bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptoms Experienced by Patients with Carpal Tunnel Syndrome
Authors: Gupta Sanjoy K. , Benstead Timothy J. 
Published: February 2016

ABSTRACT:Background:Patients with carpal tunnel syndrome (CTS) sometimes report sensory symptoms outside the median nerve distribution. This study was designed to provide a more detailed assessment of these symptoms.Methods:Patients with clinical suspicion of upper limb neuromuscular lesions were divided into those with electrodiagnostic (EDX) evidence of CTS, and those without. CTS patients with superimposed nerve abnormalities were excluded. Motor and sensory symptoms were assessed in the exclusive CTS patients.Results:Over 50% of patients with exclusive CTS reported tingling or numbness over the whole hand, ulnar or radial nerve distributions. Some patients reported symptoms proximal to the wrist. Sensory signs did not extend beyond the median nerve distribution. Numbness and nocturnal pain were predictive of positive EDX evidence of CTS.Conclusions:Sensory symptoms outside the distribution of the median nerve are common in CTS. For enhanced sensitivity in diagnosis it is useful to be aware of these “atypical” symptoms. Reports of numbness and nocturnal pain are strong indicators of CTS.
Prevalence of Cerebral Palsy in Alberta
Authors: Robertson Charlene M.T. , Svenson Lawrence W. , Joffres Michel R. 
Published: February 2016

ABSTRACT:Background:In spite of scattered reports to the contrary, concern is continually expressed that the frequency of cerebral palsy has not decreased with modern perinatal/neonatal care. Overall, epidemiological information on cerebral palsy is scant. The generally accepted prevalence is 2 to 2.5 per thousand school-age children.Methods:A population-based record linkage study of a presently living cohort of 96,359 children born from April, 1985 through March, 1988 and followed over an eight-year tracking period captured the diagnostic codes for all fee-for-service physician claims, all hospital separations and individual birth data from the Department of Vital Statistics of the Government of Alberta. The ICD-9 code "343" was used to identify subjects. The childhood prevalence and frequency by birthweight- specific sub-groups of cerebral palsy were determined.Results:Two hundred and forty-eight living children with confirmed cerebral palsy after age three years (congenital, 229 [92.3%]; probable acquired 19 [7.7%]) were identified giving an overall prevalence of 2.57 per 1000. Seventy percent were diagnosed before their third birthday. Cohort prevalence of cerebral palsy for low birthweight children (< 2500 grams) was 17.7, very low birthweight (< 1500 grams), 78.5; and extremely low birthweight (< 1000 grams), 98.4. Low birthweight children made up just over one-third of cases in this study.Conclusions:Cerebral palsy continues to affect a significant number of children suggesting the prevalence of cerebral palsy has not decreased. The proportion of affected children with low birthweight in this study is less than that reported in the literature.
Identification of Six Novel SOD1 Gene Mutations in Familial Amyotrophic Lateral Sclerosis
Authors: Boukaftane Y. , Khoris J. , Moulard B. , Salachas F. , Meininger V. , Malafosse A. , Camu W. , Rouleau G.A. 
Published: February 2016

ABSTRACT:Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the premature death of motor neurons. In approximately 10% of the cases the disease is inherited as autosomal dominant trait (FALS). It has been found that mutations in the Cu/Zn superoxide dismutase gene (SODl) are responsible for approximately 15% of FALS kindreds. We screened affected individuals from 70 unrelated FALS kindreds and identified 10 mutations, 6 of which are novel. Surprisingly, we have found a mutation in exon 3, which includes most of the active site loop and Zn2+binding sites, a region where no previous SOD1 mutations have been found. Our data increase the number of different SODl mutations causing FALS to 55, a significant fraction of the 154 amino acids of this relatively small protein.
Management of Status Epilepticus
Authors: Aminoff Michael J. 
Published: February 2016

AbstractThe pharmacologic management of major motor status epilepticus is summarized. When general anesthesia is required, the electroencephalogram (EEG) is used for monitoring the adequacy of treatment. The EEG findings may also be important in recognizing status epilepticus and monitoring its response to treatment when this is clinically difficult, as when it occurs in comatose or pharmacologically paralyzed patients or in the context of severe brain damage. Finally, the EEG helps to clarify the nature of motor activities of uncertain basis in patients in the intensive care unit and has indicated that non-convulsive seizures or status are more common than clinically suspected in such patients.
Continuous EEG Monitoring in the Intensive Care Unit
Authors: Kay John 
Published: February 2016

