Canadian Journal of Neurological Sciences最新文献_第10页

The Current State of Care for Tuberous Sclerosis Complex in Canada. 加拿大结节性硬化症的护理现状。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-04-02 DOI: 10.1017/cjn.2025.58

Robyn Whitney, Maryam Nabavi Nouri, Lauren Sham, Katherine Muir, Andrea V Andrade, Mary B Connolly, Elizabeth J Donner, Cathy Evanochko, Jennifer Flinn, Andrew A House, Raymond H Kim, Christine Kowal, Philippe Major, Paula Teixeira Marques, Ana Suller-Marti, Elisabetta Trinari, Mila Valcic, Colin Wilbur, Maria Zak, Mark R Keezer

引用次数: 0

Evaluating Levetiracetam Weight-Based Dosing in Benzodiazepine-Refractory Status Epilepticus. 苯二氮卓难治性癫痫持续状态中左乙拉西坦体重给药的评价。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-27 DOI: 10.1017/cjn.2025.56

Nasma Torfah, Anthony Lau, Hans Haag, David Yeom, Vivien Cao, Trana Hussaini

{"title":"Evaluating Levetiracetam Weight-Based Dosing in Benzodiazepine-Refractory Status Epilepticus.","authors":"Nasma Torfah, Anthony Lau, Hans Haag, David Yeom, Vivien Cao, Trana Hussaini","doi":"10.1017/cjn.2025.56","DOIUrl":"10.1017/cjn.2025.56","url":null,"abstract":"Background: Levetiracetam (LEV) is an antiseizure medication (ASM) used as a second line after benzodiazepines for status epilepticus treatment. Current literature lacks direct head-to-head comparisons between different LEV loading dose strategies, leading to uncertainty about superior dosing methods and thus clinical practice variations.Methods: A retrospective cohort study was designed to compare efficacy and safety of low (<30 mg/kg) versus high (≥30 mg/kg) weight-based LEV loading doses in adults with benzodiazepine-refractory status epilepticus (BRSE). The primary outcome of this study was termination of BRSE. No requirement for additional ASM after LEV was a surrogate for BRSE termination. Secondary endpoints included endotracheal intubation, intensive care unit (ICU) admission, 30-day all-cause mortality and adverse drug reactions. Statistical analysis included discrete and inferential statistics, including logistic regression and win-ratio analysis, to control for potential confounding variables.Results: Of the 106 patients included in this study, 54 (51%) did not require additional ASM after LEV, thereby achieving seizure termination. There was a higher proportion of patients with seizure termination in the higher weight-based dosing group as compared to the lower weight-based group (66% vs 40%, respectively; aOR 3.07; 95% CI: 1.36-7.21). There were lower rates for endotracheal intubation, ICU admission and all-cause mortality in the higher dosing group. Adverse events were comparable between the both groups.Conclusion: LEV's high weight-based loading dose strategy (≥30 mg/kg) is more effective in the termination of BRSE as compared to the lower weight-based loading dose strategy (<30 mg/kg).","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-5"},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722681","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

Intractable Focal Epilepsy from Neurobrucellosis. 神经布鲁氏菌病引起的顽固性局灶性癫痫。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-26 DOI: 10.1017/cjn.2025.55

Zachariah I Hasan, Jacqueline Barnes, Sarah Ganji, Alexander Andrews, Prishanya Pillai, Gholam K Motamedi

引用次数: 0

Reviewer Comment on Fleet et al. "Secondary Stroke Prevention in Ontario: A Population Based Cohort Study". 对Fleet等人的评论。安大略省二级中风预防：一项基于人群的队列研究。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-21 DOI: 10.1017/cjn.2025.24

Manav V Vyas, Charlotte Lee

引用次数: 0

Altered Cortical Excitability and Inhibition in Patients with Primary Dystonia: A Transcranial Magnetic Stimulation Study. 原发性肌张力障碍患者的皮质兴奋性和抑制性改变：经颅磁刺激研究。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-19 DOI: 10.1017/cjn.2025.50

Debjyoti Dhar, Nitish Kamble, Amitabh Bhattacharya, Vikram Holla, Ravi Yadav, Pramod Kumar Pal

