheaval on the few neurology departments in hospitals and private practices.

Status of neurology medical school education

Science.gov (United States)

Ali, Imran I.; Isaacson, Richard S.; Safdieh, Joseph E.; Finney, Glen R.; Sowell, Michael K.; Sam, Maria C.; Anderson, Heather S.; Shin, Robert K.; Kraakevik, Jeff A.; Coleman, Mary; Drogan, Oksana

2014-01-01

Objective: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. Methods: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Results: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were “very satisfied” or “somewhat satisfied,” but more than half experienced “burnout” and 35% had considered relinquishing their role. Conclusion: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. PMID:25305155

Quantitative Evaluation System of Soft Neurological Signs for Children with Attention Deficit Hyperactivity Disorder.

Science.gov (United States)

Kaneko, Miki; Yamashita, Yushiro; Iramina, Keiji

2016-01-18

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Soft neurological signs (SNS) are minor neurological abnormalities in motor performance, and are used as one evaluation method for neurodevelopmental delays in children with ADHD. Our aim is to establish a quantitative evaluation system for children with ADHD. We focused on the arm movement called pronation and supination, which is one such soft neurological sign. Thirty three children with ADHD aged 7-11 years (27 males, six females) and twenty five adults participants aged 21-29 years old (19 males, six females) participated in our experiments. Our results suggested that the pronation and supination function in children with ADHD has a tendency to lag behind that of typically developing children by several years. From these results, our system has a possibility to objectively evaluate the neurodevelopmental delay of children with ADHD.

Psychologic theories in functional neurologic disorders.

Science.gov (United States)

Carson, A; Ludwig, L; Welch, K

2016-01-01

In this chapter we review key psychologic theories that have been mooted as possible explanations for the etiology of functional neurologic symptoms, conversion disorder, and hysteria. We cover Freudian psychoanalysis and later object relations and attachment theories, social theories, illness behavior, classic and operant conditioning, social learning theory, self-regulation theory, cognitive-behavioral theories, and mindfulness. Dissociation and modern cognitive neuroscience theories are covered in other chapters in this series and, although of central importance, are omitted from this chapter. Our aim is an overview with the emphasis on breadth of coverage rather than depth. © 2016 Elsevier B.V. All rights reserved.

Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

LENUS (Irish Health Repository)

Costelloe, L

2012-02-01

BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

Neurological Manifestations of Dengue Infection

Directory of Open Access Journals (Sweden)

Guo-Hong Li

2017-10-01

Full Text Available Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS, peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

Delayed xenon post-conditioning mitigates spinal cord ischemia/reperfusion injury in rabbits by regulating microglial activation and inflammatory factors.

Science.gov (United States)

Yang, Yan-Wei; Wang, Yun-Lu; Lu, Jia-Kai; Tian, Lei; Jin, Mu; Cheng, Wei-Ping

2018-03-01

The neuroprotective effect against spinal cord ischemia/reperfusion injury in rats exerted by delayed xenon post-conditioning is stronger than that produced by immediate xenon post-conditioning. However, the mechanisms underlying this process remain unclear. Activated microglia are the main inflammatory cell type in the nervous system. The release of pro-inflammatory factors following microglial activation can lead to spinal cord damage, and inhibition of microglial activation can relieve spinal cord ischemia/reperfusion injury. To investigate how xenon regulates microglial activation and the release of inflammatory factors, a rabbit model of spinal cord ischemia/reperfusion injury was induced by balloon occlusion of the infrarenal aorta. After establishment of the model, two interventions were given: (1) immediate xenon post-conditioning-after reperfusion, inhalation of 50% xenon for 1 hour, 50% N 2 /50%O 2 for 2 hours; (2) delayed xenon post-conditioning-after reperfusion, inhalation of 50% N 2 /50%O 2 for 2 hours, 50% xenon for 1 hour. At 4, 8, 24, 48 and 72 hours after reperfusion, hindlimb locomotor function was scored using the Jacobs locomotor scale. At 72 hours after reperfusion, interleukin 6 and interleukin 10 levels in the spinal cord of each group were measured using western blot assays. Iba1 levels were determined using immunohistochemistry and a western blot assay. The number of normal neurons at the injury site was quantified using hematoxylin-eosin staining. At 72 hours after reperfusion, delayed xenon post-conditioning remarkably enhanced hindlimb motor function, increased the number of normal neurons at the injury site, decreased Iba1 levels, and inhibited interleukin-6 and interleukin-10 levels in the spinal cord. Immediate xenon post-conditioning did not noticeably affect the above-mentioned indexes. These findings indicate that delayed xenon post-conditioning after spinal cord injury improves the recovery of neurological function by reducing

African Journal of Neurological Sciences: Editorial Policies

African Journals Online (AJOL)

African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

Epigenetic mechanisms in neurological disease.

Science.gov (United States)

Jakovcevski, Mira; Akbarian, Schahram

2012-08-01

The exploration of brain epigenomes, which consist of various types of DNA methylation and covalent histone modifications, is providing new and unprecedented insights into the mechanisms of neural development, neurological disease and aging. Traditionally, chromatin defects in the brain were considered static lesions of early development that occurred in the context of rare genetic syndromes, but it is now clear that mutations and maladaptations of the epigenetic machinery cover a much wider continuum that includes adult-onset neurodegenerative disease. Here, we describe how recent advances in neuroepigenetics have contributed to an improved mechanistic understanding of developmental and degenerative brain disorders, and we discuss how they could influence the development of future therapies for these conditions.

Intrahemispheric subdural hematoma complicated with chronic neurologic diseases

International Nuclear Information System (INIS)

Sakashita, Yasuo; Kuzuhara, Shigeki; Fuse, Shigeru; Yamanouchi, Hiroshi; Toyokura, Yasuo

1987-01-01

Two patients had interhemispheric subdural hematoma (ISH) without clinical signs or symptoms characteristic of ISH. The first patient, a 74-year-old woman with 7 years' history of Parkinson's disease, complained of unresponsiveness and akinesia. The treatment for suspected worsening of the disease failed to improve her conditions. Computed tomography (CT) showed hyperdensity along the falx from the frontal falx over the tentorium. Subsequent CT on the 23rd hospital day showed disappearance of hyperdensity, confirming ISH. The second patient, a 76-year-old woman with multiple cerebral infarction, was referred for loss of consciousness and vomiting. Neurological examination failed to reveal additional or augmented neurological deficits. Computed tomography showed a right parasagittal thin crescent hyperdensity with a flat medial border and a convex lateral border, extending from the anterior falx to the mid-falx. The hyperdensity disappeared on the 47th hospital day. These findings suggest the usefulness of CT as the only procedure when ISH features are not seen. (Namekawa, K.)

Neurologic Complications of Transplantation.

Science.gov (United States)

Dhar, Rajat

2018-02-01

Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

Effects of music and music therapy on mood in neurological patients

OpenAIRE

Raglio, Alfredo; Attardo, Lapo; Gontero, Giulia; Rollino, Silvia; Groppo, Elisabetta; Granieri, Enrico

2015-01-01

Mood disorder and depressive syndromes represent a common comorbid condition in neurological disorders with a prevalence rate that ranges between 20% and 50% of patients with stroke, epilepsy, multiple sclerosis, and Parkinson’s disease. Notwithstanding, these conditions are often under-diagnosed and under-treated in the clinical practice and negatively affect the functional recovery, the adherence to treatment, the quality of life, and even the mortality risk. In addition, a bidirectional as...

Epileptogenic focus localization: a new approach

Energy Technology Data Exchange (ETDEWEB)

Tavares, Vânia [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences of the University of Lisbon, Lisboa (Portugal); Ribeiro, André Santos [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences of the University of Lisbon, Lisboa (Portugal); Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London (United Kingdom); Capela, Carlos; Cerqueira, Luís [Department of Neuroradiology, Centro Hospitalar Lisboa Central, Lisbon (Portugal); Ferreira, Hugo Alexandre [Institute of Biophysics and Biomedical Engineering, Faculty of Sciences of the University of Lisbon, Lisboa (Portugal)

2015-05-18

Epilepsy is one of the most important chronic neurological disorders worldwide affecting more than 50 million people of all ages. Among these, almost 20% of epilepsy cases are uncontrollable and have an unknown source of this abnormal electrical activity. Present techniques for the detection of epileptogenic foci include electroencephalography (EEG), positron emission tomography, and multimodal EEG/functional magnetic resonance imaging (fMRI), all with limitations in terms of spatial and temporal resolutions. In order to overcome some of those limitations a novel approach using fMRI alone was developed based on the hypotheses that the epileptogenic focus shows Blood Oxygen Level Dependent (BOLD) temporal profiles distinct from the remaining brain parenchyma during interictal activity and that the epileptogenic focus BOLD signals show lower complexity than healthy parenchyma. In this novel approach, bi-dimensional temporal clustering analysis, a data-driven technique, was used to identify brain regions with similar temporal profiles. Then, the BOLD signals of these regions were assessed regarding complexity using detrended fluctuation analysis and also using a modified multiscale entropy algorithm in order to identify which of those regions corresponded to epileptogenic tissue. In order to demonstrate the applicability of the developed method three epileptic patients were analyzed comprising two types of epilepsy: unilateral and bilateral temporal lobe epilepsies. The results showed that this method is able to detect the brain regions associated with epileptogenic tissue. The results also showed that the epileptogenic focus influences the dynamics of related brain networks. This could be a key factor in the applicability of this method to other epilepsy cases. Finally, new perspectives are envisioned concerning the use of this method in the medical care of epilepsy. In particular, by improving this method using simultaneous structural, functional, and metabolic

Epileptogenic focus localization: a new approach

International Nuclear Information System (INIS)

Tavares, Vânia; Ribeiro, André Santos; Capela, Carlos; Cerqueira, Luís; Ferreira, Hugo Alexandre

2015-01-01

Epilepsy is one of the most important chronic neurological disorders worldwide affecting more than 50 million people of all ages. Among these, almost 20% of epilepsy cases are uncontrollable and have an unknown source of this abnormal electrical activity. Present techniques for the detection of epileptogenic foci include electroencephalography (EEG), positron emission tomography, and multimodal EEG/functional magnetic resonance imaging (fMRI), all with limitations in terms of spatial and temporal resolutions. In order to overcome some of those limitations a novel approach using fMRI alone was developed based on the hypotheses that the epileptogenic focus shows Blood Oxygen Level Dependent (BOLD) temporal profiles distinct from the remaining brain parenchyma during interictal activity and that the epileptogenic focus BOLD signals show lower complexity than healthy parenchyma. In this novel approach, bi-dimensional temporal clustering analysis, a data-driven technique, was used to identify brain regions with similar temporal profiles. Then, the BOLD signals of these regions were assessed regarding complexity using detrended fluctuation analysis and also using a modified multiscale entropy algorithm in order to identify which of those regions corresponded to epileptogenic tissue. In order to demonstrate the applicability of the developed method three epileptic patients were analyzed comprising two types of epilepsy: unilateral and bilateral temporal lobe epilepsies. The results showed that this method is able to detect the brain regions associated with epileptogenic tissue. The results also showed that the epileptogenic focus influences the dynamics of related brain networks. This could be a key factor in the applicability of this method to other epilepsy cases. Finally, new perspectives are envisioned concerning the use of this method in the medical care of epilepsy. In particular, by improving this method using simultaneous structural, functional, and metabolic

Chapter 44: history of neurology in Italy.

Science.gov (United States)

Bentivoglio, Marina; Mazzarello, Paolo

2010-01-01

The chapter starts from the Renaissance (although the origins of Italian neurology can be traced back to the Middle Ages), when treatises of nervous system physiopathology still followed Hippocratic and Galenic "humoral" theories. In Italy, as elsewhere in Europe, the concepts of humoral pathology were abandoned in the 18th century, when neurology was influenced by novel trends. Neurology acquired the status of clinical discipline (as "clinic of mental diseases") after national reunification (declared in 1861 but completed much later). At the end of the 19th and first decades of the 20th century, eminent Italian "neuropsychiatrists" (including, among many others, Ugo Cerletti, who introduced electroconvulsive shock therapy in 1938) stimulated novel knowledge and approaches, "centers of excellence" flourished, and "Neurological Institutes" were founded. In the first half of the 20th century, the history of Italian neurology was dominated by World Wars I and II (which stimulated studies on the wounded) and the fascist regime in-between the Wars (when the flow of information was instead very limited). Italy became a republic in 1946, and modern neurology and its distinction from psychiatry were finally promoted. The chapter also provides detailed accounts of scientific societies and journals dedicated to the neurological sciences in Italy.

Can repetitive transcranial magnetic stimulation increase muscle strength in functional neurological paresis? A proof-of-principle study.

Science.gov (United States)

Broersma, M; Koops, E A; Vroomen, P C; Van der Hoeven, J H; Aleman, A; Leenders, K L; Maurits, N M; van Beilen, M

2015-05-01

Therapeutic options are limited in functional neurological paresis disorder. Earlier intervention studies did not control for a placebo effect, hampering assessment of effectivity. A proof-of-principle investigation was conducted into the therapeutic potential of repetitive transcranial magnetic stimulation (rTMS), using a single-blind two-period placebo-controlled cross-over design. Eleven patients received active 15 Hz rTMS over the contralateral motor cortex (hand area), in two periods of 5 days, for 30 min once a day at 80% of resting motor threshold, with a train length of 2 s and an intertrain interval of 4 s. Eight of these eleven patients were also included in the placebo treatment condition. Primary outcome measure was change in muscle strength as measured by dynamometry after treatment. Secondary outcome measure was the subjective change in muscle strength after treatment. In patients who received both treatments, active rTMS induced a significantly larger median increase in objectively measured muscle strength (24%) compared to placebo rTMS (6%; P difference due to treatment, i.e. patients did not perceive these objectively measured motor improvements (P = 0.40). Our findings suggest that rTMS by itself can potentially improve muscle weakness in functional neurological paresis disorder. Whereas patients' muscle strength increased as measured with dynamometry, patients did not report increased functioning of the affected hand, subjectively. The results may indicate that decreased muscle strength is not the core symptom and that rTMS should be added to behavioral approaches in functional neurological paresis. © 2015 EAN.

Microglial Lectins in Health and Neurological Diseases

Directory of Open Access Journals (Sweden)

Jian Jing Siew

2018-05-01

Full Text Available Microglia are the innate sentinels of the central nervous system (CNS and are responsible for the homeostasis and immune defense of the CNS. Under the influence of the local environment and cell-cell interaction, microglia exhibit a multidimensional and context-dependent phenotypes that can be cytotoxic and neuroprotective. Recent studies suggest that microglia express multitudinous types of lectins, including galectins, Siglecs, mannose-binding lectins (MBLs and other glycan binding proteins. Because most studies that examine lectins focus on the peripheral system, the functions of lectins have not been critically investigated in the CNS. In addition, the types of brain cells that contribute to the altered levels of lectins present in diseases are often unclear. In this review, we will discuss how galectins, Siglecs, selectins and MBLs contribute to the dynamic functions of microglia. The interacting ligands of these lectins are complex glycoconjugates, which consist of glycoproteins and glycolipids that are expressed on microglia or surrounding cells. The current understanding of the heterogeneity and functions of glycans in the brain is limited. Galectins are a group of pleotropic proteins that recognize both β-galactoside-containing glycans and non- β-galactoside-containing proteins. The function and regulation of galectins have been implicated in immunomodulation, neuroinflammation, apoptosis, phagocytosis and oxidative bursts. Most Siglecs are expressed at a low level on the plasma membrane and bind to sialic acid residues for immunosurveillance and cell-cell communication. Siglecs are classified based on their inhibitory and activatory downstream signaling properties. Inhibitory Siglecs negatively regulate microglia activation upon recognizing the intact sialic acid patterns and vice versa. MBLs are expressed upon infection in cytoplasm and can be secreted in order to recognize molecules containing terminal mannose as an innate immune

Neurological caricatures since the 15th century.

Science.gov (United States)

Lorusso, Lorenzo

2008-01-01

During the Renaissance, different artists began to draw medical illustrations from various viewpoints. Leonardo da Vinci was among those who sought to portray the emotional as well as the physical qualities of man. Other European artists described caricatural aspects of medical activities. In Northern Europe, Albrecht Durer, Hieronymus Bosch, and Pieter Brueghel were also famous for drawing caricatures. Later English artists, notably William Hogarth, Thomas Rowlandson, James Gillray, and the Cruikshanks, satirized life in general and the medical profession in particular. In Spain, Francisco Goya's works became increasingly macabre and satirical following his own mysterious illness and, in France, Honore Daumier used satire and humor to expose medical quackery. Also physicians such as Charles Bell and Jean-Martin Charcot were talented caricaturists. Their own personal artistic styles reflected their approach and gave a different "image" of neurology. Caricatures were popular portraits of developments in science and medicine and were frequently used whenever scientific language was too difficult to disseminate, in particular in the field of neurology.

Education Research: Neurology training reassessed

Science.gov (United States)

Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

2012-01-01

Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training. PMID:23091077

2017 Military Services Gender Relations Focus Groups: Active Duty

Science.gov (United States)

2018-04-30

Office of People Analytics Office of People Analytics (OPA) Defense Research, Surveys, and Statistics Center 4800 Mark Center Drive, Suite 06E22...Relations (2017 MSGR) Focus Groups among active duty members. This is the third6 administration of gender relations focus groups. This introductory ...Enlisted, Male “It is true statistically , a majority of sexual assaults there is alcohol or drugs. In the military, it’s into the alcohol more than

Development and validation of the positive affect and well-being scale for the neurology quality of life (Neuro-QOL) measurement system.

