journal
https://read.qxmd.com/read/38715732/the-pns-nurse-program-a-health-care-support-concept-for-patients-with-immune-mediated-peripheral-nervous-system-diseases
#41
JOURNAL ARTICLE
Marc Pawlitzki, Marcia Gasis, Lars Masanneck, Sven G Meuth, Tobias Ruck
BACKGROUND: Immune-mediated peripheral nervous system (PNS) disorders pose diagnostic and therapeutic challenges, necessitating collaborative, patient-centered care. Limited access to specialized centers leads to delayed diagnosis and care, as seen during the COVID-19 pandemic. To address these challenges, accessible specialized care is crucial. On-site support plays a vital role in advising and assisting patients and caregivers, enabling multidisciplinary care for PNS diseases. RECENT FINDINGS: The PNS Nurse Education Program tackles these complexities, using specialized nurses experienced in multiple sclerosis and Parkinson disease...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38699600/understanding-abnormal-examination-findings-during-concussion-recovery-a-retrospective-chart-review
#42
JOURNAL ARTICLE
Nicholas S Streicher, Michael Popovich, Andrea Almeida, Bara Alsalaheen, Ingrid K Ichesco, Jeremiah Freeman, Matt Lorincz, James T Eckner
BACKGROUND AND OBJECTIVE: Physical examination findings in athletes with sport-related concussion (SRC) are not well described in the literature. The objective of this study was to describe physical examination findings during the first month following concussion in athletes, with a focus on the effect of sex, age, and time since injury. METHODS: This was a retrospective electronic medical record (EMR) review of physical examination findings in 500 patients aged 6-24 who were initially seen within 15 days of SRC at a multidisciplinary outpatient academic concussion clinic between 2017 and 2019...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38699599/diagnosis-and-treatment-of-spontaneous-intracranial-hypotension-role-of-epidural-blood-patching
#43
REVIEW
Andrew L Callen, Deborah I Friedman, Simy Parikh, Jill C Rau, Wouter I Schievink, Jeremy K Cutsforth-Gregory, Timothy J Amrhein, Elena Haight, Robert P Cowan, Meredith J Barad, Jennifer M Hah, Tracy Jackson, Connie Deline, Andrea J Buchanan, Ian Carroll
PURPOSE OF REVIEW: This review focuses on the challenges of diagnosing and treating spontaneous intracranial hypotension (SIH), a condition caused by spinal CSF leakage. It emphasizes the need for increased awareness and advocates for early and thoughtful use of empirical epidural blood patches (EBPs) in suspected cases. RECENT FINDINGS: SIH diagnosis is hindered by variable symptoms and inconsistent imaging results, including normal brain MRI and unreliable spinal opening pressures...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38690148/expanding-the-spectrum-of-congenital-myopathy-linked-to-variants-in-the-mybpc1-gene-a-clinical-report
#44
Pierre-Louis Lanvin, Dong Li, Solène Conrad, Armelle Magot, Xavier Micaelli, Yann Péréon, Marie Vincent, Bertrand Isidor, Damien Sternberg, Elizabeth M McCormick, Hakon Hakonarson, Sandra Mercier, Marni J Falk
OBJECTIVES: Heterozygous missense variants in MYBPC1 have been recently identified in 13 patients from 6 families with congenital myopathy with tremor. All the patients had mild skeletal myopathy invariably associated with a distinctive myogenic tremor and hypotonia with gradual clinical improvement. However, no phenotypic description has been reported for the neonatal respiratory impairment that patients may suffer. METHODS: We report 3 new patients from 2 independent families with congenital myopathy with tremor...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38682006/clinic-based-characterization-of-adolescents-and-young-adults-with-migraine-psychological-functioning-headache-days-and-disability
#45
JOURNAL ARTICLE
Robert C Gibler, Maya A Marzouk, James Peugh, Brooke L Reidy, Michelle M Ernst, Morgan L Daffin, Scott W Powers, Marielle Kabbouche Samaha, Joanne Kacperski, Andrew D Hershey, Hope O'Brien, Shalonda K Slater
BACKGROUND AND OBJECTIVES: This cross-sectional observational study retrospectively examined clinical data collected from adolescents and young adults (AYAs) seeking care in a specialty headache clinic. We characterized participants' headache characteristics and psychological functioning and examined the association between self-reported anxiety and depressive symptoms and headache frequency, severity, and disability. METHODS: During their clinic visit, AYAs ( M age = 18...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38682005/use-of-acid-suppression-therapy-and-odds-of-migraine-and-severe-headache-in-the-national-health-and-nutrition-examination-survey
