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PRACTICAL NEUROLOGY最新文献

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Cavernous sinus thrombosis: then and now.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-22 DOI: 10.1136/pn-2024-004396
Christopher Y Itoh, Eelco F M Wijdicks
{"title":"Cavernous sinus thrombosis: then and now.","authors":"Christopher Y Itoh, Eelco F M Wijdicks","doi":"10.1136/pn-2024-004396","DOIUrl":"https://doi.org/10.1136/pn-2024-004396","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883174","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}
引用次数: 0
Tetrodotoxin toxicity: an increasing threat. 河豚毒素中毒：威胁与日俱增。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-14 DOI: 10.1136/pn-2024-004368
Emily Burton, Alastair Ward, Lachlan Tamlin, Shaddy El-Masri, Rudy Goh, Roula Ghaoui, Stephen Bacchi
{"title":"Tetrodotoxin toxicity: an increasing threat.","authors":"Emily Burton, Alastair Ward, Lachlan Tamlin, Shaddy El-Masri, Rudy Goh, Roula Ghaoui, Stephen Bacchi","doi":"10.1136/pn-2024-004368","DOIUrl":"https://doi.org/10.1136/pn-2024-004368","url":null,"abstract":"<p><p>A man aged in his sixties presented to the emergency department with vomiting, dizziness and generalised weakness preceded by perioral and peripheral paraesthesias for several hours. He did not speak English and was visiting from overseas. Examination revealed multidirectional nystagmus, subtle bilateral ptosis, marked bilateral upper limb dysmetria and heel-shin ataxia, with mild proximal limb weakness. Brain imaging was unremarkable. Further history revealed the man had gone fishing and eaten a fish he had caught earlier that day. He was subsequently diagnosed with tetrodotoxin toxicity from pufferfish ingestion. He was managed supportively and made a complete recovery. Tetrodotoxicity has been hitherto considered rare outside of Southeast Asia, but rising water temperatures and human interventions have facilitated the migration of marine species containing tetrodotoxin to a wider geographical range.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824660","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}
引用次数: 0
Neurogenic disease with high CK: think muscle.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-05 DOI: 10.1136/pn-2024-004401
Andrea Barp, Paola Tonin, Salvatore Stano, Gaetano Nicola Vattemi, Marta Cheli, Giulia Marchetto, Matteo De Iorio, Riccardo Zuccarino
{"title":"Neurogenic disease with high CK: think muscle.","authors":"Andrea Barp, Paola Tonin, Salvatore Stano, Gaetano Nicola Vattemi, Marta Cheli, Giulia Marchetto, Matteo De Iorio, Riccardo Zuccarino","doi":"10.1136/pn-2024-004401","DOIUrl":"https://doi.org/10.1136/pn-2024-004401","url":null,"abstract":"<p><p>HyperCKaemia is common in several myopathies but can accompany other disorders, including neuropathies. However, distinguishing neurogenic from myopathic hyperCKaemia is not always straightforward. A 58-year-old man had experienced muscle cramps and fatiguability since aged 3 years, with persistently high serum creatine kinase (CK). A positive family history prompted genetic testing for Charcot-Marie-Tooth disease type 1A, which was positive. However, his serum CK remained persistently high and neurological examination 17 years later identified diffuse muscle atrophy and weakness. Genetic testing for dystrophinopathy identified a novel missense variant on the <i>DMD</i> gene. Patients whose serum CK is in 'myopathic range', even those with definite neurogenic disease, should be investigated for additional myopathy, since this may require additional monitoring for pulmonary and cardiac complications.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787371","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}
引用次数: 0
Sniffed levamisole-adulterated cocaine mimicking acute demyelinating encephalomyelitis.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-04 DOI: 10.1136/pn-2024-004343
Joshua Yap, Kayla Ward, Simon Broadley
{"title":"Sniffed levamisole-adulterated cocaine mimicking acute demyelinating encephalomyelitis.","authors":"Joshua Yap, Kayla Ward, Simon Broadley","doi":"10.1136/pn-2024-004343","DOIUrl":"https://doi.org/10.1136/pn-2024-004343","url":null,"abstract":"<p><p>A 38-year-old man developed headache, dysarthria and dysphasia after insufflation of cocaine. Brain imaging showed multiple white matter lesions, suggesting acute disseminated encephalomyelitis (ADEM), but the clinical features were atypical for demyelination. These lesions may represent a levamisole-associated vascular endotheliopathy, with a mechanism similar to posterior reversible encephalopathy syndrome. Levamisole is a no longer used chemotherapeutic agent but is a legally acquirable veterinary antihelminthic and is often used to adulterate cocaine. Given the rise in cocaine-related hospitalisations, this case raises awareness of an important ADEM mimic.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781597","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}
引用次数: 0
Progressive tetraparesis and bulbar symptoms.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-04 DOI: 10.1136/pn-2024-004394
Carolina Cunha, Henrique Coimbra de Lemos Queirós, Marco Almeida, Daniela Pereira, João Parente Freixo, Patrícia Marques, Fernando Matias, João Durães
{"title":"Progressive tetraparesis and bulbar symptoms.","authors":"Carolina Cunha, Henrique Coimbra de Lemos Queirós, Marco Almeida, Daniela Pereira, João Parente Freixo, Patrícia Marques, Fernando Matias, João Durães","doi":"10.1136/pn-2024-004394","DOIUrl":"https://doi.org/10.1136/pn-2024-004394","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781596","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}
引用次数: 0
Visual allesthesia as manifestation of migraine aura.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-03 DOI: 10.1136/pn-2024-004381