Science.gov (United States)

Salsman, John M; Victorson, David; Choi, Seung W; Peterman, Amy H; Heinemann, Allen W; Nowinski, Cindy; Cella, David

2013-11-01

To develop and validate an item-response theory-based patient-reported outcomes assessment tool of positive affect and well-being (PAW). This is part of a larger NINDS-funded study to develop a health-related quality of life measurement system across major neurological disorders, called Neuro-QOL. Informed by a literature review and qualitative input from clinicians and patients, item pools were created to assess PAW concepts. Items were administered to a general population sample (N = 513) and a group of individuals with a variety of neurologic conditions (N = 581) for calibration and validation purposes, respectively. A 23-item calibrated bank and a 9-item short form of PAW was developed, reflecting components of positive affect, life satisfaction, or an overall sense of purpose and meaning. The Neuro-QOL PAW measure demonstrated sufficient unidimensionality and displayed good internal consistency, test-retest reliability, model fit, convergent and discriminant validity, and responsiveness. The Neuro-QOL PAW measure was designed to aid clinicians and researchers to better evaluate and understand the potential role of positive health processes for individuals with chronic neurological conditions. Further psychometric testing within and between neurological conditions, as well as testing in non-neurologic chronic diseases, will help evaluate the generalizability of this new tool.

International electives in neurology training

Science.gov (United States)

Lyons, Jennifer L.; Coleman, Mary E.; Engstrom, John W.

2014-01-01

Objective: To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. Background: There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. Methods: A survey was distributed to all program directors in the United States and Canada (December 2012–February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Results: Approximately half of responding programs (53%) allow residents to pursue global health–related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%–9% of residents (55% of programs) and 10%–19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. Conclusions: In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority

Optimal conditions for the generation of the third harmonic of focused radiation in a self-interaction regime

International Nuclear Information System (INIS)

Kulagin, I A; Usmanov, T

1998-01-01

A method developed for the analysis of the interaction of wave beams in a self-interaction regime is used to determine the changes in the optimal conditions for third-harmonic generation with changes in the degree of focusing of the fundamental-frequency radiation in isotropic media. Conditions under which a redistribution of the intensities and phases of the interacting wave beams reduces the efficiency of third-harmonic generation are identified. It is shown that, under strong focusing conditions, there may be additional extrema in the dependence of the intensity of the harmonic on the density of the medium. (nonlinear optical phenomena)

Epidemiology and trend of neurological diseases associated to HIV/AIDS. Experience of Mexican patients 1995-2009.

Science.gov (United States)

Ramírez-Crescencio, M A; Velásquez-Pérez, L; Ramírez-Crescencio, María Antonieta; Velásquez-Pérez, Leora

2013-08-01

The aim of this study was to identify the main neurological conditions associated with HIV/AIDS in Mexican patients treated at the National Institute of Neurology and Neurosurgery (NINN) in Mexico city, the main referral center for patients with disorders of the central and peripheral nervous system. An observational, transversal and descriptive analysis was performed. We reviewed the databases from the Department of Epidemiology and the medical records of patients with AIDS seen during the period from January 1st, 1995 to December 31, 2009. 320 patients were detected, the main conditions related to HIV/AIDS were brain toxoplasmosis (42%), cerebral criptoccocosis (28%), tuberculous meningitis (8.7%), linfoma no Hodking (3.75%), acute HIV infection (3.4%) and AIDS dementia complex (3%). No specific trend on morbility and mortality were detected during the period of study. In Mexico the most common neurological complications of HIV/AIDS are opportunistic infections. Copyright © 2013 Elsevier B.V. All rights reserved.

Neurology of ciguatera

Science.gov (United States)

Pearn, J

2001-01-01

Ciguatera is a widespread ichthyosarcotoxaemia with dramatic and clinically important neurological features. This severe form of fish poisoning may present with either acute or chronic intoxication syndromes and constitutes a global health problem. Ciguatera poisoning is little known in temperate countries as a potentially global problem associated with human ingestion of large carnivorous fish that harbour the bioaccumulated ciguatoxins of the photosynthetic dinoflagellate Gambierdiscus toxicus. This neurotoxin is stored in the viscera of fish that have eaten the dinoflagellate and concentrated it upwards throughout the food chain towards progressively larger species, including humans. Ciguatoxin accumulates in all fish tissues, especially the liver and viscera, of "at risk" species. Both Pacific (P-CTX-1) and Caribbean (C-CTX-1) ciguatoxins are heat stable polyether toxins and pose a health risk at concentrations above 0.1 ppb. The presenting signs of ciguatera are primarily neurotoxic in more than 80% of cases. Such include the pathognomonic features of postingestion paraesthesiae, dysaesthesiae, and heightened nociperception. Other sensory abnormalities include the subjective features of metallic taste, pruritis, arthralgia, myalgia, and dental pain. Cerebellar dysfunction, sometimes diphasic, and weakness due to both neuropathy and polymyositis may be encountered. Autonomic dysfunction leads to hypotension, bradycardia, and hypersalivation in severe cases. Ciguatoxins are potent, lipophilic sodium channel activator toxins which bind to the voltage sensitive (site 5) sodium channel on the cell membranes of all excitable tissues. Treatment depends on early diagnosis and the early administration of intravenous mannitol. The early identification of the neurological features in sentinel patients has the potential to reduce the number of secondary cases in cluster outbreaks.

 PMID:11118239

Quantitative Evaluation System of Soft Neurological Signs for Children with Attention Deficit Hyperactivity Disorder

Directory of Open Access Journals (Sweden)

Miki Kaneko

2016-01-01

Full Text Available Attention deficit hyperactivity disorder (ADHD is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Soft neurological signs (SNS are minor neurological abnormalities in motor performance, and are used as one evaluation method for neurodevelopmental delays in children with ADHD. Our aim is to establish a quantitative evaluation system for children with ADHD. We focused on the arm movement called pronation and supination, which is one such soft neurological sign. Thirty three children with ADHD aged 7–11 years (27 males, six females and twenty five adults participants aged 21–29 years old (19 males, six females participated in our experiments. Our results suggested that the pronation and supination function in children with ADHD has a tendency to lag behind that of typically developing children by several years. From these results, our system has a possibility to objectively evaluate the neurodevelopmental delay of children with ADHD.

Gc protein-derived macrophage activating factor (GcMAF): isoelectric focusing pattern and tumoricidal activity.

Science.gov (United States)

Mohamad, Saharuddin Bin; Nagasawa, Hideko; Sasaki, Hideyuki; Uto, Yoshihiro; Nakagawa, Yoshinori; Kawashima, Ken; Hori, Hitoshi

2003-01-01

Gc protein is the precursor for Gc protein-derived macrophage activating factor (GcMAF), with three phenotypes: Gc1f, Gc1s and Gc2, based on its electrophoretic mobility. The difference in electrophoretic mobility is because of the difference in its posttranslational sugar moiety composition. We compared the difference between Gc protein and GcMAF electrophoretic mobility using the isoelectric focusing (IEF) method. The tumoricidal activity of GcMAF-treated macrophage was evaluated after coculture with L-929 cell. The tumoricidal mechanism was investigated using TNF bioassay and nitric oxide (NO) release. The difference in Gc protein and GcMAF electrophoretic mobility was detected. The tumoricidal activity of GcMAF-treated macrophage was detected, but no release of TNF and NO was detected. The difference of isoelectric focusing mobility in Gc protein and GcMAF would be useful to develop a GcMAF detection method. GcMAF increased macrophage tumoricidal activity but TNF and NO release were not involved in the mechanism.

Quality of life of unaffected siblings of children with chronic neurological disorders.

Science.gov (United States)

Rana, Pratyaksha; Mishra, Devendra

2015-06-01

To study quality of life (QoL) of the siblings of children with chronic neurological disorders. Between 1st August and 30th September, 2013, 50 children aged 12-18 y, whose child sibling was suffering from a chronic neurological disorder, were enrolled (Study group). Fifty age- and sex- matched siblings of apparently non-neurologically affected children were enrolled as controls (Control group). Those with more than one affected child or any affected adult in the family were excluded. QoL was assessed by a validated version of the WHOQOL-BREF in Hindi, and QoL was compared between cases and controls. The disorders in the index cases included cerebral palsy, 18 (15 with epilepsy); autism, 15; mental retardation, 12 and epilepsy, 5. The QoL in all domains was significantly poorer in the study group as compared to the controls. 64% study group children had insufficient knowledge about their sibling's condition. More than 1/4th study subjects faced difficulties in studies, play or work. There was no difference among the groups with regard to number of siblings who had 'dropped from the school'. The QoL of unaffected siblings of children with chronic neurological disorders was significantly impaired. Health-workers may consider including older siblings of neurologically affected children during family-counseling sessions, to provide information and suggest coping strategies. This intervention is likely to improve the functioning of the family unit as a whole.

Disrupted avoidance learning in functional neurological disorder: Implications for harm avoidance theories

Directory of Open Access Journals (Sweden)

Laurel S. Morris

Full Text Available Background: Functional neurological disorder (FND is an elusive disorder characterized by unexplained neurological symptoms alongside aberrant cognitive processing and negative affect, often associated with amygdala reactivity. Methods: We examined the effect of negative conditioning on cognitive function and amygdala reactivity in 25 FND patients and 20 healthy volunteers (HV. Participants were first conditioned to stimuli paired with negative affective or neutral (CS+/CS− information. During functional MRI, subjects then performed an instrumental associative learning task to avoid monetary losses in the context of the previously conditioned stimuli. We expected that FND patients would be better at learning to avoid losses when faced with negatively conditioned stimuli (increased harm avoidance. Multi-echo resting state fMRI was also collected from the same subjects and a robust denoising method was employed, important for removing motion and physiological artifacts. Results: FND subjects were more sensitive to the negative CS+ compared to HV, demonstrated by a reinforcement learning model. Contrary to expectation, FND patients were generally more impaired at learning to avoid losses under both contexts (CS+/CS−, persisting to choose the option that resulted in a negative outcome demonstrated by both behavioural and computational analyses. FND patients showed enhanced amygdala but reduced dorsolateral prefrontal cortex responses when they received negative feedback. Patients also had increased resting state functional connectivity between these two regions. Conclusions: FND patients had impaired instrumental avoidance learning, findings that parallel previous observations of impaired action-outcome binding. FND patients further show enhanced behavioural and neural sensitivity to negative information. However, this did not translate to improved avoidance learning. Put together, our findings do not support the theory of harm avoidance in FND

A Case-Control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD

Directory of Open Access Journals (Sweden)

Francisco de Assis Aquino Gondim

2015-02-01

Full Text Available Neurological diseases are common in inflammatory bowel disease (IBD patients, but their exact prevalence is unknown. Method We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD and 70 with ulcerative colitis (UC] and 50 controls (gastritis and dyspepsia over 3 years. Results Our standard neurological evaluation (that included electrodiagnostic testing revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045, 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001 and 5.1 times more likely to develop autonomic complaints (p = 0.027. UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027 and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015. Conclusion In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia.

Neurological aspects of acute radiation injuries

International Nuclear Information System (INIS)

Torubarov, F.S.; Bushmanov, A.Yu.

1999-01-01

Results of the most important clinical studies of human nervous system reactions to acute radiation, carried out at Neurology Clinic of the State Research Center of Russia - Institute of Biophysics are presented. Clinical picture of changes in the nervous system in acute radiation disease caused by homologous and heterologous external irradiation is described. Main neurological syndrome of extremely severe acute radiation disease: acute radiation encephalopathy, radiation toxic encephalopathy, and hemorrhagic syndrome of the central nervous system is distinguished. Relationship between neurological disorders and the geometry of exposure are considered [ru

Factors Related to Social Support in Neurological and Mental Disorders

Science.gov (United States)

Kamenov, Kaloyan; Cabello, Maria; Caballero, Francisco Félix; Cieza, Alarcos; Sabariego, Carla; Raggi, Alberto; Anczewska, Marta; Pitkänen, Tuuli; Ayuso-Mateos, Jose Luis

2016-01-01

Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality. PMID:26900847

Factors Related to Social Support in Neurological and Mental Disorders.

Directory of Open Access Journals (Sweden)

Kaloyan Kamenov

Full Text Available Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality.

Psychological assessment of malingering in psychogenic neurological disorders and non-psychogenic neurological disorders : relationship to psychopathology levels

NARCIS (Netherlands)

van Beilen, M.; Griffioen, B. T.; Gross, A.; Leenders, K. L.

2009-01-01

Background and purpose: It remains unknown whether psychological distress causes malingering in patients with psychogenic symptoms. Methods: We studied 26 patients with psychogenic neurological disorders on psychopathology and malingering in comparison with 26 patients with various neurological

Engineered BDNF producing cells as a potential treatment for neurologic disease

Science.gov (United States)

Deng, Peter; Anderson, Johnathon D.; Yu, Abigail S.; Annett, Geralyn; Fink, Kyle D.; Nolta, Jan A.

2018-01-01

Introduction Brain-derived neurotrophic factor (BDNF) has been implicated in wide range of neurological diseases and injury. This neurotrophic factor is vital for neuronal health, survival, and synaptic connectivity. Many therapies focus on the restoration or enhancement of BDNF following injury or disease progression. Areas covered The present review will focus on the mechanisms in which BDNF exerts its beneficial functioning, current BDNF therapies, issues and potential solutions for delivery of neurotrophic factors to the central nervous system, and other disease indications that may benefit from overexpression or restoration of BDNF. Expert opinion Due to the role of BDNF in neuronal development, maturation, and health, BDNF is implicated in numerous neurological diseases making it a prime therapeutic agent. Numerous studies have shown the therapeutic potential of BDNF in a number of neurodegenerative disease models and in acute CNS injury, however clinical translation has fallen short due to issues in delivering this molecule. The use of MSC as a delivery platform for BDNF holds great promise for clinical advancement of neurotrophic factor restoration. The ease with which MSC can be engineered opens the door to the possibility of using this cell-based delivery system to advance a BDNF therapy to the clinic. PMID:27159050

Trouble with ataxia: A longitudinal qualitative study of the diagnosis and medical management of a group of rare, progressive neurological conditions

Science.gov (United States)

Ealing, John; Greenfield, Julie; Kingston, Helen; Sanders, Caroline; Payne, Katherine

2013-01-01

Objectives: An exploratory investigation of diagnosis and management in progressive ataxias: rare neurological conditions usually affecting balance, mobility and speech. Methods: A longitudinal qualitative study into the experiences of people with ataxia and neurologists. Thematic analysis and follow-up interviews were used to determine diagnosis and management issues over time. Results: People with ataxia recruited via two hospital departments and Ataxia UK were interviewed at baseline (n = 38) and 12-month follow-up (n = 31). Eight consultant neurologists were interviewed once. Patient accounts were diverse, but many expressed frustration at having an incurable condition and dissatisfaction with service outcomes. At follow-up, there was variation in their contact and satisfaction with helping agencies. Service issues regarding continuity of care and the primary/secondary care interface were evident. Neurologists’ accounts also varied. One-half reported that there is nothing that can be done, and one-half favoured specialist referral to increase the likelihood of finding an underlying aetiology within budget constraints. Conclusions: Diagnostic uncertainties existing at baseline remained for patients at follow-up interviews, although some had learned to deal with the uncertainties brought by the diagnosis of a largely untreatable condition. Care pathways only seemed to operate in the case of defined conditions, such as Friedreich’s Ataxia, the most commonly inherited cause. The findings point to a need to develop the evidence base to inform the relative utility of diagnostic procedures in the context of finite resources for patient care and support. PMID:26770684

Purinergic Receptors in Neurological Diseases With Motor Symptoms: Targets for Therapy

Directory of Open Access Journals (Sweden)

Ágatha Oliveira-Giacomelli

2018-04-01

Full Text Available Since proving adenosine triphosphate (ATP functions as a neurotransmitter in neuron/glia interactions, the purinergic system has been more intensely studied within the scope of the central nervous system. In neurological disorders with associated motor symptoms, including Parkinson's disease (PD, motor neuron diseases (MND, multiple sclerosis (MS, amyotrophic lateral sclerosis (ALS, Huntington's Disease (HD, restless leg syndrome (RLS, and ataxias, alterations in purinergic receptor expression and activity have been noted, indicating a potential role for this system in disease etiology and progression. In neurodegenerative conditions, neural cell death provokes extensive ATP release and alters calcium signaling through purinergic receptor modulation. Consequently, neuroinflammatory responses, excitotoxicity and apoptosis are directly or indirectly induced. This review analyzes currently available data, which suggests involvement of the purinergic system in neuro-associated motor dysfunctions and underlying mechanisms. Possible targets for pharmacological interventions are also discussed.

Nanomaterial-based electrochemical sensing of neurological drugs and neurotransmitters

International Nuclear Information System (INIS)

Sanghavi, Bankim J.; Swami, Nathan S.; Wolfbeis, Otto S.; Hirsch, Thomas

2015-01-01

Nanomaterial-modified detection systems represent a chief driver towards the adoption of electrochemical methods, since nanomaterials enable functional tunability, ability to self-assemble, and novel electrical, optical and catalytic properties that emerge at this scale. This results in tremendous gains in terms of sensitivity, selectivity and versatility. We review the electrochemical methods and mechanisms that may be applied to the detection of neurological drugs. We focus on understanding how specific nano-sized modifiers may be applied to influence the electron transfer event to result in gains in sensitivity, selectivity and versatility of the detection system. This critical review is structured on the basis of the Anatomical Therapeutic Chemical (ATC) Classification System, specifically ATC Code N (neurotransmitters). Specific sections are dedicated to the widely used electrodes based on the carbon materials, supporting electrolytes, and on electrochemical detection paradigms for neurological drugs and neurotransmitters within the groups referred to as ATC codes N01 to N07. We finally discuss emerging trends and future challenges such as the development of strategies for simultaneous detection of multiple targets with high spatial and temporal resolutions, the integration of microfluidic strategies for selective and localized analyte pre-concentration, the real-time monitoring of neurotransmitter secretions from active cell cultures under electro- and chemotactic cues, aptamer-based biosensors, and the miniaturization of the sensing system for detection in small sample volumes and for enabling cost savings due to manufacturing scale-up. The Electronic Supporting Material (ESM) includes review articles dealing with the review topic in last 40 years, as well as key properties of the analytes, viz., pK a values, half-life of drugs and their electrochemical mechanisms. The ESM also defines analytical figures of merit of the drugs and neurotransmitters. The

The role of emergency neurology in Italy: outcome of a consensus meeting for a Intersociety position.

