Neurology Commons^™

Posterior Fossa Decompression In Syndromic Children With Chiari-Like Posterior Fossa Crowding: A Nationwide Us-Based Study, Victor Gabriel El-Hajj, Josué Aganze Mwambali, Ihab Ahmad Al-Rikabi, Erik Öhlen, Maria Gharios, Victor E. Staartjes, Joanna M. Roy, Basel Musmar, Pascal Jabbour, Erik Edström, Adrian Elmi-Terander

Department of Neurosurgery Faculty Papers

INTRODUCTION: Posterior fossa crowding, due to cerebellar tonsil herniation, often requires surgery with posterior fossa decompression (PFD). Although most cases are due to a Chiari-1 malformation (CM1), some are due to concomitant congenital conditions, mimicking a radiological CM1. The aim of this study was to compare PFD outcomes between CM1 and the syndromic Chiari-like crowding of the posterior fossa. A national pediatric surgical database was used to compare baseline characteristics and short-term postoperative outcomes.

METHODS: Pediatric patients undergoing PFD (2012-2021) were identified in the ACS NSQIP-P database. Baseline characteristics and 30-day outcomes were compared between syndromic and non-syndromic cases. Multivariate …

Weight Loss And A Shunt On “Off”: An Odd Case Of Overshunting In An Idiopathic Intracranial Hypertension Patient Illustrative Case, Thomas Hamre, Ashley Ricciardelli, Alex Flores, Ashwin Viswanathan

Faculty, Staff and Students Publications

Background: CSF diversion with ventriculoperitoneal (VP) shunts is a common treatment for idiopathic intracranial hypertension (IIH). Rarely, overshunting can occur. Diagnosing and managing overshunting in an IIH patient with a shunt can be challenging. The authors present a unique etiology of overshunting successfully treated with shunt ligation.

Observations: A 48-year-old female with IIH who had undergone VP shunt placement with a programmable Certas valve presented with symptoms concerning for low-pressure headaches following a 25-kg weight loss. Intracranial pressure (ICP) monitoring along with an inpatient headache diary facilitated the diagnosis of intracranial hypotension secondary to CSF overdrainage through the shunt. Following …

Ezhip Boosts Neuronal-Like Synaptic Gene Programs And Depresses Polyamine Metabolism, Elham Hasheminasabgorji, Huey-Miin Chen, Taylor A Gatesman, Subhi Talal Younes, Gabrielle A Nobles, Farhang Jaryani, Heather Mao, Kwanha Yu, Benjamin Deneen, Wee Yong, Michael D Taylor, Sameer Agnihotri, Marco Gallo

Faculty, Staff and Students Publications

It is currently understood that the characteristic loss of the repressive histone mark H3K27me3 in PFA ependymoma and diffuse midline glioma (DMG) are caused by complementary mechanisms mediated by EZHIP and the oncohistone H3K27M, respectively. To support the complementarity of these mechanisms, rare H3K27M-negative DMGs express EZHIP. Interestingly, EZHIP is one of the few genes recurrently mutated in PFA. The significance of EZHIP mutations in PFA, and whether EZHIP has wider functions in addition to repression of H3K27me3 deposition, are not known. Here, we investigated the mutational landscape of EZHIP in pediatric brain tumors. We found that EZHIP mutations occur …

The Real-World Evaluation Of Remote Electrical Neuromodulation In Pediatric Migraines: A Preliminary Study., Amit Blumovich, Trevor Gerson, Mark Connelly, Tammie Wingert, Gina Jones

Manuscripts, Articles, Book Chapters and Other Papers

Background/Objectives: Pediatric migraine disrupts school performance and daily functioning. Concerns about medication overuse and limited efficacy highlight the need for non-pharmacologic treatments. The Nerivio remote electrical neuromodulation (REN) device, which is FDA-cleared for ages 8 and above, was evaluated in this study to assess real-world perceptions among patients in a pediatric neurology clinic. Methods: Patients aged 10-18 years who had used both acute medications and Nerivio completed two structured questionnaires, one reflecting on experiences with acute medication and one reflecting on experiences with acute REN treatment, assessing school and daily functioning, headache control, medication use, satisfaction, and preference. Descriptive statistics …

Cardioembolic Versus Cryptogenic Stroke: A Case Report And Discussion, Lily Sitisa, Shabir Ferdows, Jonathan Brach

Advances in Clinical Medical Research and Healthcare Delivery

Ischemic strokes account for about 85% of cerebrovascular accidents. About 30–40% of ischemic strokes are classified as cryptogenic, which is defined as an ischemic stroke of the brain without a clear etiology. This case report presents a 56-year-old male with a history of uncontrolled hypertension who was admitted to a community hospital for cardioembolic versus cryptogenic stroke. It is essential for clinicians to be familiar with cryptogenic stroke and its implications for patient care.

