Neurology Commons^™

Ossification Of The Mamillo-Accessory Ligament: A Review Of The Literature And Clinical Considerations., Graham Dupont, Emre Yilmaz, Joe Iwanaga, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Ossification of the mamillo-accessory ligament (MAL) is a misunderstood phenomenon; however, many have posited that it can result in nerve entrapment of the medial branch of the dorsal ramus causing zygapophyseal joint related low back pain. The MAL has been studied anatomically by few, yet the data indicate possible associations between ossification of this ligament and spondylosis. It has been proposed that mechanical stress upon the lumbar spine may also lead to progressive ossification of the MAL into a bony foramen.

Ossification Of The Roof Of The Porus Trigeminus With Duplicated Abducens Nerve., Graham Dupont, Juan J Altafulla, Joe Iwanaga, Koichi Watanabe, R Shane Tubbs

Articles, Abstracts, and Reports

Ossification of parts of the intracranial dura mater is common and is generally accepted as an age-related finding. Additionally, duplication of the abducens nerve along its course to the lateral rectus muscle is a known, although uncommon anatomical variant. During routine cadaveric dissection, an ossified portion of dura mater traveling over the trigeminal nerve's entrance (porus trigeminus) into the middle cranial fossa was observed unilaterally. Ipsilaterally, a duplicated abducens nerve was also observed, with a unique foramen superolateral to the entrance of Dorello's canal. To our knowledge, there has been no existing report of a simultaneous ossified roof of the …

Vgkc Antibody (Anti Lg1) Associated Limbic Encephalitis In A Young Adult With Full Recovery., Farheen Niazi, Madeeha Iftikhar, Rizwan Ali, Tahir Aziz

Pakistan Journal of Neurological Sciences (PJNS)

A young boy with no premorbids was admitted with fever, fits and psychosis. His initial investigations including cerebrospinal fluid (CSF) routine examination, electroencephalogram(EEG) and MRI brain with contrast were normal. His autoimmune encephalitis panel revealed positive voltage gated potassium channel(VGKC) antibodies, anti -leucine rich glioma inactivated 1 antibody (LG1) group and was give five doses of methylprednisolone and five sessions of plasmapheresis. Psychiatric symptoms took one month to respond. He had a complete recovery. Autoimmune limbic encephalitis should be diagnosed promptly in young patient with fit, psychosis and a high index of suspicion should be kept as initial work up …

Polyneuropathy Associated With Iga Paraproteinemia: A Case Report And Literature Review., Waleed Shahzad, Sumaira Nabi, Hafiza Faiza Mushtaq, Tehmina Inayat, Muhammad Hassan, Haris Majid Rajput, Zakir Jan, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Paraproteinemia is precipitated by an accumulation of monoclonal plasma cells or B lymphocytes. Idiopathic neuropathies that are associated with paraproteinemia account for only 10% of the neuropathies. Paraprotein acts like an antibody and is targeted against myelin and axons present in the peripheral nerves. Despite being of interest for quite a long time, the caudal relationship between paraproteinemias and peripheral neuropathies still remains a sorcery. We report a case of a middle aged male who presented with pain and parasthesias in both arms and legs. His workup revealed him to be having a paraproteinemic neuropathy consistent with IgA Lambda chains …

Is It Really Transverse Myelitis? Acute Flaccid Myelitis A Rare Entity., Hina Yusuf, Arsalan Ahmad, Ejaz Ahmed Khan

Pakistan Journal of Neurological Sciences (PJNS)

Acute Flaccid Myelitis is a relatively new and rare disease entity which was recognized for the first time in United States in 20121. Usually children below 18 years of age present with sudden onset rapidly progressive flaccid paralysis sometimes following upper respiratory tract infection. To date no cases have been reported from Afghanistan and Pakistan. We are reporting case of a young girl who presented with sudden onset flaccid paralysis and respiratory distress. Her MRI Cervical spine showed longitudinally extensive transverse myelitis. One year after the onset of disease flaccid paraparesis continued despite various treatments. It is important to report …