Science.gov (United States)

Micieli, Giuseppe; De Falco, Fabrizio A; Consoli, Domenico; Inzitari, Domenico; Sterzi, Roberto; Tedeschi, Gioacchino; Toni, Danilo

2012-04-01

A possible definition of clinical, educational and organizing aspects of emergency neurology in Italy is reported in this position paper of Emergency Neurology Intersociety Group, created in 2008 among the two neurological Societies in Italy: Società Italiana di Neurologia and Società di Neuroscienze Ospedaliere. The aim of this Group has been the evaluation of the role of neurologist in the emergency setting of Italian hospitals, as well as of the description of different scenarios in which a ward dedicated to a semi-intensive care of neurological emergencies could have a role in the actual organization of academic or general hospitals in our Country. The actual great relevance of neurologist activity in the inpatients treatment, in fact, is actually misleaded as it is the considerable significance of neurological expertise, techniques and support in hospital care pathways also involving neurological manifestations throughout the course of other diseases. Finally, the possible contents of educational programs orienting neurological specialty towards a better comprehension and management of emergency neurological problems either in terms of specific formation or of techniques to be learned by emergency neurologist, are reported as a results of the Consensus Workshop hold in Castiglioncello (LI) in September 12th, 2009.

Neurological status and ethanol preference in rats during alcohol addiction formation

Directory of Open Access Journals (Sweden)

A S Tarasov

2018-06-01

Full Text Available Aim. To estimate the features of neurological status and drinking behaviour in rats during 20 days of chronic alcohol intake. Methods. The current study was performed on 40 male Wistar rats (170-300 g. The animals from the study group were administered 15% solution of ethanol used as the only fluid source. On day 20 of the experiment the alcohol preference test and evaluation of neurological status were performed: tail-suspension (to determine paresis and paralysis, home cage motion activity (to determine gait disorders and stereotypic movements and features of horizontal beam-walking (evaluation of movement coordination were assessed, presence of the basic reflexes (startle reflex, external auditory canal reflex, corneal reflex was controlled. Results. The main neurological signs were presented as ataxic form, in which unsteady gait in beam-walking test was predominant. In the experimental groups, the signs of ataxic form of neurological deficit were demonstrated, when animals slipped off and fell off the beam within 40 s from the beginning of the test. This was associated with the significant increase of discrimination ratio in alcohol preference test. Conclusion. In rat models of chronic alcohol intake, significant changes in drinking behavior and alcohol preference test were found on day 20 of the experiment, reflecting formation of alcohol addiction; changes in drinking behavior were associated with mild and moderate neurological deficit, primarily including movement coordination disorders that illustrates the malfunction of peripheral nervous system.

Rodent neonatal germinal matrix hemorrhage mimics the human brain injury, neurological consequences, and post-hemorrhagic hydrocephalus

OpenAIRE

Lekic, Tim; Manaenko, Anatol; Rolland, William; Krafft, Paul R.; Peters, Regina; Hartman, Richard E.; Altay, Orhan; Tang, Jiping; Zhang, John H.

2012-01-01

Germinal matrix hemorrhage (GMH) is the most common neurological disease of premature newborns. GMH causes neurological sequelae such as cerebral palsy, post-hemorrhagic hydrocephalus, and mental retardation. Despite this, there is no standardized animal model of spontaneous GMH using newborn rats to depict the condition. We asked whether stereotactic injection of collagenase type VII (0.3 U) into the ganglionic eminence of neonatal rats would reproduce the acute brain injury, gliosis, hydroc...

Neurological sequelae in survivors of cerebral malaria | Oluwayemi ...

African Journals Online (AJOL)

Introduction: Cerebral malaria is a common cause of neurological sequelae and death in childhood. Information on persistent neurological sequelae post hospital discharge and their predisposing factors are scarce. Methods: This is a prospective study describing persisting neurological impairments post discharge among ...

Comparative audit of clinical research in pediatric neurology.

Science.gov (United States)

Al-Futaisi, Amna; Shevell, Michael

2004-11-01

Clinical research involves direct observation or data collection on human subjects. This study was conducted to evaluate the profile of pediatric neurology clinical research over a decade. Trends in pediatric neurology clinical research were documented through a systematic comparative review of articles published in selected journals. Eleven journals (five pediatric neurology, three general neurology, three general pediatrics) were systematically reviewed for articles involving a majority of human subjects less than 18 years of age for the years 1990 and 2000. Three hundred thirty-five clinical research articles in pediatric neurology were identified in the 11 journals for 1990 and 398 for 2000, a 19% increase. A statistically significant increase in analytic design (21.8% vs 39.5%; P = .01), statistical support (6% vs 16.6%; P neurology over a decade. Trends apparently suggest a more rigorous approach to study design and investigation in this field.

Common gene-network signature of different neurological disorders and their potential implications to neuroAIDS.

Directory of Open Access Journals (Sweden)

Vidya Sagar

Full Text Available The neurological complications of AIDS (neuroAIDS during the infection of human immunodeficiency virus (HIV are symptomized by non-specific, multifaceted neurological conditions and therefore, defining a specific diagnosis/treatment mechanism(s for this neuro-complexity at the molecular level remains elusive. Using an in silico based integrated gene network analysis we discovered that HIV infection shares convergent gene networks with each of twelve neurological disorders selected in this study. Importantly, a common gene network was identified among HIV infection, Alzheimer's disease, Parkinson's disease, multiple sclerosis, and age macular degeneration. An mRNA microarray analysis in HIV-infected monocytes showed significant changes in the expression of several genes of this in silico derived common pathway which suggests the possible physiological relevance of this gene-circuit in driving neuroAIDS condition. Further, this unique gene network was compared with another in silico derived novel, convergent gene network which is shared by seven major neurological disorders (Alzheimer's disease, Parkinson's disease, Multiple Sclerosis, Age Macular Degeneration, Amyotrophic Lateral Sclerosis, Vascular Dementia, and Restless Leg Syndrome. These networks differed in their gene circuits; however, in large, they involved innate immunity signaling pathways, which suggests commonalities in the immunological basis of different neuropathogenesis. The common gene circuits reported here can provide a prospective platform to understand how gene-circuits belonging to other neuro-disorders may be convoluted during real-time neuroAIDS condition and it may elucidate the underlying-and so far unknown-genetic overlap between HIV infection and neuroAIDS risk. Also, it may lead to a new paradigm in understanding disease progression, identifying biomarkers, and developing therapies.

Use of focused ultrasonication in activity-based profiling of deubiquitinating enzymes in tissue

OpenAIRE

Nanduri, Bindu; Shack, Leslie A.; Rai, Aswathy N.; Epperson, William B.; Baumgartner, Wes; Schmidt, Ty B.; Edelmann, Mariola J.

2016-01-01

To develop a reproducible tissue-lysis method that retains enzyme function for activity-based protein profiling, we compared four different tissue lysis methods of bovine lung tissue: focused ultrasonication, standard sonication, mortar & pestle method, and homogenization combined with standard sonication. Focused ultrasonication and mortar & pestle methods were sufficiently effective for activity-based profiling of deubiquitinases in tissue and focused ultrasonication had also the fastest pr...

[Sir William Richard Gowers: author of the "bible of neurology"].

Science.gov (United States)

Hirose, Genjiro

2014-11-01

William Richard Gowers is one of the great pioneers in neurology and the author of the well-known neurology textbook, "A Manual of Diseases of the Nervous System." His concepts of neurology are based on meticulously and carefully accumulated knowledge of history, observations, and neurological examinations of patients with various neurological diseases. He is not only a great neurologist but also a great teacher who loves teaching students and physicians through well-prepared lectures. We can glean the essence of the field of neurology through his life story and numerous writings concerning neurological diseases.

Neurology check list. 5. rev. and enl. ed.

International Nuclear Information System (INIS)

Grehl, Holger; Reinhardt, Frank

2013-01-01

The neurology check list covers the following issues, organized in four parts: Grey part - diagnostic fundamentals, therapeutic principles: clinical neurological examination, liquor puncture, specific laboratory diagnostics, neurophysical diagnostics, imaging techniques, therapeutic principles, legal aspects, neurological assessment. Green Part - leading syndromes and leading symptoms. Blue part - neurological disease appearance: pains in head and face, pain syndrome, congenital and development disturbances, liquor circulation disturbances, ZNS hemorrhages, tumors and neoplasm, paraneoplastic syndromes, inflammatory diseases of the nervous system, dementia diseases, metabolic and other encephalopathy, cerebellum diseases and system surmounting processes, movement degeneration, basal ganglion diseases, epilepsy, non-epileptic attacks, medulla diseases, brain nerve diseases, plexus lesions, radicular lesions, peripheric neuropathy, neuromuscular transfer disturbances, muscular diseases. Red part: neurological intensive medicine.

Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

Science.gov (United States)

Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L

2016-04-01

As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program

Neutron activation analysis of the central nervous system tissues in neurological diseases

Energy Technology Data Exchange (ETDEWEB)

Yasui, Masayuki; Ota, Kiichiro [Wakayama Medical Coll. (Japan); Sasajima, Kazuhisa

1994-07-01

As the diseases due to excessive metals in living bodies and the metals of their causes, Minamata disease due to Hg, itai-itai disease due to Cd, dialysis brain disease due to Al, hemochromatosis due to Fe, Wilson disease due to Cu and so on have been known. Also as the neural diseases, in which the possibility that metals take part in them is presumed, there are amyotrophic lateral sclerosis, Alzheimer disease, Parkinson disease, Parkinsonism dementia and so on. In order to know the causes of the diseases due to excessive metals in living bodies and neurological diseases, the authors have measured Cu, Ca, Al, Mn, Zn and Fe in central nervous system tissues by activation analysis nondestructive method. The cases investigated were 4 cases of hepatocerebral diseases, 6 cases of ALS, 4 cases of Parkinson disease, 4 cases of Parkinsonism dementia, 4 cases of multiple sclerosis and 5 cases without CNS disease for the control. The method of measurement is described. The results for respective diseases are reported. Cu and Fe are in the relation of mirror images, and Cu formed Cu-superoxide dismutase (SOD) similarly to Zn and Mn as SOD carrier metals, and protects living bodies and CNS from oxidative stress. (K.I.).

Loss of SYNJ1 dual phosphatase activity leads to early onset refractory seizures and progressive neurological decline

DEFF Research Database (Denmark)

Hardies, Katia; Cai, Yiying; Jardel, Claude

2016-01-01

SYNJ1 encodes a polyphosphoinositide phosphatase, synaptojanin 1, which contains two consecutive phosphatase domains and plays a prominent role in synaptic vesicle dynamics. Autosomal recessive inherited variants in SYNJ1 have previously been associated with two different neurological diseases...... with intractable epilepsy and tau pathology. We performed whole exome or genome sequencing in three independent sib pairs with early onset refractory seizures and progressive neurological decline, and identified novel segregating recessive SYNJ1 defects. A homozygous missense variant resulting in an amino acid...

[Features of neurologic semiotics at chronic obstructive pulmonary disease].

Science.gov (United States)

Litvinenko, I V; Baranov, V L; Kolcheva, Iu A

2011-01-01

Chronic obstructive pulmonary disease (COPD) is actual pathology, when it forms the mixed hypoxemia. In the conditions of a chronic hypoxemia structures of organism with high level of metabolic processes, namely brain tissues, suffer. Character of defeat of the central nervous system at that pathology is insufficiently studied. In this article we studied and analysed the presence of such changes as depression, anxiety, cognitive impairment and features of neurologic semiotics at COPD in 50 patients.

The tablet device in hospital neurology and in neurology graduate medical education: a preliminary study.

Science.gov (United States)

George, Pravin; Newey, Christopher R; Bhimraj, Adarsh

2015-01-01

There is limited literature on tablet devices for neurohospitalists and in neurological graduate medical education. This study evaluated utilization, benefits, and limitations of customized tablets on inpatient neurology practice and resident education. The hypothesis was the perception of the tablet would be positive, given their portability, convenience to accessing point-of-care reference, and accessibility to the electronic medical record. Second-generation iPads with neurology-specific applications and literature were provided to our in-hospital general, stroke, and consult neurology teams. After 1 year, residents on these teams were surveyed on demographic data, familiarity, and utilization of the iPad and their perceptions of the device. All 27 residents responded to the survey. Most participants (23 of 27) used a tablet while on inpatient service. Twelve regularly utilized the neurology-specific apps and/or accessed scientific articles. Technologically savvy residents felt significantly more comfortable using tablets and were more quickly acquainted with the features. Thirteen respondents wanted a formal orientation on the advanced features of the tablet independent of their familiarity with the device or level of technological comfort. Overall, the perception was that the tablet was beneficial for inpatient clinical care and as an educational reference. Participants became easily familiarized with the device features quickly, regardless of whether they owned one previously or not. Most physicians indicated interest in advanced features of tablets; however, a formal orientation may be beneficial for optimal utilization. A reliable network connection is essential to in-hospital use of tablet devices. Additional research pertaining to patient outcomes, objective educational benefit, and cost-effectiveness is necessary.

Survey on current practices for neurological prognostication after cardiac arrest.

Science.gov (United States)

Friberg, Hans; Cronberg, Tobias; Dünser, Martin W; Duranteau, Jacques; Horn, Janneke; Oddo, Mauro

2015-05-01

To investigate current practices and timing of neurological prognostication in comatose cardiac arrest patients. An anonymous questionnaire was distributed to the 8000 members of the European Society of Intensive Care Medicine during September and October 2012. The survey had 27 questions divided into three categories: background data, clinical data, decision-making and consequences. A total of 1025 respondents (13%) answered the survey with complete forms in more than 90%. Twenty per cent of respondents practiced outside of Europe. Overall, 22% answered that they had national recommendations, with the highest percentage in the Netherlands (>80%). Eighty-nine per cent used induced hypothermia (32-34 °C) for comatose cardiac arrest patients, while 11% did not. Twenty per cent had separate prognostication protocols for hypothermia patients. Seventy-nine per cent recognized that neurological examination alone is not enough to predict outcome and a similar number (76%) used additional methods. Intermittent electroencephalography (EEG), brain computed tomography (CT) scan and evoked potentials (EP) were considered most useful. Poor prognosis was defined as cerebral performance category (CPC) 3-5 (58%) or CPC 4-5 (39%) or other (3%). When prognosis was considered poor, 73% would actively withdraw intensive care while 20% would not and 7% were uncertain. National recommendations for neurological prognostication after cardiac arrest are uncommon and only one physician out of five uses a separate protocol for hypothermia treated patients. A neurological examination alone was considered insufficient to predict outcome in comatose patients and most respondents advocated a multimodal approach: EEG, brain CT and EP were considered most useful. Uncertainty regarding neurological prognostication and decisions on level of care was substantial. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Behavioral activation in TFP: The role of the treatment contract in transference-focused psychotherapy.

Science.gov (United States)

Yeomans, Frank E; Delaney, Jill C; Levy, Kenneth N

2017-09-01

Transference-focused psychotherapy (TFP) is a manualized evidence-based treatment for borderline and other severe personality disorders that is based on psychoanalytic object relations theory. Similar to other psychodynamic psychotherapies, TFP focuses on changing psychological structures, but also focuses on symptom and behavioral change, particularly the importance of being active (e.g., obtaining a job or involvement in similar activities). In TFP, the establishment of the treatment contract, also known as the treatment frame, is where goals such as work and other activities are agreed upon. The focus on such activities is particularly relevant to the concept of behavioral activation. We provide a clinical vignette to illustrate how TFP utilizes behavioral activation in facilitating treatment outcome both at the behavioral level and at the psychological level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Management of nuclear PRs activity with optimal conditions

International Nuclear Information System (INIS)

Ohnishi, Teruaki

1997-01-01

A methodology is proposed to derive optimal conditions for the activity of nuclear public relations (PRs). With the use of data-bases available at present, expressions were derived which connect the budget allocated for the PRs activity with the intensity of stimulus for four types of activity of the advertisement in the press, the exclusive publicity, the pamphlet and the advertisement on television. Optimal conditions for the activity were determined by introducing a model describing a relation between the intensity of stimulus and the extent of the change of public's attitude to nuclear energy, namely the effect of PRs activity, and also by giving the optimal ratio of allocation of the budget among the four types of activity as a function of cost versus effectiveness of each type. Those optimal conditions, being for the ratio of allocation of the budget, the execution time and the intensity of each type of activity at that time, vary depending on the number of household in a target region, the target class of demography, the duration time of activity, and the amount of budget for the activity. It becomes clear from numerical calculation that the optimal conditions and the effect of activity show quite strong non-linearity with respect to the variation of those variables, and that the effect of PRs activity averaged over all public in the target region becomes to be maximum, in Japan, when the activity is executed with the optimal conditions determined for the target class of middle- and advanced-aged women. The management of nuclear PRs activity becomes possible by introducing such a method of fixation of optimal conditions for the activity as described here. (author)

Diagnostic overshadowing in a population of children with neurological disabilities: A cross sectional descriptive study on acquired ADHD.

