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A Case Study and Review of the Literature Regarding Extradural Spinal Arachnoid Cyst 脊髓硬膜外蛛网膜囊肿病例分析及文献回顾
Pub Date : 2023-04-19 DOI: 10.31038/jnnc.2023521
Belgacem Ibrahim
Arachnoid cysts are spaces containing cerebrospinal fluid partitioned into an arachnoid-formed sheath and are a rare cause of symptomatic spinal cord compression. This case study examined a patient with spastic paraparesis who underwent surgery to remove the cystic lesion and push back the marrow. Post-op control spinal MRI showed total excision of the cyst, and the patient has progressed well and has fully recovered from his deficit. Nabors divides extradural arachnoid cysts into three types: type 1, type 2
蛛网膜囊肿是一种含有脑脊液的空间,分裂成蛛网膜形成的鞘,是一种罕见的脊髓压迫症状。本病例研究检查了一位痉挛性截瘫患者,他接受了手术切除囊性病变并将骨髓推回。术后对照脊柱MRI显示囊肿完全切除,患者进展良好,已完全从缺陷中恢复。Nabors将硬膜外蛛网膜囊肿分为三类:1型,2型
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引用次数: 0
Therapeutic Effect and Safety of Rectal Ozone Therapy in Mild and Moderate Symptomatic SARS CoV-2 Positive Patients 直肠臭氧治疗轻、中度症状SARS - CoV-2阳性患者的疗效及安全性
Pub Date : 2023-01-23 DOI: 10.31038/jnnc.2023514
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引用次数: 0
Neurosarcoidosis: What are the Evocative Signs on Magnetic Resonance Imaging (MRI) 神经结节病:磁共振成像(MRI)的诱发症状是什么?
Pub Date : 2022-08-30 DOI: 10.31038/jnnc.2022513
C. Ayadi, N. Amsiguine, N. Kettani, M. Fikri, M. Jiddane, F. Touarsa
nerve involvement, facial nerve palsy, general signs: Tiredness, joint The key sequence is contrast-weighted T1, shows focal or general leptomeningeal enhancement, node or smooth, about the basal aspects of the brain and the polygon of Willis ; sometimes it goes along the spaces of the Wirshow Robbin, as it may mimic parenchymal lesions. Parenchymal involvement is the most common and diverse, appearing as intraparenchymal masses or nodules, periventricular white matter involvement, or extension of leptomeningeal lesions through perivascular spaces.
神经受累,面神经麻痹,一般征象:疲倦,关节。关键顺序是对比加权T1,显示局灶性或全局性轻脑膜增强,结节或平滑,关于脑基底面和威氏多边形;有时它沿着Wirshow Robbin的间隙,因为它可能模仿实质病变。实质受累是最常见和多样的,表现为实质内肿块或结节,脑室周围白质受累,或小脑膜病变通过血管周围间隙延伸。
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引用次数: 0
Facial Paralysis Revealing an Atypical Metastasis of Breast Cancer 面瘫揭示乳腺癌的非典型转移
Pub Date : 2022-08-30 DOI: 10.31038/jnnc.2022512
Facial paralysis has many etiologies, the most frequent is the idiopathic cause, which is a diagnosis of elimination, then infectious, traumatic, and tumoral causes, dominated by the parotid tumor. Breast cancer rarely gives a perineural metastasis, estimated at 0.6%, of all secondary localizations, with a suggestive clinical presentation, especially the slow and progressive mode of appearance, the involvement of multiple cranial nerves, recurrent paresis, and a history of cancer. Perineural metastases of breast cancer are rare, but can occur, and this case demonstrates that any symptomatology in the patient with breast cancer must be considered in the overall context.
