International Journal of Neurology and Neurotherapy最新文献

{"title":"Unusual Simultaneous Occurrence of Cerebral Arterial and Venous Thromboembolism in the Setting of Antithrombin 3 (AT3) Deficiency","authors":"K. Ajit, Malhotra Vickrant","doi":"10.23937/2378-3001/1410115","DOIUrl":"https://doi.org/10.23937/2378-3001/1410115","url":null,"abstract":"","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78372648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed Cerebral Coil Found in Peripheral Circulation after Endovascular Embolization: A Rare Complication and Review","authors":"Shaikh Nissar, Nawaz Shoaib, A. Sumayya, Khan Adnan, Alkubaisi Aisha, Momin Umais Zaid, Thabet Abdulnasser","doi":"10.23937/2378-3001/1410112","DOIUrl":"https://doi.org/10.23937/2378-3001/1410112","url":null,"abstract":"Endovascular embolization of cerebral aneurysm is common in clinical practice. The rare complication of endovascular embolization is coil misplacement. Most of the reported coil misplacements occur due to premature release of a coil into the cerebral circulation. We report a case of a coil lost into the peripheral circulation due to failed detachment from the micro-catheter at the right place. Case: A young lady without medical history, presented at the emergency department with severe headache. Her consciousness level deteriorated, and her GCS dropped to 5, requiring immediate intubation, sedation and ventilation. Computer tomography and angiography showed a giant supraclinoid aneurysm of the left internal carotid artery. She was taken for endovascular coiling under general anesthesia and one coil was successfully inserted in the aneurysm. During the insertion of the second coil, it was not possible to detach the coil from the micro-catheter, the coil got stuck at the level of the carotid bifurcation and after several failed attempts to remove it, the coil was swept away into the general circulation and went undetected on fluoroscopy. Next day extremity X-ray showed the coil in the left popliteal artery. Patient was taken for angiography, the misplaced coil was successfully removed and the aneurysm was completely embolized. Her condition improved with supportive care and by day 14 she was successfully extubated and discharged home after another week. Conclusion: During embolization coil can fail to get detached from the catheter and can go into the peripheral circulation.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84418224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not All Severe Primary Headaches are Migraines - Tension Type Headaches are Far More Common Yet often Labelled as Migraines","authors":"G. BeranRoy","doi":"10.23937/2378-3001/1410111","DOIUrl":"https://doi.org/10.23937/2378-3001/1410111","url":null,"abstract":"Introduction: This paper reinforces the concept that headaches reside on a continuum with migraine type headache at one end of the spectrum and Tension Type Headache (TTHs) at the other with what used to be referred to as tension/vascular headaches, along that continuum. Background information: This brief overview of headaches is based upon almost half a century of clinical neurological experience by the author, rather than an in depth analysis of definitions and is also dependent upon impressions of patient responses to treatment. Results: Based upon clinical experience, one of the most common complaints that present to the neurologist is that of chronic headache, or headache in general, and so long as the headache is significantly intrusive it is referred to the consultant as a case of migraine even if the evidence favours an alternative headache type such as TTH. Discussion: This paper confirms the concept, demonstrated in previous studies, that there is a continuum spectrum of headache types, with patients moving along that continuum with changing presentations at various times during a long history of headaches.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88022076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Oblique Subcostal Transversus Abdominis Plane Block Effectiveness in Amyotrophic Lateral Sclerosis Patients Undergoing Laparoscopic Cholecystectomy","authors":"O. Serhat, Topcu Hulya","doi":"10.23937/2378-3001/1410106","DOIUrl":"https://doi.org/10.23937/2378-3001/1410106","url":null,"abstract":"ALS is a rare motor neuron disease. Since surgical procedures exacerbate ALS, surgical procedures are not usually applied except in the necessary cases. Pulmonary complications are the main cause of mortality in ALS patients, because respiratory and swallowing muscles may be affected. Although opioids provide effective analgesia, they are not the best choice in ALS patients because they can cause nausea-vomiting and have negative effects on respiratory functions. Oblique Subcostal Transversus Abdominis Plane Block provides highly effective analgesia in laparoscopic cholecystectomy operations. In this case report, we evaluated the effectiveness of the OSTAP block in ALS patients, which is one of the rare diseases and rarely underwent Laparoscopic Cholecystectomy. As far as we know, this case report is the first and only in literature. Laparoscopic Cholecystectomy was performed under general anesthesia on a 56-year-old male patient. Unilateral OSTAP block (30 ml 0.25%) was applied. The patient's postoperative 10th-hour pain score was 4, and 75 mg diclofenac sodium i.m. administered. The patient did not need any other analgesics. In this case; we detected that the OSTAP block provides effective analgesia.