Márcio Pinheiro Lima, José Luiz Pedroso, Orlando G P Barsottini, Flavio Moura Rezende Filho
{"title":"Visual allesthesia as manifestation of migraine aura.","authors":"Márcio Pinheiro Lima, José Luiz Pedroso, Orlando G P Barsottini, Flavio Moura Rezende Filho","doi":"10.1136/pn-2024-004381","DOIUrl":"https://doi.org/10.1136/pn-2024-004381","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773231","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}
引用次数: 0
Neurological Sweet's syndrome: a rare but treatable manifestation of an autoinflammatory disease.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-03 DOI: 10.1136/pn-2024-004379
Gareth Zigui Lim, Jiekai Tan, Joyce Siong-See Lee, Xin Rong Lim, Tianrong Yeo
{"title":"Neurological Sweet's syndrome: a rare but treatable manifestation of an autoinflammatory disease.","authors":"Gareth Zigui Lim, Jiekai Tan, Joyce Siong-See Lee, Xin Rong Lim, Tianrong Yeo","doi":"10.1136/pn-2024-004379","DOIUrl":"https://doi.org/10.1136/pn-2024-004379","url":null,"abstract":"<p><p>Sweet's syndrome is an autoinflammatory disease characterised by systemic symptoms and a cutaneous neutrophilic dermatosis. Neurological involvement is rare but important to recognise. Patients may have headache, confusion, seizures, and focal neurological deficits; MR brain scanning may show widespread T2-hyperintense lesions, with a CSF pleocytosis. Clinicians should suspect neurological Sweet's syndrome in patients with central nervous system dysfunction, who have unexplained fever or systemic inflammation, and a pustular neutrophilic dermatosis. The condition responds well to corticosteroids, which can prevent long-term neurological sequalae.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773227","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}
引用次数: 0
Somatosensory evoked potentials: technique, interpretation and clinical applications.
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-12-03 DOI: 10.1136/pn-2024-004179
Aicee Dawn Calma, James Triplett, Steve Vucic, Con Yiannikas
{"title":"Somatosensory evoked potentials: technique, interpretation and clinical applications.","authors":"Aicee Dawn Calma, James Triplett, Steve Vucic, Con Yiannikas","doi":"10.1136/pn-2024-004179","DOIUrl":"https://doi.org/10.1136/pn-2024-004179","url":null,"abstract":"<p><p>Somatosensory evoked potentials (SSEPs) are electrical potentials that measure various parts of the ascending somatosensory pathways. They are elicited through stimulating mixed nerves, with subsequent orthodromic stimulation of sensory nerves. Despite advances in imaging, SSEPs complement both the clinical examination and peripheral neurophysiological studies when assessing the functional integrity of the sensory pathways, being especially helpful when imaging is inconclusive. We describe the technique of performing SSEPs and the anatomical substrates of their waveforms, and we highlight important clinical applications both in central and peripheral nervous system disorders.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773229","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}
引用次数: 0
Neurological complications of immune checkpoint inhibitors: a practical guide. 免疫检查点抑制剂的神经并发症：实用指南。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-11-26 DOI: 10.1136/pn-2024-004327
Aisling S Carr, Frederick William Vonberg, Shiwen Koay, Kate Young, Heather Shaw, Anna Olsson-Brown, Mark Willis
{"title":"Neurological complications of immune checkpoint inhibitors: a practical guide.","authors":"Aisling S Carr, Frederick William Vonberg, Shiwen Koay, Kate Young, Heather Shaw, Anna Olsson-Brown, Mark Willis","doi":"10.1136/pn-2024-004327","DOIUrl":"https://doi.org/10.1136/pn-2024-004327","url":null,"abstract":"<p><p>Immune checkpoint inhibition unleashes the power of the immune system against tumour cells. Immune checkpoint inhibitors (ICIs) block the inhibitory effects of cytotoxic T-lymphocyte associated protein 4, programmed death protein 1, programmed death ligand 1 and lymphocyte activation gene 3 molecules on T-cells, and so enhance physiological cytotoxic effects. ICIs can significantly improve survival from cancers, including those previously associated with poor treatment response, such as metastatic melanoma. However, on-target off-tumour effects of ICIs result in immune-related adverse events. These toxicities are common and require new multidisciplinary expertise to manage. ICI neurotoxicity is relatively rare but ominous due to its severity, heterogenous manifestations and potential for long-term disability. Neurotoxic syndromes are novel and often present precipitously. Here, we describe ICI mechanisms of action, their impact on cancer outcomes and their frequency of immune-related adverse events. We focus particularly on neurotoxicity. We discuss the current appreciation of neurotoxic syndromes, management strategies and outcomes based on clinical expertise and consensus, multi-specialty guidance. The use of immunotherapy is expanding exponentially across multiple cancer types and so too will our approach to these cases.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733122","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}
引用次数: 0
Isolated optic nerve relapse in T-cell acute lymphoblastic leukaemia. T 细胞急性淋巴细胞白血病的孤立性视神经复发。
IF 2.4
PRACTICAL NEUROLOGY Pub Date : 2024-11-21 DOI: 10.1136/pn-2024-004375
Isana Nakajima, Yuko Shirouchi, Yuka Morita, Hideki Tsuji
{"title":"Isolated optic nerve relapse in T-cell acute lymphoblastic leukaemia.","authors":"Isana Nakajima, Yuko Shirouchi, Yuka Morita, Hideki Tsuji","doi":"10.1136/pn-2024-004375","DOIUrl":"https://doi.org/10.1136/pn-2024-004375","url":null,"abstract":"","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693777","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}
引用次数: 0
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