Neurology Commons^™

Cerebral Venous Sinus Thrombosis Associated With Coronavirus Infection (Covid-19), Sajid Hameed, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome (SARS) caused by the SARS-CoV-2 coronavirus. Despite its primarily respiratory involvement, an increased propensity for systemic inflammation, neuroinvasion, and thromboembolic events has been reported. This systemic prothrombotic state may predispose to cerebral venous sinus thrombosis (CVST), which is an uncommon cerebrovascular disease with hypercoagulability as one of its important risk factors. We conducted a literature search using the PubMed electronic database and reviewed the published literature for a possible association of CVST with the COVID-19 disease.

Literature Review On Drosophila Research In Parkinson’S Disease, Maryann Jaquith

Honors Projects

Parkinson’s disease (PD) is one of the most prevalent neurodegenerative diseases. It is characterized by its main symptom of a tremor that usually starts in one limb. The four cardinal symptoms of PD are tremor, rigidity, bradykinesia, and postural instability. While the four cardinal symptoms are all motor symptoms there are non-motor symptoms for PD which include cognitive changes, sleeping disorders, lightheadedness, early satiety, and mood disorders. PD is characterized by dopaminergic (DA) neuron loss and the accumulation of Lewy bodies (LB) which are predominantly composed of α-synuclein (α-Syn) protein.

α-Syn is a protein found abundantly in the brain. It …

Cerebral Cavernous Malformation Presenting As Seizures, Hazim Brohi, Ayisha Farooq, Bushra Rehan, Muhammad Mairaj Khan

Pakistan Journal of Neurological Sciences (PJNS)

Cerebral cavernous malformations (CCMs) is one of the rare vascular malformation. It is diagnosed by characteristic lesions on magnetic resonance imaging (MRI). CCMs typically appears as a “popcorn-like” masses on T2-weighted images on MRI studies.And clinically can lead to headaches, seizures,focal neurological deficits or intracerebral hemorrhages. . A familial form is suggested if lesions are multiple, and a sporadic form, if single

Prevalence Of Paternal Postpartum Depression, Aisha Noorullah, Zehra Mohsin, Taliha Munir, Rida Nasir, Misbah Malik

Pakistan Journal of Neurological Sciences (PJNS)

Background: Postpartum Depression is a type of mood disorder associated with childbirth, which can occur in both parents. It is a major public health concern because it produces insidious effects on the well-being of new born as well as on the whole family. Objective: This study aims to determine the prevalence of postpartum depression among fathers in Karachi, Pakistan. Methods: This cross sectional survey was conducted among fathers, purposive convenient and snowball sampling was used to approach 120 participants after obtaining permission from Al-Khidmat Hospital and Combined Military Hospital (CMH).Participants were aged between 20-50 years, had a newly born child …

Referral Patterns And Diagnoses At A Single Neurophysiology Center In Quetta, Pakistan: An Audit Of 1600 Cases, Ahmad Wali, Ehtisham Khalid2, Hazar Khan, Abdul Nasir, Mr Abdullah

Pakistan Journal of Neurological Sciences (PJNS)

Neurophysiologic tests such as EEG, video EEG, Polysomnography (PSG), Nerve conduction studies (NCS) and electromyography (EMG) are the next steps after neurological examinations. These tests play a significantly important role in the decision-making and management of various neurological diseases. Data regarding the availability and frequency of these tests are not being compiled in Pakistan eventually resulting in a lack of awareness about these tests among physicians as well as patients. This motivated us to conduct a medical audit to assess frequencies, mode of referral, and final conclusion of these tests in detail. A total of 1600 tests were included. Among …

A Case Of Guillain-Barré Syndrome Presented With Abnormal Pupil Without Ophthalmoplegia, Kiran Abbas, Hassan Haroon, Noorulain Qureshi, Ritesh Pahwani, Suneel Kumar

Pakistan Journal of Neurological Sciences (PJNS)

A 50-year-old man, resident of Balochistan, Pakistan presented with acute progressive tetraparesis associated with a unilateral dilated pupil. He had normal ocular movement, but the right pupil was dilated and unresponsive to light or accommodation reflexes. This is the first case from Pakistan.