Aortic Valvular Papillary Fibroelastoma Presenting As Transient Ischemic Attacks, Mahrukh Tariq, Zauraiz Anjum, Joel Shapiro

Advances in Clinical Medical Research and Healthcare Delivery

We present an aortic valve Papillary Fibroelastoma diagnosed on a transesophageal echo (TEE) in 2020 in a patient who had been presenting with recurrent CNS symptoms since 2013 without any known cause. She had clean imaging including transthoracic echo (TTE) and the Fibroelastoma was discovered only on a TEE in 2020. We hope to highlight the elusive nature of the lesion as an obscure cause of CNS symptomatology.

Associations Of Estrogen With Modifiable And Non-Modifiable Risk Factors For Dementia: A Narrative Review, Sarah Gregory, Katie Bridgeman, Hannah Darwin, Mariapaola Barbato, Laura Booi, Anna Serrat, Antonella Chadha, Francesca Farina, Natalie Jenkins, Beverly Cheserem

Brain and Mind Institute

Female sex is associated with higher incidence and risk of dementia. Estrogen may rep-resent one important mechanism contributing to the increase in incidence rates. In thisreview, we synthesize narratively the evidence for associations between estrogen—across the life course from menarche to menopause, estrogen-containing hormonalcontraception and hormone replacement therapies, and pregnancy—with potentialmodifiable risk factors for dementia. These include education, hearing loss, traumaticbrain injury, hypertension, alcohol use, obesity, smoking, depression, physical inactiv-ity, diabetes, low-density lipoprotein (LDL) cholesterol, social isolation, air pollution,and untreated visual loss, as well as apolipoprotein E ε4. In addition, evidence is sum-marized for associations with sleep, diet, and stress. …

New Onset Of Comorbidities In People With Epilepsy In A National Healthcare Claims Database., Edward Faught, Emily Klatte, Clarence T Wade, Sean Stern, Wesley T Kerr

Neuroscience Articles

PURPOSE: This study evaluated the rate of new occurrence of select comorbidities in adults after events of uncontrolled epilepsy versus controlled epilepsy.

METHODS: The HealthVerity Marketplace Inovalon healthcare claims database was used. Adults (≥18 years) with an epilepsy diagnosis (ICD-10-CM G40*) prescribed at least one antiseizure medication (ASM) between January 1, 2015, and December 31, 2021, were included. Patients were categorized as having either a first-filled or third-filled ASM. The first ASM filled was defined as no ASMs filled for at least 1 year of enrollment. Uncontrolled epilepsy events within 1 year of new ASM initiation were: seizure-related inpatient or …

Identifying Sex- And Gender-Specific Endocrinological, Lifestyle, Psychosocial, And Socio-Cultural Targets For Alzheimer's Disease Prevention In Africans: The Female Brain Health And Endocrine Research In Africa (Fember-Africa) Project, Chinedu Momoh, Benard Aliwa, Lukoye Atwoli, Karen Blackmon, Edna Bosire, Samuel Gitau, Harrison Kaleli, Ciru Kamanda, Linda Khakali, Rachel Maina, Peter Mativo, Sylvia Mbugua, Zul Merali, Kendi Muchungi, Anne Njogu, Douglas Nyankira, Alice Ondieki, Catherine Onyancha, Stanely Onyango, Jasmit Shah, Sheena Shah, Cynthia Smith, Dilraj Sokhi, Sheila Waa, Thomas Thesen

Brain and Mind Institute

Dementia rates are rising globally, with the burden increasing most rapidly in low- tomiddle-income countries. Despite this, research into Alzheimer’s disease and relateddementias (ADRD) among African populations remains limited, with existing modelsbased on Western cohorts that overlook sex-, gender-, and ancestry-specific factors.The Female Brain Health and Endocrine Research in Africa (FemBER-Africa) project,hosted at the Brain and Mind Institute, Aga Khan University, Kenya, will establish adeeply phenotyped cohort of 250 African individuals across the ADRD spectrum. Itwill assess sex-specific risk factors linked to ethnicity, lifestyle, and endocrinologicalvariables using fluid-based biomarkers (blood and saliva), neuroimaging (magneticresonance imaging and positron emission tomography), and …

