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27 papers 25 to 100 followers A medical student's readings for neurology clerkship.
By Kevin Hu PGY2
David W Dodick
Migraine is a chronic paroxysmal neurological disorder characterised by multiphase attacks of head pain and a myriad of neurological symptoms. The underlying genetic and biological underpinnings and neural networks involved are coming sharply into focus. This progress in the fundamental understanding of migraine has led to novel, mechanism-based and disease-specific therapeutics. In this Seminar, the clinical features and neurobiology of migraine are reviewed, evidence to support available treatment options is provided, and emerging drug, device, and biological therapies are discussed...
March 31, 2018: Lancet
Anita Holdcroft, Ian Power
No abstract text is available yet for this article.
March 22, 2003: BMJ: British Medical Journal
J Aviram, G Samuelly-Leichtag
BACKGROUND: The management of chronic pain is a complex challenge worldwide. Cannabis-based medicines (CBMs) have proven to be efficient in reducing chronic pain, although the topic remains highly controversial in this field. OBJECTIVES: This study's aim is to conduct a conclusive review and meta-analysis, which incorporates all randomized controlled trials (RCTs) in order to update clinicians' and researchers' knowledge regarding the efficacy and adverse events (AEs) of CBMs for chronic and postoperative pain treatment...
September 2017: Pain Physician
Y Kawakami, M Chikama, T Tanimoto, Y Shimamura
Four cases of the cheiro-oral syndrome are reported, with a review of the clinical symptoms and signs and the neuroradiological methods used to demonstrate the responsible lesion. In each case, angiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed. The lesion was found in the thalamus in three cases and in the pons in one. Infarction had occurred in three cases and haemorrhage in one. Angiography revealed normal findings in all cases. CT at the onset of the symptoms demonstrated a small haemorrhage in the thalamus in one case but was not helpful in the others, and MRI was required to identify infarction...
March 1989: Journal of Neurology
Lars Wallentin, Renato D Lopes, Michael Hanna, Laine Thomas, Anne Hellkamp, Sunil Nepal, Elaine M Hylek, Sana M Al-Khatib, John H Alexander, Marco Alings, John Amerena, Jack Ansell, Philip Aylward, Jozef Bartunek, Patrick Commerford, Raffaele De Caterina, Cetin Erol, Veli-Pekka Harjola, Claes Held, John D Horowitz, Kurt Huber, Steen Husted, Matyas Keltai, Fernando Lanas, Liu Lisheng, John J V McMurray, Byung-Hee Oh, Mårten Rosenqvist, Witold Ruzyllo, Philippe Gabriel Steg, Dragos Vinereanu, Denis Xavier, Christopher B Granger
BACKGROUND: In the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial, apixaban compared with warfarin reduced stroke and systemic embolism, major bleeding, and mortality. We evaluated treatment effects in relation to 2 predictions of time in therapeutic range (TTR). METHODS AND RESULTS: The trial randomized 18 201 patients with atrial fibrillation to apixaban 5 mg twice daily or warfarin for at least 12 months...
June 4, 2013: Circulation
Mark H Ebell
No abstract text is available yet for this article.
August 15, 2017: American Family Physician
Colin P Derdeyn, Marc I Chimowitz, Michael J Lynn, David Fiorella, Tanya N Turan, L Scott Janis, Jean Montgomery, Azhar Nizam, Bethany F Lane, Helmi L Lutsep, Stanley L Barnwell, Michael F Waters, Brian L Hoh, J Maurice Hourihane, Elad I Levy, Andrei V Alexandrov, Mark R Harrigan, David Chiu, Richard P Klucznik, Joni M Clark, Cameron G McDougall, Mark D Johnson, G Lee Pride, John R Lynch, Osama O Zaidat, Zoran Rumboldt, Harry J Cloft
BACKGROUND: Early results of the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis trial showed that, by 30 days, 33 (14·7%) of 224 patients in the stenting group and 13 (5·8%) of 227 patients in the medical group had died or had a stroke (percentages are product limit estimates), but provided insufficient data to establish whether stenting offered any longer-term benefit. Here we report the long-term outcome of patients in this trial...
January 25, 2014: Lancet
Phillip A Low, Victoria A Tomalia
Orthostatic hypotension (OH) occurs when mechanisms for the regulation of orthostatic BP control fails. Such regulation depends on the baroreflexes, normal blood volume, and defenses against excessive venous pooling. OH is common in the elderly and is associated with an increase in mortality rate. There are many causes of OH. Aging coupled with diseases such as diabetes and Parkinson's disease results in a prevalence of 10-30% in the elderly. These conditions cause baroreflex failure with resulting combination of OH, supine hypertension, and loss of diurnal variation of BP...