A Rare Presentation Of Acute Flaccid Myelitis In Covid-19 Patient: A Case Report, Liaquat Ali, Adnan Khan, Osama Elalamy, Beatriz Canibano, Mohammad Al Hatou, Ghulam Adeli, Islam Ahmed, Ambreen Iqrar, Ahmed Abdussalam, A Saif Ibrahim, Sundus Sardar

Pakistan Journal of Neurological Sciences (PJNS)

SARS-CoV-2 virus enters human cells via ACE-2 receptors and causes multiple organs dysfunction. These ACE-2 receptors are in cells surface of human lung, liver, heart, kidney and blood vessels. The expression of ACE2 receptors in cortical neurons, glial cells and spinal cord cells create nervous system susceptible to SARS-CoV-2 attack and may be a source of different neurological deficits including myelitis in COVID-19 patients.

Parkinson's Disease- "Move Together To End": Theme For World Brain Day 2020, Abdul Malik

Pakistan Journal of Neurological Sciences (PJNS)

World Federation of Neurology (WFN) promoting brain health through its educational, skills development & advocacy activities. Since 2014 WFN had been focused to organized dedicated awareness drive in all the WFN members countries round the globe.

Improved Urinary Continence For Stroke Survivors In Inpatient Rehab, Lauren Logan, Evelyn Laws, Charmika Schuster, Emily Sharawara, Steven Anderson, Shireen Hussien, Robin Nelson, Ann Sandstedt, Nadine Tranquilla, Natalie Swearingen, Diane Clark

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No abstract provided.

Letter: Thrombotic Neurovascular Disease In Covid-19 Patients., Ahmad Sweid, Batoul Hammoud, Joshua H. Weinberg, Mazen Oneissi, Eytan Raz, Maksim Shapiro, Maureen Deprince, Stavropoula Tjoumakaris, Michael R. Gooch, Nabeel A. Herial, Hekmat Zarzour, Victor Romo, Robert Rosenwasswer, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Although the respiratory system is the primary target of the coronavirus, studies have demonstrated a strong tropism to the central nervous system (CNS).^1,2 The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. This receptor is also found in the CNS and plays a crucial role in autoregulating cerebral perfusion pressure.^3,4 Additionally, epidemiological data demonstrated increased mortality due to cardiovascular and cerebrovascular diseases during flu pandemics due to a hypercoagulable state.^5,6 The triad of neuroinvasion of SARS-CoV-2, induction of hypercoagulable state,^{5-9 …}

Inadvertent Stone Migration During Pneumatic Lithotripsy: Still A Conundrum In The 21st Century, Ali Akbar Zehri, Miten Patel, Philip Adebayo, Authar Ali

General Surgery, East Africa

Currently, an ideal gadget to stop retrograde stone migration remains a holy grail, and the hunt for such a device is still ongoing in the 21st century. The quest for an ideal instrument is driven by the need to reduce cost, minimize ancillary procedure rates, reduce the device's operative time, and improve the stone-free rate. The purpose of the present review is to provide an update on the use of preventive measures that are used to stop retrograde stone migration during pneumatic lithotripsy for ureteric stone management.

Currently, an ideal gadget to stop retrograde stone migration remains a holy grail, …

Postinfectious Cerebellar Syndrome With Paraneoplastic Antibodies: An Association Or Coincidence?, Sajid Hameed, Mukesh Kumar, Pal Satyajit Singh Athwal, Sukhmanii Kahlon, Nimit Dalal

Section of Neurology

Cerebellar ataxia has a very broad differential diagnosis in adults, including paraneoplastic and postinfectious etiologies. We report a case of a 56-year-old male presented with right-sided cerebellar dysfunction preceded by fever and headache. He was diagnosed with subacute postinfectious cerebellar ataxia. Blood serology showed the presence of anti-amphiphysin and anti-Ri (ANNA-2, antineuronal nuclear autoantibody type 2) antibodies, which have a known association with cerebellar syndrome. The patient subsequently improved with the steroids. Although no evidence of an underlying tumor was found in the patient, the presence of the paraneoplastic antibodies remains a mystery. We suggest a probable association of these …