Science.gov (United States)

Hendriksen, J G M; Peijnenborgh, J C A W; Aldenkamp, A P; Vles, J S H

2015-09-01

Diagnostic overshadowing refers to the underdiagnosis of comorbid conditions in children with known neurological diagnoses. To demonstrate diagnostic overshadowing we determined the prevalence of attention deficit-hyperactivity disorders (ADHD) in a cohort of children with a wide range of neurological disabilities. The study cohort consisted of 685 children (mean age 10.3 years, SD: 3.1; 425 boys and 260 girls) who visited a tertiary outpatient multidisciplinary clinic for neurological learning disabilities. Patients with ADHD were identified by retrospective chart review using DSM-IV criteria. The prevalence of ADHD in this cohort was 38.8% (266 children); of these children only 28.2% (75 children) were diagnosed with ADHD before referral. ADHD is a common problem in children with neurological disabilities and may be underdiagnosed due to overshadowing of somatic, physical or syndromal features of the disability. In our heterogeneous population ADHD was overshadowed in 71.8% of the cases. This finding may have important implications for diagnosis and treatment of mental health needs in children with neurological disabilities. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Diverse Neurological Manifestations of Lead Encephalopathy ...

African Journals Online (AJOL)

Three patients with lead encephalopathy due to industrial poisoning are presented. They all showed a wide spectrum of neurological manifestations, which mimic other neurological presentations. It is emphasised that lead poisoning still occurs in industry, despite efforts at prevention. S. Afr. Med. J., 48, 1721 (1974) ...

Neurological complications following adult lung transplantation

NARCIS (Netherlands)

Mateen, F. J.; Dierkhising, R. A.; Rabinstein, A. A.; van de Beek, D.; Wijdicks, E. F. M.

2010-01-01

The full spectrum of neurologic complications and their impact on survival in lung recipients has not been reported. A retrospective cohort review of the Mayo Clinic Lung Transplant Registry (1988-2008) was performed to determine the range of neurologic complications in a cohort of adult lung

[Cinema and neurology: early educational applications].

Science.gov (United States)

Collado-Vázquez, Susana; Carrillo, Jesús M

2015-03-01

Since its earliest days, cinema has been used in the teaching of neurology both to illustrate the professor's explanations and to make learning easier for students. To analyse some of the first applications of cinema to the teaching and learning of neurology. Shortly after the birth of the film projector it became apparent that it could be a valuable aid in teaching medicine, and especially neurology. Initially, actual recordings made by doctors themselves were used, and later documentaries, short films and feature films were employed as means of showing diagnostic and therapeutic methods, as well as different pathological signs, such as movement disorders. The intention was not to replace other methodologies but instead to complement them and to make the process of acquiring knowledge easier. Applying cinema in teaching is a useful way to portray the contents of different subjects, especially in the field of neurology, and to favour the acquisition of both specific and cross-disciplinary competences, with very positive results being obtained among students.

The assessment of minor neurological dysfunction in infancy using the Touwen Infant Neurological Examination : strengths and limitations

NARCIS (Netherlands)

Hadders-Algra, Mijna; Heineman, Kirsten R.; Bos, Arend F.; Middelburg, Karin J.

Aim Little is known of minor neurological dysfunction (MND) in infancy. This study aimed to evaluate the inter-assessor reliability of the assessment of MND with the Touwen Infant Neurological Examination (TINE) and the construct and predictive validity of MND in infancy. Method Inter-assessor

How physical therapists instruct patients with stroke: an observational study on attentional focus during gait rehabilitation after stroke

NARCIS (Netherlands)

Kal, Elmar; van den Brink, Henrieke; Houdijk, Han; van der Kamp, John; Goossens, Paulien Helena; van Bennekom, Coen; Scherder, Erik

2018-01-01

People without neurological impairments show superior motor learning when they focus on movement effects (external focus) rather than on movement execution itself (internal focus). Despite its potential for neurorehabilitation, it remains unclear to what extent external focus strategies are

Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia: A case study

Directory of Open Access Journals (Sweden)

Hamid Nasiri

2015-01-01

Full Text Available Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia): A case study.

Science.gov (United States)

Nasiri, Hamid; Ebrahimi, Amrollah; Zahed, Arash; Arab, Mostafa; Samouei, Rahele

2015-05-01

Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia) was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

Are the French neurology residents satisfied with their training?

Science.gov (United States)

Codron, P; Roux, T; Le Guennec, L; Zuber, M

2015-11-01

There have been dramatic changes in neurology over the past decade; these advances require a constant adaptation of residents' theoretical and practical training. The French Association of Neurology Residents and the College of Neurology Teachers conducted a national survey to assess the French neurology residents' satisfaction about their training. A 16-item questionnaire was sent via e-mail to French neurology residents completing training in 2014. Data were collected and processed anonymously. Of eligible respondents, 126 returned the survey, representing approximately 40% of all the French neurology residents. Most residents (78%) rated their clinical training favorably. Seventy-two percent reported good to excellent quality teaching of neurology courses from their faculty. However, many residents (40%) felt insufficient their doctoral thesis supervision. All residents intended to enter fellowship training after their residency, and most of them (68%) planned to practice in a medical center. French neurology residents seemed satisfied with the structure and quality of their training program. However, efforts are required to improve management of the doctoral thesis and make private practice more attractive and accessible during the residency. In the future, similar surveys should be scheduled to regularly assess neurology residents' satisfaction and the impact of the forthcoming national and European reforms. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Clinical trials in neurology: design, conduct, analysis

National Research Council Canada - National Science Library

Ravina, Bernard

2012-01-01

.... Clinical Trials in Neurology aims to improve the efficiency of clinical trials and the development of interventions in order to enhance the development of new treatments for neurologic diseases...

[Neurology in medieval regimina sanitatis].

Science.gov (United States)

de Frutos González, V; Guerrero Peral, A L

2011-09-01

In medical medieval literature some works about dietetics stand out. Dietetics, as a separate branch of medicine, includes not only food or drinks, but other environmental factors influencing on health. They are known as regimina sanitatis or salutis, and specially developed in the Christian west. They generally consisted of a balance between the Galenic "six non-natural things"; factors regulating health and its protection: environment, exercise, food, sleep, bowel movements and emotions. After reviewing the sources and defining the different stages of this genre, we have considered three of the most out-standing medieval regimina, the anonymous Regimen sanitatis salernitanum, Arnaldo de Vilanova's Regimen sanitatis ad regem aragonum and Bernardo de Gordon's Tractatus of conservatione vite humane. In them we review references to neurological disease. Though not independently considered, there is a significant presence of neurological diseases in the regimina. Dietetics measures are proposed to preserve memory, nerves, or hearing, as well as for the treatment of migraine, epilepsy, stroke or dizziness. Regimina are quiet representative among medical medieval literature, and they show medieval physicians vision of neurological diseases. Dietetics was considered useful to preserve health, and therapeutics was based on natural remedies. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

[Neurology of hysteria (conversion disorder)].

Science.gov (United States)

Sonoo, Masahiro

2014-07-01

Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

Functional Neuroanatomy and Neurophysiology of Functional Neurological Disorders (Conversion Disorder).

Science.gov (United States)

Voon, Valerie; Cavanna, Andrea E; Coburn, Kerry; Sampson, Shirlene; Reeve, Alya; LaFrance, W Curt

2016-01-01

Much is known regarding the physical characteristics, comorbid symptoms, psychological makeup, and neuropsychological performance of patients with functional neurological disorders (FNDs)/conversion disorders. Gross neurostructural deficits do not account for the patients' deficits or symptoms. This review describes the literature focusing on potential neurobiological (i.e. functional neuroanatomic/neurophysiological) findings among individuals with FND, examining neuroimaging and neurophysiological studies of patients with the various forms of motor and sensory FND. In summary, neural networks and neurophysiologic mechanisms may mediate "functional" symptoms, reflecting neurobiological and intrapsychic processes.

African Journal of Neurological Sciences: Journal Sponsorship

African Journals Online (AJOL)

African Journal of Neurological Sciences: Journal Sponsorship. Journal Home > About the Journal > African Journal of Neurological Sciences: Journal Sponsorship. Log in or Register to get access to full text downloads.

New digital reference current generation for shunt active power filter under distorted voltage conditions

Energy Technology Data Exchange (ETDEWEB)

Abdusalam, Mohamed; Karimi, Shahram; Saadate, Shahrokh [Groupe de Recherche en Electrotechnique et Electronique de Nancy (GREEN), CNRS UMR 7037 (France); Poure, Philippe [Laboratoire d' Instrumentation Electronique de Nancy (LIEN), EA 3440, Universite Henri Poincare - Nancy Universite, B.P. 239, 54506 Vandoeuvre les Nancy Cedex (France)

2009-05-15

In this paper, a new reference current computation method suitable for shunt active power filter control under distorted voltage conditions is proposed. The active power filter control is based on the use of self-tuning filters (STF) for the reference current generation and on a modulated hysteresis current controller. This active filter is intended for harmonic compensation of a diode rectifier feeding a RL load under distorted voltage conditions. The study of the active filter control is divided in two parts. The first one deals with the harmonic isolator which generates the harmonic reference currents and is experimentally implemented in a DS1104 card of a DSPACE prototyping system. The second part focuses on the generation of the switching pattern of the inverter by using a modulated hysteresis current controller, implemented in an analogue card. The use of STF instead of classical extraction filters allows extracting directly the voltage and current fundamental components in the {alpha}-{beta} axis without phase locked loop (PLL). The performances are good even under distorted voltage conditions. First, the effectiveness of the new proposed method is mathematically studied and verified by computer simulation. Then, experimental results are presented using a DSPACE system associated with the analogue current controller for a real shunt active power filter. (author)

Neurologic deficit after resection of the sacrum.

Science.gov (United States)

Biagini, R; Ruggieri, P; Mercuri, M; Capanna, R; Briccoli, A; Perin, S; Orsini, U; Demitri, S; Arlecchini, S

1997-01-01

The authors describe neurologic deficit (sensory, motor, and sphincteral) resulting from sacrifice of the sacral nerve roots removed during resection of the sacrum. The anatomical and functional bases of sphincteral continence and the amount of neurologic deficit are discussed based on level of sacral resection. A large review of the literature on the subject is reported and discussed. The authors emphasize how the neurophysiological bases of sphincteral continence (rectum and bladder) and of sexual ability are still not well known, and how the literature reveals disagreement on the subject. A score system is proposed to evaluate neurologic deficit. The clinical model of neurologic deficit caused by resection of the sacrum may be extended to an evaluation of post-traumatic deficit.

Regulations in the United States for cell transplantation clinical trials in neurological diseases

Institute of Scientific and Technical Information of China (English)

He Zhu; Yuanqing Tan; Qi Gu; Weifang Han; Zhongwen Li; Jason S Meyer; Baoyang Hu

2015-01-01

Objective: This study aimed to use a systematic approach to evaluate the current utilization, safety, and effectiveness of cell therapies for neurological diseases in human. And review the present regulations, considering United States (US) as a representative country, for cell transplantation in neurological disease and discuss the challenges facing the field of neurology in the coming decades. Methods:A detailed search was performed in systematic literature reviews of cellular‐based therapies in neurological diseases, using PubMed, web of science, and clinical trials. Regulations of cell therapy products used for clinical trials were searched from the Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Results: Seven most common types of cell therapies for neurological diseases have been reported to be relatively safe with varying degrees of neurological recovery. And a series of regulations in US for cellular therapy was summarized including preclinical evaluations, sourcing material, stem cell manufacturing and characterization, cell therapy product, and clinical trials. Conclusions:Stem cell‐based therapy holds great promise for a cure of such diseases and will value a growing population of patients. However, regulatory permitting activity of the US in the sphere of stem cells, technologies of regenerative medicine and substitutive cell therapy are selective, theoretical and does not fit the existing norm and rules. Compiled well‐defined regulations to guide the application of stem cell products for clinical trials should be formulated.

Molecular imaging in neurology and neuroscience

International Nuclear Information System (INIS)

Schreckenberger, M.

2007-01-01

Molecular imaging in neurology and neuroscience is a suspenseful and fast developing tool in order to quantitatively image genomics and proteomics by means of direct and indirect markers. Because of its high-sensitive tracer principle, nuclear medicine imaging has the pioneering task for the methodical progression of molecular imaging. The current development of molecular imaging in neurology changes from the use of indirect markers of gene and protein expression to the direct imaging of the molecular mechanisms. It is the aim of this article to give a short review on the status quo of molecular imaging in neurology with emphasis on clinically relevant aspects. (orig.)

Coenzyme Q10 and Neurological Diseases

Directory of Open Access Journals (Sweden)

Gabriele Siciliano

2009-12-01

Full Text Available Coenzyme Q10 (CoQ10, or ubiquinone is a small electron carrier of the mitochondrial respiratory chain with antioxidant properties. CoQ10 supplementation has been widely used for mitochondrial disorders. The rationale for using CoQ10 is very powerful when this compound is primary decreased because of defective synthesis. Primary CoQ10 deficiency is a treatable condition, so heightened “clinical awareness” about this diagnosis is essential. CoQ10 and its analogue, idebenone, have also been widely used in the treatment of other neurodegenerative disorders. These compounds could potentially play a therapeutic role in Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, Friedreich’s ataxia, and other conditions which have been linked to mitochondrial dysfunction. This article reviews the physiological roles of CoQ10, as well as the rationale and the role in clinical practice of CoQ10 supplementation in different neurological diseases, from primary CoQ10 deficiency to neurodegenerative disorders.

White Paper: Movement System Diagnoses in Neurologic Physical Therapy.

Science.gov (United States)

Hedman, Lois D; Quinn, Lori; Gill-Body, Kathleen; Brown, David A; Quiben, Myla; Riley, Nora; Scheets, Patricia L

2018-04-01

The APTA recently established a vision for physical therapists to transform society by optimizing movement to promote health and wellness, mitigate impairments, and prevent disability. An important element of this vision entails the integration of the movement system into the profession, and necessitates the development of movement system diagnoses by physical therapists. At this point in time, the profession as a whole has not agreed upon diagnostic classifications or guidelines to assist in developing movement system diagnoses that will consistently capture an individual's movement problems. We propose that, going forward, diagnostic classifications of movement system problems need to be developed, tested, and validated. The Academy of Neurologic Physical Therapy's Movement System Task Force was convened to address these issues with respect to management of movement system problems in patients with neurologic conditions. The purpose of this article is to report on the work and recommendations of the Task Force. The Task Force identified 4 essential elements necessary to develop and implement movement system diagnoses for patients with primarily neurologic involvement from existing movement system classifications. The Task Force considered the potential impact of using movement system diagnoses on clinical practice, education and, research. Recommendations were developed and provided recommendations for potential next steps to broaden this discussion and foster the development of movement system diagnostic classifications. The Task Force proposes that diagnostic classifications of movement system problems need to be developed, tested, and validated with the long-range goal to reach consensus on and adoption of a movement system diagnostic framework for clients with neurologic injury or disease states.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A198).

The beginnings of the Southern Child/Pediatric Neurology Society.

Science.gov (United States)

Dyken, Paul Richard; Bodensteiner, John B

2015-04-01

The founding and early development of the Southern Pediatric Neurology Society was in many ways parallel to that of the Child Neurology Society. The organization started out as the Southern Child Neurology Society but the name was changed at the time of incorporation so as to avoid confusion of identity and purpose with the larger Child Neurology Society. Although there are archives of early days and the later development of the Southern Pediatric Neurology Society, the details have never been set down in a narrative explaining the events that led to the development of the organization. In this paper, we try to produce a written record of the history of the founding and early development of the Southern Pediatric Neurology Society. © The Author(s) 2014.

Creutzfeldt-Jakob disease: A great masquerade in neurology, a rare case report from South India

Directory of Open Access Journals (Sweden)

Sivaprakash Varadan

2015-01-01

Full Text Available Creutzfeldt-Jakob disease (CJD is a rare, fatal neurodegenerative disease caused by an infectious protein called prion and is characterized by spongiform changes, neuronal loss, reactive astrocytic proliferation, and accumulation of pathologic cellular protein. Clinical presentation of CJD is characterized by rapidly progressive dementia, neurologic symptoms and visual impairment, and the development of akinetic mutism, which can mimic many neurological conditions. The diagnosis is based on clinical presentation, electroencephalogram, and typical cerebrospinal fluid and magnetic resonance imaging (MRI findings. Literature on the incidence and prevalence of CJD is lacking in South India. We report the case of a 57-year-old woman with progressive dementia and typical neurologic symptoms, myoclonic jerks, and MRI findings of CJD. This case highlights the need for a high index of suspicion to diagnose CJD.

[Deficiency, disability, neurology and television series].

Science.gov (United States)

Collado-Vázquez, Susana; Martínez-Martínez, Ariadna; Cano-de-la-Cuerda, Roberto

2015-06-01

The portrayal of neurological disability and deficiency on television has not always been approached in the same way, but has instead tended to reflect the standpoint taken by society with regard to these issues and how they are dealt with according to the prevailing conceptions and values at each particular time. To address the appearance of neurological pathologies in television series and to ponder on the image they have in such contexts. Deficiency and disability of neurological origin have often been depicted on television in series, telefilms and documentaries, and in a wide variety of ways. Here we examine different television series and how they have dealt with neurological pathology, its diagnosis and its treatment, as well as the figure of the healthcare professional and social-familial adaptation. Examples cited include series such as House MD, Glee, American Horror Story, Homeland or Game of Thrones. Television series are a useful tool for making some neurological pathologies better known to the public and for dispelling the myths surrounding others, provided that the pathologies are dealt with in a realistic manner, which is not always the case. More care should be taken with regard to the way in which health professionals are portrayed in television series, as it is not always done correctly and may mislead viewers, who take what they see on the TV as being real.