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75989261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial Hemorrhage Associated with Sildenafil Use: A Very Rare Complication","authors":"M. Guntel, H. Can, Fatma Gok, Goncagul Tangulec, Unal Balikel, Nur Usta Busra","doi":"10.23937/2378-3001/1410099","DOIUrl":"https://doi.org/10.23937/2378-3001/1410099","url":null,"abstract":"Intracerebral hemorrhage (ICH) (International Classification of Diseases, 9th Revision) is a neurological deficit documented by brain CT or MRI showing the presence of an intracranial bleed in the parenchyma of the brain. ICH is a serious cerebrovascular condition associated with high mortality and morbidity in adults It can be classified as primary and secondary according to etiology. Primary intracranial hemorrhage often develops due to hypertension or amyloid angiopathy. Secondary intracranial hemorrhage causes are often tumor, aneurysm and vascular anomalies. Trauma is the most common reason of seconder ICH. Sildenafil citrate is a potent vasodilator agent used in the treatment of erectile dysfunction. Among its side effects, intracranial hemorrhage is a very rare complication. We present a case of a 54-year-old patient who was brought to the emergency department due to nausea, vomiting and confusion after the use of sildenafil. The patient was diagnosed with intracranial hemorrhage in the setting of sildenafil use after excluding other causes.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87367779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CANOMAD: A Multi-Faceted Disease","authors":"Júlia Machado Rickli, Gabriela Pomaleski, M. Gonçalves","doi":"10.20944/preprints202004.0303.v1","DOIUrl":"https://doi.org/10.20944/preprints202004.0303.v1","url":null,"abstract":"Objective: Elucidate the main clinical aspects of the CANOMAD spectrum. Methods: Bibliographical review trough databases (PubMed, Google Scholar, Orphanet, Oxford Academic) of articles from 1985 (1) to 2019 and later selection of the most applicable of the above, in order to construct a non-systematic review. Conclusion: CANOMAD is a chronic-ataxic autoimmune neuropathy associated with IgM monoclonal gammopathy. The correct diagnosis of this rare and multi-faceted disease will help optimal treatment.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91142186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications as Poor Prognostic Factors in Patients with Hemorrhagic Stroke: A Hospital-Based Stroke Registry","authors":"P. Taslim, Wijaya Vincent Ongko","doi":"10.23937/2378-3001/1410096","DOIUrl":"https://doi.org/10.23937/2378-3001/1410096","url":null,"abstract":"Introduction: Stroke patients commonly experience various medical complications during their rehabilitation stay. Understanding complications in hemorrhagic stroke patients can determine the patient’s prognosis. Aim: This study aimed to explore complications as prognostic factors among patients with hemorrhagic stroke. Methods: This was an observational analytic study with retrospective design. We analyzed the medical records of 480 patients admitted with hemorrhagic stroke between 2017 and 2018 at Bethesda Hospital, Indonesia. Disability, mortality, and length of stay (LoS) were assessed as clinical outcomes for this study. Multivariate logistic regression was used to analyze the data. Results: The data were obtained from 480 patients with hemorrhagic stroke that majority of males (58.5%), with ≤ 60-years-old (52.3%), stroke onset > 3 hours (87.5%), and had stroke for the first time (82.9%). The most common complications were GI tract bleeding (19.8%), whereas the least was decubitus ulcer (1.5%). There were 25.8% patients died during hospitalization period. Among 356 survivors, there were no significant prognosis factors of disability in subjects. Logistic regression found stroke onset ≥ 3 hours (OR: 0.34; 95% CI: 0.19-0.59; p ≤ 0.001) and GI tract bleeding (OR: 30.8; 95% CI: 16.93-55.88; p ≤ 0.001) to be an independent predictors of mortality in hemorrhagic stroke, whereas GI tract bleeding (OR: 0.54; 95% CI: 0.31-0.95; p = 0.03) and UTI (OR: 4.73; 95% CI: 1.11-20.1; p = 0.04) were also an independent predictors of prolonged length of stay in hemorrhagic stroke. Conclusion: This study identify complications as prognostic factors in hemorrhagic stoke patients. Stroke onset > 3 hours, GI tract bleeding, and UTI were independent predictors of poor prognosis in hemorrhagic stroke. There was no prognosis factor that affects disability in subjects.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81195261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological Warfare and Snake Venom for Poliomyelitis and ALS: The Little Known Entwined History of Failed Ethics and a Reasonable Therapeutic Hypothesis","authors":"M RiveraVictor","doi":"10.23937/2378-3001/1410092","DOIUrl":"https://doi.org/10.23937/2378-3001/1410092","url":null,"abstract":"This paper describes a complicated history taken place during World War II (WWII) when military intentions for acquiring biological weapon superiority knowledge was obtained in some cases through atrocious investigations in human beings disregarding ethical and moral principles. After the war, Murray Sanders (1910-1988), a young military officer and American scientist became incidentally entwined with the U.S. military concern over the Japanese bacteriological knowledge, unbeknown by the Allies that was being acquired through human experiments. In a second stage of his career (between 1949 and 1983), Sanders investigated the potential therapeutic characteristics of snake venom, obtained several U.S. patents on the formulation and an Investigational New Drug (IND) license from the Food and Drug Administration (FDA). While he was well-intentioned and cared for his patients, Sanders utilized protocols non-sanctioned by Independent Ethics Committees and openly administered detoxified snake venom neurotoxin or Modified Neurotoxin (MNT) to patients with poliomyelitis and later used it in Amyotrophic Lateral Sclerosis (ALS). While Sanders