Kristin M Ikeda, Anita N Datta, Aristides Hadjinicolaou, Gianluca D'Onofrio, Juan Pablo Appendino, Julia Jacobs-Levan, Eliane Kobayashi, Rajesh Ramachandrannair, Esther Bui
Subspecialty neurology fellowship training is becoming increasingly more common and a requirement to practice at academic institutions. This is especially true for electroencephalography (EEG) and epilepsy, as neurology residency does not usually provide adequate exposure to this complex field. Little is known about the availability and content of epilepsy fellowships in Canada. This study aims to identify this information and characterize available programs. Eight pediatric and eight adult epilepsy fellowship programs were identified. There was a wide range in the availability of resources in many centers, but all centers provided exposure to core EEG and epilepsy skills.
{"title":"Landscape of Postgraduate Epilepsy Education in Canada: A Survey of Canadian Epilepsy Fellowship Programs.","authors":"Kristin M Ikeda, Anita N Datta, Aristides Hadjinicolaou, Gianluca D'Onofrio, Juan Pablo Appendino, Julia Jacobs-Levan, Eliane Kobayashi, Rajesh Ramachandrannair, Esther Bui","doi":"10.1017/cjn.2025.10519","DOIUrl":"https://doi.org/10.1017/cjn.2025.10519","url":null,"abstract":"<p><p>Subspecialty neurology fellowship training is becoming increasingly more common and a requirement to practice at academic institutions. This is especially true for electroencephalography (EEG) and epilepsy, as neurology residency does not usually provide adequate exposure to this complex field. Little is known about the availability and content of epilepsy fellowships in Canada. This study aims to identify this information and characterize available programs. Eight pediatric and eight adult epilepsy fellowship programs were identified. There was a wide range in the availability of resources in many centers, but all centers provided exposure to core EEG and epilepsy skills.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-5"},"PeriodicalIF":2.2,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168071","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}
Abdullah Illeyyan, Omar Shihadeh, Sadeen Eid, Muath Hussein, Fatima Al Sada, Noman Shah, Ahmed Balfakih, Abdulnasser Thabet, Amr El Mohamad, Ali Msheik, Sirajeddin Belkhair
{"title":"Impact of Surgical Timing on Neurological Outcomes in Acute Lumbar Disc Herniation: Ultra-Early Versus Delayed Microdiscectomy.","authors":"Abdullah Illeyyan, Omar Shihadeh, Sadeen Eid, Muath Hussein, Fatima Al Sada, Noman Shah, Ahmed Balfakih, Abdulnasser Thabet, Amr El Mohamad, Ali Msheik, Sirajeddin Belkhair","doi":"10.1017/cjn.2026.10566","DOIUrl":"https://doi.org/10.1017/cjn.2026.10566","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-19"},"PeriodicalIF":2.2,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168136","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}
Meghan Maiani, Anna Bourgeois, Dejana Nikitovic, Margaret Grant, Karim F Damji, Kiran P Manhas, Fiona Costello, Adam Kirton
{"title":"Healthcare provider perspectives on the assessment and management of cerebral visual impairment in children.","authors":"Meghan Maiani, Anna Bourgeois, Dejana Nikitovic, Margaret Grant, Karim F Damji, Kiran P Manhas, Fiona Costello, Adam Kirton","doi":"10.1017/cjn.2026.10564","DOIUrl":"https://doi.org/10.1017/cjn.2026.10564","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-28"},"PeriodicalIF":2.2,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159464","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}
Lama Aljomah, Rabporn Suntornlohanakul, Areej Mahjoub, Helen Branson, Ahmed Naqvi, E Ann Yeh
{"title":"Thinking outside of the MOGAD box: when does CNS-HLH make more sense?","authors":"Lama Aljomah, Rabporn Suntornlohanakul, Areej Mahjoub, Helen Branson, Ahmed Naqvi, E Ann Yeh","doi":"10.1017/cjn.2026.10556","DOIUrl":"https://doi.org/10.1017/cjn.2026.10556","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120934","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}
Xueming Li, Weijiang Ding, Yan Lu, Meiying Sun, Enwang Xu
Background: Early detection of respiratory decline is crucial in amyotrophic lateral sclerosis (ALS). We tested if nocturnal polysomnography (PSG) predicts dyspnea onset in mild ALS patients with preserved daytime function.
