Neurology Commons^™

The (R)- Isomer Of Isometheptene Decreases Trigeminal Sensitivity In A Rat Model Of Primary Headache, Jessica Perino, Ms, Nathan T. Fried, Phd, Michael L. Oshinsky, Phd, Bruce Daugherty, Phd, Mba, Seth Lederman, Md, Melanie B Elliott, Phd

Department of Neurosurgery Posters

Introduction

Isometheptene is thought to be the active ingredient of the commonly known headache medication, Midrin. Previously, we found only the (R) enantiomer to be effective in alleviating headache behavior in two models of headache compared to the (S) enantiomer.

Experiments using electrical and mechanical stimulation of the dura in animals with no history of head pain have been used to elucidate the mechanisms of the trigeminovascular system at the level of the trigeminal ganglion, trigeminal nucleus caudalis, periaqueductal gray, and the thalamus. The limitation of these acute models is that electrical and mechanical stimulation of the dural blood vessels …

1st Place Research Paper: The Effectiveness Of Yoga Therapy On An Adult, Post-Stroke Population: A Systematic Review, Baylor E. Hogan

Kevin and Tam Ross Undergraduate Research Prize

Objectives: The objectives of this paper are to (1) give a brief overview of stroke pathophysiology (2) outline yoga as a therapeutic strategy (3) present the current research on yoga rehabilitation for stroke (4) discuss the efficacy of yoga for chronic stroke.

Methods: Relevant terms were searched in PubMed, Web of Science, Academic OneFile, ScienceDirect, and Google Scholar electronic databases. Studies were excluded if they contained pediatric stroke, non-stroke neurological diseases, or subjects with comorbidities. Statistically significant data was extracted for the primary measures of nine trials.

Results: Four studies measured statistically significant outcomes (p<0.05). These included improvements in balance, independence, endurance, trait anxiety, fear of falling, self-efficacy, pain, strength, range of motion (ROM), activity, participation, and quality of life (QoL). Discussion: Lack of statistical significance in post-stroke depression (PSD) measures may be due to inadequate intervention length or a psychosocial cause of depression. Improvements in balance, flexibility, and strength from yoga participation permitted progress in disability and functionality. Finally, overall health-related quality of life (HRQL) is affected by the severity of mental disorders and physical disability. Yoga can have a positive effect in both domains and therefore, may improve HRQL.

Conclusion: …

Paired Associative Transspinal And Transcortical Stimulation Produces Bidirectional Plasticity Of Human Cortical And Spinal Motor Pathways, Luke Dixon, Mohamed Ibrahim, Danielle Santora

Dissertations, Theses, and Capstone Projects

Anatomical, physiological, and functional connectivity exists between primary motor cortex (M1) and spinal cord neurons. Paired associative stimulation (PAS) produces enduring changes in M1 based on the Hebbian principle of associative plasticity. The present study aims to discover immediate neurophysiological changes on human corticomotor pathways by pairing noninvasive transspinal and transcortical stimulation via transcranial magnetic stimulation (TMS). We delivered paired transspinal and transcortical stimulation for 40-min at precise interstimulus intervals with TMS being delivered after (transspinal-transcortical PAS) or before (transcortical-transspinal PAS) transspinal stimulation. Transspinal-transcortical PAS markedly decreased intracortical inhibition, increased intracortical facilitation and M1 excitability with concomitant decreases of motor …

1H-Mrs Metabolites In Adults With Down Syndrome: Effects Of Dementia, Ai-Ling Lin, David Powell, Allison Caban-Holt, Gregory A. Jicha, William C. Robertson, Brian T. Gold, Roberta Davis, Erin L. Abner, Donna M. Wilcock, Frederick A. Schmitt, Elizabeth Head