Rett syndrome: a neurological disorder with metabolic components

Science.gov (United States)

Kyle, Stephanie M.

2018-01-01

Rett syndrome (RTT) is a neurological disorder caused by mutations in the X-linked gene methyl-CpG-binding protein 2 (MECP2), a ubiquitously expressed transcriptional regulator. Despite remarkable scientific progress since its discovery, the mechanism by which MECP2 mutations cause RTT symptoms is largely unknown. Consequently, treatment options for patients are currently limited and centred on symptom relief. Thought to be an entirely neurological disorder, RTT research has focused on the role of MECP2 in the central nervous system. However, the variety of phenotypes identified in Mecp2 mutant mouse models and RTT patients implicate important roles for MeCP2 in peripheral systems. Here, we review the history of RTT, highlighting breakthroughs in the field that have led us to present day. We explore the current evidence supporting metabolic dysfunction as a component of RTT, presenting recent studies that have revealed perturbed lipid metabolism in the brain and peripheral tissues of mouse models and patients. Such findings may have an impact on the quality of life of RTT patients as both dietary and drug intervention can alter lipid metabolism. Ultimately, we conclude that a thorough knowledge of MeCP2's varied functional targets in the brain and body will be required to treat this complex syndrome. PMID:29445033

[Neurological syndromes associated with homocystein dismetabolism].

Science.gov (United States)

Shirokov, E A; Leonova, S F

2006-01-01

The article summarizes the results of clinical, neurological, and laboratory examination of patients with hyperhomocysteinemia. The data obtained suggest the existence of common pathobiochemical mechanisms of homocystein, cholesterol, and myelin dysmetabolism. The authors demonstrate that neurological manifestations of hyperhomocysteinemia are associated with the processes of demyelinization in the central and peripheral nervous systems.

Neurological and ocular fascioliasis in humans.

Science.gov (United States)

Mas-Coma, Santiago; Agramunt, Verónica H; Valero, María Adela

2014-01-01

Fascioliasis is a food-borne parasitic disease caused by the trematode species Fasciola hepatica, distributed worldwide, and Fasciola gigantica, restricted to given regions of Africa and Asia. This disease in humans shows an increasing importance, which relies on its recent widespread emergence related to climate and global changes and also on its pathogenicity in the invasive, biliary, and advanced chronic phases in the human endemic areas, mainly of developing countries. In spite of the large neurological affection capacity of Fasciola, this important pathogenic aspect of the disease has been pronouncedly overlooked in the past decades and has not even appear within the numerous reviews on the parasitic diseases of the central nervous system. The aim of this wide retrospective review is an in-depth analysis of the characteristics of neurological and ocular fascioliasis caused by these two fasciolid species. The terms of neurofascioliasis and ophthalmofascioliasis are restricted to cases in which the direct affection of the central nervous system or the eye by a migrant ectopic fasciolid fluke is demonstrated by an aetiological diagnosis of recovered flukes after surgery or spontaneous moving-out of the fluke through the orbit. Cases in which the ectopic fluke is not recovered and the symptoms cannot be explained by an indirect affection at distance may also be included in these terms. Neurofascioliasis and ophthalmofascioliasis cases are reviewed and discussed. With regard to fascioliasis infection giving an indirect rise to neurological affection, the distribution and frequency of cases are analysed according to geography, sex, and age. Minor symptoms and major manifestations are discussed. Three main types of cases are distinguished depending on the characteristics of their manifestations: genuine neurological, meningeal, and psychiatric or neuropsychic. The impressive symptoms and signs appearing in each type of these cases are included. Brain examination

Atrial Fibrillation - A Common Ground for Neurology and Cardiology.

Science.gov (United States)

Abukhalil, Fawzi; Bodhit, Aakash; Cai, Peter Y; Ansari, Saeed; Thenkabail, Spandana; Ganji, Sarah; Saravanapavan, Pradeepan; Chandra Shekhar, Chandana; Waters, Michael F; Beaver, Thomas M; Shushrutha Hedna, Vishnumurthy

2013-01-01

Atrial fibrillation (AF) has a huge impact on clinical stroke because it is the primary cause of cardio-embolism, which constitutes ~20% of all strokes. As a result, there is a great need to explore safer and more effective primary and secondary prophylactic agents. In this article, we discuss the overlapping issues pertaining to AF from both a neurology and cardiology standpoint. We focus on the dynamic interplay of neurovascular and cardiovascular diseases in relation to AF, traditional and novel risk factors for AF leading to stroke, impact of AF on cognitive decline, and current upstream medical and surgical options for embolism prophylaxis.

Opinion & Special Articles: Mentoring in neurology

Science.gov (United States)

Lee, Paul R.

2014-01-01

Effective academic mentoring significantly affects a physician's choice of career, academic productivity, and professional trajectory. The mentoring relationship is necessary for the continued success of medical training. It is critical to cultivate a climate in which mentoring can thrive. In order to improve the quality and outcomes of mentoring, we must adopt a comprehensive plan. There are interventions at every level of training that will ensure that the current cohort of neurologists receives the requisite expertise needed to flourish and inspire future trainees. Professional organizations must articulate a comprehensive vision of mentoring. Institutions must create an infrastructure to support mentors. Mentors should work in active partnerships with their mentees to forge sustained, productive relationships. Mentees must actively contribute to their own mentoring. Proper mentorship will ensure a bright future for academic neurology. PMID:24616198

Just Another Aspie/NT Love Story: A Narrative Inquiry Into Neurologically-Mixed Romantic Relationships

Directory of Open Access Journals (Sweden)

Marlo Goldstein Hode

2014-06-01

Full Text Available This paper explores the complexities, issues, and challenges of neurologically mixed romantic relationships; specifically focusing on relationships in which one partner is diagnosed with Asperger’s syndrome. Using a narrative approach to data drawn from online discussion boards, blogs, autobiographies, and research articles, the findings are presented in the form of a narrative reconstruction. Reconstructing data into a fictional, non-traceable format is a fruitful method of attending to the ethical and privacy issues inherent in online research. Starting with a discussion of autism and Asperger’s communication and traits, identity politics, and online community building, this article articulates some of the ways that neurological differences result in real differences in emotional needs, sensory perceptions, and ways of thinking and communicating in romantic relationships.

Adolescents' Views on Active and Non-Active Videogames: A Focus Group Study.

Science.gov (United States)

Simons, Monique; de Vet, Emely; Hoornstra, Sjoukje; Brug, Johannes; Seidell, Jaap; Chinapaw, Mai

2012-06-01

Active games require whole-body movement and may be an innovative tool to substitute sedentary pastime with more active time and may therefore contribute to adolescents' health. To inform strategies aimed at reducing sedentary behavior by replacing non-active with active gaming, perceptions and context of active and non-active gaming are explored. Six focus groups were conducted with adolescents 12-16 years old representing a range of education levels. A semistructured question route was used containing questions about perceptions and the context of gaming. The adolescents had positive attitudes toward active gaming, especially the social interactive aspect, which was greatly appreciated. A substantial number of adolescents enjoyed non-active games more than active ones, mainly because of better game controls and more diversity in non-active games. Active games were primarily played when there was a social gathering. Few game-related rules and restrictions at home were reported. Given the positive attitudes of adolescents and the limited restrictions for gaming at home, active videogames may potentially be used in a home setting as a tool to reduce sedentary behavior. However, to make active games as appealing as non-active games, attention should be paid to the quality, diversity, and sustainability of active games, as these aspects are currently inferior to those of traditional non-active games.

Neurological eponyms--who gets the credit? Essay review.

Science.gov (United States)

Okun, Michael S

2003-03-01

The recent publication of Neurological Eponyms by Peter Koehler and colleagues has revived the interest in neurological eponyms and raised important questions about their use. Many investigators have contributed to the body of knowledge that defines the specialty of neurology. We honor them by associating their names with neurological diseases. The history of neurological eponyms provides us with an opportunity to reexamine the important question of who gets the credit. Additional issues have surfaced including why certain eponyms tend to stick in the literature and others disappear, as well as the important realization that lengthy modern descriptions may require name eponyms for simplification. Eponyms can be confusing as to whether they refer to a disease or a syndrome and this confusion can impact the diagnosis and treatment of patients. There is an inevitable evolution of certain eponyms as our understanding of entities expands. This paper provides an overview of neurological eponyms with the explanation of the potential reasons why names were associated with neurological diseases. These included first case reports, relating isolated cases, years of observation, defining neuroanatomy, physician sufferer, new physical examination maneuvers, academic climate, the advent of a new procedure, fame, and competition amongst investigators. Important issues have surfaced regarding sharing credit amongst investigators, name priority, crediting the wrong investigator, and lack of a defined system to award credit. Since eponym use is based on a peer dependent system, each neurologist must make a more critical appraisal of who gets the credit and understand the differences between diseases and syndromes in order to better preserve neurological history.

Neurologic Complications of Psychomotor Stimulant Abuse.

Science.gov (United States)

Sanchez-Ramos, Juan

2015-01-01

Psychomotor stimulants are drugs that act on the central nervous system (CNS) to increase alertness, elevate mood, and produce a sense of well-being. These drugs also decrease appetite and the need for sleep. Stimulants can enhance stamina and improve performance in tasks that have been impaired by fatigue or boredom. Approved therapeutic applications of stimulants include attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. These agents also possess potent reinforcing properties that can result in excessive self-administration and abuse. Chronic use is associated with adverse effects including psychosis, seizures, and cerebrovascular accidents, though these complications usually occur in individuals with preexisting risk factors. This chapter reviews the adverse neurologic consequences of chronic psychomotor stimulant use and abuse, with a focus on two prototypical stimulants methamphetamine and cocaine. © 2015 Elsevier Inc. All rights reserved.

Neurologic signs and symptoms frequently manifest in acute HIV infection

Science.gov (United States)

Fletcher, James L.K.; Valcour, Victor; Kroon, Eugène; Ananworanich, Jintanat; Intasan, Jintana; Lerdlum, Sukalaya; Narvid, Jared; Pothisri, Mantana; Allen, Isabel; Krebs, Shelly J.; Slike, Bonnie; Prueksakaew, Peeriya; Jagodzinski, Linda L.; Puttamaswin, Suwanna; Phanuphak, Nittaya; Spudich, Serena

2016-01-01

Objective: To determine the incidence, timing, and severity of neurologic findings in acute HIV infection (pre–antibody seroconversion), as well as persistence with combination antiretroviral therapy (cART). Methods: Participants identified with acute HIV were enrolled, underwent structured neurologic evaluations, immediately initiated cART, and were followed with neurologic evaluations at 4 and 12 weeks. Concurrent brain MRIs and both viral and inflammatory markers in plasma and CSF were obtained. Results: Median estimated HIV infection duration was 19 days (range 3–56) at study entry for the 139 participants evaluated. Seventy-three participants (53%) experienced one or more neurologic findings in the 12 weeks after diagnosis, with one developing a fulminant neurologic manifestation (Guillain-Barré syndrome). A total of 245 neurologic findings were noted, reflecting cognitive symptoms (33%), motor findings (34%), and neuropathy (11%). Nearly half of the neurologic findings (n = 121, 49%) occurred at diagnosis, prior to cART initiation, and most of these (n = 110, 90%) remitted concurrent with 1 month on treatment. Only 9% of neurologic findings (n = 22) persisted at 24 weeks on cART. Nearly all neurologic findings (n = 236, 96%) were categorized as mild in severity. No structural neuroimaging abnormalities were observed. Participants with neurologic findings had a higher mean plasma log10 HIV RNA at diagnosis compared to those without neurologic findings (5.9 vs 5.4; p = 0.006). Conclusions: Acute HIV infection is commonly associated with mild neurologic findings that largely remit while on treatment, and may be mediated by direct viral factors. Severe neurologic manifestations are infrequent in treated acute HIV. PMID:27287217

[Online survey of the organizational structures of emergency neurology in Germany].

Science.gov (United States)

Topka, H; Pfefferkorn, T; Andres, F; Kastrup, A; Klein, M; Niesen, W; Poppert, H

2017-06-01

In 2007, the first poll among neurologists provided some insight into the organizational structures of emergency neurology in Germany. Given that emergency neurology as well as emergency medicine in general have undergone substantial changes during the last decade, the subcommittee Neurological Emergency Medicine of the German Neurological Society conducted a follow-up study to explore current structures supporting neurological emergency medicine in German neurological hospitals. Between July and September 2016, an online questionnaire was e‑mailed to 675 neurologists in institutions participating in in-patient neurological care. Of these, some 32% (university hospitals 49%) answered. Neurological patients represent 12-16% and hence a significant proportion of emergency patients. The fraction of in-patients admitted to hospitals via emergency departments amounted to 78% (median) in general hospitals and 52% in university hospitals. Most emergency departments are organized as an interdisciplinary structure combining conservative with surgical disciplines frequently led by an independent department head. Neurology departments employ rather diverse strategies to organize neurological emergency care. Also, the way emergency patients are assigned to different disciplines varied largely. Currently, neurological patients represent a rather growing fraction of patients in emergency departments. An increasing proportion of neurology in-patients enter the hospital via emergency departments. Neurology departments in Germany face increasing challenges to cope with large numbers of neurological emergency patients. While most of the participating neurologists indicated suffering predominantly from scarce personal resources both in neurology and neuroradiology, an independent neurological emergency department was not considered an option.

Revisiting the Molecular Mechanism of Neurological Manifestations in Antiphospholipid Syndrome: Beyond Vascular Damage

Science.gov (United States)

Carecchio, M.; Cantello, R.; Comi, C.

2014-01-01

Antiphospholipid syndrome (APS) is a multiorgan disease often affecting the central nervous system (CNS). Typically, neurological manifestations of APS include thrombosis of cerebral vessels leading to stroke and requiring prompt initiation of treatment with antiplatelet drugs or anticoagulant therapy. In these cases, alterations of the coagulation system at various levels caused by multiple effects of antiphospholipid antibodies (aPL) have been postulated to explain the vascular damage to the CNS in APS. However, several nonvascular neurological manifestations of APS have progressively emerged over the past years. Nonthrombotic, immune-mediated mechanisms altering physiological basal ganglia function have been recently suggested to play a central role in the pathogenesis of these manifestations that include, among others, movement disorders such as chorea and behavioral and cognitive alterations. Similar clinical manifestations have been described in other autoimmune CNS diseases such as anti-NMDAR and anti-VGCK encephalitis, suggesting that the spectrum of immune-mediated basal ganglia disorders is expanding, possibly sharing some pathophysiological mechanisms. In this review, we will focus on thrombotic and nonthrombotic neurological manifestations of APS with particular attention to immune-mediated actions of aPL on the vascular system and the basal ganglia. PMID:24741580

The Profile of Neurology Patients Evaluated in the Emergency Department

Directory of Open Access Journals (Sweden)

Ufuk Emre

2009-09-01

Full Text Available OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood count, serum glucose level, urea, creatine, erythrocyte sedimentation rate, and D-dimer levels and imaging findings were retrospectively evaluated based on patient charts. RESULTS: Impaired consciousness was the most frequent reason for neurological consultation (19.7%. Among these patients, ischemic stroke was diagnosed in 27.9%, hypoxic encephalopathy in 18.2%, cerebral hemorrhage in 9.1%, and 11% had no neurological diagnosis. Other common reasons for neurological consultation were vertigo, headache, seizure, and stroke. Clinical findings were related to other systemic causes in 43.7% of the study group. Focal neurological findings were present, especially in patients that presented with ischemic and hemorrhagic stroke, epilepsy, and hypoxic encephalopathy. CONCLUSION: In emergency departments, metabolic causes should be ruled out in patients with impaired consciousness and the absence of focal neurological signs. Intracranial structural disorders must be evaluated when focal neurological signs are present. Cautiously prepared algorithms and neurological examination training will help improve the accuracy of emergency department diagnoses

Neurological disorders in children with autism

Directory of Open Access Journals (Sweden)

N. N. Zavadenko

2015-01-01

Full Text Available During a clinical examination of children with autistic spectrum disorders, attention should be drawn to both their major clinical manifestations and neurological comorbidities. The paper considers the mechanisms of autism-induced neurological disorders, the spectrum of which may include manifestations, such as retarded and disharmonic early psychomotor development; the specific features of sensory perception/processing; rigidity and monotony of motor and psychic reactions; motor disinhibition and hyperexcitability; motor stereotypies; uncoordinated movements; developmental coordination disorders (dyspraxia; impaired expressive motor skills; speech and articulation disorders; tics; epilepsy. It describes the specific features of neurological symptoms in Asperger’s syndrome, particularly in semantic-pragmatic language disorders, higher incidence rates of hyperlexia, motor and vocal tics. The incidence rate of epilepsy in autistic spectrum disorders is emphasized to be greater than the average population one. At the same time, the risk of epilepsy is higher in mentally retarded patients with autism. Identification of neurological disorders is of great importance in determining the tactics of complex care for patients with autistic spectrum disorders. 

[Anesthesia for patients with neurological diseases].