Methods: In this study, 41 mild ALS patients (ALS Functional Rating Scale-Revised [ALSFRS-R] ≥ 37, sitting forced vital capacity [FVC] ≥80% predicted, no dyspnea) and 41 matched controls underwent baseline assessment, including ALSFRS-R scoring, pulmonary function tests, and overnight PSG. ALS patients were followed for 12 months. Baseline apnea-hypopnea index (AHI) and oxygen saturation (mean SpO2, minimum SpO2) were analyzed as continuous predictors and using exploratory thresholds (AHI ≥ 5 events/h, min SpO2 ≤ 88%, mean SpO2 ≤ 95%) for dyspnea onset (Dyspnea-ALS-15 [DALS-15] > 0).
Results: Compared to controls, ALS patients had significantly higher AHI (p = 0.004) and lower minimum SpO2 (p = 0.018). The ALSFRS-R orthopnea subscore showed a significant positive correlation with mean and minimum SpO2 (P < 0.05). Cox regression identified baseline AHI (HR 1.08 per event/h; 95% CI 1.01-1.15, p = 0.028) and minimum SpO2 (HR 0.94 per %; 95% CI 0.88-0.99, p = 0.033) as independent predictors of dyspnea onset within 12 months. Thresholds AHI ≥ 5 (HR 2.28, p = 0.031) and min SpO2 ≤ 88% (HR 2.42, p = 0.027) also predicted increased risk. Patients meeting ≥1 threshold (n = 25/37) showed trends toward greater FVC and ALSFRS-R decline.
Conclusions: In patients with mild ALS and normal daytime function, specific nocturnal PSG parameters (AHI, minimum SpO2) predicted the risk of dyspnea within 12 months. This longitudinal study provides novel evidence that PSG could identify early respiratory vulnerability in the incipient stage, earlier than conventional FVC-based monitoring, supporting its potential utility in refining early intervention strategies. Validation in larger cohorts is warranted.
背景：在肌萎缩性侧索硬化症（ALS）中，早期发现呼吸衰退是至关重要的。我们测试了夜间多导睡眠图（PSG）是否能预测轻度肌萎缩侧索硬化症患者白天功能保留时的呼吸困难发作。方法：在本研究中，41例轻度ALS患者（ALS功能评定量表-修订版[ALSFRS-R]≥37，预测坐位用力肺活量[FVC]≥80%，无呼吸困难）和41例匹配对照进行基线评估，包括ALSFRS-R评分、肺功能检查和夜间PSG。ALS患者随访12个月。基线呼吸暂停低通气指数（AHI）和氧饱和度（平均SpO2，最低SpO2）作为连续预测指标进行分析，并使用探索性阈值（AHI≥5事件/小时，最小SpO2≤88%，平均SpO2≤95%）诊断呼吸困难发作（dyspnea - als -15 [DALS-15] >）。结果：与对照组相比，ALS患者的AHI显著增高（p = 0.004），最低SpO2显著降低（p = 0.018）。ALSFRS-R骨科评分与SpO2均值和最小值呈正相关（P < 0.05）。Cox回归确定基线AHI （HR 1.08 /事件/小时；95% CI 1.01-1.15, p = 0.028）和最低SpO2 （HR 0.94 / %; 95% CI 0.88-0.99, p = 0.033）是12个月内呼吸困难发作的独立预测因子。阈值AHI≥5 （HR 2.28, p = 0.031）和最小SpO2≤88% （HR 2.42, p = 0.027）也预示着风险增加。≥1阈值的患者（n = 25/37）有FVC升高和ALSFRS-R下降的趋势。结论：在轻度ALS患者中，白天功能正常，特定的夜间PSG参数（AHI，最小SpO2）预测12个月内呼吸困难的风险。这项纵向研究提供了新的证据，证明PSG可以在早期阶段识别早期呼吸易损，比传统的基于fvc的监测更早，支持其在完善早期干预策略方面的潜在效用。在更大的队列中验证是有必要的。
{"title":"Nocturnal Hypoxia and Sleep-Disordered Breathing as Potential Early Biomarkers of Respiratory Progression in Mild ALS.","authors":"Xueming Li, Weijiang Ding, Yan Lu, Meiying Sun, Enwang Xu","doi":"10.1017/cjn.2026.10557","DOIUrl":"10.1017/cjn.2026.10557","url":null,"abstract":"<p><strong>Background: </strong>Early detection of respiratory decline is crucial in amyotrophic lateral sclerosis (ALS). We tested if nocturnal polysomnography (PSG) predicts dyspnea onset in mild ALS patients with preserved daytime function.