Neurology Commons^™

Posterior Cortical Atrophy: Characteristics From A Clinical Data Registry., Jennifer J Olds, William L Hills, Judith Warner, Julie Falardeau, Lori Haase Alasantro, Mark L Moster, Robert A Egan, Wayne T Cornblath, Andrew G Lee, Benjamin M Frishberg, Roger E Turbin, David M Katz, John A Charley, Victoria S Pelak

Department of Neurology Faculty Papers

No abstract provided.

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

Permanent Pre-Operative Cerebrospinal Fluid Diversion In Paediatric Patients With Posterior Fossa Tumours, Ummey Hani, Saqib Kamran Bakhshi, Muhammad Shahzad Shamim

Section of Neurosurgery

Management options for obstructive hydrocephalus in children with posterior fossa tumours have been debated upon throughout the course of neurosurgical practice. Permanent pre-operative CSF diversion via ventricular shunts or endoscopic third ventriculostomy have been employed to prevent the possible persistence of hydrocephalus after tumour removal, but is considered unnecessary and even dangerous amongst a large group of neurosurgeons. In this paper, we have reviewed the literature for the merits and demerits of pre-operative permanent CSF diversion in paediatric patients presenting with posterior fossa tumours.

Association Of Bipolar I Disorder With Conversion Disorder And Syncope- A Retrospective Clinical Study From Pakistan, Qurat Ul Ain Khan, Sana Younus, Hania Hasan, Muhammad Zaman Khan

Pakistan Journal of Neurological Sciences (PJNS)

Bipolar I disorder (BD I) is a chronic mood disorder that begins in early adulthood. Its association with conversion disorder and syncope has not been widely studied, especially in Pakistani population.

Movement Disorder Associated With Celiac Disease And Thyroid Dysfunction:Case Report, Ramla Nayaib Hashmi, Ummul Kiram, Rabbia Tariq

Pakistan Journal of Neurological Sciences (PJNS)

Autoimmune movement disorders are uncommon yet likely treatable conditions. It is challenging to diagnose and manage these disorders, ultimately leading to a significant morbidity in terms of functional disability of patient. It is troublesome for practicing neurologists to identify whether the antibodies which are detected during the work up of these autoimmune movement disorders are merely incidental or have pathogenic role. This will help them to decide regarding whether to start immunotherapy or not. Here we have discussed two patients of movement disorder who were found to have positive work up for other autoimmune diseases. Available Literature on autoimmune movement …

Acute Colonic Pseudo Obstruction (Ogilvie Syndrome) In A Patient With Hemorrhagic Stroke: A Case Report., Muhammad Dawood Sohail, Haroon Khan, Zainab Alam, Sardar M Alam

Pakistan Journal of Neurological Sciences (PJNS)

Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome is a functional motility disorder of the colonic bowel without any organic or mechanical obstruction. Autonomic disturbance which is one of the underlying factors that can lead to Ogilvie syndrome, is caused by stroke. Acute colonic pseudo- obstruction (ACPO) in the setting of stroke is not often reported in medical literature. Various modalities of treatment strategies are recommended including conservative approaches, medical therapies, endoscopic and surgical procedures. We will discuss a patient suffering from a hemorrhagic stroke in the right basal ganglia that developed Acute Colonic Pseudo Obstruction and improved subsequently with conservative …

Knowledge And Use Of The International Classification Of Functioning, Disability And Health (Icf) Among Health Professionals In A Developing Country, Sidra K. Jafri, Olaf Kraus De Camargo

Pakistan Journal of Neurological Sciences (PJNS)

The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) provides a biopsychosocial framework for understanding all the factors that should be considered while managing any health condition. The ICF has been employed for clinical, academic, research, and policymaking purposes in developed as well as developing countries. There is a great disparity in the representation in the literature regarding knowledge and potential application of the ICF in professional practice around the world especially from low middle-income countries like Pakistan. This study aims to evaluate the profile and knowledge of health professionals in Pakistan about the application of …

Obstructive Sleep Apnea In Middle Age Male Smokers, Muhammad Hassan, Saad Ali Ansari, Farzana Salman, Raafay Kamal Khan, Waleed Shahzad, Ehsan-Ur- Rehman, Omer Hassaan, Aftab Ahmed, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

OBJECTIVE: Obstructive sleep apnea is the most common type of sleep apnea. This was designed to establish the relationship between smoking and obstructive sleep apnea. Methods:This cross-sectional study was conducted at the outpatient department of Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from August 2018 to November 2018 (dates mentioned in methods are different) and comprised of males aged 30-50 years. Participants were divided into two groups of smokers and non-smokers and Berlin questionnaire was used to collect data employing systemic random sampling. SPSS 22 was used for analysis. Results:There were 768 male participants in the study equally split between …

