Neurology Alert
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Migraine Prophylaxis in Children
In a randomized, double-blind, placebo-controlled trial of migraine prophylaxis in children ages 8-17 years, treatment with neither amitriptyline nor topiramate showed significant differences in headache frequency or headache-related disability compared to placebo.
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Outcomes in Patients Treated with Therapeutic Hypothermia After In-hospital Cardiac Arrest
Current guidelines recommend the use of therapeutic hypothermia in patients with in-hospital cardiac arrest, even though its efficacy has been demonstrated only in randomized trials after out-of-hospital cardiac arrest. This non-randomized, observational cohort study based on a large national registry found that the use of therapeutic hypothermia was associated with lower likelihood of survival and less favorable neurological outcome in patients successfully resuscitated after an in-hospital cardiac arrest.
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Statins Associated with Lower Parkinson’s Risk in Diabetics
In approximately 50,000 individuals with Parkinson’s disease and diabetes, identified from a National Health Insurance database in Taiwan, statin use was dose-dependently associated with lower risk of Parkinson’s disease. This strengthens the argument for a possible protective role of statins.
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Intravenous Glyburide to Reduce Brain Swelling in Large Hemispheric Infarction
In a Phase II, randomized, multicenter prospective trial, intravenous glyburide failed to improve outcomes in patients with large hemispheric infarction, although there was a reduction in neuroimaging and biomarkers of cerebral edema.
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RESCUEicp: A Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension
Decompressive craniectomy for the treatment of refractory intracranial hypertension in patients with severe traumatic brain injury reduced mortality but increased rates of vegetative states, lower severe disability, and upper severe disability compared to continued medical management.
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Zika Virus Infection and Guillain-Barré Syndrome
Guillain-Barré syndrome is a defined complication of Zika virus infection and presents in a typical manner, similar to other post-viral GBS syndromes.
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Headaches in the Elderly: A Non-specific Marker for Stroke Risk
Non-migrainous headaches, for which there are many causes, appear to be a risk factor for stroke in an elderly population, but the mechanism is uncertain.
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Disease Rebound After Stopping Fingolimod in Patients with Relapsing-Remitting Multiple Sclerosis
A review of patients with relapsing-remitting multiple sclerosis who discontinued fingolimod therapy showed that five out of 46 (10.9 %) of these patients developed a rebound phenomenon between 4 to 16 weeks, where disease activity returns and often exceeds pre-treatment levels.
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Functional Outcomes in Acute Ischemic Stroke Patients Receiving Prehospital Thrombolysis in Mobile Stroke Units
Deployment of a mobile stroke treatment unit in the field results in a higher percentage of patients treated with intravenous tPA, at a shorter interval from onset of symptoms, and results in better outcomes.
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Cancer in Autoimmune Necrotizing Myositis
Immune-mediated necrotizing myopathy is a distinct syndrome that can be differentiated from polymyositis and dermatomyositis, and is commonly associated with underlying malignancy.