Canadian Journal of Neurological Sciences最新文献

{"title":"Brachial Plexopathy Due to Benzalkonium Chloride Poisoning: An Unprecedented Toxicity.","authors":"Berkay Yalçınkaya, Ahmet Furkan Çolak, Hilmi Berkan Abacıoğlu, Alp Çetin","doi":"10.1017/cjn.2025.10418","DOIUrl":"10.1017/cjn.2025.10418","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042406","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}

{"title":"Clinical Relevance and Prognostic Significance of Isolated Angiitis of the Vasa Vasorum in Temporal Artery Biopsies.","authors":"Shervin Pejhan, Lillian Barra, Pari Basharat, Larry H Allen, Lulu L C D Bursztyn, Alain Proulx, Ruo Yan Chen, Morgan Smith, Montana Hackett, Robert Hammond","doi":"10.1017/cjn.2025.10413","DOIUrl":"10.1017/cjn.2025.10413","url":null,"abstract":"<p><strong>Background: </strong>Temporal arteritis (TA) is the most common vasculitis over age 50. Untreated, many patients will suffer blindness or stroke. Gold standard diagnosis is achieved by temporal artery biopsy. The aim of this study was to investigate the relevance of small vessel inflammation.</p><p><strong>Methods: </strong>Our dataset was comprised of 72 temporal artery biopsies subjected to a blinded uniform re-examination paired with clinical data including demographics, history, physical examination and laboratory findings. Documented pathology variables included the presence or absence of TA, angiitis of vasa vasorum (AVV) and inflammation of small peri-adventitial vessels (small vessel vasculitis, SVV).</p><p><strong>Results: </strong>Clinical and pathological variables were subjected to multivariate analysis. In brief, 25% of cases were identified as TA, 20% as isolated AVV, 7% as isolated SVV and 5% as mixed isolated AVV/SVV, while 43% had no inflammation (NI). All cases of TA were accompanied by small vessel inflammation: 95% exhibited AVV with or without SVV, and 5% exhibited SVV alone, demonstrating a strong association between TA and small vessel inflammation. Of the 24 cases with isolated AVV/SVV, 26% received a clinical diagnosis of TA within one year in comparison to 13% of cases that had NI. Furthermore, isolated AVV/SVV was identified in 25% of patients with a high clinical probability for TA, 60% of whom acquired a diagnosis of TA on clinical grounds within one year of follow-up.</p><p><strong>Conclusions: </strong>Our findings suggest that isolated AVV/SVV identifies a subgroup of patients with a higher risk of harboring or developing TA.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042327","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}

{"title":"Intraventricular Primary Diffuse Meningeal Melanomatosis.","authors":"Alexander D Rebchuk, Thomas J Zwimpfer","doi":"10.1017/cjn.2025.10426","DOIUrl":"10.1017/cjn.2025.10426","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042322","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}

{"title":"Levator Palpebrae Myositis: A Rare cause of Eyelid Ptosis. Proposal for Diagnosis and Management.","authors":"Jessica M Pouso-Diz, Jose A Castiñeira, Emilio Rodriguez-Castro","doi":"10.1017/cjn.2025.10420","DOIUrl":"10.1017/cjn.2025.10420","url":null,"abstract":"<p><p>Idiopathic orbital myositis is a rare inflammatory condition that predominantly affects multiple extraocular muscles. Isolated involvement of a single muscle is very uncommon. Isolated levator palpebrae myositis is a diagnostic challenge that should be considered in patients with periocular pain and complete eyelid ptosis without ophthalmoparesis or pupillary dysfunction. We propose a comprehensive set of diagnostic tests to identify the underlying etiology and a recommended treatment regimen. Additionally, we present a case from our clinical practice that illustrates this rare presentation, of which few cases have been described in the literature.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042404","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}

{"title":"Unique Patient with Ataxia with Oculomotor Apraxia Type 1: A Novel Homozygous Variant in <i>APTX</i> Gene and Delayed Onset Age.","authors":"Zhengzhe Sun, Shan Jin, Xiang Fang, Wenming Yang","doi":"10.1017/cjn.2025.10408","DOIUrl":"10.1017/cjn.2025.10408","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-3"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980133","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}

{"title":"Factors Affecting Access to Neurosurgical Care in Diverse Communities in Canada: A Qualitative Scoping Review.","authors":"Joshua A Bougadis, Piper C Rome, Tharushi N Perera, Julius O Ebinu","doi":"10.1017/cjn.2025.10411","DOIUrl":"10.1017/cjn.2025.10411","url":null,"abstract":"<p><strong>Introduction: </strong>Access to neurosurgical care is essential for addressing elective and non-elective neurosurgical conditions. Disparities in healthcare access in Canada persist, disproportionately affecting rural, Indigenous and socioeconomically disadvantaged populations. This scoping review sought to identify barriers and facilitators influencing neurosurgical access to care while highlighting gaps in the literature on equity-deserving groups.</p><p><strong>Methods: </strong>A systematic literature search of articles published from January 2000 to August 2024 was conducted using MEDLINE, EMBASE, Cochrane Library, PsycINFO and Scopus. Gray literature from governmental and non-governmental organizations was also reviewed. Of 1400 identified records, eight studies met the inclusion criteria. These studies were analyzed using inductive coding and thematic analysis to explore socioeconomic, geographic, racial, gender-based and cultural barriers.</p><p><strong>Results: </strong>Four major themes emerged: delays in access, alternative healthcare options, policy barriers and communication and coordination. Barriers including transportation gaps, socioeconomic inequities and systemic discrimination were prominent, especially for rural and Indigenous populations. Facilitators like telehealth and improved inter-hospital coordination showed promise but were hindered by infrastructure limitations and cultural misalignments. Few studies addressed the intersectionality of these barriers, highlighting gaps in understanding their cumulative impact.</p><p><strong>Conclusion: </strong>The findings in this review underscore the need for systemic reforms, including equitable resource allocation, digital infrastructure expansion and culturally congruent care. Addressing these barriers is critical to ensuring timely and equitable neurosurgical care across Canada. Future research should prioritize intersectional approaches to better understand overlapping access challenges and evaluate the efficacy of tailored interventions.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980055","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}

