Neurologist最新文献_第9页

Feasibility and Clinical Outcome Predictors of Mechanical Thrombectomy in Distal Arterial Occlusion Causing Acute Ischemic Stroke: A Monocentric Retrospective Study. 机械取栓治疗远端动脉闭塞引起急性缺血性脑卒中的可行性和临床预后预测:一项单中心回顾性研究。

IF 1.1 4区医学

Neurologist Pub Date : 2024-07-01 DOI: 10.1097/NRL.0000000000000543

Beihai Ge, Limei Pan, Huihua Liu

{"title":"Feasibility and Clinical Outcome Predictors of Mechanical Thrombectomy in Distal Arterial Occlusion Causing Acute Ischemic Stroke: A Monocentric Retrospective Study.","authors":"Beihai Ge, Limei Pan, Huihua Liu","doi":"10.1097/NRL.0000000000000543","DOIUrl":"10.1097/NRL.0000000000000543","url":null,"abstract":"Background: The feasibility and clinical outcome predictors of mechanical thrombectomy (MT) for strokes caused by distal arterial occlusion (DAO) remain the subject of debate.Methods: A retrospective analysis was conducted of patients with consecutive acute ischemic stroke treated using MT. Clinical and procedural-associated factors were studied to compare the efficacy, safety, and short-term and long-term outcomes of MT between the proximal arterial occlusion (PAO) and DAO groups. The predictors of a good functional outcome in the DAO group were also identified.Results: A total of 116 patients were included in this study, of whom 23 (19.8%) underwent MT for DAO. A higher complete recanalization rate was independently associated with PAO in adjusted models [adjusted odds ratio, 0.596; 95% CI, 0.377-0.941]. The measures of safety and clinical outcome showed no significant differences between the DAO and PAO groups. The National Institute of Health stroke scale (NIHSS) score on admission, hybrid technique use, and complete recanalization rate emerged as independent predictors of a good functional outcome in the DAO group.Conclusions: The efficacy, safety, and short-term and long-term outcomes of DAO thrombectomy were similar to those of PAO thrombectomy. The good functional outcome predictors of MT in DAO included NIHSS on admission, hybrid technique use, and complete recanalization. Overall, the findings lead us to propose that MT may be considered a feasible option for treating DAO after a careful risk-benefit analysis.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"212-217"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11219071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cerebral Tumefactive Inflammatory Lesion Occurrence During Ixekizumab Treatment in a Patient With Active Psoriatic Arthritis. 一名活动性银屑病关节炎患者在伊克珠单抗治疗期间出现脑肿瘤性炎症病变

IF 1.1 4区医学

Neurologist Pub Date : 2024-07-01 DOI: 10.1097/NRL.0000000000000551

Antonio Marangi, Francesco Benvenuti, Linda Mazzai, Giulio Riva, Diana Polo, Ilaria Franceschetti, Pierino De Sandre, Mariano Agostino Zanusso, Giovanni Scanelli, Francesco Perini

{"title":"Cerebral Tumefactive Inflammatory Lesion Occurrence During Ixekizumab Treatment in a Patient With Active Psoriatic Arthritis.","authors":"Antonio Marangi, Francesco Benvenuti, Linda Mazzai, Giulio Riva, Diana Polo, Ilaria Franceschetti, Pierino De Sandre, Mariano Agostino Zanusso, Giovanni Scanelli, Francesco Perini","doi":"10.1097/NRL.0000000000000551","DOIUrl":"10.1097/NRL.0000000000000551","url":null,"abstract":"Introduction: Ixekizumab is an anti-interleukin-17A (IL-17A) humanized monoclonal antibody approved for the treatment of moderate-to-severe plaque psoriasis, active psoriatic arthritis, and ankylosing spondylitis. Central nervous system inflammatory manifestations are atypical during therapy with IL-17A inhibitors, with only one case of myelitis described to date.Case report: A 72-year-old man with a medical history of active psoriatic arthritis was admitted to our department owing to the acute onset of left face numbness 1 month after the first ixekizumab administration. Magnetic resonance imaging of the brain displayed a large T2-hyperintense infratentorial lesion involving the root of the fifth and seventh left cranial nerves. A thorough laboratoristic and instrumental work-up did not show elements suggestive of extracerebral neoplasms or infections. Therefore, neuronavigation-assisted brain biopsy was performed, and histologic analysis of the lesion revealed the presence of wide aggregates of foamy histiocytes diffusely infiltrating the brain parenchyma, in the absence of malignant tissue or histologic elements suggestive of central nervous system infections or primary histiocytoses. Steroid treatment (dexamethasone 8 mg/daily) was then administered with subsequent clinical amelioration. One month after hospital discharge, a brain magnetic resonance imaging showed a nearly complete resolution of the lesion.Conclusion: This is the first case of a cerebral inflammatory lesion occurring during treatment with ixekizumab. Although very rare, neurological complications may occur during anti-IL-17A therapies, thus leading to the need for careful monitoring of patients exposed to these drugs.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"246-249"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

