Neurohospitalist最新文献

{"title":"Corrigendum to \"Elsberg Syndrome with Albuminocytologic Dissociation - A Guillain-Barré Syndrome Mimic or Guillain-Barré Syndrome Variant?\"","authors":"","doi":"10.1177/19418744261475055","DOIUrl":"https://doi.org/10.1177/19418744261475055","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/19418744241233621.].</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261475055"},"PeriodicalIF":0.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flecainide Induced Myoclonus and Severe Asthenia Necessitating Intensive Care Unit Management and Intubation: A Case Report.","authors":"Justin Shewmaker, Andrew Schlachter, Joseph Blunck","doi":"10.1177/19418744261475823","DOIUrl":"10.1177/19418744261475823","url":null,"abstract":"<p><p>Flecainide is class Ic antiarrhythmic drug with a narrow therapeutic range. Adverse drug reactions during flecainide therapy are predominately cardiac in nature. Severe neurological adverse drug reactions have rarely been described. We describe the case of a 71-year-old female who developed myoclonus and severe asthenia requiring intubation and management in the neuroscience intensive care unit. Immediate discontinuation of flecainide and supportive care to allow for drug elimination was the primary treatment. Resolution of flecainide neurotoxicity resolved after 5 days of stopping flecainide. Clinicians should be cognizant of potential neurologic toxicity of flecainide.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261475823"},"PeriodicalIF":0.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Inflammatory Biomarkers for Development of Acute Stroke in Hospitalized COVID-19 Patients.","authors":"Mohsen Sedighi, Mohammad Hasan Shahabi, Maryam Akbarpour, Alireza Amanollahi, Nader Tavakoli, Hamed Basir Ghafouri","doi":"10.1177/19418744261474897","DOIUrl":"10.1177/19418744261474897","url":null,"abstract":"<p><strong>Background and purpose: </strong>COVID-19 neurological complications have been well reported and increased level of interleukin-6 (IL-6) is proposed as a main contributing factor in stroke development. We investigate relationship between inflammatory biomarkers and acute stroke development in COVID-19 patients.</p><p><strong>Methods: </strong>Demographic and clinical data of hospitalized COVID-19 patients including patient characteristics and laboratory biomarkers in stroke patients and controls were comparatively analyzed. Logistic regression analysis was used to analyze predictors of stroke development and receiver-operating characteristic (ROC) curve was used to discriminate main predictors for predicting stroke development.</p><p><strong>Results: </strong>Of the 1753 COVID-19 patients, 20 patients developed acute stroke and 80 patients were also selected as controls. Mean age of stroke patients and controls was 66.32 ± 23.07 and 54.98 ± 16.14, respectively (<i>P</i> = 0.017). Cardiovascular disease was more frequent in stroke patients (<i>P</i> = 0.049). Mean systolic blood pressure in stroke patients and controls respectively was 125.74 ± 17 017 and 118.09 ± 10.52 mmHg (<i>P</i> = 0.020). Mean SpO2 was lower in stroke patients (86.11 ± 4.50 vs 88.68 ± 3.92, <i>P</i> = 0.015) and baseline IL-6 in stroke patients showed a 3-fold increase compared with controls (<i>P</i> = 0.001). ICU admission (<i>P</i> = 0.001), decreased level of consciousness (<i>P</i> = 0.001), length of stay (<i>P</i> = 0.002), and mortality rate (<i>P</i> = 0.001) differed significantly between stroke patients and controls. Age (univariate [OR: 1.03, <i>P</i> = 0.017], multivariate [OR: 1.04, <i>P</i> = 0.019]), SpO2 (univariate [OR: 0.86, <i>P</i> = 0.021], multivariate [OR: 0.82, <i>P</i> = 0.040]), and IL-6 (univariate [OR: 3.62, <i>P</i> = 0.001], multivariate [OR: 5.19, <i>P</i> = 0.001]) were associate with stroke development.</p><p><strong>Conclusions: </strong>High baseline IL-6 level was a potential predictor of stroke development in COVID-19 patients. Also, hypoxia and aging were associated with stroke development.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261474897"},"PeriodicalIF":0.