AbstractBackground:Electroencephalography (EEG) is playing an increasingly important role in the management of comatose patients in the intensive care unit.Methods:The techniques of EEG monitoring are reviewed. Initially, standard, discontinuous recordings were performed in intensive care units (ICUs). Later, continuous displays of “raw EEG” (CEEG) were used. More recently, the addition of quantitative techniques allowed for more effective reading.Results and Conclusions:Applications of continuous EEG to clinical problems are discussed. The most useful role of CEEG appears to be the detection and management of nonconvulsive seizures. There is a need for controlled studies to assess the role for CEEG in neuro-ICUs and general ICUs.
Women's Issues in the Treatment of Epilepsy
Authors: Bruni J. 
Published: February 2016

ABSTRACT:Background:The management of women with epilepsy involves a number of important issues including conception control, sexual dysfunction and fertility, the effect of seizures on the fetus, possible changes in seizure frequency during pregnancy, potential teratogenic effects of antiepileptic drugs and management issues during pregnancy. The primary goal in the treatment of women with epilepsy remains optimal seizure control in the absence of unacceptable adverse effects. The advantages and disadvantages of the new antiepileptic drugs in women remain to be fully established but these new agents allow a wider choice for improved seizure control
Consequences of Epilepsy: Why do We Treat Seizures?
Authors: Jones Michael W. 
Published: February 2016

ABSTRACT:Improving health-related quality of life in epileptic patients, rather than simply reducing seizures, has become the principal goal in epilepsy management. Reducing seizure frequency is one of the main factors contributing to improved quality of life. Evidence for and risk of the following potential adverse effects of seizures is reviewed: brain damage from seizures, sudden unexpected death, status epilepticus, kindling, falls or injury and psychosocial consequences. Although the evidence for seizure frequency influencing some of these factors is not clear-cut, as a whole, they offer a strong impetus toward an aggressive approach to controlling recurrent seizures in most cases.
Malignant Rhabdoid Tlimor of Brain: An Aggressive Clinical Entity
Authors: Fisher B.J. , Siddiqui J. , MacDonald D. , Cairney A.E. , Ramsey D. , Munoz D. , Del Maestro R. 
Published: February 2016

AbstractObjective: We report three patients with malignant rhabdoid tumor (MRT) of the brain, two children and an adult. There were three purposes to this report: to describe the clinical course in an adult with MRT; to describe the interesting histopathological metamorphosis of one of the tumors; and to report the outcome of the treatment regimens we used in order to help guide future treatment. Since these tumors are quite rare it is important to continue to try new regimens in the search for effective therapy rather than to repeat ineffective ones.Method: Report of three patients.Results: The clinical course in all three patients was typical of these aggressive neoplasms in that chemotherapy and radiotherapy were ineffective in modifying the rapid deterioration leading to death.Conclusions: MRT can occur in adults. Autopsy in one patient showed that the tumor seemed to undergo an evolution in appearance when compared with the original pathology specimen from craniotomy. Administration of systemic therapy should be prompt and include intrathecal chemotherapy.
Addison’s Disease Presenting with Cerebral Edema
Authors: Geenen Caroline , Tein Ingrid , Ehrlich Robert M. 
Published: February 2016

ABSTRACT:Background: Increased intracranial pressure with encephalopathy has rarely been reported in Addison’s disease. Method: Case Study. Results: A 16-year-old female who presented with cerebral edema of unknown etiology was eventually diagnosed as having Addison’s disease. She had early morning headaches, fatiguability, diarrhea and deterioration in school performance. She was hyponatremic with a serum sodium of 128 mmol/L and hyperkalemic with a serum potassium of 5.9 mmol/L. She had a low serum osmolality (264 mosm), high urine osmolality (533 mosm) and high urine sodium (87 mosm). She had a postural drop in blood pressure and diffuse hyperpigmentation. An ACTH stimulation test revealed a low baseline Cortisol and no response to ACTH. Plasma renin activity was increased. Serum ACTH was elevated. She responded well to intravenous fluids and solu-cortef and was discharged on hydrocortisone and florinef. She remains well 18 months after the acute episode with no neurologic complaints or findings. Conclusion: Addison’s Disease should be considered in the differential diagnosis of symptomatic cerebral edema and idiopathic intracranial hypertension.
Vagal Nerve Complex in Normal Development and Sudden Infant Death Syndrome
Authors: Becker L.E. , Zhang W. 
Published: February 2016