HaNDL Syndrome: The Innocent Lymphocytic Pleocytosis. HaNDL综合征:单纯淋巴细胞增多症。

IF 1.1 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000546

Kadriye Güleda Keskin, Irem Carus, Isil Kalyoncu Aslan, Eren Gözke

{"title":"HaNDL Syndrome: The Innocent Lymphocytic Pleocytosis.","authors":"Kadriye Güleda Keskin, Irem Carus, Isil Kalyoncu Aslan, Eren Gözke","doi":"10.1097/NRL.0000000000000546","DOIUrl":"10.1097/NRL.0000000000000546","url":null,"abstract":"Introduction: HaNDL syndrome is a transient and rare condition that presents with neurological deficit and headache accompanied by lymphocytosis on cerebrospinal fluid (CSF) analysis. It is usually characterized by spontaneous recovery without neurological sequelae. This is a benign condition, which has not yet been adequately defined and includes many diseases in the differential diagnosis. We indicated 2 different cases that applied with acute neurological findings.Case report: Two patients who were admitted to our hospital with transient neurological deficits and headaches were evaluated. There was no significant pathology in cranial imaging and EEG reports. Lymphocytic pleocytosis was observed in CSF. Patients were followed up with attacks but were discharged without deficits. We diagnosed the patients with HaNDL syndrome with clinical features, imaging, and laboratory findings.Conclusion: HaNDL is an underdiagnosed syndrome and it should be considered especially for young patients with headaches is prominent without a risk factor for ischemia, recurrent episodes with neurological symptoms, CSF pleocytosis, and normal imaging findings.Therefore, we wanted to raise awareness for the existence of this rare disease which is a waste of time by performing unnecessary tests and therapies during the diagnosis period.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"163-165"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mechanical Thrombectomy in Anticoagulated Patients With Acute Ischemic Stroke: A Meta-Analysis. 急性缺血性脑卒中抗凝患者机械取栓:荟萃分析

IF 1.2 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000542

HaoLiang Zhang, Shiqin Chen, QianYuan Zhu, ZongShan Li, Tian Lv, Chengjiang Liu

{"title":"Mechanical Thrombectomy in Anticoagulated Patients With Acute Ischemic Stroke: A Meta-Analysis.","authors":"HaoLiang Zhang, Shiqin Chen, QianYuan Zhu, ZongShan Li, Tian Lv, Chengjiang Liu","doi":"10.1097/NRL.0000000000000542","DOIUrl":"10.1097/NRL.0000000000000542","url":null,"abstract":"Background: According to a previous studies, mechanical thrombectomy(MT) is safe for anticoagulated patients. However, the safety and prognosis of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKA) have not been compared with those of MT.This meta-analysis aimed at determining the efficacy of DOACs or VKA for patients after MT.Review summary: We searched PubMed, Embase, Web of Science databases, and Cochrane from their inception to Aug 2022. Revman 5.3 served for the meta-analysis. The meta-analysis included 12 studies that covered 3571 patients, finding that after MT treatment, DOACs significantly decreased the symptomatic intracerebral hemorrhage [odd ratio (OR)=0.49, 95% CI 0.30-0.80, P =0.004] and mortality (OR=0.63, 95% CI 0.48-0.83, P =0.001) compared with VKA. Meanwhile, no obvious differences were found between DOACs and VKA after MT treatment in terms of in any hemorrhagic transformation (OR=1.07, 95% CI 0.84-1.37, P =0.59), good functional outcome (OR=1.06, 95% CI 0.88-1.27, P =0.53), and successful arterial recanalization (OR=1.24, 95% CI 1.00-1.53, P =0.05).Conclusions: This meta-analysis demonstrates that the application of DOACs in MT treatment for anticoagulated patients with acute ischemic stroke is safer than that in the VKA group. However, further studies are necessary to confirm these results.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"194-203"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intracranial Hypertension Associated With Poly-Cranio-Radicular-Neuropathies: A Case Report and Review of the Literature. 与多发性颅脊髓神经病相关的颅内高血压：病例报告和文献综述。