A Review Of Brain Death Protocols Across The Globe And Need For Brain Death Guideline For Pakistan., Mohammad Wasay, Syeda Batool Mujtaba, Mughis Sheerani, Saleem Barech, Rashid Jooma

Pakistan Journal of Neurological Sciences (PJNS)

The concept of brain death was first formally presented in United States of America in 1968 (Ad Hoc Committee of the Harvard Medical School to examine the definition of Brain Death, 1968) in part to facilitate organ donation. It is a widely accepted term in most countries but some like Japan do not consider it as death. According toAAN, brain death is defined as death due to irreversible loss of function of the entire brain — comparable to circulatory death, which is defined as irreversible loss of function of the circulatory system. The purpose of our study is to review …

Concussion: A Review Of Epidemiology, Presentation And Treatment., Sidra Saleem, Arsalan Anwar, Fahham Asghar, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

A direct impact on the head can cause a Mild Traumatic Brain Injury or Concussion. It is a neuronal brain injury with or without loss of consciousness. Each year, approximately 69 million people are estimated to suffer from Concussion. Around 80-90% of these Concussion cases resolve within a week. The most commonly reported post-concussion symptoms include headache, cognitive changes, sleep disturbances, and depression. Essential in the approach to patients with concussion includes a detailed history taking and physical examination. Imaging modalities like Magnetic Resonance Images (MRI) of the brain may not show any significant changes; therefore more sensitive tests, like …

A Rare Presentation Of Pulmonary Sarcomatoid Carcinoma With Left Atrial Involvement And Spinal Metastasis Presenting With An Ischemic Infarct., Hina Imtiaz, Muhammad Dawood Amir Sheikh

Pakistan Journal of Neurological Sciences (PJNS)

Pulmonary Sarcomatoid Carcinoma is a rare, aggressive tumor comprising of both epithelial and mesenchymal cells. It is important to distinguish it from other lung tumors due to its poor prognosis and extensive metastasis. We present a case of a 36 year old female patient who initially presented with right sided weakness and slurred speech due to an ischemic infarct of the left basal ganglia. Further workup revealed a lung mass extending to the left atrium with spinal metastasis. Sarcomatoid Carcinoma remains a diagnostic challenge due to its early recurrence and atypical presentation.

Cns Tuberculosis And Stroke, Burden, Management Challenges And Future Needs For Care And Research, A H Jokhio, Simon M Bell, Mohammad Wasay, Arshad Majid

Pakistan Journal of Neurological Sciences (PJNS)

An estimated 10 million cases of Tuberculosis (TB) and 1.6 million deaths due to this disease occurred worldwide in 2017 (1). About 1.7 billion people, 23% of the world’s population are estimated to have latent TB infection and are thus at risk of developing active TB disease during their life time. TB is mostly common in developing countries and Pakistan ranks 5th among 30 high-burden countries and 5th for Drug Resistant TB (DRTB). The incidence of TB in Pakistan is 267 per 100,000 (1) with an estimated 525,000 cases in 2017 including 57,000 cases among those who were less than …

Factors Influencing Severity In Acute Ischemic Strokes, Inam E Khuda, Intisar Siddiqui, Saad Munzar, Rashid Nazir, Arsalan Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Background: Stroke severity is one of the factors that determines stroke related disability. We explored possible associations between stroke severity and commonly evaluated clinical parameters of stroke patients. Objective: To determine the relationships between clinical features including routine in- hospital investigations done in first 24 hours of admission and variations in the stroke severity. Patients and Methods: This was a retrospective, analytical study performed in the Department of Neurology at Shifa International Hospital, Shifa Tameer-e-Millat University, Islamabad, Pakistan. Adult patients admitted with ischemic stroke, over a period of 39 months, with Middle Cerebral Artery infarctions, were included. National Institute of …

Effects Of Intermittent Fasting On Taste Modulation And Perception, Sajid Hameed, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Two Nights Of Recovery Sleep Restores Hippocampal Connectivity But Not Episodic Memory After Total Sleep Deprivation, Ya Chai, Zhuo Fang, Fan Nils Yang, Sihua Xu, Yao Deng, Andrew Raine, Jieqiong Wang, Meichen Yu, Mathias Basner, Namni Goel, Junghoon J. Kim, David A. Wolk, John A. Detre, David F. Dinges, Hengyi Rao

Publications and Research

Sleep deprivation significantly impairs a range of cognitive and brain function, particularly episodic memory and the underlying hippocampal function. However, it remains controversial whether one or two nights of recovery sleep following sleep deprivation fully restores brain and cognitive function. In this study, we used functional magnetic resonance imaging (fMRI) and examined the effects of two consecutive nights (20-hour time-in-bed) of recovery sleep on resting-state hippocampal connectivity and episodic memory deficits following one night of total sleep deprivation (TSD) in 39 healthy adults in a controlled in-laboratory protocol. TSD significantly reduced memory performance in a scene recognition task, impaired hippocampal …