ABSTRACT:Background:Although the pathogenesis of sudden infant death syndrome (SIDS) is not understood, one of the major hypotheses is that a subtle defect in respiratory circuitry is an important underlying factor. The vagus nerve is a critical component of respiratory control, but its neuroanatomic complexity has limited its investigation in human disease.Methods:Correlating developmental studies on different parts of the vagus nerve allows a more comprehensive assessment of its maturation process. Comparison of the normal developing vagus nerve with nerves examined in SIDS patients suggests alterations in the nucleus tractus solitarius and dorsal vagal nucleus as well as in the peripheral vagus nerve.Results and Conclusions:The persistence of dendritic spines and lack of appropriate axonal growth implies delays in vagal maturation. Since nodose ganglia can be examined in vitro from autopsy material, perturbation to this system can be explored to evaluate further the mechanism involved in terminal vagal maturation. Although the reason for the delayed vagal maturation in SIDS is not apparent, the presence of astrogliosis in the region of the vagal nuclei is consistent with an exposure to hypoxic-ischemic events some time before death.
Acute Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage
Authors: Mehta V. , Holness R. O. , Connolly K. , Walling S. , Hall R. 
Published: February 2016

ABSTRACT:Background:Acute hydrocephalus is a potentially treatable cause of early neurological deterioration after aneurysmal subarachnoid hemorrhage (§AH).Methods:A retrospective study of 105 consecutive cases of aneurysmal SAH was undertaken to determine those factors significantly related to the development of acute hydrocephalus. Acute hydrocephalus was diagnosed when the bicaudate index was greater than the 95,h percentile for age on a CT scan within 72 hours of the ictus.Results:Thirty-one percent of the patients developed acute hydrocephalus. Grade of SAH was a significant factor for the development of acute hydrocephalus on univariate analysis as 87% of patients with acute hydrocephalus (29/32) presented with at least grade 3 (Hunt-Hess) SAH (p < 0.05). In addition, posterior circulation aneurysms on univariate analysis were associated with acute hydrocephalus (p < 0.05). Both premorbid hypertension and intraventricular blood (p < 0.05) were predictors for acute hydrocephalus, whereas intracisternal blood, age and sex were not. On multivariate linear regression analysis, factors found to be significantly associated with acute hydrocephalus were premorbid hypertension, intraventricular blood, CSF diversion and definitive shunt procedures. External ventricular drainage was not associated with any instances of rebleeding. Thirty-seven percent (10/27) of patients with acute hydrocephalus who survived were improved by pre-operative external ventricular drainage.Conclusions:Patients with acute hydrocephalus following SAH can be safely treated with external ventricular drainage. Multiple factors can be identified to predict those patients who will develop acute hydrocephalus post aneurysmal rupture. Approximately 30% of those patients with acute hydrocephalus will require definitive shunt placement. Acute hydrocephalus occurred in 31% of aneurysmal SAH patients in this series.
Mechanisms Underlying Functional Recovery Following Stroke
Authors: Lee Robert G. , Donkelaar Paul van 
Published: February 2016

AbstractThis article reviews recent evidence from animal experiments indicating that there is considerable potential for reorganization of representations and functions in sensory and motor cortex following localized lesions or various manipulations of peripheral target structures. Three major mechanisms for this plastic reorganization are considered: unmasking of existing but functionally inactive pathways, sprouting of fibers from surviving neurons and formation of new synapses, and redundancy of CNS circuitry allowing alternative pathways to take over functions. Studies using positron emission tomography or transcranial magnetic stimulation suggest that similar forms of neuroplasticity may occur in the human brain and could contribute to functional recovery following stroke. The potential therapeutic implications are discussed.
Isolated Suprascapular Nerve Palsy: a Review of Nine Cases
Authors: Berry Henry , Kong Kester , Hudson Alan R. , Moulton Richard J. 
Published: February 2016