IF 1.2 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000559

James E Eaton, Ipek Oguz, Habeeb Kazimuddin, Francesca Bagnato

{"title":"Intracranial Hypertension Associated With Poly-Cranio-Radicular-Neuropathies: A Case Report and Review of the Literature.","authors":"James E Eaton, Ipek Oguz, Habeeb Kazimuddin, Francesca Bagnato","doi":"10.1097/NRL.0000000000000559","DOIUrl":"10.1097/NRL.0000000000000559","url":null,"abstract":"Introduction: We present the case of a gentleman who developed rapidly progressive vision loss, ophthalmo-paresis, and flaccid quadriparesis in the context of severe intracranial hypertension. We reviewed the available cases in the literature to increase awareness of this rare clinical entity.Case Report:A 36-year-old man developed rapidly progressive vision loss, ophthalmo-paresis, and flaccid quadriparesis. He had an extensive workup, only notable for severe intracranial hypertension, >55 cm of H 2 O. No inflammatory features were present, and the patient responded to CSF diversion. Few similar cases are available in the literature, but all show markedly elevated intracranial pressure associated with extensive neuroaxis dysfunction. Similarly, these patients improved with CSF diversion but did not appear to respond to immune-based therapies.Conclusions: We term this extensive neuroaxis dysfunction intracranial hypertension associated with poly-cranio-radicular-neuropathy (IHP) and distinguish it from similar immune-mediated clinical presentations. Clinicians should be aware of the different etiologies of this potentially devastating clinical presentation to inform appropriate and timely treatment.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"166-169"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-Term Exposure to Air Pollution and the Incidence and Mortality of Stroke: A Meta-Analysis. 短期空气污染暴露与中风的发病率和死亡率:一项荟萃分析。

IF 1.2 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000544

Wenjian Lin, Jie Pan, Jiahe Li, Xiaoyu Zhou, Xueyuan Liu

{"title":"Short-Term Exposure to Air Pollution and the Incidence and Mortality of Stroke: A Meta-Analysis.","authors":"Wenjian Lin, Jie Pan, Jiahe Li, Xiaoyu Zhou, Xueyuan Liu","doi":"10.1097/NRL.0000000000000544","DOIUrl":"10.1097/NRL.0000000000000544","url":null,"abstract":"Background: The relationship between short-term exposure to various air pollutants [particulate matter <10 μm (PM 10 ), particulate matter <2.5 μm (PM 2.5 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide, and ozone (O 3 )] and the incidence and mortality of stroke remain unclear.Review summary: We conducted a comprehensive search across databases, including PubMed, Web of Science, and others. A random-effects model was employed to estimate the odds ratios (OR) and their 95% CIs. Short-term exposure to PM 10 , PM 2.5 , NO 2 , SO 2 , and O 3 was associated with increased stroke incidence [per 10 μg/m 3 increase in PM 2.5 : OR = 1.005 (95% CI: 1.004-1.007), per 10 μg/m 3 increase in PM 10 : OR = 1.006 (95% CI: 1.004-1.009), per 10 μg/m 3 increase in SO 2 : OR = 1.034 (95% CI: 1.020-1.048), per 10 μg/m 3 increase in NO 2 : OR = 1.029 (95% CI: 1.015-1.043), and O 3 for per 10 μg/m 3 increase: OR: 1.006 (95% CI: 1.004-1.007)]. In addition, short-term exposure to PM 2.5 , PM 10 , SO 2, and NO 2 was correlated with increased mortality from stroke [per 10 μg/m 3 increase in PM 2.5 : OR = 1.010 (95% CI: 1.006-1.013), per 10 μg/m 3 increase in PM 10 : OR = 1.004 (95% CI: 1.003-1.006), per 10 μg/m 3 increase in SO 2 : OR = 1.013 (95% CI: 1.007-1.019) and per 10 μg/m 3 increase in NO 2 : OR = 1.012 (95% CI: 1.008-1.015)].Conclusion: Reducing outdoor air pollutant levels may yield a favorable outcome in reducing the incidence and mortality associated with strokes.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"179-187"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138483324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurological Diagnosis: Artificial Intelligence Compared With Diagnostic Generator. 神经学诊断：人工智能与诊断生成器的比较。