Sanders-Brown Center on Aging Faculty Publications

To determine if proton magnetic resonance spectroscopy (¹H-MRS) detect differences in dementia status in adults with Down syndrome (DS), we used ¹H-MRS to measure neuronal and glial metabolites in the posterior cingulate cortex in 22 adults with DS and in 15 age- and gender-matched healthy controls. We evaluated associations between ¹H-MRS results and cognition among DS participants. Neuronal biomarkers, including N-acetylaspartate (NAA) and glutamate-glutamine complex (Glx), were significantly lower in DS patients with Alzheimer's should probably be changed to Alzheimer (without ' or s) through ms as per the new naming standard disease (DSAD) when …

Cerebral Venous Engorgement In Hydrops Fetalis, Adnan I. Qureshi, Thomas Kohl

Articles

A 34-year-old gravida was diagnosed with hydrops fetalis, hydrothorax with cardiac compression, hygroma, ascites, and subcutaneous edema at 20 weeks of gestation...

Neuromyelitis Optica (Devic’S Disease) In A 10 Years Old Boy., Dr.Farida Jan, Amber Shabir, Shahnaz Ibrahim

Pakistan Journal of Neurological Sciences (PJNS)

Neuromyelitis optica (NMO) also known as Devic’s disease is an acute demyelinating disorder combined with optic neuritis and transverse myelitis.A 10 years old boy presented in the ER with the complaints of fever and back pain for past 10 days and inability to walk for 6-7 days. He had developed urinary retention and constipation for the past 5 days along with abdominal distension. There was also blurring of vision in the left eye with only light perception and rapid afferent papillary defect was present while the right eye was normal. The provisional diagnosis was Transverse myelitis vsNeuromyelitisoptica (NMO). CSF revealed …

10-Year Pattern Of Admissions In Psychiatric Unit At A Tertiary Care Hospital In Pakistan., Raza Ur Rahman, Abdul Ghani Khan, Naila Naerm Shahbaz

Pakistan Journal of Neurological Sciences (PJNS)

To identify the pattern of psychiatric morbidity in hospitalized patients of a tertiary care unit.Design; Details of patient’s admissions from the case register of psychiatric unit were recorded retrospectively.The study was conducted in Dept. of Psychiatry Jinnah Postgraduate Medical Centre JPMC Karachi and included data of ten years. RESULTS;- TA total of 5527 patients were hospitalized during period of ten years (1995 – 2004). Among them 62.612% (n = 3461) were males and 37.38 (n = 2066) were females. The majority of patients were in the age range of 15 – 44 years. On the basis of ICD classification, mood …

Preventing Stroke At Door Step– Need For A Paradigm Shift In Delivery Of Preventive Healthcare, Ismail A. Khatri, Saad Farooq, Muneeza A. Khatri

Pakistan Journal of Neurological Sciences (PJNS)

Although stroke is a preventable disease, it is increasing globally. Only few risk factors are responsible for much of the leading noncommunicable diseases, yet those remain poorly controlled, despite being the most affordable way of promoting health and preventing disease [1]. Lifestyle modification including cessation of smoking, making aerobic physical activity a routine, certain changes in diet, and aggressive management of risk factors are all part of stroke prevention strategies [2].

Frequency Of Cranial Autonomic Symptoms (Cas) In Migraine Patients, Sadaf Nasir, Naureen Abrar, Khalid Sher, Shahnaz Shahnaz

Pakistan Journal of Neurological Sciences (PJNS)

Of all the painful states that afflict humans, headache is undoubtedly the most frequent and common reason for seeking medical help. Headache has over 300 different types and different etiologies; migraine is one of them and continues being an under diagnosed condition in many of cases as it can be accompanied by symptoms commonly associated with other causes of facial pain. Out of 28 million people in USA who have history of headache and symptoms which mimic the typical migraine only 48% are diagnosed of migraine.