AbstractBackgroundIn nine patients, suprascapular nerve palsy followed serious accidents associated with fractures of the cervical vertebrae, clavicle or scapula and after weight lifting, wrestling and a fall on the elbow or shoulder.MethodAll patients were examined as to muscle wasting, weakness and shoulder fixation. EMG examination was done in all cases and six patients underwent surgical exploration.ResultsThe palsy was incomplete on clinical and EMG examination in all patients. On exploration, scarring, entrapment, tethering or kinking at the suprascapular notch was found in four and two had post-traumatic neuromas.ConclusionsIn contrast to published studies, none of our patients presented with shoulder pain, a spontaneous onset nor with involvement limited to the infraspinatus muscle. The differential diagnosis should include C5 root lesion, brachial plexus neuritis, frozen shoulder and tear of the rotator cuff.
Sudden ‘Stroke-Like’ Onset of Hemiparesis Due to Herpetic Encephalitis
Authors: AbdulJabbar Mohammad , Ghozi Ibrahim , Haq Anwar , Korner Hanz 
Published: February 2016

AbstractBackground/ObjectiveHerpes simplex encephalitis usually has a progressive cause. Sudden neurological deficits are unusual.MethodCase study.ResultsA 17-year-old girl presented with an acute onset focal neurological deficit followed one week later by the more classical feature of altered level of consciousness, fever and focal seizures. The diagnosis of hepetic encephalitis was made by magnetic resonance imaging (MRI) and by the significant increase in cerebrospinal fluid titres of antibodies against herpes simplex type I.ConclusionHerpetic encephalitis should be considered in the differential diagnosis of acute stroke in young patients even in the absence of encephalitic features, if common etiological factors such as embolization and intracerebral bleed are excluded.
An Open Trial of Pyridostigmine in Post-poliomyelitis Syndrome
Authors: Trojan Daria A. , Cashman Neil R. 
Published: February 2016

AbstractBackgroundOne of the major symptoms of postpoliomyelitis syndrome (PPS) is disabling generalized fatigue. Subjects with PPS also report muscle fatiguability and display electrophysiologic evidence of anticholinesterase-responsive neuromuscular junction transmission defects, suggesting that anticholinesterase therapy may be useful in the management of disabling fatigue.MethodsWe initiated an open trial of the oral anticholinesterase pyridostigmine, up to 180 mg per day, in 27 PPS patients with generalized fatigue and muscle fatiguability. Response to pyridostigmine was assessed with the Hare fatigue scale, the modified Barthel index for activities of daily living, and a modified Klingman mobility index.ResultsTwo patients could not tolerate the medication. After one month of therapy, 16 patients (64%) reported a reduction in fatigue on the Hare fatigue scale; three of 16 showed improvement on the modified Barthel index for activities of daily living, and two of 16 experienced improvement on a modified Klingman mobility index. Pyridostigmine responders were significantly more fatigued than non-responders on the pre-treatment Hare score, but were not significantly different with regard to age, sex, age at acute poliomyelitis, or severity of acute poliomyelitis.ConclusionsPyridostigmine may be useful in the management of fatigue in selected patients with PPS. Response to pyridostigmine may be predicted by severity of pre-treatment fatigue.
β-Endorphin in Multiple Trauma Victims
Authors: Guieu R. , Devaux C. , Albanese J. , Martin C. , Juin M. , Rochat H. 
Published: February 2016

AbstractBackground:In animals and in humans, stress is known to be accompanied by increased β-endorphin secretion.Methods:Blood samples from 47 patients in a state of stress induced by multiple trauma were assessed for β-endorphin concentration by radioimmunoassays.Results:We show that there is a clearcut correlation (Spearman’s R = 0.72, P = 2.1 x 10”-6) between the level of consciousness evaluated with the Glasgow score and levels of circulating β-endorphin. In addition, β-endorphin levels are higher than normal in patients with Glasgow coma with scores higher than seven, and lower than normal in those with Glasgow coma scores of seven or less. Finally, in the complete absence of stress (shown by the lack of brain activity in six irreversible coma patients), there is a severe drop in the level of circulating β-endorphin.Conclusion:β-endorphin serum levels correlate with the state of consciousness of multiple trauma patients.
Antiepileptic Drug Selection and Adverse Effects: An Overview
Authors: Bruni J. 
Published: February 2016

Abstract:In choosing an antiepileptic drug, not only efficacy but also potential adverse effects have to be considered. Adverse effects that have to be taken into account include acute and chronic systemic toxicity, cognitive side effects, and teratogenesis. Acute toxicity may be dose-related, allergic or an idiosyncratic reaction. Chronic toxicity may involve the nervous system or other organs. In determining the role of new antiepileptic drugs such as lamotrigine, vigabatrin, felbamate, and gabapentin a proper evaluation of both efficacy and adverse effects is required.
How About the New Antiepileptic Drugs?
Authors: Wilder B.J. 
Published: February 2016