IF 1.2 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000560

Pasquale F Finelli

{"title":"Neurological Diagnosis: Artificial Intelligence Compared With Diagnostic Generator.","authors":"Pasquale F Finelli","doi":"10.1097/NRL.0000000000000560","DOIUrl":"10.1097/NRL.0000000000000560","url":null,"abstract":"Objective: Artificial intelligence has recently become available for widespread use in medicine, including the interpretation of digitized information, big data for tracking disease trends and patterns, and clinical diagnosis. Comparative studies and expert opinion support the validity of imaging and data analysis, yet similar validation is lacking in clinical diagnosis. Artificial intelligence programs are here compared with a diagnostic generator program in clinical neurology.Methods: Using 4 nonrandomly selected case records from New England Journal of Medicine clinicopathologic conferences from 2017 to 2022, 2 artificial intelligence programs (ChatGPT-4 and GLASS AI) were compared with a neurological diagnostic generator program (NeurologicDx.com) for diagnostic capability and accuracy and source authentication.Results: Compared with NeurologicDx.com, the 2 AI programs showed results varying with order of key term entry and with repeat querying. The diagnostic generator yielded more differential diagnostic entities, with correct diagnoses in 4 of 4 test cases versus 0 of 4 for ChatGPT-4 and 1 of 4 for GLASS AI, respectively, and with authentication of diagnostic entities compared with the AI programs.Conclusions: The diagnostic generator NeurologicDx yielded a more robust and reproducible differential diagnostic list with higher diagnostic accuracy and associated authentication compared with artificial intelligence programs.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"143-145"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of Cerebral Venous Sinus Thrombosis Due to Autoimmune Diseases: A Single-Center Retrospective Observational Study. 自身免疫性疾病导致的脑静脉窦血栓的特征：一项单中心回顾性观察研究

IF 1.2 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000555

Furkan Saridas, Gizem Mesut, Yasemin Dinc, Emine Rabia Koc, Rifat Ozpar, Bahattin Hakyemez, Omer Faruk Turan

{"title":"Characteristics of Cerebral Venous Sinus Thrombosis Due to Autoimmune Diseases: A Single-Center Retrospective Observational Study.","authors":"Furkan Saridas, Gizem Mesut, Yasemin Dinc, Emine Rabia Koc, Rifat Ozpar, Bahattin Hakyemez, Omer Faruk Turan","doi":"10.1097/NRL.0000000000000555","DOIUrl":"10.1097/NRL.0000000000000555","url":null,"abstract":"Objectives: Cerebral venous sinus thrombosis (CVST) is a cerebrovascular disease characterized by thrombosis of the cerebral venous or dural sinuses. Autoimmune diseases (AD) are important causes of CVST. This study aims to reveal the differences between CVST associated with autoimmune diseases compared with other causes (OCs) and Behcet's syndrome (BS) compared with other ADs.Methods: This is a single-center retrospective study in which the medical records of 187 patients we followed with a diagnosis of CVST between 2008 and 2023 were collected retrospectively. Four neurologists collected data on initial symptoms, neurological examinations, and laboratory findings. Findings on magnetic resonance imaging and magnetic resonance venography performed on all patients (thrombosis localizations, hemorrhagic or ischemic complications, and collateralization) were re-evaluated by 2 radiologists. The results were compared with AD, other ADs, and OCs groups.Results: There were 28 cases of CVST associated with AD. Of these, 18 were BS, and 10 were other AD. Subacute-chronic onset, headache, and transverse sinus involvement were more common in AD-related patients than in OCs. However, collateralization, venous infarction, hemorrhagic transformation, and bleeding were less common. BS-related patients had earlier age, more frequent transverse sinus, less frequent cortical vein thrombosis, and better collateralization than other ADs.Conclusion: CVST is one of the rare complications in autoimmune diseases. It has a more subacute-chronic onset. Since headaches are more common, it is essential to make a differential diagnosis of CVST in autoimmune diseases with chronic headaches. Transverse sinus thrombosis is more common. Collateralization, venous infarction, and hemorrhagic transformation are less.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"152-157"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Covert Impact of Chiari Network and Eustachian Valves on Stroke: A Scoping Review and Meta-Analysis. Chiari网络和咽鼓管瓣膜对卒中的隐性影响：范围界定综述和荟萃分析。