Prevalence And Determinants Of Nomophobia Among Healthcare Workers In Nepal: A Cross-Sectional Study, Prakash Banjade, Asmita Itani, Munish Sharma, Reena Shah, Jasmit Shah, Aakansha Singh, Rahul Kashyap, Salim Surani

Brain and Mind Institute

Introduction: Nomophobia, the fear of being without a mobile phone, has become a significant concern in the current digital age. Healthcare professionals rely heavily on mobile devices for communication and information access. This cross-sectional study aimed to assess the prevalence and determinants of nomophobia among healthcare workers in Nepal.

Methods: A modified Nomophobia Questionnaire (NMP-Q) was used to determine nomophobia scores. Demographic characteristics such as age, gender, race, type of smartphone, hours spent on a smartphone, and type of medical specialty were considered to evaluate nomophobia in diverse groups of healthcare workers. Summary statistics were presented as frequencies …

Evaluating The Impact Of Alcohol On Dementia: Evidence From 13 Developing Countries, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission on Dementia Prevention identified alcoholconsumption as a risk factor contributing to a global increase in dementia cases by onepercent.

Method: We used a panel VAR model to analyze the impact of alcohol consumption ondementia prevalence in 13 developing countries with different alcohol tax systems.

Result: In countries with progressive alcohol tax systems, an increase in taxes onbeer and spirits leads to a 10 percent reduction in per capita alcohol consumption.This decline corresponds to a 4 percent reduction in dementia prevalence within fouryears. In countries with hybrid alcohol tax systems, a combination of alcohol bansand tax …

Plasma Biomarkers In Neuropsychiatric Syndromes: A Narrative Review, Zahinoor Ismail, Dylan X Guan, Ganesh Babulal, James Bateman, Marc Cantillon, Byron Creese, Fabrizia D'Antonio, Corinne Fischer, Jennifer Gatchel, Chinedu Momoh

Brain and Mind Institute

Neuropsychiatric symptoms (NPS) are common features of neurodegenerative disease (NDD) but are relatively understudied compared to cognition, especially regarding biomarkers. Further, emerging evidence describes the utility of systematic assessment of NPS across the cognitive continuum, even in advance of dementia. In this narrative review, we discuss the role of plasma biomarkers in relation to NPS across the cognitive continuum of unimpaired, subjective cognitive decline, mild cognitive impairment, and dementia. While Alzheimer's disease is the primary focus, vascular, Lewy body, and frontotemporal dementia etiologies are also discussed. Literature searches included NPS and dementia-related search terms with additional literature identified based on …

Lymphoma Imaging In Hiv And Non-Hiv Patients: A Retrospective Cross-Sectional Study With Clinical And Pathological Correlation, Poonamjeet Loyal, Edward Chege, Jasmit Shah, Anne Mwirigi, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Patients with Human Immunodeficiency Virus (HIV)have an atypical imaging pattern of lymphoma. There is paucity of literature on differences in tumor volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and prognosis.

Methods: This was a retrospective cross-sectional study of patients with non-Hodgkin lymphoma which were categorized into HIV positive and HIV negative. The tumor burden, disease sites, international prognostic score and Ki-67 index were recorded. Continuous variables were analyzed using the Kruskal Wallis test and categorical variables with Fisher’s Exact test.

Results …

Redefining Central Nervous System Multiple Myeloma: From Rare Phenomenon To Emerging Entity, Ian Landry, Adam F. Binder, Marc Yorker, Sarah Ramirez

Department of Medical Oncology Faculty Papers

BACKGROUND: Central nervous system involvement in multiple myeloma (CNS-MM) is considered a rare but devastating manifestation of extra-medullary disease (EMD) associated with aggressive biology and dismal outcomes. Treatment advances over the past few decades have improved survival in patients with MM, however, it has not translated into a similar survival benefit for those with CNS-MM. Early recognition and targeted management of CNS-MM remain major clinical challenges.

