Epilepsy is a chronic medical condition affecting millions of people in the United States. It is characterized by uncontrolled seizures. Epilepsy has a huge social and economic impact on patients and their caregivers. Management of uncontrolled epilepsy is done under the supervision of a neurologist. However, it has been shown in the literature that chronic epilepsy
{"title":"Epilepsy and Concomittant Pseudoseizures: The Diagnostic Dilemma","authors":"Batool F. Kirmani, D. Mungall","doi":"10.5580/2cf1","DOIUrl":"https://doi.org/10.5580/2cf1","url":null,"abstract":"Epilepsy is a chronic medical condition affecting millions of people in the United States. It is characterized by uncontrolled seizures. Epilepsy has a huge social and economic impact on patients and their caregivers. Management of uncontrolled epilepsy is done under the supervision of a neurologist. However, it has been shown in the literature that chronic epilepsy","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129177096","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}
Epilepsy is a complex neurological disorder caused by abnormal, sudden, excessive electrical discharges of the neurons in the brain. There are many different seizure types and epileptic syndromes, but all involve abnormal electrical activity. It has been shown that 30% of patients with epilepsy remain medically intractable. For these patients, many of whom have failed multiple classes of antiepileptic drugs (AEDs) and/or surgical procedures, newly FDAapproved drugs are of particular interest.
{"title":"Efficacy and Tolerability of Vimpat in Patients with Intractable Epilepsy","authors":"Batool F. Kirmani, D. Mungall","doi":"10.5580/2cf2","DOIUrl":"https://doi.org/10.5580/2cf2","url":null,"abstract":"Epilepsy is a complex neurological disorder caused by abnormal, sudden, excessive electrical discharges of the neurons in the brain. There are many different seizure types and epileptic syndromes, but all involve abnormal electrical activity. It has been shown that 30% of patients with epilepsy remain medically intractable. For these patients, many of whom have failed multiple classes of antiepileptic drugs (AEDs) and/or surgical procedures, newly FDAapproved drugs are of particular interest.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126758673","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}
Keppra XR Extended release (levetiracetam extended-release tablets) recently became available for use as an add-on to other antiepileptic treatments for people with partial onset seizures who were 16 years of age and older as of September 2008. There is limited data about its efficacy and tolerability at the present time. We retrospectively analyzed data from 25 epilepsy patients who received Keppra XR ranging from 500 3000 mg per day as standard once a day dosing. The mean age was 33.8 years. 19 (76%) patients have partial and 6 (24%) have generalized epilepsy. In 17 (68%) patients, Keppra XR was used as monotherapy and in 8 (40 %) as adjunctive therapy. A favorable response to Keppra XR was seen in 21 (84%) patients in terms of efficacy. No major side-effects were reported. However, Keppra XR was tapered off in 4 subjects secondary to dizziness, somnolence and lack of efficacy. From our limited retrospective analysis, Keppra XR was also found to be effective as a monotherapy.
{"title":"Retrospective Analysis Of Efficacy And Tolerability Of Keppra XR In An Outpatient Setting","authors":"Batool F. Kirmani, Gary J. Jones, E. Crisp","doi":"10.5580/2cb3","DOIUrl":"https://doi.org/10.5580/2cb3","url":null,"abstract":"Keppra XR Extended release (levetiracetam extended-release tablets) recently became available for use as an add-on to other antiepileptic treatments for people with partial onset seizures who were 16 years of age and older as of September 2008. There is limited data about its efficacy and tolerability at the present time. We retrospectively analyzed data from 25 epilepsy patients who received Keppra XR ranging from 500 3000 mg per day as standard once a day dosing. The mean age was 33.8 years. 19 (76%) patients have partial and 6 (24%) have generalized epilepsy. In 17 (68%) patients, Keppra XR was used as monotherapy and in 8 (40 %) as adjunctive therapy. A favorable response to Keppra XR was seen in 21 (84%) patients in terms of efficacy. No major side-effects were reported. However, Keppra XR was tapered off in 4 subjects secondary to dizziness, somnolence and lack of efficacy. From our limited retrospective analysis, Keppra XR was also found to be effective as a monotherapy.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"311 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124421884","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}
H. Foyaca-Sibat, M. Salazar-Campos, L. Ibanez-Valdes
Ocular cysticercosis is caused by the growth of the larvae of Taenia solium within the ocular tissues and the cysts may be located in descending order of frequency, sub retinal (35%), vitreous (22%), conjunctiva (22%), anterior segment (5%) and orbit (1%). The extraocular muscle form is the most common type of orbital cysticercosis. In the ocular form, the most favored sites are the vitreous and the sub retinal space whereas the inferior rectus and the medial rectus are the most common extraocular muscles involved. Intraocular cysticercosis is predominant in the Western countries, whereas extraocular is more common in the Indian population and several authors have attributed geographic and environmental factors.