Two Cases Of Hyperkalemia Presenting As Acute Demyelinating Polyneuropathy: Clinical And Electrophysiological Reversibility With In 72 Hours With Potassium Correction., Waseem Tariq, Arsalan Ahmad,Md

Pakistan Journal of Neurological Sciences (PJNS)

GullianBarre syndrome (GBS) is the most common cause of acute flaccid paralysis.Hypokalemia can present with flaccid paralysis and nerve conduction studies show axonal neuropathy.Here we present two cases who were initially admitted with suspicion of GBS but later on baseline investigations showed very high serumpotassium and in both cases nerve conduction showed acute demyelinating polyneuropathy.They were admitted in high dependency units and urgent dialysis was done.In first case NCS were repeated 72 hours of correction of hyperkalemia and they showed significant improvement. In second patient NCSwere repeated after 24 hours and they showed mild improvement in all parameters.

Frequency Of Intraventricular Extension In Intracerebral Hemorrhage And Its Outcome At Day 30., Farheen Niazi,, Muhammad Irshad

Pakistan Journal of Neurological Sciences (PJNS)

Intracerebral hemorrhage (ICH) accounts for 10 to 15% of all strokes, and is found to have a disproportionately high morbidity and mortality.1 Extension of the hemorrhage intothe ventricles (40% occurrence) can happen early or late in the course of events.2 OBJECTIVE: To determine the frequency of Intraventricular extension in patients with intracerebralhaemorrhage and its outcome at day 30 by measuring disability using Modified Rankin Scale.STUDY DESIGN: Descriptive case series.PLACE AND DURATION OF STUDY: Study was carried out from 1st December 2010 to 31st May, 2011 in the department of Neurology, PIMS, Islamabad, Pakistan SUBJECT AND METHODS:93 patients of intracerebralhaemorrhage were …

10thannual Neurology Research Day, May 2016 Abstracts Shifa International Hospital, Islamabad, Rohaan Noor, Komal Gilani, Umer Farooq, Sabul Zafar, Fatima Aurangzaib.

Pakistan Journal of Neurological Sciences (PJNS)

Burden of headache has been assessed in adults in countries worldwide, and is high, but data for children and adolescents is sparse. The objective of this study is to fill the information gap for adolescents.

Surgical Outcome Of Benign Intracranial Hypertension In Terms Of Improvement In Vision, Naeem Ul Haq, Naseer Hassan, Muhammad Ishaq, Muhammad Usman

Pakistan Journal of Neurological Sciences (PJNS)

To know about surgical outcome of benign intracranial hypertension in terms of improvement of vision.METHODOLOGY ; This Prospective observational study was conducted at of 22 patients operated in neurosurgery unit lady reading hospital Peshawar from Jan 2011 to Jun2014. Written consent was obtained from all the patients or their relatives All patients of either age and sex with Diagnosed cases of BIH were included in the study, Patients with depressed conscious level, malignant hypertension, space occupying lesion in brain on MRI and those Patients unfit or unwilling for surgery were excluded from the study. Patients particulars like age ,gender , …

Salmonella Meningitis A Rare Presentation In Adult, Saira Naeem,, Shobha Luxmi,, Anum Latif

Pakistan Journal of Neurological Sciences (PJNS)

Salmonella is a leading cause of food-borne infections worldwide. There are more than 2500 different serovars of salmonella enterica found to date, causing primarily gastroenteritis. However, the infection may occur elsewhere and produce characteristic clinical syndromes. Meningitis is a rare complication that occurs in less than 1% of clinical salmonellosis.

Utility Of Intraoperative Neurophysiological Monitering (Ionm) In Various Surgeries At A Tertery Care Hospital In Karachi, Pakistan., Liaquat Ali, Ambreen Iqrar, Dr Bhojo Khealani, Syed Irshad Murtaza, Ejaz Karim, Tahira Binish, Zaitoon Shivji

Pakistan Journal of Neurological Sciences (PJNS)

Utility of real time multimodal intraoperative neurophysiological monitoring in different intracranial, spinal and peripheral nerve at a tertiary care hospital in Karachi Pakistan.Study design: A retrospective observational study Place and duration of study: Patients admitted in neurology and neurosurgery services as well as out-patients presenting to the clinical neurophysiology lab at the Aga Khan University Hospital Karachi between January 2012 to December 2013.Methodology: The study consisted of 14 patients undergoing different intracranial, spinal and peripheral nerve surgeries including correction of spinal scoliosis, spinal cord lesion ,acoustic neuroma resection and plexus and peripheral nerve repaired. Among the electrophysiological methods patients were …

