Neurology Commons^™

Case Based Review On Headaches And Cerebral Venous Thromboembolism Post Covid-19 Infection, Aishwarya Raich, Tanvir Khosla, Vishnu Halthore, Ali Abu-Alya, Venkatachalam Veerappan

Far West Division GME Research Day 2023

No abstract provided.

Sudden Onset Ams, Focal Weakness, Fever And Aphasia Due To Intracranial Subdural Empyema In Left Temporo-Parietal Lobe, Lily Hyunjung Lim, Menachem M. Nagar, Pallavi Aneja

East Florida Division GME Research Day 2023

Intracranial subdural empyema (ISE) is a rare infection of brain, which occurs when pus is collectively located in the space between dura and arachnoid matter. In the past, its mortality was nearly 100%, if it was not treated appropriately within 24-48 hours. Thanks to improvement of diagnostic modalities and treatment, its mortality has dramatically decreased. Though, it can still cause a devastating consequence if it is not managed in a timely manner. The common etiology of ISE is different depending on the age group. In younger patients, it occurs frequently as a complication of infection in neighboring structures like sinusitis …

Exploring The Reduction Of Ipap Below Epap In The Therapy Of Obstructive Sleep Apnea, William Noah, Sue Lynn Myhre

TriStar Division Research Day 2023

No abstract provided.

Thyroid Steal Syndrome Secondary To Active Hyperthyroid State, Harrison Humphries, Johnathon Chung, Reza Pirzadeh, Wesley Jones, Mohamad Ezzeldin

Gulf Coast Division GME Research Day 2022

No abstract provided.

What Internal Variables Affect Sensorimotor Rhythm Brain-Computer Interface (Smr-Bci) Performance?, Alex J. Horowitz, Christoph Guger, Milena Korostenskaja

HCA Healthcare Journal of Medicine

In this review article, we aimed to create a summary of the effects of internal variables on the performance of sensorimotor rhythm-based brain computer interfaces (SMR-BCIs). SMR-BCIs can be potentially used for interfacing between the brain and devices, bypassing usual central nervous system output, such as muscle activity. The careful consideration of internal factors, affecting SMR-BCI performance, can maximize BCI application in both healthy and disabled people. Internal variables may be generalized as descriptors of the processes mainly dependent on the BCI user and/or originating within the user. The current review aimed to critically evaluate and summarize the currently accumulated …

What External Variables Affect Sensorimotor Rhythm Brain-Computer Interface (Smr-Bci) Performance?, Alex J. Horowitz, Christoph Guger, Milena Korostenskaja

HCA Healthcare Journal of Medicine

Sensorimotor rhythm-based brain-computer interfaces (SMR-BCIs) are used for the acquisition and translation of motor imagery-related brain signals into machine control commands, bypassing the usual central nervous system output. The selection of optimal external variable configuration can maximize SMR-BCI performance in both healthy and disabled people. This performance is especially important now when the BCI is targeted for everyday use in the environment beyond strictly regulated laboratory settings. In this review article, we summarize and critically evaluate the current body of knowledge pertaining to the effect of the external variables on SMR-BCI performance. When assessing the relationship between SMR-BCI performance and …

Hyperglycemia Followed By An Abrupt Decrease Of Blood Glucose Is A Rare Cause Of Posterior Reversible Encephalopathy Syndrome (Pres), Liza Garabet Diramerian, Nabila Ashraf, Admir Syla, Armen Malkhasian, Jason Madey

HCA Healthcare Journal of Medicine

Introduction

Posterior Reversible Encephalopathic Syndrome (PRES) is a clinical syndrome of headache, confusion or decreased level of consciousness, visual changes, seizures and focal neurologic signs associated with characteristic neuroimaging findings of posterior cerebral white matter edema. In most cases, PRES is precipitated by sudden increase in blood pressure; however, in the case presented here, the etiology was different as it was secondary to extreme changes in glucose levels.

