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1.
Mymensingh Med J ; 29(1): 121-128, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915347

RESUMO

Cerebral palsy (CP) is a non- progressive disorder of movement and posture due to a lesion of the developing brain. It is the commonest physical disability in childhood that affects function and development. Neuro imaging is currently recommended as a standard evaluation in children with cerebral palsy. This hospital based cross-sectional study was conducted in Paediatric Neurology out-patient department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2015 to December 2015 to see the frequency and pattern of neuro-imaging findings in children with cerebral palsy. A total of 130 cases those who were attended and diagnosed as cerebral palsy based on history, clinical examination and neuro developmental assessment included in this study. All patients were sent to radiology & imaging department of same hospital for CT scan of brain. Among total 130 cerebral palsy patients male were more affected than female (88 boys and 42 girls) with male to female ratio 2.09: 1. Their ages ranged between 6-72 months with a mean age 25.6 months. The commonest age group was 6-24 months (46.9%). Common mode of delivery was normal vaginal delivery (62.3%) & Perinatal asphyxia (PNA) occurred in 66.9% cases. The commonest type of cerebral palsy was spastic form. Among them most cases were quadriplegic type, 64 cases (53.3%). Other cases were hemiplegic 27(20.7%) diplegic 13(10.0%). Total 84.7% had documented cerebral neuroimaging abnormalities; among them, diffuse cortical atrophy (46.9%), encephalomalacic change (19.9%), malformation (6.1%), and calcification (5.3%). CT scan was normal in 15.3% cases of cerebral palsy. The commonest co morbidity was speech delay (50%). Most of the patient with CP had abnormal CT scan finding though some patient had normal CT scan. Diffuse cerebral atrophy and encephalomalacic changes constitute frequent CT neuroimaging findings and commonly found in quadriplegic type of cerebral pulsy patients. Though diagnosis of cerebral palsy is essentially clinical, neuro imaging improves the understanding of the neuro-anatomical basis for function in CP. Etiology, type of CP and extent of motor impairments can easily be identified by the neuro imaging.


Assuntos
Encéfalo/fisiopatologia , Paralisia Cerebral/diagnóstico por imagem , Neuroimagem/métodos , Bangladesh , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neurologia
2.
Rev Med Suisse ; 16(676-7): 68-71, 2020 Jan 15.
Artigo em Francês | MEDLINE | ID: mdl-31961088

RESUMO

New studies confirm the possibility of late thrombolysis. Meta-analyses have confirmed that CGRP inhibitors are efficacious for migraines. Cladribine is a new oral treatment for relapsing-remitting multiple sclerosis. Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a new clinical entity accounting for cognitive decline in old patients. The timing of levodopa introduction has no effect on the long-term course of idiopathic Parkinson's disease. Hypophosphatemia helps distinguish between seizures and syncopes in the emergency department. A second course of intravenous immunoglobulins provides no benefit for severe Guillain Barre syndrome. Outdoor therapy improves clinical scales in patients with disorder of consciousness. Ultrasound guided lumbar puncture improves the yield of the procedure.


Assuntos
Síndrome de Guillain-Barré , Esclerose Múltipla Recidivante-Remitente , Neurologia , Cladribina , Humanos , Imunoglobulinas Intravenosas , Neurologia/tendências
3.
Ophthalmologe ; 116(12): 1134-1135, 2019 12.
Artigo em Alemão | MEDLINE | ID: mdl-31797115
4.
Psychiatr Hung ; 34(4): 451-460, 2019.
Artigo em Húngaro | MEDLINE | ID: mdl-31767806

RESUMO

Current writing is a tribute of respect, on the occasion of his 80th birthday, to professor László Tringer. In a somewhat unusual way, instead of a bouquet of 80 flowers, a bunch of 80 limericks is presented for him with compliments. The origin of the idea is that professor Tringer himself also writes poems and rhymes in his leasure time. The celebrated professor is an eminently recognized person in the profession, and he is one of the founding fathers of modern psychiatry in Hungary. After receiving the diploma in medical sciences, he has obtained one in psychology and in theology as well. Beside other qualifications he has specializations in psychiatry, neurology, clinical pharmacology, clinical psychology, psychotherapy, addictology and geriatry. Thanks to the providence, the author of the current writing has many common and unforgettable experiences with him. The 80 limericks on the one hand refer to these mutual memories and on the other hand reflect the author's subjective observations on some areas of the society, life situations, character depictions, psychiatry, other medical professions, mental functions, the brain's structural and neurochemical features, and several hints for life conduct. It is assumed that professor Tringer may not necessarily agree with all of these opinions. Nevertheless, these might serve as a basis for further mutual (and for him now over 80 years) inspiring consultations and intellectual adventures.