{"title":"Cysticercosis Of The Extraocular Muscles. Our Experience And Review Of The Medical Literature.","authors":"H. Foyaca-Sibat, M. Salazar-Campos, L. Ibanez-Valdes","doi":"10.5580/2c8d","DOIUrl":"https://doi.org/10.5580/2c8d","url":null,"abstract":"Ocular cysticercosis is caused by the growth of the larvae of Taenia solium within the ocular tissues and the cysts may be located in descending order of frequency, sub retinal (35%), vitreous (22%), conjunctiva (22%), anterior segment (5%) and orbit (1%). The extraocular muscle form is the most common type of orbital cysticercosis. In the ocular form, the most favored sites are the vitreous and the sub retinal space whereas the inferior rectus and the medial rectus are the most common extraocular muscles involved. Intraocular cysticercosis is predominant in the Western countries, whereas extraocular is more common in the Indian population and several authors have attributed geographic and environmental factors.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129706685","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}
Cysticercosis, a parasitic infection caused by the larval form of the pork tapeworm, Taenia solium, is increasingly recognized as a cause of epilepsy, headache, and neurological signs when it is located in the brain, optic nerve or spinal cord, known as neurocysticercosis. Anecdotal clinical presentations in patients with severe posterior fossa involvement may include signs of bilateral fourth nerve palsy, facial myokymia, upbeat nystagmus, periodic alternating nystagmus, and rhythmic oculopalatal myoclonus. In patients presenting huge cystic lesions due to posterior fossa neurocysticercosis, intermittent severe headache, epilepsy, signs of raised intracranial pressure, cerebellar signs and cranial nerves signs can be seen as well.We have developed a theoretical explanation for this mechanism based on the hemodynamic characteristic of the blood flow which to be subjected to the opinion of other authors.
{"title":"Cerebellar Neurocysticercosis and Novel Hypotheses.","authors":"H. Foyaca-Sibat, L. Ibanez-Valdes","doi":"10.5580/2c8e","DOIUrl":"https://doi.org/10.5580/2c8e","url":null,"abstract":"Cysticercosis, a parasitic infection caused by the larval form of the pork tapeworm, Taenia solium, is increasingly recognized as a cause of epilepsy, headache, and neurological signs when it is located in the brain, optic nerve or spinal cord, known as neurocysticercosis. Anecdotal clinical presentations in patients with severe posterior fossa involvement may include signs of bilateral fourth nerve palsy, facial myokymia, upbeat nystagmus, periodic alternating nystagmus, and rhythmic oculopalatal myoclonus. In patients presenting huge cystic lesions due to posterior fossa neurocysticercosis, intermittent severe headache, epilepsy, signs of raised intracranial pressure, cerebellar signs and cranial nerves signs can be seen as well.We have developed a theoretical explanation for this mechanism based on the hemodynamic characteristic of the blood flow which to be subjected to the opinion of other authors.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"2007 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127299475","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}
Purpose: Movement disorders like chorea, hemichorea-hemiballismus, choreoathetosis has been documented earlier with diabetes mellitus. We in our study have analyzed clinical and radiological characteristics of movement disorders occurring in association with diabetes. Methods: Patients admitted with movement disorders were screened for the presence of Diabetes. Patients with history of diabetes or new onset diabetes were analyzed for their clinical presentation and radiological characteristics, and the recovery of movement disorders with treatment of diabetes. Results: A total of eleven patients who presented with involuntary movements were found to have diabetes. Of these, five patients presented with hemiballismushemichorea, three with hemichorea, and two patients with choreoathetosis and one with generalized chorea-ballismus. The age of the patients ranged between 45–73 years. In three patients, it was the presenting symptom of diabetes without any previous history of diabetes. The glycemic status as assessed by HbA1C was very poor, with values more than 10 % in all the 11 patients. In nine patients, the Brain CT showed hyperdensity in the region of putamen. In all the patients, the involuntary movements resolved completely or decreased with treatment of diabetes. Conclusion: Movement disorders are associated with diabetes. The early recognisation of the clinical and radiological features of these movement disorders is necessary, as prompt control of the glycemic status will result in rapid recovery of these involuntary movements and will have good prognosis.