{"title":"A National Modified Delphi Consensus on the Referral and Management of NF1 Plexiform Neurofibroma.","authors":"Lucie Lafay-Cousin, Sébastien Perreault, Dal Singh, Katie Larner, Vijay Ramaswamy","doi":"10.1017/cjn.2025.10409","DOIUrl":"10.1017/cjn.2025.10409","url":null,"abstract":"<p><strong>Background and objectives: </strong>Neurofibromatosis type 1 (NF1) is a genetic disorder. Up to 50% of NF1 patients develop plexiform neurofibromas (PN). Despite revisions in diagnostic standards, there remains a lack of consensus on referral, treatment, monitoring and transition processes for NF1-PN. The study aimed to establish a Canada-wide consensus on the best practice for referral and management of patients with NF1-PN to help generate guidance where evidence on the long-term use of MEK inhibitors is lacking.</p><p><strong>Methods: </strong>The study used a modified Delphi method. The steering committee (SC) identified 4 topics of focus and developed 44 consensus statements. Following ratification, 43 statements were developed into an online survey sent to 113 healthcare practitioners (HCPs) involved in NF1-PN management across Canada. Respondents used a 4-point Likert scale to indicate agreement with each statement. The threshold for consensus agreement was 75%.</p><p><strong>Results: </strong>A total of 56 responses were received, predominantly from Ontario. Most respondents were neuro-oncologists (34%) and had over 11 years of experience (57%). Consensus was reached on 41 of 43 statements (95%), enabling the SC to develop recommendations for NF1-PN patient care and a treatment algorithm outlining key timings for treatment and management.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first national Delphi consensus on NF1-PN. Strong agreement was seen from HCPs on critical timings in NF1-PN treatment and management. The proposed recommendations and treatment algorithm provide a framework to enhance patient care and support ongoing research into optimizing care for NF1-PN patients, not just in Canada but globally.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980059","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}

{"title":"Asymmetry and Alignment: Physician Perspective on Patient-Based Evidence for Improving Health Communication.","authors":"Shelagh K Genuis, Westerly Luth, Wendy S Johnston","doi":"10.1017/cjn.2025.10407","DOIUrl":"10.1017/cjn.2025.10407","url":null,"abstract":"<p><p>We investigated the response of experienced amyotrophic lateral sclerosis physicians to patient-based evidence pertaining to health communication. Fifteen expert amyotrophic lateral sclerosis (ALS) physicians participated in an in-person focus group. Focusing on clinical feasibility and first-hand experience, participants discussed recommendations from people with ALS and caregivers for improving communication. Data were qualitatively analyzed using conventional content analysis. Findings demonstrated shared and differing perspectives, and communication challenges. Findings suggest a difference in perspective centered on how to achieve the shared goal of patient-centered communication. We discuss asymmetry between healthcare professional perspectives and patient-based evidence, and opportunities for alignment that will advance effective health communication.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980076","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}

{"title":"Quality of Life in Patients with Chronic Inflammatory Demyelinating Neuropathies Treated with Subcutaneous Immunoglobulin.","authors":"Adnan Almasri, Vera Bril, Hans Katzberg","doi":"10.1017/cjn.2025.10416","DOIUrl":"10.1017/cjn.2025.10416","url":null,"abstract":"<p><p>Multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) are immune-mediated peripheral nerve disorders. Treatment typically involves immunoglobulin therapy, with both intravenous (IVIG) and subcutaneous (SCIG) routes being used. Although multiple studies have determined that these therapies are effective and comparable, a comprehensive assessment of quality of life (QoL) has not been systematically reviewed. This review aims to evaluate QoL in patients with MMN and CIDP who are treated with SCIG, including those who have made the transition from IVIG to SCIG. We conducted a comprehensive search of electronic databases for studies that measured QoL outcomes in MMN and CIDP patients receiving SCIG. The primary outcome was the change in QoL scores as measured by validated tools compared with baseline values collected during IVIG treatment. Secondary outcomes included adverse effects, treatment satisfaction and functional status. Our review suggests that SCIG may offer comparable QoL outcomes to IVIG with potential benefits in self-administration and reduced systemic adverse effects. This review provides evidence-based insights into the comparative effectiveness of SCIG and IVIG in improving QoL for MMN and CIDP patients. Future research should aim to standardize QoL assessment tools and include larger, long-term studies to better capture the nuanced benefits of SCIG.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980081","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}

{"title":"Multiscale Analysis of Mesial Temporal Lobe Epilepsy: Anatomo-Electrophysio-Pathologic Differentiation - CORRIGENDUM.","authors":"P Narayanan Nambiar, H G Gray, K Alorabi, J Lau, A Thurairajah, A Khan, A Suller-Marti","doi":"10.1017/cjn.2025.10384","DOIUrl":"https://doi.org/10.1017/cjn.2025.10384","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1"},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980066","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}