</p><p><strong>Methods: </strong>In this study, 41 mild ALS patients (ALS Functional Rating Scale-Revised [ALSFRS-R] ≥ 37, sitting forced vital capacity [FVC] ≥80% predicted, no dyspnea) and 41 matched controls underwent baseline assessment, including ALSFRS-R scoring, pulmonary function tests, and overnight PSG. ALS patients were followed for 12 months. Baseline apnea-hypopnea index (AHI) and oxygen saturation (mean SpO<sub>2</sub>, minimum SpO<sub>2</sub>) were analyzed as continuous predictors and using exploratory thresholds (AHI ≥ 5 events/h, min SpO<sub>2</sub> ≤ 88%, mean SpO<sub>2</sub> ≤ 95%) for dyspnea onset (Dyspnea-ALS-15 [DALS-15] > 0).</p><p><strong>Results: </strong>Compared to controls, ALS patients had significantly higher AHI (p = 0.004) and lower minimum SpO<sub>2</sub> (p = 0.018). The ALSFRS-R orthopnea subscore showed a significant positive correlation with mean and minimum SpO<sub>2</sub> (P < 0.05). Cox regression identified baseline AHI (HR 1.08 per event/h; 95% CI 1.01-1.15, p = 0.028) and minimum SpO<sub>2</sub> (HR 0.94 per %; 95% CI 0.88-0.99, p = 0.033) as independent predictors of dyspnea onset within 12 months. Thresholds AHI ≥ 5 (HR 2.28, p = 0.031) and min SpO<sub>2</sub> ≤ 88% (HR 2.42, p = 0.027) also predicted increased risk. Patients meeting ≥1 threshold (n = 25/37) showed trends toward greater FVC and ALSFRS-R decline.</p><p><strong>Conclusions: </strong>In patients with mild ALS and normal daytime function, specific nocturnal PSG parameters (AHI, minimum SpO<sub>2</sub>) predicted the risk of dyspnea within 12 months. This longitudinal study provides novel evidence that PSG could identify early respiratory vulnerability in the incipient stage, earlier than conventional FVC-based monitoring, supporting its potential utility in refining early intervention strategies. Validation in larger cohorts is warranted.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114676","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}
Prateek Malik, Hao Li, Lee Cyn Ang, Cheryl Foster, Seth Andrew Climans
{"title":"Dexamethasone Obscures and Molecular Diagnostics Illuminate Diagnosis of Primary CNS Lymphoma Mimicking Glioblastoma.","authors":"Prateek Malik, Hao Li, Lee Cyn Ang, Cheryl Foster, Seth Andrew Climans","doi":"10.1017/cjn.2025.10522","DOIUrl":"https://doi.org/10.1017/cjn.2025.10522","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101108","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}
Kyah Kang, Ria Grewal, Cyrus Boelman, Mary B Connolly, Linda Huh, Anita N Datta
{"title":"Highly Purified Cannabidiol Treatment Outcomes in Pediatric Patients with Highly Refractory Epilepsy at Tertiary Center.","authors":"Kyah Kang, Ria Grewal, Cyrus Boelman, Mary B Connolly, Linda Huh, Anita N Datta","doi":"10.1017/cjn.2026.10554","DOIUrl":"https://doi.org/10.1017/cjn.2026.10554","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-26"},"PeriodicalIF":2.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088234","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}