Case Presentation

A 49-year-old female with a past medical history of hypertension and diabetes mellitus, type 2 was brought to the emergency room with a chief complaint of visual changes for 1 …

Guillain-Barré Syndrome In A Patient With Sickle Cell Anemia, Kunjan Udani, Pooja Patel, Dveet Patel, Hajra Awwab, Nino Balanchivadze

HCA Healthcare Journal of Medicine

A 24-year-old African American male with a history of sickle cell anemia (Hb S/S) presented to an outside hospital with acute colitis, acute renal failure and sickle cell crisis and was treated with supportive measures. On day 3 of hospitalization, he developed bilateral ascending paralysis with sacral numbness. Magnetic resonance imaging (MRI) demonstrated epidural lipomatosis, which was attributed as the cause of his paralysis. He was transferred to our facility for neurosurgery evaluation. Based on the physical examination, Guillain-Barré Syndrome (GBS) was suspected. This conclusion lead to a lumbar puncture with cerebrospinal fluid (CSF) analysis that confirmed the diagnosis. He …

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …

Neuropsychiatric Presentation Of Covid-19: A Case Report Of Disinhibition In An Acute Sars-Cov-2 Infection, I. Jack Abramson, Kristy A. Fisher, Clara V. Alvarez, Jacqueline Horan Fisher

HCA Healthcare Journal of Medicine

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system; therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician with a history of stable Bipolar Disorder for decades, hospitalized for persistent COVID-19 symptoms with documented positive serology, who presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate the viral infection. We postulate neuroinvasion as the putative origin of the patient’s psychiatric instability. Further investigation is needed to expand upon our understanding of the …

Perampanel-Induced Cataplexy In A Young Male With Generalized Epilepsy, Kelsey Kenaan, Mohsin Zafar, Ronnie Bond, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Perampanel (Fycompa) is a newer anti-epileptic drug believed to exert its effects in the central nervous system by inhibiting post-synaptic glutamate receptors. However, the precise therapeutic mechanism is unknown. The most common neuropsychiatric side effect is affective dysregulation; there are also reports of psychosis. We describe a 32 year old African American male with recurring generalized tonic-clonic (GTC) seizures, who presented to our hospital with onset of mood lability for several months, after Perampanel was added to his antiepileptic medications. Perampanel administration was temporarily withheld, and subsequently on restarting, noted to be coincident with neuropsychiatric symptomatology, including motor weakness in …

Microhemorrhages In Professional Motocross Athletes: A Case Series, Brianna Millsaps, Phillip R. Worts, Scott O. Burkhart, David C. Berg

HCA Healthcare Journal of Medicine

Introduction: Motocross is a sport in which riders race 250–450 cc four-stroke dirt bikes and are potentially subjected to a high frequency of head injuries starting at a very young age. The objective of this case series is to present the findings following gradient echo T2-weighted MRI (SWI) upon clinical evaluation after a concussion in 4 young professional motocross racers.

Clinical Findings: Microhemorrhages were found in 2 of 4 riders. Areas of microhemorrhages were not aligned with a previously positive CT finding from a prior concussion in 1 rider.

Conclusions: Microhemorrhages were found in 2 young motocross riders following a …

Red Ear Syndrome: A Case Presentation And Discussion, Jared Brackenrich, Samantha Sternad, Chad Johnston

HCA Healthcare Journal of Medicine

Introduction: Red Ear Syndrome (RES) is a condition often considered to be a localized form of erythromelalgia. It can be related to structural cervical defects or idiopathic. RES is generally very difficult to treat.

Discussion: A 57-year-old male presented to the dermatology clinic complaining of a 4-month history of intermittent redness and severe burning of bilateral ears. On examination, the patient exhibited edematous erythema and tenderness to palpation affecting the right and left ear and right malar cheek. A skin biopsy revealed mild superficial perivascular lymphocytic infiltrate with hypertrophy of endothelial cells. The patient was found to have a normal …

Impact Of Order Set Use On Stroke Care, Bilal Nadeem, Edward Waseleski, Meryem Maras-Casey, Sabih Alam, Adnan Faruqui, Michael Gutierrez, Maruthsakhi Molugu, Christina Oricompil, Ashar Mahmood, Katherine Torralba, Fatima Agha, Nour Tlimat, Olu Oyesanmi, Irina Davis, Salman Muddassir, Nikolay Mitzov

West Florida Division GME Research Day 2020

• A case control study on stroke patients was recently completed for a quality improvement (QI) investigation.
• The objective was to determine if the use of either Hemorrhagic or Ischemic Stroke Order Set had an effect on the length of stay (LOS) or adherence to current stroke guideline recommendations

Acute Disseminated Encephalomyelitis, Ashan Hatharasinghe, Hossein Akhondi, Don Pepito

HCA Healthcare Journal of Medicine

Introduction: Acute Disseminated Encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder of the central nervous system. Clinical manifestations include encephalopathy, motor deficits, ataxia, and meningeal signs. In most cases, ADEM is preceded by either vaccination or viral illness. Here, we present a case with neither of the two predisposing elements.