Nine-Year Prospective Efficacy And Safety Of Brain-Responsive Neurostimulation For Focal Epilepsy, Dileep R Nair, Kenneth D Laxer, Peter B Weber, Anthony M Murro, Yong D Park, Gregory L Barkley, Brien J Smith, Ryder P Gwinn, Michael J Doherty, Katherine H Noe, Richard S Zimmerman, Gregory K Bergey, William S Anderson, Christianne Heck, Charles Y Liu, Ricky W Lee, Toni Sadler, Robert B Duckrow, Lawrence J Hirsch, Robert E Wharen, William Tatum, Shraddha Srinivasan, Guy M Mckhann, Mark A Agostini, Andreas V Alexopoulos, Barbara C Jobst, David W Roberts, Vicenta Salanova, Thomas C Witt, Sydney S Cash, Andrew J Cole, Gregory A Worrell, Brian N Lundstrom, Jonathan C Edwards, Jonathan J Halford, David C Spencer, Lia Ernst, Christopher T Skidmore, Michael R Sperling, Ian Miller, Eric B Geller, Michel J Berg, A James Fessler, Paul Rutecki, Alica M Goldman, Eli M Mizrahi, Robert E Gross, Donald C Shields, Theodore H Schwartz, Douglas R Labar, Nathan B Fountain, W Jeff Elias, Piotr W Olejniczak, Nicole R Villemarette-Pittman, Stephan Eisenschenk, Steven N Roper, Jane G Boggs, Tracy A Courtney, Felice T Sun, Cairn G Seale, Kathy L Miller, Tara L Skarpaas, Martha J Morrell, Rns System Ltt Study

Faculty, Staff and Students Publications

OBJECTIVE: To prospectively evaluate safety and efficacy of brain-responsive neurostimulation in adults with medically intractable focal onset seizures (FOS) over 9 years.

METHODS: Adults treated with brain-responsive neurostimulation in 2-year feasibility or randomized controlled trials were enrolled in a long-term prospective open label trial (LTT) to assess safety, efficacy, and quality of life (QOL) over an additional 7 years. Safety was assessed as adverse events (AEs), efficacy as median percent change in seizure frequency and responder rate, and QOL with the Quality of Life in Epilepsy (QOLIE-89) inventory.

RESULTS: Of 256 patients treated in the initial trials, 230 participated in …

The Effects Of Direct Brain Stimulation In Humans Depend On Frequency, Amplitude, And White-Matter Proximity, Uma R Mohan, Andrew J Watrous, Jonathan F Miller, Bradley C Lega, Michael R Sperling, Gregory A Worrell, Robert E Gross, Kareem A Zaghloul, Barbara C Jobst, Kathryn A Davis, Sameer A Sheth, Joel M Stein, Sandhitsu R Das, Richard Gorniak, Md, Paul A Wanda, Daniel S Rizzuto, Michael J Kahana, Joshua Jacobs

Department of Neurology Faculty Papers

BACKGROUND: Researchers have used direct electrical brain stimulation to treat a range of neurological and psychiatric disorders. However, for brain stimulation to be maximally effective, clinicians and researchers should optimize stimulation parameters according to desired outcomes.

OBJECTIVE: The goal of our large-scale study was to comprehensively evaluate the effects of stimulation at different parameters and locations on neuronal activity across the human brain.

METHODS: To examine how different kinds of stimulation affect human brain activity, we compared the changes in neuronal activity that resulted from stimulation at a range of frequencies, amplitudes, and locations with direct human brain recordings. We …

Dramatic Outcomes In Epilepsy: Depression, Suicide, Injuries, And Mortality, Boulenouar Mesraoua, Dirk Deleu, Al Hail Hassan, Melykian Gayane, Alsheikh Lubna, Musab Abdalhalim Ali, Torbjorn Tomson, Bassel Abou Khalil, J Helen Cross, Ali A Asadi-Pooya

Department of Neurology Faculty Papers

In this narrative review, we will discuss some of the significant risks and dramatic consequences that are associated with epilepsy: depression, suicide, seizure-related injuries, and mortality, both in adults and in children. Considering the high prevalence of depression among people with epilepsy (PWE), routine and periodic screening of all PWE for early detection and appropriate management of depression is recommended. PWE should be screened for suicidal ideation regularly and when needed, patients should be referred for a psychiatric evaluation and treatment. When starting an antiepileptic drug (AED) or switching from one to another AED, patients should be advised to report …

Cardiorespiratory Fitness Diminishes The Effects Of Age On White Matter Hyperintensity Volume, Nathan F. Johnson, Ahmed A. Bahrani, David K. Powell, Gregory A. Jicha, Brian T. Gold