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Oropouche Virus Disease.","authors":"Mary Benson-Gallanis, Lakshmi Chauhan, Amanda L Piquet, Kenneth L Tyler, Daniel M Pastula","doi":"10.1177/19418744261468427","DOIUrl":"10.1177/19418744261468427","url":null,"abstract":"","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261468427"},"PeriodicalIF":0.6,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proprioceptive Stimuli as a Trigger for Leucine-Rich Glioma-Inactivated-1 (LGI1) IgG Associated Autoimmune Seizures, a Case Report.","authors":"Ashutosh Gupta, Miles D Holmes, Divyanshu Dubey, Shirin Jamal Omidi, Megan Goyal, Shitiz Sriwastava, Rajesh K Gupta","doi":"10.1177/19418744261463745","DOIUrl":"10.1177/19418744261463745","url":null,"abstract":"<p><p>Leucine-rich glioma-inactivated-1 (LGI1) IgG-associated autoimmune encephalitis typically presents with faciobrachial dystonic seizures, hyponatremia, and temporal lobe MRI abnormalities. However, the clinical spectrum of LGI1 IgG-associated AE extends beyond these classical features, with reports of diverse seizure semiologies and atypical presentations challenging traditional diagnostic paradigms. This study reports a male in his late 60s presenting with recurrent episodes of right foot cramping and electric shock-like pain, progressing to generalized tonic-clonic seizures. Initial workup suggested chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), but LGI1 IgG antibodies were subsequently detected. Despite treatment with intravenous immunoglobulin (IVIG), the seizures persisted. This case highlights the heterogeneity in LGI1 encephalitis presentations. The patient's proprioceptive-induced reflex seizures represent a rare manifestation of the disease. Treatment with rituximab, a B-cell depleting therapy, resulted in significant improvement, suggesting its potential effectiveness in LGI1 encephalitis with a resistant seizure course. The case also emphasizes the intricate interplay between the mesial temporal lobe, basal ganglia, and frontal regions in LGI1 encephalitis pathophysiology.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261463745"},"PeriodicalIF":0.6,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Health Record-Based Estimates of Acute Disseminated Encephalomyelitis Epidemiology in a Large Healthcare Network, 2000-2025.","authors":"Alexandra Balshi, John P Dempsey, Yanli Zhang-James, Jacob A Sloane","doi":"10.1177/19418744261463751","DOIUrl":"https://doi.org/10.1177/19418744261463751","url":null,"abstract":"<p><strong>Background: </strong>Acute disseminated encephalomyelitis (ADEM) is a rare, rapidly progressive, immune-mediated demyelinating disorder with limited contemporary data describing its epidemiology in adults and real-world uptake of myelin oligodendrocyte glycoprotein (MOG) autoantibody testing.</p><p><strong>Methods: </strong>We used the TriNetX global collaborative network (112 contributing healthcare organizations) to estimate ADEM prevalence and incidence rates from 2000 to 2025, both overall and stratified by age of onset, sex, race, and ethnicity. We also assessed uptake of MOG autoantibody testing among people with an ADEM diagnosis code.</p><p><strong>Results: </strong>We identified 4911 ADEM cases among 153,342,461 individuals from 2000 to 2025. Overall period prevalence was 3.26 (95% CI [confidence interval] 3.17-3.35) per 100,000 persons and overall incidence rate was 0.63 per 100,000 person-years (95% CI: 0.61-0.65). ADEM diagnosis codes were most frequently recorded in those ≤14 years old. Estimated were similar between sexes, lower among Black compared to White individuals, but similar across other racial groups and ethnicities. Only 11% of ADEM-coded individuals had documented MOG autoantibody testing.</p><p><strong>Conclusion: </strong>In a large, real-world, electronic health record network, ADEM diagnosis codes were most frequently recorded in children, though cases were observed across the adult age range. MOG autoantibody testing was uncommon.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261463751"},"PeriodicalIF":0.6,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Images in Clinical Neurology: A Case of Poorly Differentiated Chondrosarcoma.","authors":"Nikolas Toksoy, Matthew Smith, Nathaniel Mohney","doi":"10.1177/19418744261461690","DOIUrl":"https://doi.org/10.1177/19418744261461690","url":null,"abstract":"","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261461690"},"PeriodicalIF":0.7,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Problem Solving: A 35-Year-Old Pregnant Woman With Subacute Encephalopathy.","authors":"Parth A Patel, Giandor Saltz, Jing Wang, Hamid Ali, Fenwick Nichols, Zachery Rohm","doi":"10.1177/19418744261461695","DOIUrl":"https://doi.org/10.1177/19418744261461695","url":null,"abstract":"<p><p>A previously healthy 35-year-old woman in her third trimester of pregnancy presented with 2 weeks of progressive cognitive dysfunction, behavioral changes, and headache. Neurological examination was nonfocal, without evidence of meningeal irritation. Brain MRI showed multifocal punctate diffusion-restricting lesions in the subcortical white matter. The etiology was initially unclear despite extensive testing, Several days later, the patient presented again with worsening symptoms and interval radiographic progression. Ultimately, the constellation of clinical features and diagnostic findings suggested a unifying diagnosis. We discuss her clinical course and highlight the diagnostic reasoning. This case emphasizes the importance of maintaining a broad differential diagnosis and integrating evolving clinical and radiographic features, while balancing pregnancy-specific diagnostic and therapeutic considerations, in the evaluation of subacute encephalopathy.