面瘫的病因很多,最常见的是特发性原因,诊断为消除性,其次是感染性、外伤性和肿瘤性原因,以腮腺肿瘤为主。乳腺癌很少发生神经周围转移,约占所有继发病灶的0.6%,其临床表现具有暗示性,特别是表现缓慢和进行性,累及多颅神经,复发性麻痹和有癌症史。乳腺癌的神经周围转移是罕见的,但也可能发生,本病例表明,乳腺癌患者的任何症状都必须在整体背景下考虑。
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引用次数: 0
Ivermectin and Zuranolone: A Double Standard in the Literature 伊维菌素和唑诺酮:文献中的双重标准
Pub Date : 2022-03-10 DOI: 10.31038/jnnc.2022511
C. Ross
J Neurol Neurocrit Care, Volume 5(1): 1–2, 2022 Three recent publications illustrate the ongoing double standard concerning the effectiveness of ivermectin for treatment of early outpatient cases of COVID-19 infection. It seems to be true that ivermectin has no beneficial effect for seriously ill hospitalized patients – its potential utility is for reducing the frequency of transition from early mild outpatient cases to severely ill hospitalized cases. Lack of effectiveness inside hospitals does not prove a lack of effectiveness in outpatient populations.
最近发表的三篇文章说明了关于伊维菌素治疗早期门诊COVID-19感染的有效性的双重标准。伊维菌素对住院重症患者似乎没有任何有益作用,这似乎是事实——它的潜在效用在于减少从早期轻度门诊病例过渡到重症住院病例的频率。医院内部缺乏有效性并不证明门诊人群缺乏有效性。
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引用次数: 0
How the Medical Profession Contributes to COVID-19 Vaccine Hesitancy 医学界是如何导致COVID-19疫苗犹豫的
Pub Date : 2021-10-14 DOI: 10.31038/jnnc.2021434
C. Ross
J Neurol Neurocrit Care, Volume 4(3): 1–3, 2021 Hopefully the pandemic will be over within another year. In the meantime, the medical profession and public health officials continue to denigrate and sanction ‘anti-maskers’ and ‘anti-vaxxers’, as discussed in previous papers [1-6]. This behavior inflames the people characterized as anti-vaxxers and anti-maskers, increases polarization, and breeds distrust in the medical profession. These effects of the denigration and sanctions can do nothing but increase vaccine hesitancy. The medical profession should stop putting all blame for vaccine hesitancy on a misinformed public, and instead should examine its own contributions to vaccine hesitancy. I am double vaccinated. There are a number of topics that illustrate the unhelpful attitudes and unscientific statements of doctors and public health officials during the pandemic. These are reviewed below.
中华神经病学杂志,第4卷(3):1-3,2021年与此同时,医学界和公共卫生官员继续诋毁和制裁“反蒙面者”和“反vaxxers”,正如之前的论文所讨论的[1-6]。这种行为激怒了反疫苗者和反口罩者,加剧了两极分化,并滋生了对医学界的不信任。这些诋毁和制裁的影响只能增加对疫苗的犹豫。医学界不应再把疫苗犹豫的所有责任归咎于被误导的公众,而应审视自己对疫苗犹豫的贡献。我打了两次疫苗。有许多话题说明了医生和公共卫生官员在大流行期间的无益态度和不科学言论。下面对它们进行了回顾。
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引用次数: 0
Multiple Target Repetitive Transcranial Magnetic Stimulation (rTMS) Combined with Neurofeedback for Complete Resolution of Severe OCD, Bipolar Depression, and Anxiety 多靶点重复经颅磁刺激(rTMS)联合神经反馈治疗重度强迫症、双相抑郁和焦虑
Pub Date : 2021-08-20 DOI: 10.31038/jnnc.2021433
A. Elahi