OBJECTIVE: This literature review summarizes the current literature on epidemiology, risk factors, clinical features, diagnostic modalities, and therapeutic approaches to CNS-MM. It focuses on emerging biomarkers and new treatment options that may affect the …

Association Of Component Strategies Of The Target Stroke Phase 3 Nationwide Quality Improvement Program With Accelerated Door-To-Puncture And Door-In-Door-Out Times For Ischemic Stroke Endovascular Thrombectomy In The United States, Brian Mac Grory, Kaiz S. Asif, Haolin Xu, Brooke Alhant, Jay Lusk, David Hasan, Soojin Park, Amelia K. Boehme, Ameer E. Hassan, Kyle M. Fargen

School of Medicine Publications

Background: The Target Stroke Phase III program is a national quality improvement initiative led by the American Heart Association, which sought to improve the quality of care for patients with acute stroke undergoing acute reperfusion therapy including endovascular thrombectomy (EVT).

Methods: A retrospective, observational cohort study was performed using data from the American Heart Association Get With The Guidelines-Stroke Program between January 1, 2017, and March 31, 2022. Three categories of patients were analyzed: (1) patients who arrived directly at the thrombectomy hospital and had EVT, (2) patients who were transferred in from a nonthrombectomy hospital and had EVT, and …

Sensory-Selective Peripheral And Neuraxial Nerve Blockade With 2',6'-Pipecoloxylidide, Claire A Ostertag-Hill, Shuanglong Chen, Tianrui Xue, Rachelle Shao, Matthew Torre, Bin Feng, Zahra Vahedi, Longtu Chen, Steven J Staffa, Yueqin Zheng, Daniel S Kohane

Duncan NRI Faculty and Staff Publications

Background: Safe sensory-selective local anesthetics would be a major advance in the management of acute and chronic pain. This articles describes the sensory-selective local anesthetic properties and the toxicity profile of a known metabolite of amino-amide local anesthetics, 2',6'-pipecoloxylidide (PPX).

Methods: PPX was synthesized and made into its hydrochloride salt. PPX or ropivacaine (ROP) were injected at the sciatic nerve or intrathecally in rats, who then underwent modified hotplate (sensory) testing and weight-bearing (motor) testing. Rats injected with PPX or ROP were assessed for clinical toxicity endpoints. Conduction blockade was studied with single-unit recordings in mice. Biocompatibility was assessed histologically. …

Neural Signatures And Personalized Neuromodulation In A Subject Experiencing Context-Dependent Inhibitory Control Deficits, Layth S Mattar, Shraddha Shah, Lily S Chamakura, Denise Oswalt, Yue Zhang, Davin Devara, Jung Uk Kang, Zahra Jourahmad, Ryan Jafri, Geoffrey Liu, Joshua Adkinson, Isabel A Danstrom, Xiaoxu Fan, Yvonne Y Reed, Kelly R Bijanki, Alica Goldman, Lu Lin, Vaishnav Krishnan, Nicole R Provenza, Andrew J Watrous, Sameer A Sheth, Sarah R Heilbronner, Garrett P Banks, Eleonora Bartoli

Faculty, Staff and Students Publications

The ability to override prepotent actions is critical to control impulses and adjust behavior depending on goals and contextual needs. In this study, we investigate the inhibitory control abilities of a patient diagnosed with Klüver-Bucy Syndrome following a left temporal resection. The patient presented with disruptive hypersexuality symptoms akin to compulsions, leading to the inability to control and suppress inappropriate actions. The patient was recruited for the current research study while undergoing intracranial monitoring for epilepsy, to investigate the cognitive and neural processes underlying the patient's inhibitory control symptoms. We formulated the hypothesis that a reactive inhibitory control deficit emerges …

Cognitive Reserve Predicts Baseline Tau Burden In The Us Pointer Trial Imaging Cohort, Valory N Pavlik, Chris J Weber, Joseph C Masdeu, Laura D Baker, Melissa M Yu, Michele York, Rachel A Whitmer, Susan M Landau, Theresa M Harrison, Tomas M Holland, Laura Lovato

Faculty, Staff and Students Publications

Introduction: Higher cognitive reserve (CR) is associated with reduced dementia risk. We hypothesized that higher CR is associated with less baseline Alzheimer's disease (AD) pathology in the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) cohort.

Methods: A subsample of participants underwent amyloid beta and tau positron emission tomography imaging. Regression analysis was used to model the association between educational attainment (EA) as a CR proxy measure, amyloid positivity, and entorhinal cortex (ERC) and meta-temporal region of interest (meta-ROI) tau standardized uptake value ratio (SUVR).

Results: In 911 participants with complete imaging data, higher …

Botulinum Toxin In Stiff Person Syndrome: How Useful Is It In Helping Muscle Stiffness And Spasms?, Marinos Dalakas

Department of Neurology Faculty Papers

No abstract provided.

