Medical Specialties Commons^™

The Significance Of A Triple Flexion Reflex In The Acute Spinal Cord Injured Patient: A Case Report And Review Of The Literature, S. K. Fetouh, S. Kolli, R. J. Marino, N. D. Martin, A. L. Schreiber

Department of Rehabilitation Medicine Faculty Papers

The TFR is a sign of upper motor neuron impairment. It does not typically appear for several days after an injury but in patients with pre-existing myelopathy, an early onset exaggerated Babinski response exhibited as a TFR may occur. It is important not to misinterpret such responses as volitional movements, particularly in patients with cognitive dysfunction where the history and physical examination may be limited. Failure to immobilize the spine and to administer adjunct steroid therapy may be detrimental to the patient. Education of initial response physicians may prevent overlooking an acute SCI.

Surgical Interventions For Malignant Middle Cerebral Infarction--Saving Lives And Functionality Or Increasing Disabled Survivors?, Maria Khan, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Posterior Reversible Encephalopathy Syndrome: A Case Series In Patients With Eclampsia, Rohana Naqi, Humera Ahsan, Muhammad Azeemuddin

Department of Radiology

Posterior Reversible Encephalopathy Syndrome (PRES) refers to a clinicoradiologic entity with characteristic features on neuro-imaging and non-specific symptoms comprising headache, confusion, visual disturbances and seizures. The lesions in PRES are thought to be due to vasogenic oedema, predominantly in the posterior cerebral hemispheres, and are reversible with appropriate management. We report 3 cases of acute PRES who had eclampsia and presented with recurrent episodes of seizures and hypertension. Their MRI scan showed diffuse abnormal signal intensities involving predominantly deep white matter of the occipital lobes. Based on the findings the most probable diagnosis of PRES was suggested. They were started …

Surgical Interventions For Malignant Middle Cerebral Infarction--Saving Lives And Functionality Or Increasing Disabled Survivors?, Maria Khan, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Brain Research To Ameliorate Impaired Neurodevelopment - Home-Based Intervention Trial (Brain-Hit), Jan L. Wallander, Elizabeth Mcclure, Fred Biasini, Shivaprasad S. Goudar, Omrana Pasha, Elwyn Chomba, Darlene Shearer, Linda Wright, Vanessa Thorsten, Hrishikesh Chakraborty, Sangappa M. Dhaded, Niranjana S. Mahantshetti, Roopa M. Bellad, Zahid Abbasi, Waldemar Carlo

Community Health Sciences

Background: This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low-and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low-and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality …

Impact Of Insurance Status On Migraine Care In The United States, Andrew Wilper, Steffie Woolhandler, David U. Himmelstein, Rachel Nardin

Publications and Research

Objective
To determine whether insurance status is associated with differential outpatient treatment of migraine in the United States.

Methods
We analyzed 11 years of data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (1997–2007), which survey patient visits to doctors’ offices, hospital outpatient departments, and emergency departments (EDs) in the United States. We used logistic regression to determine whether insurance status was associated with the prescription of standard migraine therapy, defined as 1) a triptan or dihydroergotamine and 2) a prophylactic agent.

Results
We identified 6,814 individual patient visits for migraine, representing 68.6 million …

Future Of Neurology In Pakistan, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Risk Factors For Ischemic Stroke In Patients Attending Tertiary Hospital In Quetta, Ms. Barech, Sm Sadiq, Ak Zarkoon, M Gulandam, Kaleem Ullah

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Early Outcome Of Subthalamic Nucleus – Deep Brain Stimulation (Stn-Dbs) In The Advanced Stage Of Parkinson Disease – A Trial Of Iranian Patients, G.A. Shahidi, Mohammad Rohani, Bahram H, Javad M

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Pediatrics Neurolgy, Shamshad Gulab

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Neurosurgery, Mohsin Qadeer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Spectrum Of Chronic Acquired Immune Neuropathies, K. Sher, H Firdaus, S Ali

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Post Cardiac Surgery Opthalamoplegia Due To Pitutary Apolexy, M. Khan, M Shahzad Shamim, Aa Siddiqui

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Approach To Symptomatic Migraine - A Reviewof Literature, Ayesha Kk, Rushna Raza, Sahar Zafar

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Fatal Primary Intraventricular Hemorrhage In 3rd Trimester Of Pregnancy With Rescue Of Baby, S. Tamizuddin, M Hashmi, Ismail A. Khatri

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Overview Of Surgical Management Of Infectious Non Suppurative Brain Lesions (Part Ii), M.S. Shamim, Sa Enam, S.F Ali, R.P Ali, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

17th Annual Psn Meeting, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Walk On, Australia: An Exceptional Approach To Spinal Cord Injury, Amanda Randall

Inquiry Journal 2010

No abstract provided.

