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Reframing postconcussional syndrome as an interface disorder of neurology, psychiatry and psychology.

Persistent symptoms following a minor head injury can cause significant morbidity, yet the underlying mechanisms for this are poorly understood. The shortcomings of the current terminology that refer to non-specific symptom clusters is discussed. This update considers the need for a multi-dimensional approach for the heterogenous mechanisms driving persistent symptoms after mild traumatic brain injury. Relevant pathophysiology is discussed to make the case for mild traumatic brain injury to be conceptualized as an interface disorder spanning neurology, psychiatry and psychology. The relevance …

Emergency medicine physicians' perspectives on diagnostic accuracy in neurology: a qualitative study.

OBJECTIVES: We sought to understand the knowledge, attitudes, and beliefs of emergency medicine (EM) physicians towards non-specific neurological conditions and the use of clinical decision support (CDS) to improve diagnostic accuracy. METHODS: We conducted semi-structured interviews of EM physicians at four emergency departments (EDs) affiliated with a single US healthcare system. Interviews were conducted until thematic saturation was achieved. Conventional content analysis was used to identify themes related to EM physicians' perspectives on acute diagnostic neurology; directed content ana…

Corneal Confocal Microscopy to Image Small Nerve Fiber Degeneration: Ophthalmology Meets Neurology.

Neuropathic pain has multiple etiologies, but a major feature is small fiber dysfunction or damage. Corneal confocal microscopy (CCM) is a rapid non-invasive ophthalmic imaging technique that can image small nerve fibers in the cornea and has been utilized to show small nerve fiber loss in patients with diabetic and other neuropathies. CCM has comparable diagnostic utility to intraepidermal nerve fiber density for diabetic neuropathy, fibromyalgia and amyloid neuropathy and predicts the development of diabetic neuropathy. Moreover, in clinical intervention trials of patients with diabetic and

Telemedicine in Behavioral Neurology-Neuropsychiatry: Opportunities and Challenges Catalyzed by COVID-19.

Coronavirus 2019 (COVID-19) has profoundly impacted the well-being of society and the practice of medicine across health care systems worldwide. As with many other subspecialties, the clinical paradigm in behavioral neurology and neuropsychiatry (BN-NP) was transformed abruptly, transitioning to real-time telemedicine for the assessment and management of the vast majorities of patient populations served by our subspecialty. In this commentary, we outline themes from the BN-NP perspective that reflect the emerging lessons we learned using telemedicine during the COVID-19 pandemic. Positive deve…

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG).

Neuromyelitis optica spectrum disorder (NMOSD), autoimmune encephalitis (AE), myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are antibody-mediated neurological diseases. They have mostly female predominance, affecting many women during childbearing age. Interactions between the underlying disease (or necessary treatment) and pregnancy can occur in every of these illnesses. Herein, we present the characteristics of NMOSD, AE, MG and LEMS in general, and review published data regarding the influence of the different diseases on fertility, pregnancy, puerperium, treatment str

Формирующийся спектр неврологии COVID-19: клинические, радиологические и лабораторные выводы.

Предварительные клинические данные свидетельствуют о том, что инфекция с острым острым респираторным синдромом коронавирус 2 (SARS-COV-2) связана с неврологическим и нейропсихиатрическим заболеванием. В ответ на это в начале марта 2020 года в Национальной больнице Квин-Сквер было организовано еженедельное междисциплинарное совещание по виртуальной коронавирусной болезни 19 (COVID-19) с целью обсуждения и начала понимания неврологических презентаций у пациентов с предполагаемыми неврологическими расстройствами, связанными с COVID-19. Подробные клинические и параклинические данные были собраны в

Совпадение в аннотации оригинала
Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness. Responding to this, a weekly virtual coronavirus disease 19 (COVID-19) neurology multi-disciplinary meeting was established at the National Hospital, Queen Square, in early March 2020 in …

The Controversial Role of Homocysteine in Neurology: From Labs to Clinical Practice.

Homocysteine (Hcy) is a sulfur-containing amino acid that is generated during methionine metabolism. Physiologic Hcy levels are determined primarily by dietary intake and vitamin status. Elevated plasma levels of Hcy can be caused by deficiency of either vitamin B12 or folate. Hyperhomocysteinemia (HHcy) can be responsible of different systemic and neurological disease. Actually, HHcy has been considered as a risk factor for systemic atherosclerosis and cardiovascular disease (CVD) and HHcy has been reported in many neurologic disorders including cognitive impairment and stroke, independent of

Acquired Ocular Motor Nerve Palsy in Neurology Clinics: A Prospective Multicenter Study.