July 2015: Journal of Clinical Neurology
R J Harvey, M Skelton-Robinson, M N Rossor
OBJECTIVES: To determine the prevalence of dementia in people under the age of 65 in a large catchment area, and use these figures to estimate the number of younger people affected by dementia in the UK. DESIGN: Epidemiological catchment area prevalence survey. SETTING: The London boroughs of Kensington and Chelsea, Westminster, and Hillingdon with a total population of 567500 people. PARTICIPANTS: All residents of the catchment area with dementia, where the illness began before the age of 65 years...
September 2003: Journal of Neurology, Neurosurgery, and Psychiatry
Renata Teles Vieira, Leonardo Caixeta, Sergio Machado, Adriana Cardoso Silva, Antonio Egidio Nardi, Oscar Arias-Carrión, Mauro Giovanni Carta
Presenile Dementia or Early Onset Dementia (EOD) is a public health problem, it differs from Senile Dementia, and encloses a significant number of cases; nevertheless, it is still poorly understood and underdiagnosed. This study aims to review the prevalence and etiology of EOD, comparing EOD with Senile Dementia, as well as to show the main causes of EOD and their prevalence in population and non-population based studies. The computer-supported search used the following databases: Pubmed/Medline, ISI Web of Knowledge and Scielo...
2013: Clinical Practice and Epidemiology in Mental Health: CP & EMH
Mario Masellis, Kayla Sherborn, Pedro Neto, Dessa A Sadovnick, Ging-Yuek R Hsiung, Sandra E Black, Sadhana Prasad, Meghan Williams, Serge Gauthier
This paper summarizes the body of literature about early-onset dementia (EOD) that led to recommendations from the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. A broader differential diagnosis is required for EOD compared with late-onset dementia. Delays in diagnosis are common, and the social impact of EOD requires special care teams. The etiologies underlying EOD syndromes should take into account family history and comorbid diseases, such as cerebrovascular risk factors, that may influence the clinical presentation and age at onset...
July 31, 2013: Alzheimer's Research & Therapy
Dulanji K Kuruppu, Brandy R Matthews
Young-onset dementia is a neurologic syndrome that affects behavior and cognition of patients younger than 65 years of age. Although frequently misdiagnosed, a systematic approach, reliant upon attainment of a detailed medical history, a collateral history, neuropsychological testing, laboratory studies, and neuroimaging, may facilitate earlier and more accurate diagnosis with subsequent intervention. The differential diagnosis of young-onset dementia is extensive and includes early-onset forms of adult neurodegenerative conditions including Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementias, Huntington's disease, and prion disease...
September 2013: Seminars in Neurology
Brendan J Kelley, Bradley F Boeve, Keith A Josephs
BACKGROUND: Onset of dementia before age 45 years presents a difficult clinical circumstance, having a broad differential diagnosis and numerous psychosocial implications for the patient and their family. Few data exist regarding the demographics characterizing this population or the etiologic diagnoses among those affected. OBJECTIVES: To characterize the demographic characteristics and the etiologic causes of dementia with age at onset younger than 45 years. DESIGN: Observational, retrospective, single-cohort study...
November 2008: Archives of Neurology
Jonathan Emberson, Kennedy R Lees, Patrick Lyden, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Ruediger von Kummer, Maarten Lansberg, Richard I Lindley, Gordon Murray, Jean Marc Olivot, Mark Parsons, Barbara Tilley, Danilo Toni, Kazunori Toyoda, Nils Wahlgren, Joanna Wardlaw, William Whiteley, Gregory J del Zoppo, Colin Baigent, Peter Sandercock, Werner Hacke
BACKGROUND: Alteplase is effective for treatment of acute ischaemic stroke but debate continues about its use after longer times since stroke onset, in older patients, and among patients who have had the least or most severe strokes. We assessed the role of these factors in affecting good stroke outcome in patients given alteplase. METHODS: We did a pre-specified meta-analysis of individual patient data from 6756 patients in nine randomised trials comparing alteplase with placebo or open control...