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261461695"},"PeriodicalIF":0.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13259886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance Use and Toxicology Screening in Young Adults With Acute Ischemic Stroke.","authors":"Emily R Fisher, Chad M Aldridge, Rohini Bhole, Bradford B Worrall, Christopher Holstege, Nassima Ait-Daoud Tiouririne, Karen C Johnston","doi":"10.1177/19418744261459528","DOIUrl":"https://doi.org/10.1177/19418744261459528","url":null,"abstract":"<p><strong>Background and purpose: </strong>Substance use is rising among young adults with stroke. We aimed to assess the prevalence of substance use, and the use of toxicology screening in the diagnostic evaluation, for young individuals with acute ischemic stroke (AIS) at a single comprehensive stroke center.</p><p><strong>Methods: </strong>This retrospective study was conducted at a single comprehensive stroke center in individuals ages 18 to 55 years old with AIS from 2020-24. Cases of AIS and recent substance use, or the use of cocaine, methamphetamine, marijuana, opioids, or other illicit substances within 30 days of admission, were compared to those with AIS and no substance use. Descriptive statistics and least absolute shrinkage and selection operator (LASSO) modeling were completed to evaluate predictors of toxicology screening.</p><p><strong>Results: </strong>Of 425 encounters screened, 307 were eligible for inclusion. Recent substance use was documented in 21.5% of encounters. Individuals with recent substance use were younger (median age 46 vs 51 years old in controls). Toxicology screens were ordered for 29.3% of all encounters, and in 27.9% of cryptogenic strokes. Models did not identify a variable that predicted the performance of toxicology screening.</p><p><strong>Conclusions: </strong>Recent substance use was documented in about 1 in 5 young individuals with AIS. Further research is needed to understand the relationship between AIS and substance use, and the appropriate use of toxicology screening in stroke care.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261459528"},"PeriodicalIF":0.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital Resource Use in Ischemic Stroke: Rising Costs and Extended Stays in the U.S. From 2016 to 2022.","authors":"Mian Urfy, Mariam Tariq Mir","doi":"10.1177/19418744261455207","DOIUrl":"https://doi.org/10.1177/19418744261455207","url":null,"abstract":"<p><strong>Background and purpose: </strong>Understanding trends in hospital length of stay (LOS) and costs for ischemic stroke is essential for improving care delivery and resource allocation. We evaluated national trends from 2016 to 2022, with a focus on the COVID-19 pandemic.</p><p><strong>Methods: </strong>We performed a retrospective analysis using the National Inpatient Sample including adults (≥18 years) with a primary diagnosis of ischemic stroke (ICD-10-CM I63.x). Hospital charges were converted to estimated costs using cost-to-charge ratios and adjusted to 2022 U.S. dollars. Trends were compared between pre-COVID (2016-2019) and COVID-era (2020-2022) periods. Illness severity was stratified by the APR-DRG index, and Pearson correlation assessed the relationship between annual mean LOS and costs.</p><p><strong>Results: </strong>Among 953 325 ischemic stroke hospitalizations, mean LOS rose from 6.4 days in 2016 to 7.8 days in 2022. Mean hospital costs increased from $19,014 to $28,733 over the same period. COVID-era hospitalizations had significantly higher LOS (7.44 vs 6.47 days; <i>P</i> < 0.001) and costs ($27,006 vs $20,568; <i>P</i> < 0.001) compared to pre-COVID admissions. Annual mean LOS and costs were strongly correlated (r = 0.974, <i>P</i> < 0.001), and greater illness severity was associated with longer LOS and higher costs.</p><p><strong>Conclusions: </strong>Hospital LOS and costs for ischemic stroke increased markedly from 2016 to 2022, with a sharp rise during the COVID-19 period. While LOS and costs were strongly correlated, additional factors-including illness severity, complication rates, and treatment complexity-likely contribute to rising expenditures. These findings underscore economic burden of stroke care and need for efficient inpatient care models.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744261455207"},"PeriodicalIF":0.7,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13212420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}