{"title":"Altered Cortical Excitability and Inhibition in Patients with Primary Dystonia: A Transcranial Magnetic Stimulation Study.","authors":"Debjyoti Dhar, Nitish Kamble, Amitabh Bhattacharya, Vikram Holla, Ravi Yadav, Pramod Kumar Pal","doi":"10.1017/cjn.2025.50","DOIUrl":"10.1017/cjn.2025.50","url":null,"abstract":"Background: The literature on cortical excitability, inhibitory and facilitatory properties of the brain in patients with primary dystonia is not well elucidated. We aimed to study the changes in these neurophysiological parameters in patients with dystonia using transcranial magnetic stimulation (TMS).Methods: Patients with primary dystonia of presumed genetic etiology (n = 36) and an equal number of healthy controls (HC) (n = 36) were recruited from May 2021 to September 2022. TMS was done using single and paired pulse paradigms. The left motor cortex was stimulated, and responses were recorded from the contralateral first dorsal interosseus muscle. Resting motor threshold (RMT), central motor conduction time, contralateral silent period (cSP), ipsilateral silent period (iSP), short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were recorded. All patients underwent whole exome sequencing.Results: The mean age of patients was 36.6 ± 13.5 years. There was a significant reduction of cSP (79.5 ± 33.8 vs 97.5 ± 25.4, p = 0.02) and iSP (42.3 ± 13.5 vs 53.8 ± 20.8, p = 0.003) in patients compared to HC. SICI was significantly enhanced in patients (0.38 ± 0.23) compared to HC (0.51 ± 0.24, p = 0.006). RMT was higher (42.1 ± 7.9 vs 37.1 ± 6.4%, p = 0.032) with enhanced SICI (0.36 ± 0.21 vs 0.56 ± 0.25, p = 0.004) in patients with generalized dystonia (n = 20) compared to HC. The genetically determined subgroup (n = 13) had significantly enhanced SICI compared to HC (0.23 ± 0.15 vs 0.51 ± 0.23, p = 0.001).Conclusions: Patients with primary dystonia have altered cortical excitability and inhibition with significantly reduced silent period and enhanced intracortical inhibition suggestive of impaired GABAergic neurotransmission.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659797","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

Reviewer Comment on Taghdiri et al. "Access to Endovascular Thrombectomy: Does Driving Time to Comprehensive Stroke Center Matter More than Rurality?" Taghdiri等人的评论。“获得血管内血栓切除术：开车到综合中风中心的时间比乡村更重要吗？”

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-17 DOI: 10.1017/cjn.2025.10

Mahesh Kate, Aleksander Tkach

引用次数: 0

Early Malignant Transformation of Intracranial Epidermoid Cyst: A Case Report and Systematic Review. 颅内表皮样囊肿早期恶性转化1例报告及系统回顾。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-13 DOI: 10.1017/cjn.2025.45

Chia-Chen Tsai, Mirna Hennawy, Stephen Yip, Kira Tosefsky, Justin Oh, Mostafa Fatehi, Rebecca Harrison, Alexander D Rebchuk

引用次数: 0

Access to Virtual Physician Care among Persons with Dementia in Urban and Rural Areas: A Repeated Cross-Sectional Study. 城市和农村地区痴呆症患者获得虚拟医生护理的机会：一项重复的横断面研究

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-13 DOI: 10.1017/cjn.2025.43

Tomi T Odugbemi, Laura C Maclagan, Zhiyin Li, Jun Guan, Richard H Swartz, Colleen J Maxwell, R Liisa Jaakkimainen, Susan E Bronskill