#46
JOURNAL ARTICLE
Margaret Slavin, Cara L Frankenfeld, Alexander B Guirguis, Elizabeth K Seng
BACKGROUND AND OBJECTIVES: Headache is an adverse event associated with the use of proton pump inhibitors (PPIs). Recently, migraine has emerged more specifically as a potential adverse event with PPI use. The objectives of this work were to capitalize on existing data to evaluate the association between migraine and severe headache prevalence and use of acid-suppression therapy, including PPIs, H2 receptor antagonists (H2RAs), and generic antacids; to compare risk from PPIs vs H2RAs; and to assess for potential mitigation by a dietary factor affected by acid-suppression therapy...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38660576/early-developmental-intervention-and-enriched-environment-in-cdkl5-developmental-and-epileptic-encephalopathy-a-case-report
#47
Martina Giorgia Perinelli, Cecilia Naboni, Ganna Balagura, Elisabetta Amadori, Maria Stella Vari, Valeria Capra, Camelia Lentoiou, Thomas Foiadelli, Fabio Sirchia, Antonella Luparia, Gianluigi Marseglia, Luca A Ramenghi, Pasquale Striano
OBJECTIVES: CDKL5 developmental and epileptic encephalopathy (CDKL5-DEE) is a rare X-linked dominant genetic disorder. Family-centered Early Intervention (EI) programs, which promote axonal plasticity and synaptic reorganization through exposure to an enriched environment, should be integrated into clinical practice. However, there is presently a dearth of dedicated EI protocols for patients with CDKL5-DEE and cerebral visual impairment (CVI). METHODS: We present a girl with a deletion of the CDKL5 gene (MIM*300203)...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38617555/caregiver-experiences-and-burden-in-moderate-advanced-dementia-with-lewy-bodies
#48
JOURNAL ARTICLE
Melissa J Armstrong, Yunfeng Dai, Kaitlin Sovich, Brian LaBarre, Henry L Paulson, Susan M Maixner, Julie A Fields, Angela M Lunde, Leah K Forsberg, Bradley F Boeve, Carol A Manning, James E Galvin, Angela S Taylor, Zhigang Li
BACKGROUND AND OBJECTIVES: Dementia with Lewy bodies (DLB) is a common degenerative dementia, but research on caregiver experiences in late stages is lacking. This study aimed to investigate the caregiving experience in moderate-advanced DLB to identify opportunities for improving care and support. METHODS: Dyads of individuals with moderate-advanced DLB and their primary informal caregivers were recruited from specialty clinics, advocacy organizations, and research registries...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38617554/operational-impact-of-neurology-rural-access-model-reflections-on-the-importance-of-demand-shaping
#49
JOURNAL ARTICLE
Alexis Kurek, Kennedy Boone-Sautter, Cynthia M Hingtgen, Aiesha Ahmed
BACKGROUND AND OBJECTIVES: Demand for specialty neurologic care has been steadily increasing over the past several decades, and health systems are needing to meet the demands of their patients while managing a dwindling workforce. This retrospective study investigates the operational impact of a regional neurology clinic staffed by advanced practice providers with remote physician oversight in a "hub and spoke" delivery model to serve lower complexity patients. METHODS: A retrospective, cross-sectional study was conducted to evaluate outcomes...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38617553/sensory-processing-difficulties-and-occupational-therapy-outcomes-for-functional-neurological-disorder-a-retrospective-cohort-study
#50
JOURNAL ARTICLE
Kathryn E McCombs, Julie MacLean, Sara A Finkelstein, Susan Goedeken, David L Perez, Jessica Ranford
BACKGROUND AND OBJECTIVES: Occupational therapy (OT) consensus recommendations and articles outlining a sensory-based OT intervention for functional neurological disorder (FND) have been published. However, limited research has been conducted to examine the efficacy of OT interventions for FND. We performed a retrospective cohort study aimed at independently replicating preliminarily characterized sensory processing difficulties in patients with FND and reporting on clinical outcomes of a sensory-based OT treatment in this population...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38601858/exploring-the-potential-of-large-language-models-in-neurology-using-neurologic-localization-as-an-example
#51
EDITORIAL
Chia-Chun Chiang, Jason A Fries
No abstract text is available yet for this article.