{"title":"Movement Disorders And Diabetes, A Study From South India","authors":"Shankar S Prabhu, N. Ramya","doi":"10.5580/2c26","DOIUrl":"https://doi.org/10.5580/2c26","url":null,"abstract":"Purpose: Movement disorders like chorea, hemichorea-hemiballismus, choreoathetosis has been documented earlier with diabetes mellitus. We in our study have analyzed clinical and radiological characteristics of movement disorders occurring in association with diabetes. Methods: Patients admitted with movement disorders were screened for the presence of Diabetes. Patients with history of diabetes or new onset diabetes were analyzed for their clinical presentation and radiological characteristics, and the recovery of movement disorders with treatment of diabetes. Results: A total of eleven patients who presented with involuntary movements were found to have diabetes. Of these, five patients presented with hemiballismushemichorea, three with hemichorea, and two patients with choreoathetosis and one with generalized chorea-ballismus. The age of the patients ranged between 45–73 years. In three patients, it was the presenting symptom of diabetes without any previous history of diabetes. The glycemic status as assessed by HbA1C was very poor, with values more than 10 % in all the 11 patients. In nine patients, the Brain CT showed hyperdensity in the region of putamen. In all the patients, the involuntary movements resolved completely or decreased with treatment of diabetes. Conclusion: Movement disorders are associated with diabetes. The early recognisation of the clinical and radiological features of these movement disorders is necessary, as prompt control of the glycemic status will result in rapid recovery of these involuntary movements and will have good prognosis.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121695155","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}
Rosai-Dorfman disease (RDD) is rare, especially in the central nervous system (CNS). We report a 4-year-old boy with a neoplasm in the pineal region, verified as RDD, with no concurrent clinical lymph node involvement. Emperipolesis was also identified in this case. Fibrosis was additionally found at extranodal sites. Positive results for the S100 protein and negative findings of CD1a were important for diagnosis.
{"title":"Rosai-Dorfman Disease of the Pineal Region: A Case Report","authors":"Yong-Hao Hou, Shubin Huang, Xiao-fan Ji","doi":"10.5580/2c8f","DOIUrl":"https://doi.org/10.5580/2c8f","url":null,"abstract":"Rosai-Dorfman disease (RDD) is rare, especially in the central nervous system (CNS). We report a 4-year-old boy with a neoplasm in the pineal region, verified as RDD, with no concurrent clinical lymph node involvement. Emperipolesis was also identified in this case. Fibrosis was additionally found at extranodal sites. Positive results for the S100 protein and negative findings of CD1a were important for diagnosis.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121246713","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}
We describe a case of unremitting orolingual angioedema in conjunction with Locked-in syndrome
我们描述了一个持续的口舌血管性水肿合并闭锁综合征的病例
{"title":"A Case of Unremitting Orolingual Angioedema in Conjunction with Locked-in Syndrome","authors":"J. Cara, J. Widdows, Breanna L Gawrys","doi":"10.5580/2c0a","DOIUrl":"https://doi.org/10.5580/2c0a","url":null,"abstract":"We describe a case of unremitting orolingual angioedema in conjunction with Locked-in syndrome","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121683699","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}
M. Lilly, Melinda Hermanns, J. Beckstrand, A. Booth, M. Farlow
The purpose of this paper is to suggest an intrapersonal help for caregivers through proposing a model for understanding shadowing behavior. This model is based on Bowlby’s (1973) discussion of attachment and related concepts such as proximityseeking, the “strange situation”, and the secure base. Building on Bowlby’s discussion, Mikulincer and Shaver (2008) developed a visual representation of the dynamics of adult attachment, herein modified and explicated according to its proposed relationship to caregivers and care recipients living with Alzheimer’s disease. A potential underlying brain-based rationale, is also presented