Science.gov (United States)

Kimura, Masafumi; Saito, Shigeru

2010-09-01

Several surgical treatments can be employed for the patients with neurological disorders, such as multiple sclerosis, Guillain-Barré syndrome, Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer disease and spinal cord injury. It is possible that anesthesia related complications are induced in these neurologically complicated patients in the perioperative period. Respiratory dysfunction and autonomic nervous system dysfunction are most common in this population. Respiratory muscle weakness and bulbar palsy may cause aspiration pneumonia. Sometimes, postoperative ventilatory support is mandatory in these patients. Autonomic nervous system dysfunction may cause hypotension secondary to postural changes, blood loss, or positive airway pressure. Some therapeutic agents prescribed for neurological symptoms have drug interaction with anesthetic agents. Patients with motor neuron disease should be considered to be vulnerable to hyperkalemia in response to a depolarizing muscle relaxant. Although perioperative treatment guideline for most neurologic disorders has not been reported to lessen perioperative morbidity, knowledge of the clinical features and the interaction of common anesthetics with the drug therapy is important in planning intraoperative and postoperative management.

Interferon-gamma in progression to chronic demyelination and neurological deficit following acute EAE

DEFF Research Database (Denmark)

Renno, T; Taupin, V; Bourbonnière, L

1998-01-01

The cytokine interferon-gamma (IFNgamma) is implicated in the induction of acute CNS inflammation, but it is less clear what role if any IFNgamma plays in progression to chronic demyelination and neurological deficit. To address this issue, we have expressed IFNgamma in myelinating oligodendrocytes....... In contrast to control mice, which remit from EAE with resolution of glial reactivity and leukocytic infiltration, transgenics showed chronic neurological deficits. While activated microglia/macrophages persisted in demyelinating lesions for over 100 days, CD4(+) T lymphocytes were no longer present in CNS...

Blog and Podcast Watch: Neurologic Emergencies

Directory of Open Access Journals (Sweden)

Andrew Grock

2016-11-01

Full Text Available Introduction: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of neurologic emergencies from the AIR series. Methods: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Director’s (CORD annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an honorable mention label, if the executive board agrees that the post is accurate and educationally valuable. Results: A total of 125 blog posts and podcasts were evaluated. Key educational pearls from the 14 AIR posts are summarized, and the 20 honorable mentions are listed. Conclusion: The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians with this installment focusing on neurologic emergencies.

The effect of intrathecal baclofen treatment on activities of daily life in children and young adults with cerebral palsy and progressive neurological disorders.

Science.gov (United States)

Bonouvrié, Laura; Becher, Jules; Soudant, Dan; Buizer, Annemieke; van Ouwerkerk, Willem; Vles, Georges; Vermeulen, R Jeroen

2016-07-01

Intrathecal baclofen (ITB) treatment is applied in patients with spastic cerebral palsy (SCP), dystonic cerebral palsy (DCP) and progressive neurological disease (PND). Our aim was to investigate whether ITB treatment has a different effect on activities of daily life (ADL) in these groups. A retrospective and cross-sectional survey was conducted using a questionnaire to assess the qualitative effect of ITB (Likert scale) on different domains of functioning (mobility, personal care, communication, comfort) and satisfaction with the results. Groups were compared using non-parametric statistics. Questionnaires were completed for 68 patients (39 SCP, 13 DCP, 16 PND). Satisfaction scores were relatively high in all groups (7-8) and the positive effect on personal care and communication was similar in all groups. The PND group had the shortest follow-up and scored significantly less favourably for the effect on mobility and comfort. This is the first study to show that ITB treatment has similar effects on personal care and communication in stable and progressive neurological disease. The decrease in mobility in the PND group is likely due to the progressive nature of the disease. The different effect on comfort between groups is mainly due to the smaller effect on startles in the PND group. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Neurological surgery: the influence of physical and mental demands on humans performing complex operations.

Science.gov (United States)

Bourne, Sarah K; Walcott, Brian P; Sheth, Sameer A; Coumans, Jean-Valery C E

2013-03-01

Performing neurological surgery is an inherently demanding task on the human body, both physically and mentally. Neurosurgeons routinely perform "high stakes" operations in the setting of mental and physical fatigue. These conditions may be not only the result of demanding operations, but also influential to their outcome. Similar to other performance-based endurance activities, training is paramount to successful outcomes. The inflection point, where training reaches the point of diminishing returns, is intensely debated. For the neurosurgeon, this point must be exploited to the maximum, as patients require both the best-trained and best-performing surgeon. In this review, we explore the delicate balance of training and performance, as well as some routinely used adjuncts to improve human performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

A dedicated scholarly research program in an adult and pediatric neurology residency program.

Science.gov (United States)

Robbins, Matthew S; Haut, Sheryl R; Lipton, Richard B; Milstein, Mark J; Ocava, Lenore C; Ballaban-Gil, Karen; Moshé, Solomon L; Mehler, Mark F

2017-04-04

To describe and assess the effectiveness of a formal scholarly activity program for a highly integrated adult and pediatric neurology residency program. Starting in 2011, all graduating residents were required to complete at least one form of scholarly activity broadly defined to include peer-reviewed publications or presentations at scientific meetings of formally mentored projects. The scholarly activity program was administered by the associate residency training director and included an expanded journal club, guided mentorship, a required grand rounds platform presentation, and annual awards for the most scholarly and seminal research findings. We compared scholarly output and mentorship for residents graduating within a 5-year period following program initiation (2011-2015) and during the preceding 5-year preprogram baseline period (2005-2009). Participation in scholarship increased from the preprogram baseline (24 of 53 graduating residents, 45.3%) to the postprogram period (47 of 57 graduating residents, 82.1%, p Neurology.

MicroRNAs: Key Regulators in the Central Nervous System and Their Implication in Neurological Diseases

Directory of Open Access Journals (Sweden)

Dan-Dan Cao

2016-05-01

Full Text Available MicroRNAs (miRNAs are a class of small, well-conserved noncoding RNAs that regulate gene expression post-transcriptionally. They have been demonstrated to regulate a lot of biological pathways and cellular functions. Many miRNAs are dynamically regulated during central nervous system (CNS development and are spatially expressed in adult brain indicating their essential roles in neural development and function. In addition, accumulating evidence strongly suggests that dysfunction of miRNAs contributes to neurological diseases. These observations, together with their gene regulation property, implicated miRNAs to be the key regulators in the complex genetic network of the CNS. In this review, we first focus on the ways through which miRNAs exert the regulatory function and how miRNAs are regulated in the CNS. We then summarize recent findings that highlight the versatile roles of miRNAs in normal CNS physiology and their association with several types of neurological diseases. Subsequently we discuss the limitations of miRNAs research based on current studies as well as the potential therapeutic applications and challenges of miRNAs in neurological disorders. We endeavor to provide an updated description of the regulatory roles of miRNAs in normal CNS functions and pathogenesis of neurological diseases.

On the comparability of knowledge transfer activities - a case study at the German Baltic Sea Coast focusing regional climate services

Science.gov (United States)

Meinke, Insa

2017-06-01

In this article the comparability of knowledge transfer activities is discussed by accounting for external impacts. It is shown that factors which are neither part of the knowledge transfer activity nor part of the participating institution may have significant impact on the potential usefulness of knowledge transfer activities. Differences in the potential usefulness are leading to different initial conditions of the knowledge transfer activities. This needs to be taken into account when comparing different knowledge transfer activities, e.g., in program evaluations. This study is focusing on regional climate services at the German Baltic Sea coast. It is based on two surveys and experiences with two identical web tools applied on two regions with different spatial coverage. The results show that comparability among science based knowledge transfer activities is strongly limited through several external impacts. The potential usefulness and thus the initial condition of a particular knowledge transfer activity strongly depends on (1) the perceived priority of the focused topic, (2) the used information channels, (3) the conformity between the research agenda of service providing institutions and information demands in the public, as well as (4) on the spatial coverage of a service. It is suggested to account for the described external impacts for evaluations of knowledge transfer activities. The results show that the comparability of knowledge transfer activities is limited and challenge the adequacy of quantitative measures in this context. Moreover, as shown in this case study, in particular regional climate services should be individually evaluated on a long term perspective, by potential user groups and/or by its real users. It is further suggested that evaluation criteria should be co-developed with these stakeholder groups.

[The importance of chronic migraine in a general neurology service].

Science.gov (United States)

Gracia-Naya, M; Alarcia-Alejos, R; Modrego-Pardo, P J

Chronic migraine is a primary headache that is difficult to treat and has an important impact on the patient's quality of life. The international headache classification recently modified the criteria for chronic migraine and therefore few studies have been conducted that analyse groups according to these new criteria. AIM. To analyse a group of patients with chronic migraine who were referred to a general neurology service. The first 100 patients with migraine were selected. Researchers established and analysed a number of subgroups of patients with episodic, chronic or chronic migraine with probable headache due to medication abuse, in accordance with the International Headache Society (IHS) headache classification and its revised version from 2006. Of the total sample of 738 new patients, 100 (13.5%) suffered from migraines and of these 100 new patients with migraine 42 (5.6% of the total series) satisfied criteria for chronic migraine and 15 patients with chronic migraine met the criteria for probable headache due to medication abuse. Before visiting the neurology service, only 41% had been diagnosed as suffering from migraine, 38% had received no information about this condition, only 17% took triptans for symptomatic relief and 23% had followed some kind of preventive treatment. One notable finding was the importance of episodic and chronic migraine in a general neurology service, on applying the recent IHS criteria. A high percentage of patients with chronic migraine who were referred to the neurology service have not been diagnosed or given any information or proper treatment; an elevated degree of self-medication and medication abuse also exists. Preventive treatment and triptans in cases of intense migraines are still not commonly used in primary care.

[PECULIARITIES OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN WITH NEUROLOGICAL PATHOLOGY].

Science.gov (United States)

Zubarenko, O; Kopiyka, G; Kravchenko, T; Koval, L; Gurienko, K

2017-06-01

Neurological disorders in children highly affect the course of pneumonia, its outcome and the development of possible complications. The aim of the study was to reveal clinical and paraclinical features of community-acquired pneumonia in younger children with neurologic pathology infantile cerebral palsy. Under observation were 37 children with community-acquired pneumonia aged 1 to 3 years that suffered from spastic forms of infantile cerebral palsy. The comparison group consisted of 30 children with community-acquired pneumonia without any concomitant neurological pathology. The age of the children in the comparison and study groups was the same. The results of the study show that the presence of infantile cerebral palsy allow to relate the child to the risk group of respiratory pathology development. The course of community-acquired pneumonia in children affected by infantile cerebral palsy is characterized by rapid progression of symptoms and severity of the condition, and the clinical picture also has a number of characteristic features. Thus, cough, local physical data, classical laboratory signs of inflammation in the form of leukocytosis with neutrophil shift were noticed significantly less often in children with infantile cerebral palsy. The debut of the disease was often accompanied by bronchial obstruction, the inflammatory process was localized in the lower parts of the lungs and often matched the side of the neurologically affected part of the body. Children with cerebral palsy required a longer hospital-stay and a prolonged course of antibiotic therapy. Therefore, the risk of pneumonia in children with infantile cerebral palsy should be taken into account at the primary stage of medical care for the creation of preventive programs.

Alcohol-seeking and relapse: A focus on incentive salience and contextual conditioning.

Science.gov (United States)

Valyear, Milan D; Villaruel, Franz R; Chaudhri, Nadia

2017-08-01

Environmental stimuli that reliably accompany alcohol intake can become associated with the pharmacological effects of alcohol through classical (Pavlovian) conditioning. Of growing interest to addiction researchers is whether or not this process results in the attribution of incentive salience to alcohol-predictive cues, which could motivate alcohol-seeking behavior and relapse. To evaluate this question, we present a review of rodent behavioral studies that examined the capacity of alcohol-predictive cues to (i) support sign-tracking behavior, (ii) serve as conditioned reinforcers, and (iii) produce Pavlovian-to-instrumental transfer. A second, emerging area of research is focused on delineating the role of context in alcohol-seeking behavior and relapse. Here, we review studies showing that alcohol-associated contexts (i) support conditioned place preference, (ii) renew extinguished alcohol-seeking behavior, and (iii) modulate alcohol-seeking responses elicited by discrete alcohol-predictive cues. These behavioral effects may be mediated by unique psychological processes, and have important implications for cue-reactivity studies and neurobiological research. Copyright © 2017 Elsevier B.V. All rights reserved.

The effects of neurologic assessment E-learning in nurses.

Science.gov (United States)

Shin, Ji Yeon; Issenberg, S Barry; Roh, Young Sook

2017-10-01

A firm understanding of the preliminary assessment of a patient with neurological disorders is needed for ensuring optimal patient outcomes. The purpose of this study is to evaluate the effects of using e-learning on neurologic assessment knowledge, ability, and self-confidence among nurses. This study used a non-equivalent control group pretest-posttest design. Nurses working in the neurology and neurosurgery wards, Republic of Korea PARTICIPANTS: A convenience sample of 50 nurses was assigned to either the experimental group (n=24) or the control group (n=26). The experimental group participated in the self-directed e-learning program related to neurologic assessment, and control group underwent self-directed learning with handout. Knowledge, ability, and self-confidence were measured at pretest and posttest. There were no significant differences in knowledge (U=270, p=0.399) and self-confidence (U=241.5, p=0.171) between the two groups. Nurses in the experimental group showed higher neurologic assessment ability compared with those in the control group (U=199, p=0.028). Self-directed neurologic assessment e-learning induced improvement in the neurologic assessment ability among nurses. Self-directed e-learning can be applied for improving competencies in neurologic assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Physical activity of persons with a focus on teachers

OpenAIRE

TETOUROVÁ, Marie

2015-01-01

This thesis deals with the topic: "Physical activity of persons employed with a focus on the teaching profession." In the theoretical part concepts related to history and the intensity of teaching, teachers and related mental stress health risks. are characterized. We also deal with the influence of physical activity on human health, and the ability to reduce the occurrence of various health risks. The aim of the thesis is to monitor physical activity among teachers in kindergarten, Basic sch...

[Neurologic aspects of vibration syndrome].

Science.gov (United States)

Langauer-Lewowicka, H; Zajac-Nedza, M

1997-01-01

The authors present divergent opinions on the pathogenesis of vibratory syndrome, and primarily on its angio-neurological form, i.e. vascular, neurogenic and immunological theory. In the light of these concepts the clinical manifestations of vibratory syndrome are discussed in view of both systemic and local developments. The issues concerning neurological diagnostics with reference to the usefulness of electrophysiological methods are thoroughly analysed. Difficulties in early diagnosis and identification of symptoms that distinguish vibratory syndrome from other syndromes with similar manifestations are highlighted.

The spectrum of neurological disease associated with Zika and chikungunya viruses in adults in Rio de Janeiro, Brazil: A case series

Science.gov (United States)

da Silva, Marcus Tulius Texeira; Rosala-Hallas, Anna; Jardim, Marcia Rodrigues; Burnside, Girvan; Pamplona, Luciana; Bhojak, Maneesh; Manohar, Radhika; da Silva, Gabriel Amorelli Medeiros; Adriano, Marcus Vinicius; Brasil, Patricia; Nogueira, Rita Maria Ribeiro; Dos Santos, Carolina Cardoso; Turtle, Lance; de Sequeira, Patricia Carvalho; Brown, David W.; Griffiths, Michael J.; de Filippis, Ana Maria Bispo

2018-01-01

Background During 2015–16 Brazil experienced the largest epidemic of Zika virus ever reported. This arthropod-borne virus (arbovirus) has been linked to Guillain-Barré syndrome (GBS) in adults but other neurological associations are uncertain. Chikungunya virus has caused outbreaks in Brazil since 2014 but associated neurological disease has rarely been reported here. We investigated adults with acute neurological disorders for Zika, chikungunya and dengue, another arbovirus circulating in Brazil. Methods We studied adults who had developed a new neurological condition following suspected Zika virus infection between 1st November 2015 and 1st June 2016. Cerebrospinal fluid (CSF), serum, and urine were tested for evidence of Zika, chikungunya, and dengue viruses. Results Of 35 patients studied, 22 had evidence of recent arboviral infection. Twelve had positive PCR or IgM for Zika, five of whom also had evidence for chikungunya, three for dengue, and one for all three viruses. Five of them presented with GBS; seven had presentations other than GBS, including meningoencephalitis, myelitis, radiculitis or combinations of these syndromes. Additionally, ten patients positive for chikungunya virus, two of whom also had evidence for dengue virus, presented with a similar range of neurological conditions. Conclusions Zika virus is associated with a wide range of neurological manifestations, including central nervous system disease. Chikungunya virus appears to have an equally important association with neurological disease in Brazil, and many patients had dual infection. To understand fully the burden of Zika we must look beyond GBS, and also investigate for other co-circulating arboviruses, particularly chikungunya. PMID:29432457

Problem neurology residents: a national survey.

Science.gov (United States)

Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

2011-06-14

Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

Feeding problems in children with neurological disorders.

Science.gov (United States)

Jamroz, Ewa; Głuszkiewicz, Ewa; Grzybowska-Chlebowczyk, Urszula; Woś, Halina

2012-01-01

The aim of this study was to evaluate the prevalence of selected risk factors of weight deficiency in children with chronic metabolic diseases. The study group involved 160 children, from 2 months to 15 years (mean age 3.14 years), with diseases of the nervous system and body weight deficiency. According to the type of neurological disease the following groups of patients were separated: static encephalopathies, progressive encephalopathies, disorders of mental development of undetermined etiology, genetically determined diseases. As the exponent of malnutrition, z-score of weight-for-age standards was used. An inclusion criterion for the study group was z-score of weight-for-age children, neurological disorders, oral motor dysfunction, diseases of other organs, gastrointestinal motility disorders (oral cavity, esophagus, intestines) and type of nutritional therapy. The most advanced malnutrition was in children with progressive encephalopathies and genetically determined diseases. Seizures and muscular hypotonia were most common neurological disorders. Oral motor dysfunctions were observed in 40% of patients. Malnutrition in children with neurological disorders is associated mainly with neurological deficits. In this group of children monitoring of somatic development and early nutritional intervention are necessary.