Spectrum Of Electroencephalogram Finding In Children With Newly Diagnosed Epilepsy –An Experience At A Tertiary Care Hospital., Sanam B. Rajper, Khairunnisa Mukhtiar, Fozia Baloch, Shahnaz H. Ibrahim, Abdul Rashid Memon

Pakistan Journal of Neurological Sciences (PJNS)

Epilepsy is the most common neurological disorders that affect all age groups. It is characterized by at least two unprovoked seizures more than 24 hours apart. The most common investigation used for both diagnosis and management is an Electroencephalogram (EEG), which is relatively cheap and easy to perform. However, EEG requires technical expertise and is prone to misinterpretation. Objective: To determine the frequency of abnormal EEG findings in children with newly diagnosed epilepsy at tertiary care hospital.

Humanism And Mental Health Of Married Female Patients With Systemic Lupus Erythematosus., Hafiza Muzammal Shafiq, Dr. Muhammad Rafiq, Dr. Zahid Mahmood

Pakistan Journal of Neurological Sciences (PJNS)

Autoimmune diseases exert adverse impact on the psychological, social and physical well-being of the individuals who suffer from such diseases. Systemic lupus erythematosus is one of chronic illnesses that disturb the all areas of life especially psychosocial perspective of life. In such conditions, belief and view of patients about their own self is necessary to prognosis of their health. Studies suggest that humanism is one of those protective factors that can lead risky health towards better life.

The Mhgap; Will It Bridge The Mental Health Treatment Gap In Pakistan?, Shireen Najam, Aisha Sanober Chachar, Ayesha Mian

Pakistan Journal of Neurological Sciences (PJNS)

In Pakistan, the treatment gap for mental disorders is significantly high. Pakistan faces a unique problem of sustainable delivery. In 2009, WHO launched a mental health gap action program (mhGap) to provide evidence-based services at the primary and secondary level for the prevention and management of psychiatric and neurological disorders. This article highlights the discrepancies of the systems and issues related to mental health services provision in Pakistan. By discussing two initiatives of mhGap implementation for the Pakistani health system, authors have surveyed core areas where the sustainability of such a model can be compromised. The structural challenges marked by …

Alterations In Human Reaction Time Upon Consumption Of Taurine-Caffeine Based Energy Drink. A Gender Based Study., Asif Abbasi, Amaila Fazal, Faizan Mirza, Sadaf Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Energy drinks contains several potentially psychoactive ingredients including taurine, glucoronolactone, and caffeine that increases the human performances, reaction time and mood with relative differences to visual and auditory stimuli between both the genders.

Vagal Nerve Stimulation; Current And Future Interventions, Sidra Saleem, Muhammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Vagus Nerve is the 10th and the largest cranial nerve of the parasympathetic system, consist of approximately 20% efferent and 80% afferent. It is a big nerve, providing autonomous, cardiovascular, respiratory, gastrointestinal, immune and endocrine systems.

Perception Of Shisha Smoking & Drug Abuse Among University Students Of Karachi, Farwah Rizvi, Lubna Naz, Nazneen Zehra

Pakistan Journal of Neurological Sciences (PJNS)

Tobacco smoking in the form of cigarettes and shisha hasbecome a sign of modernization and trend among youth for pleasant and relaxing experience. Drug addiction is the most common problem in young ones nowadays causing craving practices and long-term consequences includesdisturbances in physical and mental health.

Prevalence Of Risk Factors Promoting Diabetic Neuropathy ., Aisha Qadir, Sumera Sohail1, Lubna Naz, Ghazala Yasmeen, Nazish Iqbal

Pakistan Journal of Neurological Sciences (PJNS)

Diabetic neuropathy is the worst consequence of diabetes mellitus leading to nerve dysfunction that is the cause of several complications such as pain, loss of sensitivity, damage to body systems, foot ulcers, morbidity and amputations etc. The aim of the present work was to study the prevalence of risk factors and occurrence of diabetic neuropathy in patients with diabetes, and how much diabetic neuropathy complications affect the life of diabetic patients.