reported “partial” efficacy of MNT in ALS this was not confirmed with placebo-controlled, IRB-approved clinical trials. Two well-designed placebo-controlled clinical trials performed by independent institutions sanctioned by the FDA and approved by their respective Institutional Review Boards did not yield positive results. Findings were reported in the neurological literature. Later in life Sanders was requested to testify in a Congressional Hearing on the WWII Japanese bacteriological warfare experiments and the U.S. strategy to condone culpability of war crimes in exchange for military information. This article reflects on a scientific effort spanning through several epochs and personae interacting with diverse philosophies and different objectives performing research in human beings. *Corresponding author: Victor M Rivera, MD, FAAN, Distinguished Emeritus Professor, Department of Neurology, Baylor College of Medicine, Houston, Texas, USA ReView ARticle","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"126 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76152979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromodulation for Drug-Refractory Epilepsy and Chronic Heart Failure: Targets, Delivery, Composition and Titration","authors":"Anand Inder S, Konstam Marvin A, Ardell Jeffrey L, Libbus Imad, DiCarlo Lorenzo A, Mann Douglas L","doi":"10.23937/2378-3001/1410091","DOIUrl":"https://doi.org/10.23937/2378-3001/1410091","url":null,"abstract":"Background: Vagus nerve stimulation (VNS) is used currently in the management of drug-refractory epilepsy (DRE), and is in development for treating chronic heart failure (HF). HF is accompanied by autonomic nervous system (ANS) dysfunction, consisting of sustained sympathetic hyper-activation and withdrawal of parasympathetic tone, and associated with progressive worsening of cardiovascular (CV) function and increased morbidity and mortality. We sought to compare how VNS is utilized for DRE and may potentially be employed for HF. Methods: A search was conducted in PubMed for all published articles using the search terms “vagus” OR “vagal” OR “VNS” AND “epilepsy”, and a separate search used similar search terms AND “heart failure”. Further filtering yielded the articles available as free full text, and clinical trial, prospective study, and retrospective study publications. The final selection of clinical trial/study publications in epilepsy or HF was based upon at least 3 months of follow-up and exclusion of pediatric studies. Additional information was obtained subsequently from references within these publications, and technical manuals available in the public domain. Results: For DRE, VNS is administered via the left cervical vagus nerve (CVN), and directed toward the central nervous system (CNS). No known biomarkers exist currently for real-time VNS adjustment. VNS is titrated empirically, using large and infrequent adjustments of VNS intensity and based upon achieving long term reduction in seizure frequency (RSF) and/or reaching the maximum tolerated VNS intensity. A significantly greater mean RSF has been observed after 3 months of VNS delivery using pulse frequency 30 Hz and duty cycle 9% (30 seconds on, 5 minutes off) when compared to using 1 Hz and duty cycle 14% (30 seconds on, 3 minutes off). A further reduction of mean RSF has been observed after 12 months by increasing the pulse frequency at 3 months from 1 to 30 Hz. For HF, VNS has been administered via the left or right CVN, targeting both the CNS and/or peripheral hierarchical autonomic reflex arcs that control cardiovascular function. Real-time changes in heart rate dynamics (HR and HR variability) have served as a biomarker of ANS engagement (ANSE) for titration. Titration to ANSE has been completed in 2.5 (median; range 1.6-3.6) months using 10 Hz and duty cycle 23% (18 seconds on, 1 minute off), using smaller and more frequent adjustments of VNS intensity, and has been associated with significant improvements after 6 months in HR, HR variability, CV function, and HF symptoms. Use of 1 Hz may have less clinical efficacy than occurs with a higher pulse frequency, however, intolerable side effects have occurred before ANSE using 20 Hz. Conclusions: Neuromodulation for the treatment of epilepsy and HF is not a one-size-fits-all therapy. The magnitude of long term reduction of seizure frequency in DRE, and improvements in function and symptoms in HF, may have a potential dose-depe","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78307873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Female Patient with Anti-Muscle-Specific Kinase Antibody Positive Generalized Myasthenia Gravis Responded to Salbutamol but not Pyridostigmine: A Case Report","authors":"Konishi Tetsuro","doi":"10.23937/2378-3001/1410090","DOIUrl":"https://doi.org/10.23937/2378-3001/1410090","url":null,"abstract":"Anti-muscle-specific kinase (MuSK) antibody positive generalized myasthenia gravis (MuSK-MG) is an autoimmune disease, in which deterioration of myasthenic symptoms may occur by cholinesterase inhibitor (ChE-I) treatment. Salbutamol, a sympathetic β2 receptor agonist, was an effective therapeutic drug in congenital myasthenic syndrome patients with MuSK gene abnormalities and in MuSK-MG animal model. Salbutamol was attempted to treat a female MuSK-MG patient who did not respond to ChE-I. Any acute benefit of salbutamol was not observed but her myasthenic symptoms gradually improved over a year without adversive effects. Salbutamol may be a therapeutic drug to alleviate myasthenic symptoms in MuSK-MG patients.","PeriodicalId":14172,"journal":{"name":"International Journal of Neurology and Neurotherapy","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73268090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}