Physical Therapy Faculty Publications

White matter hyperintensities (WMHs) are among the most commonly observed marker of cerebrovascular disease. Age is a key risk factor for WMH development. Cardiorespiratory fitness (CRF) is associated with increased vessel compliance, but it remains unknown if high CRF affects WMH volume. This study explored the effects of CRF on WMH volume in community-dwelling older adults. We further tested the possibility of an interaction between CRF and age on WMH volume. Participants were 76 adults between the ages of 59 and 77 (mean age = 65.36 years, SD = 3.92) who underwent a maximal graded exercise test and structural brain …

In Reply: May Cooler Heads Prevail During A Pandemic: Stroke In Covid-19 Patients Or Covid-19 In Stroke Patients?, Pascal Jabbour, Ahmad Sweid, Stavropoula Tjoumakaris, Michel Piotin, Waleed Brinjikji, Kimon Bekelis, Eytan Raz, Nader Sourour, Shahid M. Nimjee, Demetrius K. Lopes, Ameer E. Hassan, Aditya S. Pandey, L. Fernando Gonzalez, Ricardo A. Hanel, Adnan H. Siddiqui, David Hasan, Sean D. Lavine, Bernard R. Bendok

Department of Neurosurgery Faculty Papers

No abstract provided.

Feasibility Of Dual-Task Gait To Estimate Alzheimer's Related Cognitive Decline In Down Syndrome, Kathryn L. Van Pelt, Lisa Mason Koehl, Allison M. Caban-Holt, Amelia J. Anderson-Mooney, Elizabeth Head, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Introduction: The striatum and frontal lobes have been shown to have early Alzheimer's disease (AD) neuropathology and are critical for motor and cognitive function. We hypothesized gait would be associated with early-stage dementia in Down syndrome (DS), a cohort at risk for AD.

Methods: Twenty-eight participants with DS were enrolled in the study. Participants walked at their self-selected pace and while completing a dual task (counting, obstacle, or counting+obstacle).

Results: All participants were able to complete the self-paced condition and 78.57-96.42% completed the dual-task conditions. There was a trend for greater dual-task effects on gait velocity based on dementia diagnosis. …

Limbic-Predominant Age-Related Tdp-43 Encephalopathy Differs From Frontotemporal Lobar Degeneration, John L. Robinson, Sílvia Porta, Filip G. Garrett, Panpan Zhang, Sharon X. Xie, Eunran Suh, Vivianna M. Van Deerlin, Erin L. Abner, Gregory A. Jicha, Justin M. Barber, Virginia M-Y Lee, Edward B. Lee, John Q. Trojanowski, Peter T. Nelson

Epidemiology and Environmental Health Faculty Publications

TAR-DNA binding protein-43 (TDP-43) proteinopathy is seen in multiple brain diseases. A standardized terminology was recommended recently for common age-related TDP-43 proteinopathy: limbic-predominant, age-related TDP-43 encephalopathy (LATE) and the underlying neuropathological changes, LATE-NC. LATE-NC may be co-morbid with Alzheimer’s disease neuropathological changes (ADNC). However, there currently are ill-defined diagnostic classification issues among LATE-NC, ADNC, and frontotemporal lobar degeneration with TDP-43 (FTLD-TDP). A practical challenge is that different autopsy cohorts are composed of disparate groups of research volunteers: hospital- and clinic-based cohorts are enriched for FTLD-TDP cases, whereas community-based cohorts have more LATE-NC cases. Neuropathological methods also differ across laboratories. Here, …

Optimal Interventions To Address Drop Foot And Increase Gait Speed In Stroke Populations, Christopher Tran, Tommy Ngo, Dana Hazlett, Ethan Jung, Faris Alshammari

San Marcos, Summer 2020

Background: The mechanism of stroke or cerebral vascular accident (CVA) is an interruption of blood flow to the brain, which can result in many different neuromuscular impairments including drop foot. There is limited research focusing on comparative interventions for gait improvement in early stroke.

Purpose: The purpose of this study was to review the various physical thereapy interventions to benefit patients with drop foot following a single stroke.

Methods: A comprehensive systematic search was conducted within the PubMed and ProQuest databases. This study examined papers assessing conventional physical therapy for stroke patients with drop foot who had their 1st stroke …