anxiety, and depression following completing total of 41 sessions of rTMS and 15 sessions of ‘ Z-score neurofeedback’ . Patient is 33-year-old male diagnosed with over 15 years of OCD, generalized anxiety, and bipolar depression. Patient has undergone trials of Serotonin Reuptake Inhibitors (SSRIs), mood stabilizers including lithium and valproic acid, and benzodiazepines including lorazepam. At time of presentation to my clinic, patient’s self-guilt, with anxiety in environments, agoraphobia, self-worth, and extreme spells of depression, manic, and hypomanic episodes. In patient severe hypochondriasis with respect to various disorders including motor neuron disease, multiple sclerosis, and experienced various somatic symptoms including non-specific vibratory sensations of mouth, trunk, and extremities. At onset, Yale Brown Obsessive Compulsive Score (Y-BOCS) was 19, Burn’s anxiety score was 36, Burn’s depression score was 22, and PHQ-9 of Risks and benefits of rTMS including off-label use of rTMS parameters were discussed in detail with patient and written signed consent obtained. A brain MRI was obtained to include skin fiduciary markers for navigation software ( The Neural Navi gator, Brain Science Tools, Utrechet, Netherlands) 1mm sagittal and axial T1 MRI images were processed and segmented to identify several cortical targets including: left and right Dorsolateral Prefrontal Cortex (DLPFC), right OFC, left Dorsomedial the leading working model regarding the pathophysiology of OCD [4]. One randomized, sham-controlled study showed modest improvements in OCD (29% reduction on Y-BOCS) and depression (48% on HAM-D) symptoms after 14 sequential 1 Hz stimluation sessions targeting left DLPFC and SMA [11,12]. Additional randomized sham-controlled studies applying a multi-target approach and in combination with neurofeedback will be helpful and can potentially significanly increase the efficacy rate of treatment.
在总共完成41次rTMS和15次“Z-score神经反馈”之后,焦虑和抑郁。患者33岁男性,被诊断患有强迫症、广泛性焦虑和双相抑郁症超过15年。患者接受了5 -羟色胺再摄取抑制剂(SSRIs)、包括锂和丙戊酸在内的情绪稳定剂以及包括劳拉西泮在内的苯二氮卓类药物的试验。在我的诊所就诊时,患者自我内疚,环境焦虑,广场恐怖症,自我价值感,极度抑郁,躁狂和轻躁发作。患者因运动神经元疾病、多发性硬化症等各种疾病而出现严重疑病症,并出现各种躯体症状,包括口腔、躯干和四肢的非特异性振动感。发病时,耶鲁布朗强迫症评分(Y-BOCS)为19分,Burn焦虑评分为36分,Burn抑郁评分为22分,并详细讨论了rTMS的风险和益处PHQ-9,包括rTMS参数的超说明书使用,并获得了患者的书面同意。获得包含导航软件(The Neural Navi gator, brain Science Tools, Utrechet, Netherlands)的皮肤基准标记的脑MRI (The Neural Navi gator, brain Science Tools, Utrechet, Netherlands)。对1mm矢状和轴向T1 MRI图像进行处理和分割,以确定几个皮质目标,包括:左、右背外侧前额叶皮层(DLPFC)、右OFC、左背内侧,这是强迫症病理生理的主要工作模型。一项随机、假对照研究显示,在针对左侧DLPFC和SMA的14次1 Hz连续刺激后,强迫症(Y-BOCS减少29%)和抑郁(HAM-D减少48%)症状有适度改善[11,12]。应用多靶点方法并结合神经反馈的其他随机假对照研究将有所帮助,并可能显著提高治疗的有效率。
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引用次数: 0
Thoughts on the Politics of COVID-19 对新冠肺炎疫情的政治思考
Pub Date : 2021-07-24 DOI: 10.31038/jnnc.2021431
Colin A. Ross
J Neurol Neurocrit Care, Volume 4(3): 1–3, 2021 In previous papers in the Journal of Neurology and Neurocritical Care, I have provided a scholarly, referenced, data-based analysis of misinformation provided by the CDC, governments, the NIH, NIAID and leading physicians and medical journals concerning the COVID-19 pandemic [1-6]. I have had two doses of the Pfizer vaccine and am not an anti-vaxxer. Here I will provide some thoughts on the politics and social dynamics of the response to the pandemic.