Assuntos
Poesia como Assunto , Psiquiatria , História do Século XX , Humanos , Hungria , Neurologia , Psiquiatria/história , Psicoterapia
14.
Tidsskr Nor Laegeforen ; 139(14)2019 10 08.
Artigo em Norueguês | MEDLINE | ID: mdl-31592615

RESUMO

BACKGROUND: Acute dizziness may have a number of causes, including cerebrovascular stroke which can present as isolated acute vestibular syndrome. It is recommended that acute episodic dizziness be assessed using positioning tests, and acute persistent dizziness with a focus on the HINTS (Head Impulse, Nystagmus, Test of Skew) battery of tests, which can distinguish cerebrovascular stroke from vestibular neuritis. We wished to identify the prevalence, diagnostic spectrum and approach to acute dizziness in a neurological department. MATERIAL AND METHOD: We undertook a retrospective review of the medical records of all patients with acute dizziness as the primary symptom who where admitted to the department of neurology at Sørlandet Hospital, Kristiansand in 2015. RESULTS: Of 2 231 patients admitted to the department of neurology in 2015, altogether 243 (11 %) had dizziness as the primary symptom. A total of 106 patients (44 %) were examined using HINTS in its entirety. A cranial CT was performed in 213 (88 %) and MRI in 91 (37 %), and these showed relevant pathology in 1 and 4 patients, respectively. Upon discharge, 122 patients (50 %) were given a non-specific symptom diagnosis, 59 (24 %) received the diagnosis vestibular neuritis, 41 (17 %) benign paroxysmal positional vertigo, and 5 (2 %) were diagnosed with cerebrovascular stroke. Four out of five cases of cerebrovascular stroke could be classified retrospectively as acute vestibular syndrome, whereof three had typical findings determined by the HINTS test. INTERPRETATION: Acute dizziness is a frequent symptom in patients admitted to the department of neurology. Evidence-based diagnostic recommendations for the assessment of acute dizziness were not satisfactorily implemented in practice.


Assuntos
Tontura , Departamentos Hospitalares , Neurologia , Doença Aguda , Vertigem Posicional Paroxística Benigna/complicações , Vertigem Posicional Paroxística Benigna/diagnóstico , Tontura/diagnóstico , Tontura/etiologia , Medicina Baseada em Evidências , Medições dos Movimentos Oculares , Teste do Impulso da Cabeça , Humanos , Registros Médicos , Noruega , Nistagmo Patológico/diagnóstico , Admissão do Paciente , Posicionamento do Paciente , Utilização de Procedimentos e Técnicas , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Neuronite Vestibular/complicações , Neuronite Vestibular/diagnóstico
15.
Harefuah ; 158(10): 635-638, 2019 Oct.
Artigo em Hebraico | MEDLINE | ID: mdl-31576707

RESUMO

AIMS: In our article we seek to describe the initiation of new medical specialty fields in Israel, including the different considerations in the decision-making process and recent trends. BACKGROUND: Physicians' specialization by postgraduate training and specialty certification satisfies the publics' need for high quality medical treatment, supports medical institutions confidence in their medical staff qualifications, guarantees physicians' social accountability and is also linked with positive medical results. Nevertheless, fragmentation of medicine enfolds a hazard to continuity of medical care and loss of holistic perspectives, as well as hazards of systematic malfunction such as brain drain in vital basic specialties and high costs. METHODS: Information was gathered from the protocols of relevant deliberations conducted at the Scientific Council of the Israeli Medical Association, dealing with the initiation of new medical specialty fields and from relevant regulations. Numerical data was extracted from the IMA database. The information gathered was qualitatively analyzed by Template Analysis. RESULTS: Over two decades ranging between 1999 and 2019, three new medical specialties were initiated, including Emergency Medicine (1999), Pain Relief Medicine (2008) and Palliative Medicine (2012). The initiation of two other specialties, Invasive Neuro-Radiology and Metabolic Diseases, is still under process. The field of Child Development has joined an existing specialty in Pediatric Neurology, becoming a new specialty in Pediatric Neurology and Child Development in 2008, a new route for Pediatric Emergency Medicine branched out of Emergency Medicine (2008) and a new route for Pediatric Rheumatology branched out of Rheumatology (2013). We describe the different considerations taken into account, the prerequisites to initiation and milestones of the process, including grandfathering and accreditation. CONCLUSIONS: The trend of specialization in more medical fields will probably continue in the foreseen future. It will therefore continue to challenge the Scientific Council of the Israeli Medical Association with complex decision-making regarding the initiation of new medical professions or new routes within exciting professions.


