Neurolist Journal Watch

Neurology March 10, 2009

 

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Pediatric MS

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Population study in France between 1994-2003 showed no increased risk between MS and Hepatitis B vaccination

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Idiopathic optic neuritis in children with accompanying abnormalities on MRI are associated with increased risk for progression to MS

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Parkinson's Disease

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Randomized, controlled trial involving 52 patients with both Parkinson's disease and depression showed higher response rates in those treated with Nortriptyline than those of Proxetine and placebo

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Stroke

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Study of 820 autopsies of neurology patient showed that patients with fatal stroke are more likely than patients with other neurological condition to have nephroangiosclerosis. Based on the data, the study concludes that stroke patient with impaired kidney function based on laboratory studies warrants aggressive therapies for the impaired kidney function. 

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A study involving 132 patients in the Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarct and Leukoencephalopathy 
(CADASIL) Cohort was enrolled in the study to evaluate the presence of apathy. Of the 132 patients, 54 were determined to be apathetic through extensive neuropsychiatric testing. The study concludes that apathy is a common symptom among the CADASIL patients and is associated with cognitive impairment, global functional disability, and severe neuropsychiatric symptoms. The study also concluded that apathy has an independent impact on the patients' quality of life. 

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Prospective, non-randomized pilot study of Tenecteplase, a modified tPA, in patients with ischemic stroke 3-6 hours after symptom onset shows possible benefits. 

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Epilepsy

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Cross-sectional, observational, pilot study involving 24 woman found that women taking oral contraceptive pills might have lower serum valproic acid and lamotrigine levels compared to the woman taking inactive pills. The study also suggested that larger studies are needed to evaluate whether the serum levels of valproic acid and lamotrigine changes through out the natural hormonal cycles in female patients. 

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Open study evaluating the effect of trigeminal nerve stimulation on epilepsy showed reduction of seizure frequency at 12 month follow-up. 

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Headache

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Case-crossover study involving 7054 patients between May 2000 to December 2007 showed transient increase in headache patients seeking medical attention at the ER with higher ambient temperature and lower barometric pressure. Air pollutants were not found to be associated with increased headaches causing patients to seek medical evaluation.

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Case Report: A Case of Polyradiculoneuropathy, Drug Induced Hypersensitivity, and HHV-6 Infection.

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Case report involving an adult male patient who developed polyradiculoneuropathy after development of a rash induced by antibiotic therapy for acute liver diseases. The CSF PCR was positive for HHV-6 virus and HHV-6 IgG and IgM but normal protein content. The authors suggest activation of latent virus such as HHV-6 as one of the causes or factors associated with acute inflammatory peripheral nervous system diseases.

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Case Report: Corpus Callosum Dysgenesis Limits MRI Changes to One Hemisphere in Status Epileptus

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Cerebral palsy patient with EEG evidence of complex partial seizure involving R hemisphere and L sided clonic movements. MRI studies demonstrates corpus callosum dysgenesis as well as hyperintense signals through out R hemisphere. The author suggests that the absence of the corpus callosum prevented the spread of ictal charges to the contralateral hemisphere.