Initial Management Of Meningiomas: Analysis Of The National Cancer Database, Catherine R. Garcia, Stacey A. Slone, Monica Chau, Janna H. Neltner, Thomas A. Pittman, John L. Villano

Neurology Faculty Publications

BACKGROUND: Meningiomas are the most common central nervous system tumor. We describe current trends in treatment and survival using the largest cancer dataset in the United States.

METHODS: We analyzed the National Cancer Database from 2004 to 2014, for all patients with diagnosis of meningioma.

RESULTS: 201,765 cases were analyzed. Patients were most commonly White (81.9%) females (73.2%) with a median age of 64 years. Fifty percent of patients were diagnosed by imaging. Patients were reported as grade I (24.9%), grade II (5.0%), grade III (0.7%), or unknown WHO grade (69.4%). Patients diagnosed by imaging were older, received treatment in …

The Endocannabinoid System In Migraine: From Bench To Pharmacy And Back., Cristina Tassorelli, Rosaria Greco, Stephen D. Silberstein

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: Migraine is a common, highly disabling disorder. Its treatment involves acute and preventive therapy. Many of available preventive medications are not well tolerated, which results in poor compliance and limited effectiveness. Cannabinoids have been proposed for the treatment of migraine but their efficacy and tolerability are controversial.

RECENT FINDINGS: Cannabinoids modulate functions and activity of signaling pathways that have a key role in pain control. Growing preclinical evidence and initial clinical findings suggest that modulation of the endocannabinoid system, via endogenous or exogenous cannabinoids may be relevant for migraine via multiple mechanisms.

SUMMARY: The endocannabinoid system qualifies …

Recommendations For The Design Of Therapeutic Trials For Neonatal Seizures., Janet S. Soul, Ronit Pressler, Marilee Allen, Geraldine Boylan, Heike Rabe, Ron Portman, Pollyanna Hardy, Sarah Zohar, Klaus Romero, Brian Tseng, Varsha Bhatt-Mehta, Cecil Hahn, Scott Denne, Stephane Auvin, Alexander Vinks, John Lantos, Neil Marlow, Jonathan M. Davis, International Neonatal Consortium

Manuscripts, Articles, Book Chapters and Other Papers

Although seizures have a higher incidence in neonates than any other age group and are associated with significant mortality and neurodevelopmental disability, treatment is largely guided by physician preference and tradition, due to a lack of data from well-designed clinical trials. There is increasing interest in conducting trials of novel drugs to treat neonatal seizures, but the unique characteristics of this disorder and patient population require special consideration with regard to trial design. The Critical Path Institute formed a global working group of experts and key stakeholders from academia, the pharmaceutical industry, regulatory agencies, neonatal nurse associations, and patient advocacy …

Publisher Correction: Toxoplasma Modulates Signature Pathways Of Human Epilepsy, Neurodegeneration & Cancer., Huân M Ngô, Ying Zhou, Hernan Lorenzi, Kai Wang, Taek-Kyun Kim, Yong Zhou, Kamal El Bissati, Ernest Mui, Laura Fraczek, Seesandra V Rajagopala, Craig W Roberts, Fiona L Henriquez, Alexandre Montpetit, Jenefer M Blackwell, Sarra E Jamieson, Kelsey Wheeler, Ian J Begeman, Carlos Naranjo-Galvis, Ney Alliey-Rodriguez, Roderick G Davis, Liliana Soroceanu, Charles Cobbs, Dennis A Steindler, Kenneth Boyer, A Gwendolyn Noble, Charles N Swisher, Peter T Heydemann, Peter Rabiah, Shawn Withers, Patricia Soteropoulos, Leroy Hood, Rima Mcleod