BACKGROUND AND PURPOSE: This study aimed to determine the patterns and etiologies of acquired ocular motor nerve palsy (OMNP) diagnosed in neurology clinics. We also investigated the clinical features that may predict the causes other than microvascular ischemia in isolated OMNP. METHODS: We performed a prospective multicenter study that had recruited 298 patients with acquired OMNP from the neurology clinics of referral-based 9 university hospitals in Korea. We finally selected 235 patients with isolated OMNP and divided them into older (age ≥50 years, n=188) and younger (age <50 years, n=47…

Nursing review section of surgical neurology international: Part 1 lumbar disc disease.

BACKGROUND: Patients with lumbar disc disease may present with low back pain, pain that radiates down into the lower extremity (radiculopathy), and leg pain that increases with ambulation (neurogenic claudication). Patients may first undergo diagnostic studies [(magnetic resonance imaging (MRI) and computed tomographic (CT) examinations] to determine whether there is any significant nerve root or thecal sac compression. METHODS: Increasingly, patients with low back pain with/without radiculopathy are being screened by nurses rather than by neurologists or neurosurgeons/orthopedists. Recogniti

Nursing Review Section of Surgical Neurology International Part 2: Lumbar Spinal Stenosis.

BACKGROUND: The lumbar spine includes 5 lumbar vertebral bodies, L1, L2, L3, L4, and L5. At each level, there is a disc space defined by the two bones (vertebral bodies) in the back; for example, there is a disc space at the L5-S1 level etc. The normal front to back (anterior to posterior or AP diameter) measurement of the spinal canal is typically 18-20 mm, but some patients have narrowing called spinal stenosis. METHODS: Lumbar stenosis is defined by two major types. Central stenosis compresses the midline (in the middle) sac of nerve tissue (dural or thecal sac containing the lumbar nerve

Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review.

N-acetylcysteine (NAC) is recognized for its role in acetaminophen overdose and as a mucolytic. Over the past decade, there has been growing evidence for the use of NAC in treating psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes associated with these disorders, including oxidative stress, apoptosis, mitochondrial dysfunction, neuroinflammation and glutamate and dopamine dysregulation. In this systematic review we find favorable evidence for the use of NAC in several psychiatric and neurological disorders, particularly autism, Alzheimer's

Dilatation of Virchow-Robin spaces in children hospitalized at pediatric neurology department.

BACKGROUND AND PURPOSE: Dilated Virchow-Robin spaces (dVRs) have been revealed by magnetic resonance imaging (MRI) in patients with various … performed in children with different diseases of nervous system, who were hospitalized at Pediatric Neurology Department, Chair of Children and Adolescent Neurology, Jagiellonian University in the years 2010-2011. The mean age of examined children was 11.58 years, and the studied group included 27 boys and 26 girls. RESULTS: Within two years, MRI examinati …

The potential of pregabalin in neurology, psychiatry and addiction: a qualitative overview.

Pregabalin is an anticonvulsant drug that binds to the α₂δ (alpha2delta) subunit of the voltage-dependent calcium channel in central nervous system (CNS). Pregabalin decreases the release of neurotransmitters, including glutamate, norepinephrine, substance P and calcitonin gene-related peptide. Purpose of this paper is to offer a qualitative overview of the studies currently available in literature about this drug, examining the effectiveness of pregabalin in its various fields of application. Our analysis, conducted on a final selection of 349 scientific papers, shows that pregabalin may help

Spectrum of fungal infection in a neurology tertiary care center in India.

There is a paucity of studies on spectrum of fungal infections in neurology care. This study reports clinical, MRI and outcome of patients with central nervous system (CNS) fungal infections. 39 patients with CNS fungal infections treated in neurology service during the last 3 years were included and a detailed medical history and clinical examination were undertaken. Cranial MRI including paranasal sinuses were carried out and the location and nature of abnormalities were noted. Fungal infection was confirmed by CSF examination or histopathology. Death during hospital stay was noted. The medi…

Behavioral neurology in language and aphasia: from basic studies to clinical applications.

With increasing aging population, cognitive deteriorations due to neuro- degenerative diseases or stroke are so commonly observed that it is thought to be inevitable with aging. For dementia and stroke, a communication disorder due to language deterioration is one of the main problems. Behavioral neurology aims to clarify the relationship between brain function and behavior; language deterioration is one of the main targets, and its clinical applications are really useful for making better understanding of patients. Language is sequences of sound or characters that carry meanings for communica…

Effect of a multidisciplinary fall risk assessment on falls among neurology inpatients.

OBJECTIVE: To evaluate whether the addition of a physician assessment of patient fall risk at admission would reduce inpatient falls on a tertiary hospital neurology inpatient unit. PATIENTS AND METHODS: A physician fall risk assessment was added to the existing risk assessment process (clinical nurse evaluation and Hendrich II Fall Risk Model score with specific fall prevention measures for patients at risk). An order to select either "Patient is" or "Patient is not at high risk of falls by physician assessment" was added to the physician electronic admission order set. Nurses and physicians…