Amirah I Momen, Mark S Freedman, Giulia Fadda, Andrea Konig, Liesly Lee, Ruth Ann Marrie, Sarah A Morrow, Jennifer A McCombe, Natalie E Parks, Penelope Smyth, Courtney S Casserly, Dalia L Rotstein
{"title":"Demographic and clinical characteristics of aquaporin-4 antibody positive neuromyelitis optica spectrum disorder in Canadian adults.","authors":"Amirah I Momen, Mark S Freedman, Giulia Fadda, Andrea Konig, Liesly Lee, Ruth Ann Marrie, Sarah A Morrow, Jennifer A McCombe, Natalie E Parks, Penelope Smyth, Courtney S Casserly, Dalia L Rotstein","doi":"10.1017/cjn.2026.10539","DOIUrl":"https://doi.org/10.1017/cjn.2026.10539","url":null,"abstract":"","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-27"},"PeriodicalIF":2.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088262","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}
Sanaz G Biglou, Ronda Lun, Tim Ramsay, Michel Shamy, Markus Schwerzmann, Dar Dowlatshahi
The presence of right-to-left shunt has been proposed as a prominent mechanism of paradoxical embolism in patients with active cancer. We conducted a retrospective observational study including patients presenting to the Ottawa Hospital between January 2020 and December 2022 with ischemic stroke with and without active cancer. Among 491 patients (36.9% female, median age 53), 43 (8.8%) had active cancer, with 12 (27.9%, 95% CI 15-44) having a shunt. Of 448 patients without cancer, 133 (29.7%, 95% CI 25-34) had a shunt. Overall, our finding does not support the hypothesis that cancer-associated stroke is related to right-to-left shunting.
右至左分流的存在被认为是活动性癌症患者矛盾栓塞的重要机制。我们进行了一项回顾性观察性研究，纳入了2020年1月至2022年12月期间在渥太华医院就诊的伴有或不伴有活动性癌症的缺血性卒中患者。在491例患者中（36.9%为女性，中位年龄53岁），43例（8.8%）有活动性癌症，12例（27.9%,95% CI 15-44）有分流术。在448例无癌患者中，133例（29.7%,95% CI 25-34）有分流术。总的来说，我们的发现不支持癌症相关中风与右至左分流有关的假设。
{"title":"Prevalence of Right-to-Left Shunting on Echocardiography in Patients with Cancer and Stroke.","authors":"Sanaz G Biglou, Ronda Lun, Tim Ramsay, Michel Shamy, Markus Schwerzmann, Dar Dowlatshahi","doi":"10.1017/cjn.2025.10518","DOIUrl":"https://doi.org/10.1017/cjn.2025.10518","url":null,"abstract":"<p><p>The presence of right-to-left shunt has been proposed as a prominent mechanism of paradoxical embolism in patients with active cancer. We conducted a retrospective observational study including patients presenting to the Ottawa Hospital between January 2020 and December 2022 with ischemic stroke with and without active cancer. Among 491 patients (36.9% female, median age 53), 43 (8.8%) had active cancer, with 12 (27.9%, 95% CI 15-44) having a shunt. Of 448 patients without cancer, 133 (29.7%, 95% CI 25-34) had a shunt. Overall, our finding does not support the hypothesis that cancer-associated stroke is related to right-to-left shunting.</p>","PeriodicalId":56134,"journal":{"name":"Canadian Journal of Neurological Sciences","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088245","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}
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