November 29, 2014: Lancet
Yongjun Wang, Yilong Wang, Xingquan Zhao, Liping Liu, David Wang, Chunxue Wang, Chen Wang, Hao Li, Xia Meng, Liying Cui, Jianping Jia, Qiang Dong, Anding Xu, Jinsheng Zeng, Yansheng Li, Zhimin Wang, Haiqin Xia, S Claiborne Johnston
BACKGROUND: Stroke is common during the first few weeks after a transient ischemic attack (TIA) or minor ischemic stroke. Combination therapy with clopidogrel and aspirin may provide greater protection against subsequent stroke than aspirin alone. METHODS: In a randomized, double-blind, placebo-controlled trial conducted at 114 centers in China, we randomly assigned 5170 patients within 24 hours after the onset of minor ischemic stroke or high-risk TIA to combination therapy with clopidogrel and aspirin (clopidogrel at an initial dose of 300 mg, followed by 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days) or to placebo plus aspirin (75 mg per day for 90 days)...
July 4, 2013: New England Journal of Medicine
Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Lucie A van den Berg, Hester F Lingsma, Albert J Yoo, Wouter J Schonewille, Jan Albert Vos, Paul J Nederkoorn, Marieke J H Wermer, Marianne A A van Walderveen, Julie Staals, Jeannette Hofmeijer, Jacques A van Oostayen, Geert J Lycklama à Nijeholt, Jelis Boiten, Patrick A Brouwer, Bart J Emmer, Sebastiaan F de Bruijn, Lukas C van Dijk, L Jaap Kappelle, Rob H Lo, Ewoud J van Dijk, Joost de Vries, Paul L M de Kort, Willem Jan J van Rooij, Jan S P van den Berg, Boudewijn A A M van Hasselt, Leo A M Aerden, René J Dallinga, Marieke C Visser, Joseph C J Bot, Patrick C Vroomen, Omid Eshghi, Tobien H C M L Schreuder, Roel J J Heijboer, Koos Keizer, Alexander V Tielbeek, Heleen M den Hertog, Dick G Gerrits, Renske M van den Berg-Vos, Giorgos B Karas, Ewout W Steyerberg, H Zwenneke Flach, Henk A Marquering, Marieke E S Sprengers, Sjoerd F M Jenniskens, Ludo F M Beenen, René van den Berg, Peter J Koudstaal, Wim H van Zwam, Yvo B W E M Roos, Aad van der Lugt, Robert J van Oostenbrugge, Charles B L M Majoie, Diederik W J Dippel
BACKGROUND: In patients with acute ischemic stroke caused by a proximal intracranial arterial occlusion, intraarterial treatment is highly effective for emergency revascularization. However, proof of a beneficial effect on functional outcome is lacking. METHODS: We randomly assigned eligible patients to either intraarterial treatment plus usual care or usual care alone. Eligible patients had a proximal arterial occlusion in the anterior cerebral circulation that was confirmed on vessel imaging and that could be treated intraarterially within 6 hours after symptom onset...
January 1, 2015: New England Journal of Medicine
Jan D Lünemann, Falk Nimmerjahn, Marinos C Dalakas
Intravenous immunoglobulin (IVIg)-a preparation of polyclonal serum IgG pooled from thousands of blood donors-has been used for nearly three decades, and is proving to be an efficient anti-inflammatory and immunomodulatory treatment for a growing number of neurological diseases. Evidence from controlled clinical trials has established IVIg as a first-line therapy for Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy. IVIg is also an effective rescue therapy in some patients with worsening myasthenia gravis, and is beneficial as a second-line therapy for dermatomyositis and stiff-person syndrome...
February 2015: Nature Reviews. Neurology
Janet C Rucker
Nystagmus is a spontaneous, repetitive movement of the eyes caused by slow eye drifts. Clinical evaluation of nystagmus requires familiarity with the functional classes of eye movements, the types of acquired nystagmus and a differential diagnosis for each type, and the ability to differentiate acquired nystagmus from infantile nystagmus and saccadic intrusions.
February 2010: Seminars in Neurology
Janet C Rucker
Proper evaluation and treatment of acquired nystagmus requires accurate characterization of nystagmus type and visual effects. This review addresses important historical and examination features of nystagmus and current concepts of pathogenesis and treatment of gaze-evoked nystagmus, nystagmus due to vision loss, acquired pendular nystagmus, peripheral and central vestibular nystagmus, and periodic alternating nystagmus.
March 2008: Seminars in Ophthalmology
Stephen M Davis, Geoffrey A Donnan
No abstract text is available yet for this article.
May 17, 2012: New England Journal of Medicine
2014-12-29 17:03:42
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