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38596779/gpt-4-performance-for-neurologic-localization
#52
JOURNAL ARTICLE
Jung-Hyun Lee, Eunhee Choi, Robert McDougal, William W Lytton
BACKGROUND AND OBJECTIVES: In health care, large language models such as Generative Pretrained Transformers (GPTs), trained on extensive text datasets, have potential applications in reducing health care disparities across regions and populations. Previous software developed for lesion localization has been limited in scope. This study aims to evaluate the capability of GPT-4 for lesion localization based on clinical presentation. METHODS: GPT-4 was prompted using history and neurologic physical examination (H&P) from published cases of acute stroke followed by questions for clinical reasoning with answering for "single or multiple lesions," "side," and "brain region" using Zero-Shot Chain-of-Thought and Text Classification prompting...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38586238/enhancing-value-and-well-being-the-basket-of-motivators-framework-for-aligning-neurology-clinical-practices-with-performance-outcomes
#53
REVIEW
Peter N Hadar, Susanna Gallani, Lidia Moura
PURPOSE OF REVIEW: Physician burnout, which is prevalent in neurology, has accelerated in recent years. While multifactorial, a major contributing factor to burnout is a payment model that rewards volume over quality, leaving physicians overburdened and unfulfilled. The aim of this review was to investigate ways of reducing burnout while improving quality-based outcomes in a value-based health care model. RECENT FINDINGS: Burnout affects researchers, educators, clinicians, and administrators in all fields and tracks, but neurologists experience some of the worst burnout rates among specialties...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38586237/evaluation-of-a-seizure-action-plan-in-an-adult-epilepsy-center
#54
JOURNAL ARTICLE
Lucretia Long, Staci S Reynolds, Lisa S Lewis, Michelle A Webb, Crystal Epley, Sarita Maturu
BACKGROUND: Seizure action plans (SAPs) provide valuable information for patients to manage seizure emergencies, but are underutilized in adult epilepsy centers. The purpose of this project was to implement a structured SAP for adult patients with epilepsy. METHODS: A pre/postimplementation design was used. Provider SAP utilization rates were analyzed over a 16-week period. A pre and postimplementation survey assessed participant perceived impact of the SAP on knowledge and comfort associated with managing seizure emergencies...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38544885/therapeutic-responses-to-efgartigimod-for-generalized-myasthenia-gravis-in-japan
#55
JOURNAL ARTICLE
Shigeaki Suzuki, Akiyuki Uzawa, Yuriko Nagane, Masayuki Masuda, Shingo Konno, Tomoya Kubota, Makoto Samukawa, Kei Ishizuchi, Daiki Tokuyasu, Hideo Handa, Manato Yasuda, Naoki Kawaguchi, Takashi Kimura, Yasushi Suzuki, Takamichi Sugimoto, Naoya Minami, Masanori P Takahashi, Hiroyuki Murai, Kimiaki Utsugisawa
BACKGROUND AND OBJECTIVES: Efgartigimod, which has been well tolerated and efficacious in individuals with generalized myasthenia gravis (MG), is available in Japan not only for the treatment of anti-acetylcholine receptor-positive (AChR+) but also anti-muscle-specific receptor tyrosine kinase (MuSK+) and seronegative generalized MG. We report details of the use of efgartigimod for generalized MG in clinical practice in Japan. METHODS: We included patients with generalized MG in the 2021 survey of Japan Myasthenia Gravis Registry (JAMG-R) study group who received an initial cycle of efgartigimod between May and September 2022...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38525067/clinical-predictors-of-postmortem-amyloid-and-nonamyloid-cerebral-small-vessel-disease-in-middle-aged-to-older-adults
#56
JOURNAL ARTICLE
Caroline Dallaire-Théroux, Colin Smith, Simon Duchesne
BACKGROUND AND OBJECTIVES: Sporadic cerebral small vessel disease (CSVD) is a class of important pathologic processes known to affect the aging brain and to contribute to cognitive impairment. We aimed to identify clinical risk factors associated with postmortem CSVD in middle-aged to older adults. METHODS: We developed and tested risk models for their predictive accuracy of a pathologic diagnosis of nonamyloid CSVD and cerebral amyloid angiopathy (CAA) in a retrospective sample of 160 autopsied cases from the Edinburgh Brain Bank...