[The carrier model of neurology in Hungary: a proposal for the solution until 2020].

Science.gov (United States)

Bereczki, Dániel; Csiba, László; Komoly, Sámuel; Vécsei, László; Ajtay, András

2011-11-30

Based on our previous survey on the capacities of neurological services and on the predictable changes in the neurologist workforce in Hungary, we present a proposal for the organization of the structure of neurological services in the future. We discuss the diagnostic groups treated by neurologists, the neurological services and their progressive organization. Using the current capacities as baseline, we propose patient groups to be treated by neurologists in the future, and the levels of services. Based on the tendencies seen in the last years we suggest to consider to allocate acute stroke services exclusively to stroke units in neurological departments, and we identify a few other diagnostic groups where neurology should have a larger share in patient care. We define three levels for inpatient care: university departments, regional/county hospitals, city hospitals. Instead of minimum criteria we assign outpatient and inpatient standards that are functional from the economic point of view as well. University departments cover all areas of neurological services, have a function in graduate and postgraduate training, and on a regional basis they participate in professional quality assurance activities at the county and city hospital levels, and would have a more independent role in residency training. As far as patient care is concerned, the task of the regional/county hospitals would be similar to that of university departments - without the exclusively university functions. A general neurological service would be offered at the city hospital level - the representation of all subspecialties of neurology is not required. Neurorehabilitation would be organized at special units of neurological wards at the city hospital level, at independent neurorehabilitation wards in regional/county hospitals, and also as an outpatient service offered at the patients' home. The most significant organizational change would affect the outpatient neurological services. In addition

LEARNERS SATISFACTION FACTORS IN NEUROLOGY RELATED MOOCs

Directory of Open Access Journals (Sweden)

Ionela MANIU

2017-12-01

Full Text Available The aim of this article is to investigate the factors that are influencing student satisfaction in case of neurology related massive open online courses (MOOCs. We analyzed data collected from learners enrolled in 40 neurology related MOOCs, by manually looking for information in these courses reviews. The main identified satisfaction factors can be grouped into the following categories: content related factors: course content, additional materials, assignments, external research and teaching - learning related factors (teacher presentation techniques / style: engaging, clear, coherent, knowledgeable, sharing / explanation, interactive, excitement, considering student’s needs, inspiring, sense of humor. Competences, skills and objectives pursued by neurology related MOOCs are also discussed. Analyzing these factors can be useful in new courses management (design and implementation and also in understanding the needs (motivation, behaviors, perception of 21st century learners interested in neurology related fields.

Somali women's view of physical activity--a focus group study.

Science.gov (United States)

Persson, Gerthi; Mahmud, Amina Jama; Hansson, Eva Ekvall; Strandberg, Eva Lena

2014-10-23

Physical inactivity presents a major public health challenge and is estimated to cause six to ten percent of the major non-communicable diseases. Studies show that immigrants, especially women, have an increased risk of non-communicable diseases compared to ethnic Swedes. Somali immigrant women have increased rates of overweight and obesity, low fitness levels and low levels of cardiorespiratory fitness compared to non-immigrant women. These findings suggest that Somali women are at increased risk of developing lifestyle-related diseases. Few studies explore determinants of physical activity among Somali women. The aim of this study was to explore Somali women's views and experiences of physical activity after migration to Sweden. A qualitative focused ethnographic approach was used in this study. Four focus groups were conducted with twenty-six Somali women ranging from 17 to 67 years of age. Focus group discussions were recorded, transcribed verbatim and analysed using qualitative content analysis. The analysis resulted in four main themes and ten categories: Life in Somalia and Life in Sweden, Understanding and enhancing health and Facilitators and barriers to physical activity. Great differences were seen between living in Somalia and in Sweden but also similarities such as finding time to manage housework, the family and the health of the woman. The extended family is non-existent in Sweden, making life more difficult. Health was considered a gift from God but living a healthy life was perceived as the responsibility of the individual. Misconceptions about enhancing health occurred depending on the woman's previous life experience and traditions. There was an awareness of the importance of physical activity among the participants but lack of knowledge of how to enhance activity on an individual basis. Enhancing factors to an active lifestyle were identified as being a safe and comfortable environment. Some barriers, such as climate, lack of motivation and time

Diagnostic value of creatine kinase activity in canine cerebrospinal fluid.

Science.gov (United States)

Ferreira, Alexandra

2016-10-01

This study aimed to determine whether creatine kinase (CK) activity in cerebrospinal fluid (CSF) has diagnostic value for various groups of neurological conditions or for different anatomical areas of the nervous system (NS). The age, breed, results of CSF analysis, and diagnosis of 578 canine patients presenting with various neurological conditions between January 2009 and February 2015 were retrospectively collected. The cases were divided according to anatomical areas of the nervous system, i.e., brain, spinal cord, and peripheral nervous system, and into groups according to the nature of the condition diagnosed: vascular, immune/inflammatory/infectious, traumatic, toxic, anomalous, metabolic, idiopathic, neoplastic, and degenerative. Statistical analysis showed that CSF-CK alone cannot be used as a diagnostic tool and that total proteins in the CSF and red blood cells (RBCs) do not have a significant relationship with the CSF-CK activity. CSF-CK did not have a diagnostic value for different disease groups or anatomical areas of the nervous system.

Rejected applications: an early American Academy of Neurology struggles to define its membership.

Science.gov (United States)

Louis, Elan D

2014-07-22

To review membership application materials (especially rejected applications) to the American Academy of Neurology (AAN) during its formative years (1947-1953). Detailed study of materials in the AAN Historical Collection. The author identified 73 rejected applications. Rejected applicants (71 male, 2 female) lived in 25 states. The largest number was for the Associate membership category (49). These were individuals "in related fields who have made and are making contributions to the field of neurology." By contrast, few applicants to Active membership or Fellowship status were rejected. The largest numbers of rejectees were neuropsychiatrists (19), neurosurgeons (16), and psychiatrists (14). The AAN, established in the late 1940s, was a small and politically vulnerable organization. A defining feature of the fledgling society was its inclusiveness; its membership was less restrictive than that of the older American Neurological Association. At the same time, the society needed to preserve its core as a neurologic society rather than one of psychiatry or neurosurgery. Hence, the balance between inclusiveness and exclusive identity was a difficult one to maintain. The Associate membership category, more than any other, was at the heart of this issue of self-definition. Associate members were largely practitioners of psychiatry or neurosurgery. Their membership was a source of consternation and was to be carefully been held in check during these critical formative years. © 2014 American Academy of Neurology.

Neurological legal disability

Directory of Open Access Journals (Sweden)

Radhakrishna H

2006-01-01

Full Text Available Neurological disorders with a prolonged course, either remediable or otherwise are being seen increasingly in clinical practice and many such patients are young and are part of some organization or other wherein their services are needed if they were healthy and fit. The neurologists who are on the panel of these organizations are asked to certify whether these subjects are fit to work or how long they should be given leave. These certificates may be produced in the court of law and may be subjected to verification by another neurologist or a medical board. At present there are no standard guidelines in our country to effect such certification unlike in orthopedic specialty or in ophthalmology. The following is a beginning, based on which the neurologist can certify the neurological disability of such subjects and convey the same meaning to all neurologists across the country.

Differential diagnosis between dementia and psychiatric disorders: Diagnostic criteria and supplementary exams. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology.

Science.gov (United States)

Bottino, Cássio M C; de Pádua, Analuiza Camozzato; Smid, Jerusa; Areza-Fegyveres, Renata; Novaretti, Tânia; Bahia, Valeria S

2011-01-01

In 2005, the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology published recommendations for the diagnosis of Alzheimer's disease These recommendations were updated following a review of evidence retrieved from national and international studies held on PUBMED, SCIELO and LILACS medical databases. The main aims of this review article are as follows: 1) to present the evidence found on Brazilian (LILACS, SCIELO) and International (MEDLINE) databases from articles published up to May 2011, on the differential diagnosis of these psychiatric disorders and dementia, with special focus on Dementia due to Alzheimer's and vascular dementia, including a review of supplementary exams which may facilitate the diagnostic process; and2) to propose recommendations for use by clinicians and researchers involved in diagnosing patients with dementia. Differential diagnosis between dementia and other neuropsychiatric disorders should always include assessments for depression, delirium , and use of psychoactive substances, as well as investigate the use of benzodiazepines, anti-epileptics and pattern of alcohol consumption.

Education Research: Neurology resident education: Trending skills, confidence, and professional preparation.

Science.gov (United States)

Jordan, Justin T; Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M; Engstrom, John

2016-03-15

To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. © 2016 American Academy of Neurology.

Autism spectrum symptoms in children with neurological disorders.

Science.gov (United States)

Ryland, Hilde K; Hysing, Mari; Posserud, Maj-Britt; Gillberg, Christopher; Lundervold, Astri J

2012-11-12

The aims of the present study were to assess symptoms associated with an autism spectrum disorder (ASD) in children with neurological disorders as reported by parents and teachers on the Autism Spectrum Screening Questionnaire (ASSQ), as well as the level of agreement between informants for each child. The ASSQ was completed by parents and teachers of the 5781 children (11-13 years) who participated in the second wave of the Bergen Child Study (BCS), an on-going longitudinal population-based study. Out of these children, 496 were reported to have a chronic illness, including 99 whom had a neurological disorder. The neurological disorder group included children both with and without intellectual disabilities. Children with neurological disorders obtained significantly higher parent and teacher reported ASSQ scores than did non-chronically ill children and those with other chronic illnesses (pchildren with neurological disorders was moderate to high for the total score and for three sub scores generated from a factor analysis, and low to moderate for single items. The ASSQ identifies a high rate of ASD symptoms in children with neurological disorders, and a large number of children screened in the positive range for ASD. Although a firm conclusion awaits further clinical studies, the present results suggest that health care professionals should be aware of potential ASD related problems in children with neurological disorders, and should consider inclusion of the ASSQ or similar screening instruments as part of their routine assessment of this group of children.

Post dengue neurological complication

Directory of Open Access Journals (Sweden)

Hizlinda Tohid

2015-12-01

Full Text Available Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE followed by an upper respiratory tract infection (URTI weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

Body integrity identity disorder: from a psychological to a neurological syndrome.

Science.gov (United States)

Sedda, Anna

2011-12-01

Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.

Management of male neurologic patients with infertility

DEFF Research Database (Denmark)

Fode, Mikkel; Sønksen, Jens

2015-01-01

Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve...

Neurology at Escola Paulista de Medicina (1933-1995). From Fausto Guerner to José Geraldo Camargo Lima.

Science.gov (United States)

Ferraz, Henrique Ballalai; Neves, Afonso Carlos

2015-02-01

Escola Paulista de Medicina (EPM) was founded in 1933 and the first Professor of Neurology was Fausto Guerner, who could not effectively assume the teaching activities due to his premature death in 1938. Professor Guerner had had his neurological training at Paris. Professor Longo was his successor. Longo was one of the founders of Arquivos de Neuro-Psiquiatria the foremost journal of neurosciences in Latin American. Longo died in 1967 and Professor Paulo Pupo succeeded him. Pupo introduced electroencephalography in Brazil. After his death in 1970, Professor Dante Giorgi succeeded him until 1974. Professor José Geraldo Camargo Lima took over the position after Giorgi's death. He created the Neurological Emergency unit, initiated the Post-Graduation in Neurology and divided the Discipline in specialized units. During the 1980's and until his retirement in 1995, EPM had become one of most important centers of Brazil training neurologists and researchers in neurological sciences.

Neurologic emergencies in HIV-negative immunosuppressed patients.

Science.gov (United States)

Guzmán-De-Villoria, J A; Fernández-García, P; Borrego-Ruiz, P J

HIV-negative immunosuppressed patients comprise a heterogeneous group including transplant patients, patients undergoing treatment with immunosuppressors, uremic patients, alcoholics, undernourished patients, diabetics, patients on dialysis, elderly patients, and those diagnosed with severe or neoplastic processes. Epileptic seizures, focal neurologic signs, and meningoencephalitis are neurologic syndromes that require urgent action. In most of these situations, neuroimaging tests are necessary, but the findings can be different from those observed in immunocompetent patients in function of the inflammatory response. Infectious disease is the first diagnostic suspicion, and the identification of an opportunistic pathogen should be oriented in function of the type and degree of immunosuppression. Other neurologic emergencies include ischemic stroke, cerebral hemorrhage, neoplastic processes, and pharmacological neurotoxicity. This article reviews the role of neuroimaging in HIV-negative immunodepressed patients with a neurologic complication that requires urgent management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

IGF-1 derived small neuropeptides and analogues: a novel strategy for the development of pharmaceuticals for neurological conditions.

Science.gov (United States)

Guan, Jian; Gluckman, Peter D

2009-07-01

Insulin-like growth factor-1 (IGF-1) is neuroprotective and improves long-term function after brain injury. However, its clinical application to neurological disorders is limited by its large molecular size, poor central uptake and mitogenic potential. Glycine-proline-glutamate (GPE) is naturally cleaved from the IGF-1 N-terminal and it is also neuroprotective after ischemic injury, which provided a novel strategy of drug discovery for neurological disorders. GPE is not enzymatically stable, thus intravenous infusion of GPE becomes necessary for stable and potent neuroprotection. The broad effective dose range and treatment window of 3-7 h after the lesion suggest its potential for treating acute brain injuries. G-2meth-PE, a GPE analogue designed to be more enzymatic resistant, has a prolonged plasma half-life and is more potent in neuroprotection. Neuroprotection by GPE and its analogue may involve modulation of inflammation, promotion of astrocytosis, inhibition of apoptosis and vascular remodelling. Acute administration of GPE also prevents 6-OHDA-induced nigrostrial dopamine depletion. Delayed treatment with GPE does not prevent dopamine loss, but improves long-term function. Cyclo-glycyl-proline (cyclic Gly-Pro) is an endogenous DKP that may be derived from GPE. Cyclic Gly-Pro and its analogue cyclo-L-glycyl-L-2-allylproline (NNZ 2591) are both neuroprotective after ischaemic injury. NNZ2591 is highly enzymatic resistant and centrally accessible. Its peripheral administration improves somatosensory-motor function and long-term histological outcome after brain injury. Our research suggests that small neuropeptides have advantages over growth factors in the treatment of brain injury, and that modified neuropeptides designed to overcome the limitations of their endogenous counterparts represent a novel strategy of pharmaceutical discovery for neurological disorders.

Morbidity and Mortality Patterns among Neurological Patients in the ...

African Journals Online (AJOL)

Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin ...

Profile of Neurological admissions at the University of Nigeria ...

African Journals Online (AJOL)

Background: The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and ...

Introducing a checking technician allows pharmacists to spend more time on patient-focused activities.

Science.gov (United States)

Napier, Patti; Norris, Pauline; Braund, Rhiannon

2018-04-01

Internationally there is an increasing focus on the clinical and cognitive services that pharmacists can provide. Lack of time has been identified as a barrier to pharmacists increasing their clinical activities. Within the pharmacy workplace there are many tasks that can only be performed by a pharmacist. The final accuracy check of a dispensed prescription is currently the sole responsibility of pharmacists in New Zealand. This takes up a significant amount of time during a pharmacist's work day. The introduction of a checking technician role has been suggested to allow pharmacists more time to do more patient focused work. To investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities. This study utilised a self-reported work sampling technique in twelve pilot sites, selected from both the hospital and community settings. Work sampling using an electronic device was conducted at two time-points (before the implementation of a Pharmacy Accuracy Checking Technician (PACT) role and when the PACT was in place). Data was collected at 10 min intervals for the period of five days, a working week. Tasks were grouped into patient focused, dispensing and personal activities. The introduction of the PACT into the pilot sites saw a mean increase of 19% in pharmacists' patient focused activities and a mean 20% decrease in dispensing activities. The introduction of a checking technician role into New Zealand pharmacies demonstrated the potential to provide pharmacists with more time to spend on patient focused activities. Copyright © 2017 Elsevier Inc. All rights reserved.

A Review of Epidemiological Research on Adverse Neurological Effects of Exposure to Ambient Air Pollution

Science.gov (United States)

Xu, Xiaohui; Ha, Sandie Uyen; Basnet, Rakshya

2016-01-01

There is a growing body of epidemiological research reporting the neurological effects of ambient air pollution. We examined current evidence, identified the strengths and weaknesses of published epidemiological studies, and suggest future directions for research in this area. Studies were identified through a systematic search of online scientific databases, in addition to a manual search of the reference lists from the identified papers. Despite being a relatively new area of investigation, overall, there is mounting evidence implicating adverse effects of air pollution on neurobehavioral function in both adults and children. Further research is needed to expand our understanding of these relationships, including improvement in the accuracy of exposure assessments; focusing on specific toxicants and their relationships to specific health endpoints, such as neurodevelopmental disorders and neurodegenerative diseases; investigating the combined neurological effects of multiple air pollutants; and further exploration of genetic susceptibility for neurotoxicity of air pollution. In order to achieve these goals collaborative efforts are needed from multidisciplinary teams, including experts in toxicology, biostatistics, geographical science, epidemiology, and neurology. PMID:27547751

Suspecting Neurological Dysfunction From E Mail Messages ...