Discussion: A 28-year-old Hispanic female presenting with substance use and suicidal ideation was placed on an involuntary psychiatric hold, started on olanzapine and scheduled for a psychiatric facility transfer. The following day, she was noted to have neurological deficits when ambulating. Computed tomography of the brain showed a right frontal …

Metastatic Spinal Cord Compression Mimicking Cauda Equina Syndrome Illustrating Importance Of Adequate Diagnostic Imaging, Jonathan L. Holt, Joseph Hill, Farzin Farhandnejad, Karyn Doddy, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Rehabilitation Following Valproic Acid-Induced Hyperammonemic Encephalopathy (Vhe) In A Patient With Intractable Epilepsy, Dan Nguyen, Ann Ikonne, Sewon Lee, Mark Steinhauer

Physical Medicine & Rehabilitation

See additional documents.

Worsening Weakness After Posterior Cervical Decompression And Fusion; The Challenge In Diagnosis, Steven D. Kim, Joseph Hill, Farzin Farhandnejad, Karyn Doddy

Physical Medicine & Rehabilitation

See additional files.

Unmasking Severe Hypotension After Intermittent Catheter For Distended Bladder In A Patient With Cervical Spinal Cord Injury, Dennis Nguyen, Neal Ekpoudia, Ellsworth Remson, Farzin Farhandnejad, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Hispanics Have Higher Grade Intracerebral Hemorrhage Compared To Non-Hispanics, Jessica Houck Do, Tej Stead, Paul Banerjee, Latha Ganti Md

Emergency Medicine

No abstract provided.

Giant 75mm Intracranial Aneurysm Masquerading As Primary Malignancy, Andrew W. Hwang, Satvir Dhillon Md, Remus Popa

Internal Medicine

No abstract provided.

Using Simple Ct Perfusion To Help Identify Ictal Vs. Interictal Lateralized Periodic Discharges (Lpds): A Case Report, Michelle Nunes, Aqsa Ullah, Amna Imran, Enrique Serrano

Neurology

No abstract provided.

Rapidly Recurrent Basilar Artery Thrombosis Treated With Emergent Mechanical Thrombectomies And Stenting, Mark Cohen, Amna Imran, Ankur Garg

Neurology

Acute basilar artery thrombosis (BAT) is a life-threatening condition that can be treated by emergent mechanical thrombectomy (EMT). Recurrent acute BAT is a rare phenomenon. Here we describe a case of rapid recurrent acute BAT that was treated each time by EMT and finally by emergent basilar artery stenting with good outcome

Incidence Of Aspirin Effect In An Anticipated Aspirin Negative Elderly Population, Emily Gullette, Heather Rhodes Md, Brant Clatterbuck Md, Nayda Parisio Poldiak, Christoph Kaufmann

General Surgery

No abstract provided.

Guillain Barre Syndrome In A Patient With Sickle Cell Anemia, Kunjan Udani Md, Pooja Patel, Dveet Patel, Hajra Awwab, Nino Balanchivadze

Internal Medicine

No abstract provided.

Peripheral Nerve Stimulator For Treating Nummular Headaches And Occipital Neuralgia, Bruce Dixon Do, Stephen Pyles Md, Ettore Crimi Md

Anesthesiology

No abstract provided.

Spinal Cord Stimulator For Treating Pudendal Neuralgia, Bruce Dixon Do, Stephen Pyles Md, Ettore Crimi Md

Anesthesiology

No abstract provided.

Moyamoya Disease Presenting With Stroke, Timothy Collins, Chimezie Ubbaonu, Phuong Vo

Internal Medicine

No abstract provided.

Sensorimotor Polyneuropathy As The Initial Presentation Of Sarcoidosis: A Case Report Of A Rare Manifestation, Melanie Rojas, Lakshpaul Chauhan Md, Arshad M. Iqbal Md, Sadia Tufail, Nikolay Mitzov

Internal Medicine

No abstract provided.

Neurologic Manifestations Of Auto-Immune Thyroiditis - A Rare Case Of Hashimoto's Encephalopathy, Mark Cohen, Roberta Santos, Yassar Chakfe

Neurology

No abstract provided.