Review Of Various Intraoperative Neurophysiologic Monitoring Techniques, Liaquat Ali, Ambreen Iqrar, Bhojo Asumal Khealani

Pakistan Journal of Neurological Sciences (PJNS)

IONM is use to monitoring nervous tissues (including brain, spinal cord, cranial nerves and peripheral nerves) in real-time during surgeries, alert neurological injuries and corrective measures and prevent disability. There are various IONM monitoring techniques including evoke potentials (SSEP, BAEP, MEP), EMG (Free-running and triggered), NAP (Nerve action potential) and Electroencephalography (EEG) to monitor the functional integrity of neural structures. SSEP evaluates integrity of posterior column-medial lemniscus pathway. SSEP is clinical use in spinal cord surgeries, vascular surgeries (carotid endarterectomy, cerebral aneurysm surgery etc), and localization of sensor motor cortex. BAEP evaluates integrity of peripheral and central auditory pathway. BAEP …

Neuroradiology In Tuberculous Meningitisdiagnostic Significance And Prognostic Value., Sumaira Nabi, Mazhar Badshah, Shahzad Ahmed, Ali Zohair Nomani, Irfanullah Khattak

Pakistan Journal of Neurological Sciences (PJNS)

Tuberculous meningitis (TBM) is the most common and belligerent form of CNS TB.Prompt definitive diagnosis of TBM is arduous due to tedious microbiological procedures. This study was conducted to evaluate the neuroradiological findings in patients with TBM as a modality forearly diagnoses and predicting prognosis. Materials and methods: A successive series of 100 patients diagnosed with TBM admitted to the PIMS neurology ward were studied between March 2013 and April 2014. Cranial imaging results were obtained by non-contrast enhanced CT brain (NECT) and MRI (magnetic resonance imaging) brain with contrast. MRC staging on admission and in-hospital mortality were recorded.Results: The …

Ictal Crying, Ali Akbar Asadi-Pooya, Dale Wyeth, Michael R. Sperling

Department of Neurology Faculty Papers

PURPOSE: The purpose of this study was to describe a series of patients with ictal crying to estimate its occurrence and characterize the clinical features and the underlying etiology.

METHODS: We retrospectively reviewed all the long-term video-EEG reports from Jefferson Comprehensive Epilepsy Center over a 12-year period (2004-2015) for the occurrence of the terms "cry" or "sob" or "weep" in the text body. All the extracted reports were reviewed, and patients with at least one episode of documented ictal crying at the epilepsy monitoring unit (EMU) were included in the study.

RESULTS: During the study period, 5133 patients were investigated …

Carotid Ultrasound Is Not Helpful In Simple Syncope, Nicholus Yee M.D., Shilin Patel M.D., Raymond Gong

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Scott JW, Schwartz AL, Gates JD, Gerhard-Herman M, Havens JM. Choosing wisely for syncope: low-value carotid ultrasound use. J Am Heart Assoc. 2014 Aug 13;3(4). pii: e001063. doi: 10.1161/JAHA.114.001063

Accuracy Of Icd-9-Cm Codes By Hospital Characteristics And Stroke Severity: Paul Coverdell National Acute Stroke Program, Tiffany E. Chang, Judith H. Lichtman, Larry B. Goldstein, Mary G. George

Neurology Faculty Publications

Background—Epidemiological and health services research often use International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes to identify patients with clinical conditions in administrative databases. We determined whether there are systematic variations between stroke patient clinical diagnoses and ICD‐9‐CM codes, stratified by hospital characteristics and stroke severity.

Methods and Results—We used the records of patients discharged from hospitals participating in the Paul Coverdell National Acute Stroke Program in 2013. Within this stroke‐enriched cohort, we compared agreement between the attending physician's clinical diagnosis and principal ICD‐9‐CM code and determined whether disagreements varied by hospital characteristics (presence of a …