{"title":"Access to Virtual Physician Care among Persons with Dementia in Urban and Rural Areas: A Repeated Cross-Sectional Study.","authors":"Tomi T Odugbemi, Laura C Maclagan, Zhiyin Li, Jun Guan, Richard H Swartz, Colleen J Maxwell, R Liisa Jaakkimainen, Susan E Bronskill","doi":"10.1017/cjn.2025.43","DOIUrl":"10.1017/cjn.2025.43","url":null,"abstract":"Background: During the COVID-19 pandemic, virtual physician visits rapidly increased among community-dwelling older persons living with dementia (PLWD) in Ontario. Rural residents often have less access to medical care compared to their urban counterparts, and it is unclear whether access to virtual care was equitable between PLWD in urban versus rural locations.Methods: Using population-based health administrative data and a repeated cross-sectional study design, we identified and described community-dwelling PLWD between March 2020 and August 2022 in Ontario, Canada. Poisson regression was used to calculate rate ratios (RR) and 95% confidence intervals comparing rates of virtual visits between rural and urban PLWD by key physician specialties: family physicians, neurologists and psychiatrists/geriatricians.Results: Of 122,751 PLWD in our cohort, 9.2% (n = 11,304) resided in rural areas. Rural PLWD were slightly younger compared to their urban counterparts (mean age = 81 vs. 82 years; standardized difference = 0.16). There were no differences across areas by sex or income quintile. In adjusted models, rates of virtual visits were significantly lower for rural compared to urban PLWD across all specialties: family physicians (RR = 0.71 [0.69-0.73]), neurologists (RR = 0.79 [0.75-0.83]) and psychiatrists/geriatricians (RR = 0.72 [0.68-0.76]).Conclusions: PLWD in rural areas had significantly lower rates of virtual family physician, neurologist and psychiatrist/geriatrician visits compared to urban dwellers during the study period. This finding raises important issues regarding access to primary and specialist healthcare services for rural PLWD. Future work should explore barriers to care to improve health care access among PLWD in rural communities.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617978","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

Developmental Venous Anomaly Thrombosis Presenting with Intracerebral Hemorrhage. 以脑出血为表现的发育性静脉异常血栓形成。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-13 DOI: 10.1017/cjn.2025.46

Ryan Alkins, William Davalan, Alec Hughes, Donatella Tampieri

引用次数: 0

An Overview of Multiple Sclerosis Care in Rural and Urban Newfoundland and Labrador. 在农村和城市纽芬兰和拉布拉多多发性硬化症护理的概述。

IF 2.9 4区医学

Canadian Journal of Neurological Sciences Pub Date : 2025-03-12 DOI: 10.1017/cjn.2025.48

Kathleen E Fifield, Neva J Fudge, Shane T Arsenault, Sarah Anthony, Lillian McGrath, Nicholas J Snow, Fraser Clift, Mark Stefanelli, Michelle Ploughman, Craig S Moore

{"title":"An Overview of Multiple Sclerosis Care in Rural and Urban Newfoundland and Labrador.","authors":"Kathleen E Fifield, Neva J Fudge, Shane T Arsenault, Sarah Anthony, Lillian McGrath, Nicholas J Snow, Fraser Clift, Mark Stefanelli, Michelle Ploughman, Craig S Moore","doi":"10.1017/cjn.2025.48","DOIUrl":"10.1017/cjn.2025.48","url":null,"abstract":"Introduction: Limited access to multiple sclerosis (MS)-focused care in rural areas can decrease the quality of life in individuals living with MS while influencing both physical and mental health.Methods: The objectives of this research were to compare demographic and clinical outcomes in participants with MS who reside within urban, semi-urban and rural settings within Newfoundland and Labrador. All participants were assessed by an MS neurologist, and data collection included participants' clinical history, date of diagnosis, disease-modifying therapy (DMT) use, measures of disability, fatigue, pain, heat sensitivity, depression, anxiety and disease activity.Results: Overall, no demographic differences were observed between rural and urban areas. Furthermore, the categorization of primary residence did not demonstrate any differences in physical disability or indicators of disease activity. A significantly higher percentage of participants were prescribed platform or high-efficacy DMTs in semi-urban areas; a higher percentage of participants in urban and rural areas were prescribed moderate-efficacy DMTs. Compared to depression, anxiety was more prevalent within the entire cohort. Comparable levels of anxiety were measured across all areas, yet individuals in rural settings experienced greater levels of depression. Individuals living with MS in either an urban or rural setting demonstrated clinical similarities, which were relatively equally managed by DMTs.Conclusion: Despite greater levels of depression in rural areas, the results of this study highlight that an overall comparable level and continuity of care is provided to individuals living with MS within rural and urban Newfoundland and Labrador.","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607304","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