African Journals Online (AJOL)

A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

The rise of mortality from mental and neurological diseases in Europe, 1979-2009: Observational study

NARCIS (Netherlands)

J.P. Mackenbach (Johan); M. Karanikolos (Marina); C.W.N. Looman (Caspar)

2014-01-01

textabstractBackground: We studied recent trends in mortality from seven mental and neurological conditions and their determinants in 41 European countries. Methods. Age-standardized mortality rates were analysed using standard methods of descriptive epidemiology, and were related to cultural,

Neurological manifestations in Fabry's disease

DEFF Research Database (Denmark)

Møller, Anette Torvin; Jensen, Troels Staehelin

2007-01-01

. Neurological symptoms, such as burning sensations (occasionally accompanied by acroparesthesia) and stroke, are among the first to appear, and occur in both male and female patients. A delay in establishing the diagnosis of Fabry's disease can cause unnecessary problems, especially now that enzyme replacement...... treatment is available to prevent irreversible organ damage. Females with Fabry's disease who present with pain have often been ignored and misdiagnosed because of the disorder's X-linked inheritance. This Review will stress the importance of recognizing neurological symptoms for the diagnosis of Fabry...

Neurological manifestation of colonic adenocarcinoma

Directory of Open Access Journals (Sweden)

Uzair Chaudhary

2012-04-01

Full Text Available Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

Contemporary approach to neurologic prognostication of coma after cardiac arrest.

Science.gov (United States)

Ben-Hamouda, Nawfel; Taccone, Fabio S; Rossetti, Andrea O; Oddo, Mauro

2014-11-01

Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination. In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory assays, and applying one single cutoff level (eg, > 33 μg/L for NSE) for poor prognostication is not recommended. Neuroimaging, mainly diffusion MRI, is emerging as a promising tool for prognostication, but its precise role needs further study before it can be widely used. This multimodal approach might reduce false-positive rates of poor prognosis, thereby providing optimal prognostication of comatose CA survivors. The aim of this review is to summarize studies and the principal tools presently available for outcome prediction and to describe a practical approach to the multimodal prognostication of coma after CA, with a particular focus on neuromonitoring tools. We also propose an algorithm for the optimal use of such multimodal tools during the early ICU phase of post-CA coma.

Neurological manifestations of snake bite in Sri Lanka.

Directory of Open Access Journals (Sweden)

Seneviratne U

2002-10-01

Full Text Available BACKGROUND AND AIMS: Snake bite is an important cause of mortality and morbidity in certain parts of Sri Lanka. This study was designed to determine the offending snakes, neurological manifestations, disease course, and outcome in neurotoxic envenomation. METHODS AND MATERIAL: Fifty six consecutive patients admitted with neurological manifestations following snake bite were studied prospectively. Data were obtained regarding the offending snakes, neurological symptoms, time taken for onset of symptoms, neurological signs, and time taken for recovery. RESULTS: The offending snake was Russell′s viper in 27(48.2%, common and Sri Lankan krait in 19(33.9%, cobra in 3(5.4%, and unidentified in 7(12.5%. Ptosis was the commonest neurological manifestation seen in 48(85.7% followed by ophthalmoplegia (75%, limb weakness (26.8%, respiratory failure (17.9%, palatal weakness (10.7%, neck muscle weakness (7.1%, and delayed sensory neuropathy (1.8%. Neurological symptoms were experienced usually within 6 hours after the bite. Following administration of antivenom, the signs of recovery became evident within a few hours to several days. The duration for complete recovery ranged from four hours to two weeks. CONCLUSIONS: Complete recovery of neuromuscular weakness was observed in all patients except for one who died with intracerebral haemorrhage shortly after admission.

CK2—An Emerging Target for Neurological and Psychiatric Disorders

Directory of Open Access Journals (Sweden)

Julia Castello

2017-01-01

Full Text Available Protein kinase CK2 has received a surge of attention in recent years due to the evidence of its overexpression in a variety of solid tumors and multiple myelomas as well as its participation in cell survival pathways. CK2 is also upregulated in the most prevalent and aggressive cancer of brain tissue, glioblastoma multiforme, and in preclinical models, pharmacological inhibition of the kinase has proven successful in reducing tumor size and animal mortality. CK2 is highly expressed in the mammalian brain and has many bona fide substrates that are crucial in neuronal or glial homeostasis and signaling processes across synapses. Full and conditional CK2 knockout mice have further elucidated the importance of CK2 in brain development, neuronal activity, and behavior. This review will discuss recent advances in the field that point to CK2 as a regulator of neuronal functions and as a potential novel target to treat neurological and psychiatric disorders.

The Spectrum of Neurological Manifestations Associated with Gaucher Disease

Directory of Open Access Journals (Sweden)

Tamanna Roshan Lal

2017-03-01

Full Text Available Gaucher disease, the most common lysosomal storage disorder, is due to a deficiency in the enzyme glucocerebrosidase. This leads to the accumulation of its normal substrate, glucocerebroside, in tissue macrophages, affecting the hematological, visceral, bone and neurologic systems. Gaucher disease is classified into three broad phenotypes based upon the presence or absence of neurological involvement: type 1 (non-neuronopathic, type 2 (acute neuronopathic, and type 3 (subacute neuronopathic. Phenotypically, there is a wide spectrum of visceral and neurological manifestations. Enzyme replacement is effective in managing the visceral disease; however, treating the neurological manifestations has proved to be more challenging. This review discusses the various neurological manifestations encountered in Gaucher disease, and provides a brief overview regarding the treatment and ongoing research challenges.

The Profile of Neurology Patients Evaluated in the Emergency Department

OpenAIRE

Ufuk Emre; Ayşe Semra Demir; Esra Acıman; Nejla Çabuk; Sibel Kıran; Aysun Ünal

2009-01-01

OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood...

Neurologic disorders

International Nuclear Information System (INIS)

Chakeres, D.W.

1987-01-01

There is a wide range of indications for radiographic evaluation of possible cerebrovascular disease, since a wide range of neurologic symptoms can be encountered secondary to ischemia. Frequently the diagnosis of cerebrovascular disease is clear on clinical grounds, but radiographic evaluation is essential both to quantify the extent of disease and establish the underlying cause (e.g., vasculitis, embolus) while excluding other causes so that the proper therapy can follow

Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury

Directory of Open Access Journals (Sweden)

Paulina A. Toso

2014-04-01

Full Text Available OBJECTIVE: to test the clinical utility of an early amplitude-integrated electroencephalography (aEEG to predict short-term neurological outcome in term newborns at risk of neurology injury. METHODS: this was a prospective, descriptive study. The inclusion criteria were neonatal encephalopathy, neurologic disturbances, and severe respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values, and likelihood ratio (LR were calculated. Clinical and demographic data were analyzed. Neurological outcome was defined as the sum of clinical, electroimaging, and neuroimaging findings. RESULTS: ten of the 21 monitored infants (48% presented altered short-term neurologic outcome. The aEEG had 90% sensitivity, 82% specificity, 82% positive predictive value, and 90% negative predictive value. The positive LR was 4.95, and the negative LR was 0.12. In three of 12 (25% encephalopathic infants, the aEEG allowed for a better definition of the severity of their condition. Seizures were detected in eight infants (38%, all subclinical at baseline, and none had a normal aEEG background pattern. The status of three infants (43% evolved and required two or more drugs for treatment. CONCLUSIONS: in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detected early subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurological outcomes for all sick newborn.

Recombinant Tissue Plasminogen Activator Induces Neurological Side Effects Independent on Thrombolysis in Mechanical Animal Models of Focal Cerebral Infarction: A Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Mei-Xue Dong

Full Text Available Recombinant tissue plasminogen activator (rtPA is the only effective drug approved by US FDA to treat ischemic stroke, and it contains pleiotropic effects besides thrombolysis. We performed a meta-analysis to clarify effect of tissue plasminogen activator (tPA on cerebral infarction besides its thrombolysis property in mechanical animal stroke.Relevant studies were identified by two reviewers after searching online databases, including Pubmed, Embase, and ScienceDirect, from 1979 to 2016. We identified 6, 65, 17, 12, 16, 12 and 13 comparisons reporting effect of endogenous tPA on infarction volume and effects of rtPA on infarction volume, blood-brain barrier, brain edema, intracerebral hemorrhage, neurological function and mortality rate in all 47 included studies. Standardized mean differences for continuous measures and risk ratio for dichotomous measures were calculated to assess the effects of endogenous tPA and rtPA on cerebral infarction in animals. The quality of included studies was assessed using the Stroke Therapy Academic Industry Roundtable score. Subgroup analysis, meta-regression and sensitivity analysis were performed to explore sources of heterogeneity. Funnel plot, Trim and Fill method and Egger's test were obtained to detect publication bias.We found that both endogenous tPA and rtPA had not enlarged infarction volume, or deteriorated neurological function. However, rtPA would disrupt blood-brain barrier, aggravate brain edema, induce intracerebral hemorrhage and increase mortality rate.This meta-analysis reveals rtPA can lead to neurological side effects besides thrombolysis in mechanical animal stroke, which may account for clinical exacerbation for stroke patients that do not achieve vascular recanalization with rtPA.

Interest in neurology during medical clerkship in three Nigerian medical schools

Directory of Open Access Journals (Sweden)

Olanrewaju Timothy O

2010-05-01

Full Text Available Abstract Background This study sought to ascertain perception of Nigerian medical students of neurology in comparison with 7 other major medical specialties. To also determine whether neurology was the specialty students consider most difficult and the reasons for this and to appraise their opinion on how neurosciences and neurology were taught in their different universities. Methods Self-administered questionnaires were used to obtain information from randomly selected clinical students from 3 medical colleges in Nigeria (University of Ibadan, Ibadan; University of Ilorin, Ilorin; Ladoke Akintola University of Technology, Osogbo. Results Of 320 questionnaires sent out, 302 were returned given 94% response rate. Students felt they knew neurology least of all the 8 medical specialties, and were not confident of making neurological diagnoses. About 82% of the students indicated they learnt neurology best from bedside teaching, followed by use of medical textbooks. Close to 15% found online resources very useful for learning neurology and 6% indicated that group discussion was quite useful in the acquisition of knowledge on neurology. Histology and biochemistry were the preclinical subjects participants opined were least useful in learning neurology. The most frequent reasons students felt neurology was difficult were problems with understanding neuroanatomy (49%, insufficient exposure to neurological cases (41%, too many complex diagnoses (32% and inadequate neurology teachers (32%. Conclusions Nigerian medical students perceived neurology as the most difficult medical specialty and are not interested in specializing in it. Neurology education could be improved upon by provision of more bedside tutorials and increased availability of online resources to enhance learning. There is need to emphasize increased frequency of small group discussions amongst students so that they will be used to teamwork after graduation.

Excitation in temporal lobe epilepsy : focus on the glutamate-glutamine cycle

NARCIS (Netherlands)

van der Hel, W.S.

2009-01-01

Epilepsy is a common neurological disorder. Temporal lobe epilepsy (TLE) is the most frequent type of human focal epilepsy. Despite ample availability of anti-epileptic dugs, about 30% of TLE patients are pharmaco-resistant. Surgical removal of the epileptogenic focus, which usually includes the

Task analysis in neurosciences programme design - neurological ...

African Journals Online (AJOL)

Defining educational objectives is the key to achieving the goal of professional competence in students. The technique of task analysis was selected to determine components of competence in clinical neurology appropriate to the needs of primary care. A survey of neurological problems in general practice revealed that ...

Residual neurologic sequelae after childhood cerebral malaria

NARCIS (Netherlands)

van Hensbroek, M. B.; Palmer, A.; Jaffar, S.; Schneider, G.; Kwiatkowski, D.

1997-01-01

Cerebral malaria is an important cause of pediatric hospital admissions in the tropics. It commonly leads to neurologic sequelae, but the risk factors for this remain unclear and the long-term outcome unknown. The purpose of this study was to identify the common forms of neurologic sequelae that

Risk of neurological diseases among survivors of electric shocks

DEFF Research Database (Denmark)

Grell, Kathrine; Meersohn, Andrea; Schüz, Joachim

2012-01-01

Several studies suggest a link between electric injuries and neurological diseases, where electric shocks may explain elevated risks for neuronal degeneration and, subsequently, neurological diseases. We conducted a retrospective cohort study on the risk of neurological diseases among people...... in Denmark who had survived an electric accident in 1968-2008. The cohort included 3,133 people and occurrences of neurological diseases were determined by linkage to the nationwide population-based Danish National Register of Patients. The numbers of cases observed at first hospital contact in the cohort...... were compared with the respective rates of first hospital contacts for neurological diseases in the general population. We observed significantly increased risks for peripheral nerve diseases (standardized hospitalization ratio (SHR), 1.66; 95% confidence interval (CI), 1.22-2.22), for migraine (SHR, 1...

Anti-Ma2-antibody-associated encephalitis: An atypical paraneoplastic neurologic syndrome

Directory of Open Access Journals (Sweden)

Bogna Targonska

2018-05-01

Full Text Available Paraneoplastic syndromes are a heterogeneous group of conditions affecting cancer patients, where the signs and symptoms are not owing to the local effects of the tumour but instead owing to humoral or immunologic effects. We describe an unusual presentation of a paraneoplastic neurologic syndrome presenting with predominant involvement of the hypothalamus and deep grey nuclei secondary to an anterior mediastinal germinoma and associated with anti-Ma2 antibody.

Neuromodulation of lower limb motor control in restorative neurology.

Science.gov (United States)

Minassian, Karen; Hofstoetter, Ursula; Tansey, Keith; Mayr, Winfried

2012-06-01

One consequence of central nervous system injury or disease is the impairment of neural control of movement, resulting in spasticity and paralysis. To enhance recovery, restorative neurology procedures modify altered, yet preserved nervous system function. This review focuses on functional electrical stimulation (FES) and spinal cord stimulation (SCS) that utilize remaining capabilities of the distal apparatus of spinal cord, peripheral nerves and muscles in upper motor neuron dysfunctions. FES for the immediate generation of lower limb movement along with current rehabilitative techniques is reviewed. The potential of SCS for controlling spinal spasticity and enhancing lower limb function in multiple sclerosis and spinal cord injury is discussed. The necessity for precise electrode placement and appropriate stimulation parameter settings to achieve therapeutic specificity is elaborated. This will lead to our human work of epidural and transcutaneous stimulation targeting the lumbar spinal cord for enhancing motor functions in spinal cord injured people, supplemented by pertinent human research of other investigators. We conclude that the concept of restorative neurology recently received new appreciation by accumulated evidence for locomotor circuits residing in the human spinal cord. Technological and clinical advancements need to follow for a major impact on the functional recovery in individuals with severe damage to their motor system. Copyright © 2012 Elsevier B.V. All rights reserved.

Neurologic Evaluation and Management of Perioperative Nerve Injury.

Science.gov (United States)

Watson, James C; Huntoon, Marc A

2015-01-01

Neurologic injury after regional anesthesia or pain medicine procedures is rare. Postprocedural neurologic deficits may create high levels of anxiety for the patient and practitioner, although most deficits are limited in severity and can be expected to fully resolve with time. Postoperative anesthesia-related neuraxial and peripheral nerve injuries are reviewed to define an efficient, structured approach to these complications. Emphasis is placed on acutely stratifying the urgency and scope of diagnostic testing or consultation necessity, initiating appropriate definitive treatments, and defining appropriate out-of-hospital follow-up and symptom management. Studies pertinent to the recognition, evaluation, and treatment of neurologic assessment of perioperative nerve injury and published since the last advisory on the topic are reviewed and a new structured algorithmic approach is proposed. The evolving literature on postoperative inflammatory neuropathies is reviewed to help define the clinical criteria and to identify patients who would benefit from early neurological evaluation. New sections review potential acute interventions to improve neurologic outcome and long-term management of neuropathic pain resulting from perioperative nerve injury.

Cotard syndrome in neurological and psychiatric patients.

Science.gov (United States)

Ramirez-Bermudez, Jesus; Aguilar-Venegas, Luis C; Crail-Melendez, Daniel; Espinola-Nadurille, Mariana; Nente, Francisco; Mendez, Mario F

2010-01-01

The authors describe the frequency and characteristics of Cotard syndrome among neurological and psychiatric inpatients at a tertiary referral center. All inpatients from the National Institute of Neurology of Mexico (March 2007-May 2009) requiring neuropsychiatric consultation were reviewed. Among 1,321 inpatient consultations, 63.7% had neurological disease and one (0.11%) had viral encephalitis and Cotard syndrome. Of inpatients, 36.2% had pure psychiatric disorders and three (0.62%) had Cotard syndrome, associated with psychotic depression, depersonalization, and penile retraction (koro syndrome). This review discusses potential mechanisms for Cotard syndrome, including the role of a perceptual-emotional dissociation in self-misattribution in the deliré des negations.

[Deficiency, disability, neurology and cinema].

Science.gov (United States)

Collado-Vázquez, Susana; Cano de la Cuerda, Roberto; Jiménez-Antona, Carmen

2010-12-16

Cinema has been defined in many different ways, but most of them agree that it should be considered both a technique and an art. Although films often depict fantasy stories, in many cases they also reflect day-to-day realities. In its earliest days cinema was already attracted to the world of health and sickness, and frequently addressed topics like medical practice, how patients lived with their illnesses, bioethical issues, the relationship between physician and patient or research. To review the presence of neurological pathologies in the cinema with a view to identifying the main neurological disorders that have been portrayed in films. Likewise it also intends to describe the medical praxis that is employed, the relationship between physician and patient, how the experiences of the patient and the family are represented, the adaptation to social and occupational situations, and the intervention of other health care professionals related with neurological patients. Some of the most significant films that have addressed these topics were reviewed and it was seen that in some of them the illness is dealt with in a very true-to-life manner, whereas others tend to include a greater number of inaccuracies and a larger degree of fiction. Cinema has helped to shape certain ways of thinking about the health care professionals who work with neurological patients, the importance of support from the family and the social role, among other things. This confirms that resorting to cinematographic productions is a fruitful tool for stimulating a critical interest in the past and present of medical practice.