Valproate Semisodium Er For Migraine And Cluster Headache Prophylaxis., Brigitte V. Lovell, Michael J. Marmura

Department of Neurology Faculty Papers

IMPORTANCE OF THE FIELD: Migraine and cluster headache (CH) are disabling syndromes that often require prophylactic treatment. Valproate semisodium ER (VPS ER) is FDA-approved for the treatment of epilepsy, acute mania in bipolar disorder and migraine prophylaxis.

AREAS COVERED IN THIS REVIEW: We reviewed literature regarding VPS ER pharmacokinetics and its use in migraine and CH prophylaxis.

WHAT THE READER WILL GAIN: VPS ER is well studied and effective in the preventive treatment of migraine and CH. This article reviews the evidence for its use, describes how to administer and dose this medication, and reviews important safety precautions.

TAKE HOME …

Metabolic Consequences Of Antiepileptic Drugs, Scott Mintzer

Department of Neurology Faculty Papers

Purpose of Review: Chemical properties of the widely used older generation antiepileptic drugs (AEDs) suggest that they might be responsible for a number of medical comorbidities. Recent Findings: AEDs which induce the cytochrome P450 system adversely affect bone, lipid, and gonadal steroid metabolism. Specifically, phenytoin causes loss of bone mass in women, and both phenytoin and carbamazepine produce increases in serum lipids and C-reactive protein, as well as decreases in bioactive testosterone in men. Patients treated with inducing AEDs are at increased risk of fracture. Some contradictory data raise the question of whether bone mass is truly related to enzyme …

Headache In Cerebral Venous Thrombosis: Incidence, Pattern And Location In 200 Consecutive Patients., Mohammad Wasay, Suleman Kojan, Alper I Dai, George Bobustuc, Zubair Sheikh

Section of Neurology

We analyzed the incidence, pattern and location of headache in consecutive 200 Patients with proven diagnosis of CVT to identify an association between localization of headache and site of sinus involvement. Headache was present in 136 (68%) Patients. The duration of headache (reported in 128 Patients) was reported as acute (1-3 days), 81 Patients (60%), sub-acute (4-14 days), 33 Patients (24%), and chronic (more than 14 days), 14 Patients (10%). The quality of headache (reported in 72 Patients) was reported as throbbing 12 (9%), band like 27 (20%), thunderclap 7 (5%), and other (pounding, exploding, stabbing, etc.) 26 (20%). The …

The International Surgical Trial In Intracerebral Haemorrhage (Stich)--What Are Its Implications In A Resource Limited Health System Like Pakistan, Maria Khan, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Molecular Cross Talk Between Misfolded Proteins In Animal Models Of Alzheimer's And Prion Diseases, Rodrigo Morales, Lisbell D Estrada, Rodrigo Diaz-Espinoza, Diego Morales-Scheihing, Maria C Jara, Joaquin Castilla, Claudio Soto

Faculty, Staff and Student Publications

The central event in protein misfolding disorders (PMDs) is the accumulation of a misfolded form of a naturally expressed protein. Despite the diversity of clinical symptoms associated with different PMDs, many similarities in their mechanism suggest that distinct pathologies may cross talk at the molecular level. The main goal of this study was to analyze the interaction of the protein misfolding processes implicated in Alzheimer's and prion diseases. For this purpose, we inoculated prions in an Alzheimer's transgenic mouse model that develop typical amyloid plaques and followed the progression of pathological changes over time. Our findings show a dramatic acceleration …

Electronic Medical Records As A Research Tool: Evaluating Topiramate Use At A Headache Center., Michael J. Marmura, Md, Mary Hopkins, Rn, Msn, Jocelyn Andrel, Msph, William B. Young, Md, David M. Biondi, Do, Marcia F.T. Rupnow, Phd, Robert B. Armstrong, Md

Department of Neurology Faculty Papers

Background.—Electronic medical records (EMRs) are used in large healthcare centers to increase efficiency and accuracy of documentation. These databases may be utilized for clinical research or to describe clinical practices such as medication usage.

Methods.—We conducted a retrospective analysis of EMR data from a headache clinic to evaluate clinician prescription use and dosing patterns of topiramate. The study cohort comprised 4833 unique de-identified records, which were used to determine topiramate dose and persistence of treatment.

