Nervous System Diseases Commons^™

Autoimmune Encephalitis Presenting As Pseudodementia (Case Report), Renita Ng, Christie Richardson

Rowan-Virtua Research Day

Patients with autoimmune encephalitis frequently present with psychiatric symptoms including psychosis, behavioral changes, and affective disorders. Because of this, misdiagnosis of a primary psychiatric disorder in a case of autoimmune encephalitis is not uncommon. We present a case of autoimmune encephalitis in a 72 year old who was initially thought to have psuedodementia or catatonia due to variable collateral who later on LP was found to have markers and responded to steroid treatment. This case highlights the importance of maintaining a broad differential with patients who present with psychiatric alterations and to consider other causes of behavioral change.

Investigating Sleep Quality In Post-Stroke Delirium: A Scoping Review, Shay Greco, Bethany C. Young

Rowan-Virtua Research Day

Background: Delirium affects approximately 59% of hospitalized patients with intracerebral hemorrhage and is associated with poor outcomes. Sleep-wake cycle disturbances are hypothesized to contribute to delirium development, particularly in neurointensive care settings where frequent sleep interruptions occur.

Methods: We conducted a scoping review of literature published between 2014-2024 using PubMed, CINAHL, Embase, and Cochrane databases. Studies were included if they observed sleep in adult stroke populations.

Results: Four observational studies (2018-2023) met inclusion criteria, with sample sizes ranging from 20-112 participants. All studies included patients with ICH. All studies reported associations between poor sleep in patients with ICH and delirium …

A Better Road To Recovery- Effectiveness Of Osteopathic Manipulative Treatment Compared To Conventional Methods On Post-Concussion Patients, Joliana H. Eskandar

Rowan-Virtua Research Day

Background:

Concussion, a form of traumatic brain injury, often presents with sleep disturbances, headache, confusion, and memory impairment. Current treatment includes reduced screen time, physical activity, and increased rest. For decades, these treatment options have demonstrated improvement in symptoms. Recently, there is growing interest in whether using osteopathic manipulative treatment (OMT) to target structural dysfunctions is more effective. This review compares OMT to conventional treatment methods in post-concussion patients.

Methods:

This literature review uses data from clinical trials, randomized controlled trials, observational studies, and case reports within the past 10-15 years. It includes adolescents, adults, elderly, athletes, and non-athletes while …

Dural Venous Sinus Thrombosis: Be Careful When You Sneeze, Arsam F. Nadeem

Rowan-Virtua Research Day

Dural venous sinus thrombosis (DVST) is a rare but potentially life-threatening condition that accounts for approximately 0.5–1% of all strokes. It is often associated with hypercoagulable states, infections, malignancies, and systemic inflammatory diseases. Clinical presentations are highly variable and can include headaches, focal neurological deficits, seizures, and altered mental status. Given its nonspecific symptoms, DVST remains a diagnostic challenge. This report presents a case of a young male who developed a persistent headache and had transient speech changes and was ultimately diagnosed with a dural venous sinus thrombosis.

Reviewing The Effect Of Antiplatelet Therapy On Lumbar Puncture Complications, John Andre Socci

Rowan-Virtua Research Day

Reviewing The Effect of Antiplatelet Therapy on Lumbar Puncture Complications aims to assess literature that discusses the possible risks of undergoing lumbar puncture while on antiplatelet therapy. Lumbar punctures offer vital information that can help guide making accurate diagnosis and creating appropriate treatment plans. However, a large portion of the population is on antiplatelet therapy for cardiovascular and cerebrovascular disease prevention. While there are many benefits to being on these medicines, patients are at increased risk for bleeding. Thus the clinical question as to whether or not proceed with lumbar puncture on patients taking antiplatelet therapy involves weighing risks and …

Investigating Pinch-1 In Glioblastoma Multiforme: A Potential Adjuvant Therapy Target To Improve Treatment Outcomes, Saikrishna Gaddam, Dianne Langford

Rowan-Virtua Research Day

Gliomas account for approximately 80% of all brain cancers and 30% of central nervous system tumors. Glioblastoma multiforme (GBM), the most common, is unfortunately, the most aggressive glioma cancer type. Despite treatment efforts such as surgery, radiation, and chemotherapy, nearly all low-grade astrocytoma progress to GBM without complete surgical resection. Achieving full surgical removal is typically impossible, leading to an almost 100% recurrence rate of GBM after 9 months with a median survival of approximately 15 months. This poor prognosis is due to its high invasiveness and resistance to therapy. Therefore, improved therapeutic approaches are needed to reduce recurrence and …

Mechanisms Mediating The Protective Effects Of Caffeine On Alzheimer’S Disease Progression, Jessica Ivanov, Malky Bernat, Joshua Drawbaugh, Jeremy Mehta, Namira Rahmani, Saikumar Thellapally

Rowan-Virtua Research Day

Background: This review aims to examine the molecular mechanisms through which caffeine may exert neuroprotective effects against Alzheimer’s Disease (AD).