Articles, Abstracts, and Reports

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Automated Fiber Tract Reconstruction For Surgery Planning: Extensive Validation In Language-Related White Matter Tracts., Matteo Mancini, Sjoerd B. Vos, Vejay N. Vakharia, Aidan G. O'Keeffe, Karin Trimmel, Frederik Barkhof, Christian Dorfer, Salil Soman, Gavin P. Winston, Chengyuan Wu, John S. Duncan, Rachel Sparks, Sebastien Ourselin

Department of Neurosurgery Faculty Papers

Diffusion MRI and tractography hold great potential for surgery planning, especially to preserve eloquent white matter during resections. However, fiber tract reconstruction requires an expert with detailed understanding of neuroanatomy. Several automated approaches have been proposed, using different strategies to reconstruct the white matter tracts in a supervised fashion. However, validation is often limited to comparison with manual delineation by overlap-based measures, which is limited in characterizing morphological and topological differences. In this work, we set up a fully automated pipeline based on anatomical criteria that does not require manual intervention, taking advantage of atlas-based criteria and advanced acquisition protocols …

Delirium In Long Term Care Rehabilitation Residents: A Correlational Retrospective Study, Rebecca Lerma-Kjonegaard

Dissertations

Abstract Background: Delirium is associated with devastating outcomes, cognitive loss,

decreased function and an increase risk of mortality which affects patients and places a heavy burden on family and the healthcare system. The purpose of this study was to describe the relationship between select demographics, clinical characteristics, CHART- DEL-derived delirium diagnosis and ICD-10 coded discharge delirium diagnoses among Long Term Care (LTC) rehabilitation residents.

Method: A retrospective correlational design from174 LTC rehabilitation residents age 65 years or older using EMR and hard copy charts. The setting was a Southern California community hospital-based 100-bed LTC. Abstracted data included demographic characteristics (age, …

Reduced Gravity Contributes To Neutrophil To Lymphocyte Ratio Shifting And Promotion Of The Oxidative Stress Response, Amber M. Paul, Siddhita D. Mhatre, Egle Cekanaviciute, Ann-Sofie Schreurs, Candice G.T. Tahimic, Ruth K. Globus, Brian Crucian, Sharmila Bhattacharya

Publications

Spaceflight can cause immune system dysfunction, such as elevated white blood cells (WBC) and polymorphonuclear neutrophils (PMN), along with unchanged or reduced lymphocyte counts. A high PMN to lymphocyte ratio (NLR) can acts as a poor prognosis in cancer and a biomarker for subclinical inflammation however, the NLR has not been identified as a predictor of astronaut health during spaceflight. CBC data collected on board the International Space Station (ISS) was repurposed to determine the granulocyte to lymphocyte ratio (GLR) in humans and the NLR in rodents. The results displayed a progressive increase in GLR and NLR during spaceflight and …

Loss Of Nrf2 Results In Decreased Neuronal Arborization And Synaptic Density And Causes Exacerbated Age-Related Cognitive Impairment., Mikah Brandes, Nora Gray, Maya Caruso, Jonathan Zweig, Amala Soumyanath, Joseph F. Quinn

Student Research Symposium

Background: As the brain ages, free radicals accumulate and cause damage to cellular macromolecules. This increased oxidative damage is thought to contribute to the cognitive decline observed in aging. Activation of the antioxidant regulatory transcription factor NRF2 (Nuclear factor erythroid-derived 2) has been shown to improve neuronal health in aging and neurodegenerative diseases. Yet exactly how NRF2 participates in maintaining synaptic and cognitive function has not been fully elucidated. This study investigates how loss of NRF2 affects synaptic density and cognitive performance in aged mice.

Methods: Dendritic arborization and synaptic was evaluated in hippocampal neurons isolated from mice lacking NRF2 …