Results.—Within the cohort, migraine was the most common headache diagnosis (n = 3753, 77.7%), followed by tension-type headache (n = 338, 7.0%) and cluster or …

Dual-Task Interference: The Effects Of Verbal Cognitive Tasks On Upright Postural Stability In Parkinson's Disease, J. D. Holmes, M. E. Jenkins, Andrew M. Johnson, S. G. Adams, S. J. Spaulding

Occupational Therapy Publications

Although dual-task interference has previously been demonstrated to have a significant effect on postural control among individuals with Parkinson's disease, the impact of speech complexity on postural control has not been demonstrated using quantitative biomechanical measures. The postural stability of twelve participants with idiopathic Parkinson's disease and twelve healthy age-matched controls was evaluated under three conditions: (1) without a secondary task, (2) performing a rote repetition task and (3) generating a monologue. Results suggested a significant effect of cognitive load on biomechanical parameters of postural stability. Although both groups increased their postural excursion, individuals with Parkinson's disease demonstrated significantly reduced …

Improving Schizophrenia Diagnosis Through Biomarkers: An Upcoming Prospect, Syed Mohammad Asad Zaidi, Abdul Latif Bikak, Rameez-Ul Hassan

Medical College Documents

No abstract provided.

Progressive Changes In Microglia And Macrophages In Spinal Cord And Peripheral Nerve In The Transgenic Rat Model Of Amyotrophic Lateral Sclerosis, David J. Graber, William F. Hickey, Brent T. Harris

Dartmouth Scholarship

The role of neuroinflammation in motor neuron death of amyotrophic lateral sclerosis (ALS) is unclear. The human mutant superoxide dismutase-1 (hmSOD1)-expressing murine transgenic model of ALS has provided some insight into changes in microglia activity during disease progression. The purpose of this study was to gain further knowledge by characterizing the immunological changes during disease progression in the spinal cord and peripheral nerve using the more recently developed hmSOD1 rat transgenic model of ALS. Using immunohistochemistry, the extent and intensity of tissue CD11b expression in spinal cord, lumbar nerve roots, and sciatic nerve were evaluated in hmSOD1 rats that were …

Neural Activity In The Hippocampus And Perirhinal Cortex During Encoding Is Associated With The Durability Of Episodic Memory, V. A. Carr, Indre Viskontas, S. A. Engel, B. J. Knowlton

Psychology

Studies examining medial temporal lobe (MTL) involvement in memory formation typically assess memory performance after a single, short delay. Thus, the relationship between MTL encoding activity and memory durability over time remains poorly characterized. To explore this relationship, we scanned participants using high-resolution functional imaging of the MTL as they encoded object pairs; using the remember/know paradigm, we then assessed memory performance for studied items both 10 min and 1 week later. Encoding trials were classified as either subsequently recollected across both delays, transiently recollected (i.e., recollected at 10 min but not after 1 week), consistently familiar, or consistently forgotten. …

Elevated Csf Outflow Resistance Associated With Impaired Lymphatic Csf Absorption In A Rat Model Of Kaolin-Induced Communicating Hydrocephalus, Gurjit Nagra, Mark E. Wagshul, Shams Rashid, Jie Li, J Pat Mcallister Ii, Miles Johnston

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

We recently reported a lymphatic cerebrospinal fluid (CSF) absorption deficit in a kaolin model of communicating hydrocephalus in rats with ventricular expansion correlating negatively with the magnitude of the impediment to lymphatic function. However, it is possible that CSF drainage was not significantly altered if absorption at other sites compensated for the lymphatic defect. The purpose of this study was to investigate the impact of the lymphatic absorption deficit on global CSF absorption (CSF outflow resistance).

Methods

Kaolin was injected into the basal cisterns of Sprague Dawley rats. The development of hydrocephalus was assessed using magnetic resonance imaging …

Laterality, Perception, And Action During The Size-Weight Illusion, Gavin Buckingham, Nathalie S. Ranger, Melvyn A. Goodale

Psychology Presentations

In the classic size-weight illusion (SWI), a small object will feel heavier than an larger object of equal weight (Charpentier, 1891). Individuals continue to perceive this illusory difference in weight long after their gripping and lifting forces have scaled to the actual, identical, mass of the illusion-inducing stimuli (Flanagan & Beltzner, 2000).

The independence of our weight perception and fingertip force application has only been quantified in the right hand of right-handers. The immunity to this perceptual illusion may be affected by manual asymmetries (e.g., Gonzalez, Ganel & Goodale, 2006).

We examined perception of heaviness and fingertip force scaling in …