在之前发表于Journal of Neurology and Neurocritical Care的论文中,我对CDC、政府、NIH、NIAID以及主要医生和医学期刊提供的关于COVID-19大流行的错误信息进行了学术、参考、基于数据的分析[1-6]。我已经接种了两剂辉瑞疫苗,我不是一个反疫苗者。在此,我将就应对大流行的政治和社会动态提出一些看法。
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引用次数: 1
Case Report of Neuron-Binding IgGs in ALS Patient Serum in Argentina 阿根廷ALS患者血清中神经元结合igg病例报告
Pub Date : 2021-07-15 DOI: 10.31038/jnnc.2021423
Giuliana C. Di Mauro, B. Ambrosi, O. Uchitel, G. Mazzone
Our previous studies demonstrated that motor nerve terminals are a target for autoimmune response, induced by immunoglobulin’s (IgGs) from sporadic ALS patients, resulting in neuromuscular dysfunction in vivo [3]. Indeed, IgGs obtained from patients with ALS reduce Ca 2+ transients and glutamate receptor desensitization so that excitotoxic damage is facilitated in a culture brain neuron model [4]. Furthermore, we have shown that subcutaneous injection of ALS-IgG into the levator auris muscle were immunoreactive to spinal motoneurons, preferentially accumulate in the soma by binding to unknown specific cytoplasmic targets [5]. The question then arises about the role of ALS serum factors on spinal cord neurons and the inflammatory process that would be associated with the disease onset and development. In vitro spinal cord preparations have been exploited as a model to investigate early pathophysiological mechanisms of spinal cord damage and developmental changes in cellular profiles [6]. The aim of the present study was to investigate, using neonatal mouse spinal cord preparations in vitro , the effect of serum from sporadic ALS patients. Thus, sera from patients with sporadic ALS diagnosis in accordance with the El Escorial criteria [7] and from healthy volunteer subjects were tested on neuronal numbers and microglia morphology. Abstract Amyotrophic Lateral Sclerosis (ALS) is a degenerative disorder characterized by ongoing loss of motoneurons. The etiology of the sporadic ALS form it is thought to be related to immune-mediated motoneuron degeneration and death. The present study was designed to describe the effect of serum factors derived from sporadic ALS patients on mouse spinal cord preparations in vitro. Sera from patients with sporadic ALS were collected and used for immunofluorescence analysis to investigate their effects on neuronal survival and microgliosis. Our experiments demonstrated that 5 h application of serum factors (derived from three ALS patients) labeled with human IgG secondary antibody were localized to ventral spinal neurons identified with the NeuN marker. Moreover, a significant reduction in the number of ventral NeuN positive cells was observed with serum from a patient who suffered from upper motor neuron signs as criteria for ALS diagnosis (20% less compared to sham, spinal cord preparations without serum). No change in microglia number was found after exposure to ALS sera, although in two cases a significant decrease in microglial branch length was observed (28-32%). Microglia morphology showed increased number of end points and branches with serum from the patient with upper motor neuron symptoms. These observations were absent after control sera. Our data indicate that spinal cord cultures can be a useful model to further characterize the pathological processes of sporadic ALS and the immune mechanism as previously suggested in vivo . Future studies are needed to unveil the molecular mechanisms underlying this prefe