{"title":"Illumination of Shadowing Behavior in Individuals with Alzheimer’s Disease: Proximity-Seeking? As Life Becomes the “Strange Situation”","authors":"M. Lilly, Melinda Hermanns, J. Beckstrand, A. Booth, M. Farlow","doi":"10.5580/21b7","DOIUrl":"https://doi.org/10.5580/21b7","url":null,"abstract":"The purpose of this paper is to suggest an intrapersonal help for caregivers through proposing a model for understanding shadowing behavior. This model is based on Bowlby’s (1973) discussion of attachment and related concepts such as proximityseeking, the “strange situation”, and the secure base. Building on Bowlby’s discussion, Mikulincer and Shaver (2008) developed a visual representation of the dynamics of adult attachment, herein modified and explicated according to its proposed relationship to caregivers and care recipients living with Alzheimer’s disease. A potential underlying brain-based rationale, is also presented","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125524347","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}
Christos P Makos, G. Noussios, Marinos Peios, G. Balabanis, Christina Evangelinou
Background: The herpes zoster of the trigeminal nerve branches caused by Varicella Zoster Virus (VZV) is a clinical entity consisting of erythematous macules, papules, vesicles, bullae, small ulcers and erythematous plaques and characteristic short acute or pre-eruptive phases and long methherpetic periods with pain, burning or tingling in the involved dermatomes like in other peripheral nerves. The diagnosis of herpes zoster is primarily based upon history and clinical examination. The painful periods can induce misdiagnosis with dental signs like trigeminal neuralgia, odontalgia and acute pulpitis and the complications referred in the literature like tooth resorption, periapical lesions, periodontal destruction, osteomyelitis, jaw osteonecrosis and tooth exfoliation promote the dentist's role in diagnosis and management of this disease. Cases Reports:Two cases related to herpes zoster of the trigeminal nerve branches diagnosed at first stages as trigeminal neuralgia are presented in this report. Besides pathogenesis, clinical picture, jaw complications, diagnosis and therapeutic aspects are discussed.
{"title":"Herpes Zoster Of The Trigeminal Nerve-Two Cases Reports.","authors":"Christos P Makos, G. Noussios, Marinos Peios, G. Balabanis, Christina Evangelinou","doi":"10.5580/1fde","DOIUrl":"https://doi.org/10.5580/1fde","url":null,"abstract":"Background: The herpes zoster of the trigeminal nerve branches caused by Varicella Zoster Virus (VZV) is a clinical entity consisting of erythematous macules, papules, vesicles, bullae, small ulcers and erythematous plaques and characteristic short acute or pre-eruptive phases and long methherpetic periods with pain, burning or tingling in the involved dermatomes like in other peripheral nerves. The diagnosis of herpes zoster is primarily based upon history and clinical examination. The painful periods can induce misdiagnosis with dental signs like trigeminal neuralgia, odontalgia and acute pulpitis and the complications referred in the literature like tooth resorption, periapical lesions, periodontal destruction, osteomyelitis, jaw osteonecrosis and tooth exfoliation promote the dentist's role in diagnosis and management of this disease. Cases Reports:Two cases related to herpes zoster of the trigeminal nerve branches diagnosed at first stages as trigeminal neuralgia are presented in this report. Besides pathogenesis, clinical picture, jaw complications, diagnosis and therapeutic aspects are discussed.","PeriodicalId":232166,"journal":{"name":"The Internet Journal of Neurology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2010-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133811451","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}
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