Epdevatlas: Mapping Gabaergic Cells And Microglia In The Early Postnatal Mouse Brain, Josephine K. Liwang, Fae N. Kronman, Hyun-Jae Pi, Yuan-Ting Wu, Daniel J. Vanselow, Steffy B. Manjila, Deniz Parmaksiz, Donghui Shin, Yoav Ben-Simon, Michael Taormina, Sharon W. Way, Hongkui Zeng, Bosiljka Tasic, Lydia Ng, Yongsoo Kim

School of Graduate Studies Faculty Publications

During development, brain regions follow encoded growth trajectories. Compared to classical brain growth charts, high-definition growth charts could quantify regional volumetric growth and constituent cell types, improving our understanding of typical and pathological brain development. Here, we create high-resolution 3D atlases of the early postnatal mouse brain, using Allen CCFv3 anatomical labels, at postnatal days (P) 4, 6, 8, 10, 12, and 14, and determine the volumetric growth of different brain regions. We utilize 11 different cell type-specific transgenic animals to validate and refine anatomical labels. Moreover, we reveal region-specific density changes in γ-aminobutyric acid-producing (GABAergic) neurons, cortical layer-specific cell …

Microglia Sensing Of Peripheral Signals That Bridge The Brain And Body, Claire E Young, Melanie A Samuel

Faculty, Staff and Students Publications

Microglia are the resident immune cell of the brain, and alterations in microglia signaling have been implicated in many neurodegenerative disorders. While microglia responses to central cues and other brain cell types are well documented, studies are increasingly investigating the impact of peripherally derived signals on microglia function. A diverse array of peripheral cues, including dietary components, hormones, and bacteria metabolites and components from the microbiome cross the blood brain barrier and directly influence microglia state through ligand-receptor interactions. This review highlights the complexity of brain-body interactions from the perspective of microglia function and proposes the idea that microglia could …

Assessing The Efficacy Of The Cam-Icu Scale In Reducing Length Of Stay In The Icu: A Scoping Review, James Ray Davis Mph, Bsn, Rn, Donna Lynch-Smith Dnp, Aprn, Acnp-Bc, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

No abstract provided.

Injectable Microparticle-Nanoliposome Hydrogel For Extended Release Of Small Hydrophilic Molecules, Gil Aizik, Wonmin Choi, Claire A Ostertag-Hill, Matthew Torre, Daniel S Kohane

Duncan NRI Faculty and Staff Publications

Achieving sustained local release of small hydrophilic drugs is challenging and is particularly important when the drugs are toxic. To address these challenges, we developed a hybrid system comprising drug-containing microparticles embedded within a nanoliposomal hydrogel matrix. This system forms through salt-induced gelation using physiologically relevant sodium chloride concentrations (0.9%), allowing for microparticle encapsulation without harsh chemical processes. In vitro, the hybrid system exhibited a slower release of encapsulated cargo compared to microparticles or hydrogel alone. In vivo proof of principle was provided with tetrodotoxin (TTX), a small hydrophilic and ultrapotent local anesthetic, which can cause systemic toxicity if the …

Optic Pathway Abscess Caused By Clostridium Septicum Endophthalmitis From Colon Adenocarcinoma Requiring Incision And Drainage Of Optic Nerve And Chiasm, Matthews Lan, David P. Bray, Joseph Schaefer, Arbaz A. Momin, Aria Mahtabfar, Charlotte Marous, Christopher J Farrell

Department of Neurosurgery Faculty Papers

Background and importance: Optic pathway abscess formation is a rare clinical entity. To date, there are no reports of optic pathway abscess formation due to Clostridium septicum, secondary to colon adenocarcinoma. We present a video case report of a unique patient found to have C. septicum optic pathway abscess requiring craniotomy for incision and drainage of optic nerve/chiasm.

Clinical presentation: A 62-year-old woman presented with acute-onset right eye vision loss and rapidly progressive proptosis, chemosis, elevated intraocular pressure, and ophthalmoplegia requiring emergent canthotomy with cantholysis. MRI brain and orbits with and without contrast revealed enhancement of right posterior sclera …

The Fast And The Very Fast: High-Frequency Oscillations In Alzheimer's Disease, Manuel Silva-Pérez, Jeannie Chin