Methods: A literature review was done across PubMed and Embase to identify studies between 2000 and 2024, exploring the mechanism behind caffeine’s effects on AD. The criteria focused on peer-reviewed articles involving human or animal models. Information was gathered on study design, participant characteristics, caffeine consumption, proposed mechanisms, and effects on cognition.

Results: The studies support caffeine's potential as a therapeutic, neuromodulator against AD through six mechanisms: inhibition of adenosine A2A receptors, decreased amyloid-beta production and aggregation, promotion of amyloid …

Case Report: An Unexpected Case Of Spinal Cord Infarction, Julian Coz, Brittany Fera

Rowan-Virtua Research Day

We report a case of an 89-year-old male who presented to the emergency department with acute bilateral lower extremity weakness after physical exertion. His clinical examination revealed paraplegia, and imaging studies suggested spinal cord infarction (SCI) secondary to presumed atherosclerotic embolism, despite the absence of traditional cardiovascular risk factors. The differential diagnosis for acute paraplegia in the elderly is broad, including conditions like stroke, spinal cord compression, transverse myelitis, and tick paralysis. This case highlights the diagnostic challenges of SCI, particularly when the patient lacks overt risk factors for vascular disease. Despite aggressive management, including permissive hypertension and anticoagulation, the …

Developing Adaptive Clothing For Patients With Advanced Als Disease, Kadence D. Trosper

Apparel Merchandising and Product Development Undergraduate Honors Theses

In 2017, over 30,000 people were battling with Amyotrophic Lateral Sclerosis, also known as ALS. ALS is a progressive neurodegenerative disease that affects nerve cells within the brain, brain stem, and spinal cord (ALS Association, 2023). The individual’s brain loses connection with muscles, slowly taking away one’s ability to walk, talk, eat, and eventually breathe. The currently is no cure for this disease or even treatment to halt the progression, however the treatment available can help ease the symptoms. Despite the physical challenges associated with ALS, there is a significant lack of adaptive clothing options that provide comfort, functionality, and …

The Effectiveness Of Ras Treatment In Improving Gait Patterns In Patients With Parkinson’S Disease: A Literature Review, Vivian Huang, Andrea Hunt, Alicia Chopyk

Rowan-Virtua Research Day

Parkinson’s Disease (PD) is a neurodegenerative disorder involving the loss of dopaminergic neurons leading to symptoms such as tremor and gait disturbance. This results in the classic shuffling gait: stooped posture, variation in stride length, variation in cadence, reduced gait velocity, inability to maintain a steady rhythm, and an increased fear of falling. This study’s objective is to review the current literature on the use of rhythmic auditory stimulation (RAS)Ⓡ as a treatment option for PD. Previous research has looked at RASⓇ as a potential non-pharmacologic treatment because researchers hypothesize that listening to music produces an external rhythm that the …

A Case Report Of Primary Central Nervous System Lymphoma Presenting With Diabetes Insipidus, Lan Ngo, Adam Kandil

Rowan-Virtua Research Day

Diabetes insipidus (DI) is characterized by decreased secretion or action of antidiuretic hormone (ADH), resulting in polyuria, polydipsia, and potential electrolyte disturbances. Severe hypernatremia secondary to uncontrolled DI can manifest with neurologic symptoms including seizure-like activity. This case report discusses a case of central DI arising from damage to the pituitary gland as the first presentation of a brain tumor, in the context of a 56-year-old patient who presented with seizure-like activity and sensory changes.

Case Report: Idiopathic Intracranial Hypertension With Venous Sinus Stenosis In A Young Female, Zain Raza

Rowan-Virtua Research Day

We report a case of a 19-year-old female who presented with transient, painless left eye vision loss and left-sided headache for 2 weeks. The patient, a known carrier of TTN mutation, which is a gene code for titin (mutations are inherited in an autosomal dominant pattern). The patient was diagnosed with idiopathic intracranial hypertension secondary to bilateral transverse sigmoid venous sinus stenosis. The differential diagnosis included ocular migraine, transient ischemic attack) and optic neuritis, but subsequent imaging and lumbar puncture revealed elevated intracranial pressure and significant venous stenosis. This case highlights the importance of an early identification and intervention to …

Case Report: When Confusion Signals A Crisis: Rethinking The Diagnosis Of Meningitis In Geriatric Sepsis, Asma Zahid