IF 1.1 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000530

Mohammed Q Al-Sabbagh, Prasanna Eswaradass

{"title":"The Covert Impact of Chiari Network and Eustachian Valves on Stroke: A Scoping Review and Meta-Analysis.","authors":"Mohammed Q Al-Sabbagh, Prasanna Eswaradass","doi":"10.1097/NRL.0000000000000530","DOIUrl":"10.1097/NRL.0000000000000530","url":null,"abstract":"Background: The role of Chiari network (CN) and Eustachian valves (EVs) in cardioembolic strokes is still unclear. There is inconsistency in the literature regarding clinical approach to these lesions to reduce stroke risk. We aimed to describe clinical presentation, neuroimaging and cardioimaging features, as well as management approaches for CN and EV in stroke context.Review summary: A systemic search was carried out using PubMed and Web of Science following PRISMA guidelines, Supplemental Digital Content 1 ( http://links.lww.com/NRL/A123 ). We retrieved 4 case-control studies, 2 cross sectional studies as well 8 case reports, with a total of 883 patients with a mean age of 44.6 years (±13.8). The combined prevalence of EV/CN in stroke-related patent foramen ovale (PFO) patients was 50% (95% CI: 31-68). With isolated prevalence for EV and CN of 43% (95% CI: 25-63), 18% (95% CI: 12-25), respectively. Patients with history of stroke had higher prevalence of EV/CN compared with controls odds ratio=2.45 (95% CI: 1.2-5, P <0.01). All case-control and cross-sectional studies defined EV/CN by transesophageal echocardiography or intracardiac cardiography. In the 8 case reports, 7 cases were diagnosed by transesophageal echocardiography, while only 1 case was diagnosed postmortem.Conclusion: EV/CN are relatively common findings in stroke patients with PFO. While it appears that presence of EV/CN with a PFO increases the risk of cardioembolic stroke, they remain underrecognized. EV/CN should be considered as high-risk PFO features. There is a scarcity of research emphasizing their role in clinical decision making, especially PFO closure and antithrombotic therapy choice.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"188-193"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anticonvulsant Agents for Treatment of Restless Legs Syndrome: A Case Report With Lamotrigine and a Review of the Literature. 抗惊厥药物治疗不安腿综合征：使用拉莫三嗪的病例报告和文献综述。

IF 1.2 4区医学

Neurologist Pub Date : 2024-05-01 DOI: 10.1097/NRL.0000000000000552

Jawad Al-Kassmy, Mohammed Alsalmi, Woojin Kang, Philippe Huot

{"title":"Anticonvulsant Agents for Treatment of Restless Legs Syndrome: A Case Report With Lamotrigine and a Review of the Literature.","authors":"Jawad Al-Kassmy, Mohammed Alsalmi, Woojin Kang, Philippe Huot","doi":"10.1097/NRL.0000000000000552","DOIUrl":"10.1097/NRL.0000000000000552","url":null,"abstract":"Introduction: Restless Legs Syndrome (RLS) is a neurological disorder primarily treated with pregabalin and gabapentin, followed by dopamine agonists later in the process due to the risk of augmenting RLS symptoms. In addition, clinical reports have disclosed varying degrees of success employing other agents in patients unresponsive to traditional agents. Here, we present a patient who had success in the reduction of RLS symptoms with lamotrigine, a broad-spectrum anticonvulsant. Previously, lamotrigine had been used in 2 trials with successful treatment of RLS.Case report: We present a 58-year-old right-handed lady with long-standing history of smoking, hypertension, dyslipidaemia, prediabetes, gastro-esophageal reflux disease, asthma, strabismus, uterine cancer, severe and debilitating course of RLS accompanied by unexplained deterioration. The patient initially demonstrated abnormal sensation in all her limbs, which worsened with radiotherapy treatment, and was eventually diagnosed with RLS based on the diagnostic criteria. Subsequent examinations were unremarkable and revealed no further explanation for the deterioration of the RLS symptoms. While the complexity of the patient's medical history had exposed her to a variety of medications, she reported that only lamotrigine, in addition to her original regimen of methadone and pramipexole, offered significant symptomatic relief. It must be noted that no adverse side effects, including impulse-control disorder, were reported by the patient.Conclusions: We present a case of a woman whose deteriorating symptoms of RLS were successfully alleviated by the administration of lamotrigine. This is only the third case in the literature to have successfully utilized lamotrigine as a treatment option for RLS.","PeriodicalId":49758,"journal":{"name":"Neurologist","volume":" ","pages":"173-178"},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0