Abstract:No new antiepileptic drugs (AEDs) were licensed in the United States from 1978 to 1992. In late 1992, felbamate and gabapentin were recommended for approval, and in early 1993, lamotrigine. In July 1993, felbamate was licensed, and gabapentin and lamotrigine may soon follow. Lamotrigine, vigabatrin and clobazam are in use outside the US. Tiagabine, oxcarbazepine, fosphenytoin, topiramate, vigabatrin and zonisamide are in Phase II clinical testing in the US. All of the new AEDs are effective against partial and tonic-clonic seizures. Few controlled clinical trials have been done in patients with absence and myoclonic seizures. Mechanisms of action of the new drugs have not been clearly defined. The new AEDs will provide an opportunity to improve the care of epileptic patients. Even with optimal management with currently available drugs, some 30% of patients remain refractory to medical management.
Iatrogenic False Aneurysm Following Repair of Intracranial Aneurysm
Authors: Rowed David W. , Walters Beverly C. 
Published: February 2016

Abstract:False aneurysm of the intracranial arteries occurs infrequently as a complication of head injury and rarely as a consequence of other pathology. A case of false aneurysm of the supraclinoid internal carotid artery following minor intraoperative injury during clipping of a basilar-superior cerebellar aneurysm by the pterional approach is described. False aneurysm is a potential cause of recurrent intracranial hemorrhage after successful aneurysm clipping. Arterial bleeding which appears to come from the region of a branch origin should be viewed with concern even if it subsides spontaneously.
Malignant Rhabdoid Tumour of the Pineal Region
Authors: Muller Matthew , Hubbard Sherri Lynn , Provias John , Greenberg Mark , Becker Laurence E. , Rutka James T. 
Published: February 2016

Abstract:A 9-month-old male presented to hospital with signs and symptoms of raised intracranial pressure. A CT scan showed obstructive hydrocephalus from a large pineal region mass lesion into which an intratumoral hemorrhage had occurred. A posterior fossa craniectomy and subtotal excision of the mass lesion were performed. By histopathology, the lesion was a malignant rhabdoid tumour (MRT). Despite surgery and chemotherapy, the tumour grew inexorably, and the patient died four months after the initial diagnosis. MRT is a rare and highly invasive neoplasm which infrequently arises from the central nervous system. This is the first documented case of a MRT arising from the pineal region. The clinical, radiographic, and pathological features of the MRT in this patient are presented.
Failure of Iron Chelators to Protect Against Cerebral Infarction in Hypoxia-Ischemia
Authors: MacMillan V. , Fridovich I. , Davis J. 
Published: February 2016

ABSTRACT:In this study the ability of iron chelators to attenuate hypoxic-ischemic brain damage was assessed in hyperglycemic rats that were exposed to 1% carbon monoxide and right carotid occlusion. The animals received deferoxamine (50 mg/kg), manganese-deferoxamine (50 mg/kg) or vehicle i.p. 0.5 h prior to hypoxemic-ischemic exposure and at 0.5, 3 and 24 h post-exposure; with subsequent histological examination of the brain at 7 days recovery. The area of cerebral infarction was measured at three levels using video imaging methods. The mean percentage of total hemisphere that was infarcted in the three groups was: vehicle — 28.5 ± 5.0; deferoxamine — 31.7 ± 12.1; and manganese deferoxamine — 30.6 ± 6.8 (p - n.s.). The results as obtained in this preliminary study indicate that aggressive pre- and post-treatment with iron chelators has no ability to attenuate cerebral infarction in this model.
Cervical Disc Herniation Presenting with Chest Wall Pain
Authors: Yeung Michael C. , Hagen Neil A. 
Published: February 2016

ABSTRACT:This report highlights the clinical features of two patients who presented with severe neuropathic chest wall pain caused by herniated C6-7 disc, and speculates on the pathophysiology of this syndrome. Worsening of symptoms with neck movement helped localize the process as cervical spine rather than plexus in origin. Both patients had herniated C6-7 disc material compressing the spinal cord and C7 nerve root, and neurological symptoms resolved promptly following surgery. Neuropathic chest wall pain should alert the clinician to consider the diagnosis of cervical disc herniation and prompt definitive imaging of the cervical spine by myelography or magnetic resonance imaging (MRI).