Rowan-Virtua Research Day

We report the case of an 88-year-old female who presented with altered mental status, initially suspected to have urosepsis but ultimately diagnosed with streptococcal meningitis. The patient had a history of lethargy and anorexia over the past few days and was found to have sepsis. Despite initial focus on urosepsis, blood cultures revealed Streptococcus, and cerebrospinal fluid analysis confirmed bacterial meningitis. This case highlights the potential for meningitis to be overlooked in elderly patients with suspected sepsis, underscoring the importance of broad diagnostic considerations and early intervention. This case highlights the importance of considering meningitis in elderly patients presenting with …

Case Report: Todd’S Paralysis In A Patient With An Extensive Stroke History, Thuc Vu, Kishan B. Patel

Rowan-Virtua Research Day

Here we present the case of a 70-year-old patient who presented to the emergency department with altered mental status, left-sided gaze preference, left-sided hemineglect, and inability to follow commands. He had a past medical history of seizure activity and cerebrovascular accident (CVA) with residual dysarthria and was on apixaban. His symptoms began after seizure activity and improved gradually. He was ultimately diagnosed by stroke neurology as having had an episode of Todd’s Paralysis. The differential diagnosis for patients for altered mental status with neurological deficits can be vast, but, in general, Todd’s Paralysis can be an ischemic stroke mimic upon …

Case: Pituitary Mass In A Pediatric Patient, Alyssa Baldini, Carla Calvo

Rowan-Virtua Research Day

We report a case of a 16-year-old female presented to the pediatric emergency department for intermittent visual disturbance and was diagnosed with a pituitary mass resulting in episodic complete bilateral vision loss. Pediatric neurologic complaints can be challenging for a number of reasons. It is important as much as possible to obtain a detailed history from the patient and parent, conduct a relevant chart review, and identify if there have been any recent medication changes. Seeking expert consultation may also be helpful in establishing a diagnosis.

Case Report: Recurrent Miller Fisher Syndrome, Devin Hoover, Andrew Vasta, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of a 47-year-old male who presented with numbness and difficulty speaking and was diagnosed with Miller Fisher Syndrome, a variant Guillain-Barré Syndrome. The differential diagnosis for numbness and speech difficulty is broad and includes brain stem stroke, Wernicke encephalopathy, botulism, myasthenia gravis, among others. Although Miller Fisher Syndrome is rare, certain factors such as the of tumor necrosis factor-alpha antagonists may predispose a patient to the disease and its recurrence. As discovery of new tumor necrosis factor-alpha antagonists continues it will likely result in more presentations of Guillain-Barré Syndrome and its variants to the emergency department.

Miller Fisher Variant Of Guillain- Barré Syndrome, Peter Killian, Kishan B. Patel

Rowan-Virtua Research Day

We present a case of a man in his 50s who was evaluated in the emergency department for right facial droop, myalgias, and right lower extremity weakness. The patient required multiple interdisciplinary specialists for treatment and diagnosis of Guillain-Barré Syndrome (GBS). The differential for weakness and facial droop is primarily aimed at ruling out an irreversible neurological cause while investigating a potential infectious etiology. Multiple variants of GBS exist and clinical presentations can vary, including the Miller Fisher Variant. This variant features a unique presentation, affecting the corticobulbar tract, evident with the ptosis commonly seen following a gastrointestinal infection.

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

Eating Behavior Differences Across Dementia Diagnoses: The Roles Of Behavioral Symptoms And Anticipatory Physiological Responses, Charlie J. Lorkovic

Honors Program: Senior Projects (Public)

Objective: To determine how behavioral symptoms and impairment of the preparatory physiological response contribute to disordered eating behaviors in dementia, particularly frontotemporal dementia (FTD) and Alzheimer’s disease (AD).

Methods: This secondary analysis utilizes data from 242 patients (191 FTD, 51 AD) who took part in a collaborative study between the University of California, Berkeley, and the University of California, San Francisco. Preparatory physiological responses were measured as heart rate increases from a baseline to an instruction period, when participants were informed that they were about to watch an emotional film. Behavioral symptoms, including eating behaviors, were assessed using the Neuropsychiatric …

Rod Photoreceptor Regeneration In A Zebrafish Model With Retinitis Pigmentosa, Eyad Shihabeddin

Dissertations and Theses (Open Access)

A cellular hallmark of inherited retinal degenerative diseases is progressive loss of photoreceptors until one is completely blind. Unlike mammalian models, Zebrafish have the ability to naturally regenerate their neurons after injury or disease is detected. We have generated a zebrafish model with the most common autosomal dominant form of the inherited retinal degenerative disease known as Retinitis Pigmentosa. We utilize immunohistochemistry, single-cell RNA sequencing, several analysis tools, behavioral assays and oligonucleotides to characterize our zebrafish model and identify the transcription factors necessary for rod photoreceptor regeneration. We show that our zebrafish model has continuous degeneration and regeneration of rod …