我们之前的研究表明,运动神经末梢是散发性ALS患者免疫球蛋白(IgGs)诱导自身免疫反应的靶点,导致体内神经肌肉功能障碍[3]。事实上,从ALS患者身上获得的igg减少了ca2 +瞬态和谷氨酸受体脱敏,因此在培养的脑神经元模型中促进了兴奋毒性损伤[4]。此外,我们已经证明,耳提肌皮下注射ALS-IgG对脊髓运动神经元产生免疫反应,并通过结合未知的特异性细胞质靶点优先积聚在胞体中[5]。接下来的问题是肌萎缩侧索硬化症血清因子在脊髓神经元中的作用以及与疾病发生和发展相关的炎症过程。体外脊髓制剂已被用作研究脊髓损伤的早期病理生理机制和细胞发育变化的模型[6]。本研究旨在探讨散发性肌萎缩侧索硬化症(ALS)患者血清对新生小鼠脊髓体外制剂的影响。因此,根据El Escorial标准[7]诊断的散发性ALS患者的血清和健康志愿者的血清进行了神经元数量和小胶质细胞形态的检测。摘要肌萎缩性侧索硬化症(ALS)是一种以运动神经元持续丧失为特征的退行性疾病。散发性肌萎缩侧索硬化症的病因被认为与免疫介导的运动神经元变性和死亡有关。本研究旨在描述散发性肌萎缩侧索硬化症患者血清因子对体外小鼠脊髓制剂的影响。收集散发性肌萎缩侧索硬化症患者血清进行免疫荧光分析,探讨其对神经元存活和小胶质瘤的影响。我们的实验表明,5小时的应用血清因子(来自3名ALS患者)标记的人IgG二抗定位到腹侧脊髓神经元与NeuN标记。此外,将患有上运动神经元体征的患者的血清作为ALS诊断标准,观察到腹侧NeuN阳性细胞的数量显著减少(与不含血清的假性脊髓制剂相比减少20%)。暴露于ALS血清后,未发现小胶质细胞数量发生变化,尽管有两例观察到小胶质细胞分支长度显著减少(28-32%)。上运动神经元症状患者的血清显示小胶质细胞的末端和分支数量增加。对照组血清没有这些观察结果。我们的数据表明,脊髓培养可以作为一种有用的模型,进一步表征散发性ALS的病理过程和免疫机制,正如之前在体内提出的那样。未来的研究需要揭示ALS血清优先靶向神经元和小胶质细胞的分子机制。
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引用次数: 0
COVID Face Masks and the Wuhan Lab Escape Theory: An Update COVID - 19口罩与武汉实验室逃生理论:最新进展
Pub Date : 2021-06-18 DOI: 10.31038/jnnc.2021422
C. Ross
Only a few months ago, a commentary, with supporting evidence, and a supporting quotation from the former head of the CDC, that the Wuhan lab leak theory for the origin of the COVID-19 epidemic “is a rational, reasonable, and scientifically grounded theory” could have been characterized as a conspiracy theory [1]. Now, a few months later, the Wuhan lab leak theory is being acknowledged widely in the mainstream media as just that – rational, reasonable, and scientifically grounded [2,3]. The fact that Chinese military experiments have been conducted at the Wuhan Institute of Virology has recently been confirmed by Mike Pompeo, a former US Secretary of State and former Director of the CIA [3], and is stated on a US Government website [4]: “Despite the WIV presenting itself as a civilian institution, the United States has determined that the WIV has collaborated on publications and secret projects with China’s military. The WIV has engaged in classified research, including laboratory animal experiments, on behalf of the Chinese military since at least 2017.” https://ge.usembassy.gov/ fact-sheet-activity-at-the-wuhan-institute-of-virology/
就在几个月前,一篇有佐证的评论,以及前疾控中心负责人的话,称武汉实验室泄露说是“理性、合理、有科学依据的理论”,简直可以被定性为阴谋论[1]。现在,几个月后,武汉实验室泄漏理论被主流媒体广泛认可——理性、合理、有科学依据[2,3]。中国在武汉病毒研究所进行军事实验的事实最近得到了美国前国务卿、前中央情报局局长迈克·蓬佩奥(Mike Pompeo)的证实[3],并在美国政府网站上发表声明[4]:“尽管武汉病毒研究所自称是一个民间机构,但美国已经确定武汉病毒研究所与中国军方在出版物和秘密项目上进行了合作。至少自2017年以来,WIV代表中国军方从事包括实验室动物实验在内的机密研究。https://ge.usembassy.gov/ fact-sheet-activity-at-the-wuhan institute-of-virology/
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引用次数: 1
期刊
Journal of Neurology and Neurocritical Care
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