Assuntos
Médicos , Especialização , Criança , Medicina de Emergência , Humanos , Israel , Neurologia
17.
Acta Neurol Scand ; 140(6): 449-451, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31518442

RESUMO

BACKGROUND: The optic disc examination is critical for the diagnostics of several acute neurological disorders. However, dilation of the pupil is not recommended for neurological patients, which complicates ophthalmoscopy. AIMS OF THE STUDY: Present pilot study compared a portable fundus camera to an ophthalmoscope in fundus examinations of neurological emergency patients. To our knowledge, this is the first comparative study of the subject. The fundus photographs were later reviewed with an ophthalmologist. METHODS: The study included 60 adults, volunteer neurological emergency patients with either headache, cerebrovascular disorder, or acute confusional state (delirium). Patients' non-mydriatic fundus examination was conducted with an ophthalmoscope and a Smartscope Pro fundus camera. RESULTS: Fundus photography succeeded in 56 (93%), partially succeeded in 2 (3%), and failed in 2 (3%) cases compared with ophthalmoscopy that succeeded in 35 (58%), partially succeeded in 14 (23%), and failed in 11 (18%) cases (P < .0005). The researcher and the ophthalmologist agreed in the findings in 54 out of 58 cases (93%). In six cases (7%), the researcher had failed to detect a non-critical ophthalmic finding. CONCLUSIONS: The neurological fundus examination by fundus camera seems to be superior to regular ophthalmoscopy in defining the critical optic disc findings in emergency patients.


Assuntos
Fundo de Olho , Exame Neurológico/instrumentação , Oftalmoscópios , Disco Óptico/patologia , Adulto , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Neurologia/instrumentação , Neurologia/métodos , Fotografação/métodos , Projetos Piloto
18.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(7. Vyp. 2): 58-66, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31532592

RESUMO

The authors review current data on the role of the synthetic aspartic acid analogue N-acetyaspartate (NAA) in various biochemical metabolic reactions in the CNS. Its importance as a biomarker for neuropsychiatric disorders identified using magnetic resonance spectroscopy (MRS) is noted. The authors present their own results of the use of cogitum, a synthetic analogue of NAA, in children with the effects of traumatic brain injury, mental retardation, hyperactivity disorder and in the complex therapy of schizotypal disorder. Effects of cogitum on cognitive deficit, asthenia are evaluated. The neurotrophic effect of the drug, which specifically affects cognitive and asthenic disorders in these diseases, is shown.


Assuntos
Ácido Aspártico , Transtorno do Deficit de Atenção com Hiperatividade , Ácido Aspártico/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Encéfalo , Criança , Colina , Creatina , Humanos , Espectroscopia de Ressonância Magnética , Neurologia/tendências , Psiquiatria/tendências
19.
Fortschr Neurol Psychiatr ; 87(9): 474-475, 2019 09.
Artigo em Alemão | MEDLINE | ID: mdl-31519024
20.
Muscle Nerve ; 60(6): 748-752, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31495916

RESUMO

INTRODUCTION: Elevated creatine kinase (CK) level was redefined by the European Federation of Neurological Societies)EFNS(as 1.5 times the upper limit of normal. In the current study we sought to determine the sensitivity and specificity of CK testing for the diagnosis of neuromuscular disorders. METHODS: Demographics and CK levels were retrospectively extracted from an electronic database for 234 patients with neuromuscular disorders. Sensitivity, specificity, and likelihood ratios and the area under curve were determined for each diagnosis and different cutoff CK values. RESULTS: Using the EFNS cutoff values significantly reduced CK test sensitivity. Creatine kinase values >1000 IU/L showed a high likelihood (11.04) for myopathies and a low likelihood for polyneuropathies (0). DISCUSSION: European Federation of Neurological Societies cutoff values significantly reduce CK sensitivity for diagnosing neuromuscular disorders. While low CK values cannot exclude a neuromuscular disease, values >1000 IU/L are associated with a high likelihood of myopathy.


Assuntos
Creatina Quinase/sangue , Doença dos Neurônios Motores/diagnóstico , Doenças Musculares/diagnóstico , Polineuropatias/diagnóstico , Adulto , Idoso , Área Sob a Curva , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença dos Neurônios Motores/sangue , Doenças Musculares/sangue , Neurologia , Doenças Neuromusculares/sangue , Doenças Neuromusculares/diagnóstico , Polineuropatias/sangue , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/sangue , Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico , Valores de Referência , Sociedades Médicas
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