Faculty, Staff and Students Publications

Alzheimer's disease increases the risk of developing epilepsy together with cognitive decline. Early diagnosis or prediction of parameters associated with epileptic activity can greatly help in managing disease outcomes. Network hyperexcitability is a candidate of interest as a neurophysiological biomarker of Alzheimer's disease. High-frequency oscillations are increasingly recognized as potential biomarkers of hyperexcitability and epileptic activity. However, they have not yet been identified in Alzheimer's disease. In this study, we measured high-frequency oscillations via magnetoencephalography recordings in Alzheimer's disease patients with and without epileptic activity, as part of a Phase 2a randomized, double blind clinical trial of the efficacy of …

Generative Modeling For Interpretable Anomaly Detection In Medical Imaging: Applications In Failure Detection And Data Curation, Mckell E Woodland, Mais Altaie, Caleb S O'Connor, Austin H Castelo, Olubunmi C Lebimoyo, Aashish C Gupta, Joshua P Yung, Paul E Kinahan, Clifton D Fuller, Eugene J Koay, Bruno C Odisio, Ankit B Patel, Kristy K Brock

Faculty, Staff and Students Publications

This work aims to leverage generative modeling-based anomaly detection to enhance interpretability in AI failure detection systems and to aid data curation for large repositories. For failure detection interpretability, this retrospective study utilized 3339 CT scans (525 patients), divided patient-wise into training, baseline test, and anomaly (having failure-causing attributes—e.g., needles, ascites) test datasets. For data curation, 112,120 ChestX-ray14 radiographs were used for training and 2036 radiographs from the Medical Imaging and Data Resource Center for testing, categorized as baseline or anomalous based on attribute alignment with ChestX-ray14. StyleGAN2 networks modeled the training distributions. Test images were reconstructed with backpropagation and …

Advancements In Prenatal Genetic Screening And Testing: Emerging Technologies And Evolving Applications, Mona M Makhamreh, Mei Ling Chong, Ignatia B Van Den Veyver

Duncan NRI Faculty and Staff Publications

Advancements in genomic technologies have transformed prenatal genetic testing, offering more accurate, comprehensive, and noninvasive approaches to reproductive care. This review provides an in-depth overview of current methodologies and emerging innovations, including expanded carrier screening (ECS), cell-free DNA (cfDNA) testing, chromosomal microarray analysis (CMA), and sequencing-based diagnostics. We highlight how next-generation sequencing (NGS) technologies have revolutionized carrier screening and fetal genome analysis, enabling detection of a broad spectrum of genetic conditions. The clinical implementation of cfDNA has expanded from common aneuploidies to include copy number variants (CNVs), and single-gene disorders. Diagnostic testing has similarly evolved, with genome sequencing outperforming traditional …

Intracranial Neural Biomarkers Of Psychiatric Symptoms And Their Utility For Guiding Neuromodulation Therapy: A Systematic Review, Katherine E Kabotyanski, Nicole R Provenza, Sameer A Sheth

Faculty, Staff and Students Publications

The quest to develop and improve neuromodulatory therapies for treatment-resistant psychiatric disorders has been fueled by the discovery of intracranial neural biomarkers of symptom dimensions. These neural correlates shed light on the underlying neurophysiology of the disorder and may even be useful in guiding therapy delivery. This systematic review summarizes recent efforts in this field relating neural activity to behavior and symptomatology. For years, the majority of these neurobehavioral relationships had been studied in the hospital or clinic environment. Recent technological advances in implanted neuromodulation devices that permit not only stimulation, but also intracranial neural recording have enabled this research …

A Twisting Trail To Diagnosis: Unraveling Morvan’S Syndrome In Caspr2-Associated Autoimmune Encephalitis, Yashfeen M

Journal Of Indian Physician Associates

This case snippet describes the diagnostic journey and clinical management of a 72-year-old gentleman who presented with progressive cognitive decline, involuntary myoclonus, and severe insomnia. Through a detailed clinical workup, including electromyography and antibody testing, he was diagnosed with Contactin-Associated Protein-Like 2 (CASPR2) antibody-associated autoimmune encephalitis manifesting as Morvan’s syndrome, a rare but reversible neuroimmunological disorder. Prompt initiation of immunotherapy led to gradual improvement, underscoring the value of clinical suspicion, multidisciplinary care, and early intervention. This case serves as a reminder to consider autoimmune etiologies in atypical neuropsychiatric presentations, especially in elderly patients.

The Importance Of Treating Migraine Attacks Early - Even In Youth: A Real-World Argument For Neuromodulation, Mario F. P. Peres, Hsiangkuo Yuan, Cristina Tassorelli

Department of Jefferson Headache Center Papers and Presentations

No abstract provided.