June 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38720990/compulsive-repetitive-flexion-with-breath-holding-in-sagging-brain-syndrome
#57
Jeremy D Schmahmann, Wouter I Schievink
BACKGROUND AND OBJECTIVE: Spontaneous intracranial hypotension (SIH) from CSF leak commonly produces headache. It also may produce sagging brain syndrome (SBS), often with neurocognitive symptoms indistinguishable from behavioral-variant frontotemporal dementia (bvFTD). The authors describe a new clinical sign that appears to be pathognomonic of SBS. METHODS: We reviewed medical records and brain imaging in patients seen at our 2 centers who presented with SIH, SBS, and bvFTD symptoms...
April 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38585444/clinical-utility-and-diagnostic-yield-of-genetic-testing-for-inherited-neuromuscular-disorders-in-a-single-large-neuromuscular-center
#58
JOURNAL ARTICLE
Suzahn E Ebert, James B Meiling, James B Caress, Rachana K Gandhi Mehta, Vanessa Baute Penry, Araya Puwanant, Michael S Cartwright
BACKGROUND AND OBJECTIVES: Most published studies on the clinical utility of genetic testing for neuromuscular diseases (NMDs) focus on disease-specific cohorts and/or involve multiple centers. The aim of this study was to examine the clinical utility and diagnostic yield of genetic testing at a single, large neuromuscular center. Unlike previous studies, this study is unique in that it includes a broad array of patients at a single, large neuromuscular center, providing real-world data that may assist both neuromuscular specialists as well as general neurologists in decision-making regarding the need for genetic testing in patients with suspected NMDs...
April 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38585443/immediate-reactions-to-alzheimer-biomarker-disclosure-in-cognitively-unimpaired-individuals-in-a-global-truncated-randomized-trial
#59
JOURNAL ARTICLE
Joshua D Grill, Rema Raman, Karin Ernstrom, Shunran Wang, Michael C Donohue, Paul S Aisen, Jason Karlawish, David Henley, Gary Romano, Gerald Novak, H Robert Brashear, Reisa A Sperling
BACKGROUND AND OBJECTIVES: Preclinical Alzheimer disease (AD) trials simultaneously test candidate treatments and the implications of disclosing biomarker information to cognitively unimpaired individuals. METHODS: The EARLY trial was a randomized, double-blind, placebo-controlled, phase 2b/3 study conducted in 143 centers across 14 countries from November 2015 to December 2018 after being stopped prematurely because of treatment-related hepatotoxicity. Participants age 60-85 years deemed cognitively unimpaired were disclosed an elevated or not elevated brain amyloid result by a certified clinician...
April 2024: Neurology. Clinical Practice
https://read.qxmd.com/read/38585442/understanding-health-care-provider-burnout-when-caring-for-patients-with-refractory-epilepsy-in-the-united-states
#60
JOURNAL ARTICLE
Mei Lu, Enrico Speri, A Lauks, Charles Leibson, Satish C Rao
BACKGROUND AND OBJECTIVES: Among health care providers (HCPs), neurologists have one of the highest rates of burnout in the United States, compromising the quality and accessibility of patient care. Patients with refractory epilepsy are especially challenging to treat. This study aims to understand the burnout level in neurologists treating patients with refractory epilepsy and identify key contributing factors. METHODS: US board-certified pediatric/adult neurologists who devote ≥50% of their time to clinical practice and treat ≥10 unique patients with refractory epilepsy annually were invited to take a noninterventional quantitative survey, designed to capture key elements of the HCP's background, burnout level, current practice, burden domains, and satisfaction with current antiseizure medications (ASMs)...
April 2024: Neurology. Clinical Practice
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