Early Follow-Up Phone Calls To Reduce 30-Day Readmissions For Stroke Patients Discharged To Home, Olivia Gruder, Md, John Allred, Md, Frank Anzelmi, Md, Judy Diep, Md, Belle English, Md, Aniket Natekar, Md, Priyadarshee Patel, Md, Louis Porreca, Md, Sanskruti Patel, Md, Shaista Alam, Md, Rodney Bell, Md, Robin Dharia, Md, Elan Miller, Md, Diana Tzeng, Md, Fred Rincon, Md< Msc, Facp

Health Equity and Quality Improvement (HEQI) Summit

Patients admitted to the acute stroke unit with minor neurologic deficits are frequently discharged directly to home rather than to a rehabilitation center. Data from our tertiary care comprehensive stroke center has shown that in a 7-month period, 37% of patients admitted to the stroke unit were discharged home versus discharged to rehab or other location. Our average 30-day readmission rate for home discharges is 5.14%. More than 30% of these readmitted patients had been discharged on a Thursday or Friday on their index admission. When discharged home, patients typically are tasked with several responsibilities including but not limited to …

Strengthening The Synapse Between Outpatient Neurological Care And Inpatient Referral, T. Y. Chuang, M. Braslavsky, E. Isaac, M. Rehman, C. S. White, S. Thummalapenta, P. Kerns, D. Rose, E. Wong

Health Equity and Quality Improvement (HEQI) Summit

Objective

The goal of this project is to investigate if established neurology patients are appropriately referred to the emergency room. We suspect that there are patients that could be more effectively triaged to prevent unnecessary visits to the emergency department. If this is the case, implementing an intervention such as offering expedited visits or contingency plan, may reduce non-emergent inpatient consultative services5. This would also improve outpatient communication and decrease utilization of both ER and patient resources.

A Fatal Case Of Primary Amoebic Meningoencephalitis From Recreational Waters., Edward Hamaty, Saif Faiek, Minesh Nandi, David Stidd, Manish Trivedi, Hari Kandukuri

Department of Neurosurgery Faculty Papers

Background: Naegleria Fowleri is a single-cell, thermophilic amphizoid amoeba, and a rare known causative agent for primary amoebic meningoencephalitis with >97% mortality rate. The amoeba resides in freshwater lakes and ponds but can also survive in inadequately chlorinated pools and recreational waters. The mode of infection includes activities such as diving or jumping into freshwater or submerging the head under the water. Although most commonly seen in the southern United States, it is essential to keep this clinical suspicion in mind regardless of geography, as presenting symptoms can be very similar to classic bacterial meningitis.

Conclusion: As per the CDC, …

Anti-Aggregation Effects Of Phenolic Compounds On Α-Synuclein, Kenjiro Ono, Mayumi Tsuji, Tritia R. Yamasaki, Giulio M. Pasinetti

Neurology Faculty Publications

The aggregation and deposition of α-synuclein (αS) are major pathologic features of Parkinson's disease, dementia with Lewy bodies, and other α-synucleinopathies. The propagation of αS pathology in the brain plays a key role in the onset and progression of clinical phenotypes. Thus, there is increasing interest in developing strategies that attenuate αS aggregation and propagation. Based on cumulative evidence that αS oligomers are neurotoxic and critical species in the pathogenesis of α-synucleinopathies, we and other groups reported that phenolic compounds inhibit αS aggregation including oligomerization, thereby ameliorating αS oligomer-induced cellular and synaptic toxicities. Heterogeneity in gut microbiota may influence the …

Brain Structure Changes Over Time In Normal And Mildly Impaired Aged Persons, Charles D. Smith, Linda J. Van Eldik, Gregory A. Jicha, Frederick A. Schmitt, Peter T. Nelson, Erin L. Abner, Richard J. Kryscio, Richard R. Murphy, Anders H. Andersen

Neurology Faculty Publications

Structural brain changes in aging are known to occur even in the absence of dementia, but the magnitudes and regions involved vary between studies. To further characterize these changes, we analyzed paired MRI images acquired with identical protocols and scanner over a median 5.8-year interval. The normal study group comprised 78 elders (25M 53F, baseline age range 70-78 years) who underwent an annual standardized expert assessment of cognition and health and who maintained normal cognition for the duration of the study. We found a longitudinal grey matter (GM) loss rate of 2.56 ± 0.07 ml/year (0.20 ± 0.04%/year) and a …