Neurology Alert
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Triage to a Certified Stroke Center Reduces Early Mortality
In an analysis of the effect of additional travel time, receiving treatment in a primary stroke center was associated with a survival benefit for stroke patients who traveled less than 90 minutes. Traveling more than 90 minutes to reach a primary stroke center offset any benefit.
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Community Education Improves Stroke Awareness and Appropriate Emergency Response
Community education programs are essential in efforts to improve overall success in treating acute ischemic stroke.
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Distinct EEG Features May Help Prognostication of Patients with Early PAMM
Early post-anoxic multifocal myoclonus (PAMM) traditionally has been considered a grave prognostic feature in patients who remain comatose after cardiac arrest. This study defines distinct electrographic phenotypes in the setting of PAMM with substantially different prognostic outcomes.
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Functional MRI in REM Behavior Disorder Is Suggestive of Future Parkinson’s Disease
Rapid eye movement behavior disorder carries an increased risk of future Parkinson’s disease and has fMRI and DaTSCAN features that are similar to those in patients with Parkinson’s disease.
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Association of Traumatic Brain Injury with Late-life Neurodegenerative Diseases
This study analyzed pooled clinical and neuropathological data of older adults free of dementia from three prospective cohort studies and found that traumatic brain injury with loss of consciousness was associated with risk for Lewy body accumulation, Parkinson’s disease, and progression of Parkinsonism, but not dementia, Alzheimer’s disease, neuritic plaques, or neurofibrillary tangles.
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Neuropathy in Myeloma
Peripheral neuropathy is uncommon at presentation in patients with myeloma, and may be complicated by vitamin D deficiency and the neurotoxic effects of chemotherapy.
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Impulse Control Disorders in Parkinson’s: Are All Dopamine Agonists Equal Offenders?
This observational study of 425 patients with a broad range of stages of Parkinson’s disease found that long-acting pramipexole and transdermal rotigotine were less likely to be associated with impulse control disorders than were immediate-release pramipexole and any formulation of ropinirole. This study highlights differences between dopamine agonists that may affect patient care.
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Ticagrelor vs. Aspirin for Secondary Stroke Prevention — About the Same!
Ticagrelor was not found to be superior to aspirin in reducing the rate of stroke, myocardial infarction, or death within 90 days, but there was a trend toward a reduced rate of ischemic stroke, that did not reach statistical significance.
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In Patients with Intracerebral Hemorrhage, Intensive Lowering of Blood Pressure Does Not Improve Outcome
intensive treatment of patients with intracerebral hemorrhage to achieve a target systolic blood pressure < 120 mmHg did not result in a lower rate of death or disability, but did result in an increased rate of renal adverse events.
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Stiff-Person Spectrum Disorder: What Can Antibody Profiles Tell Us?
This retrospective study of 121 patients with stiff-person spectrum disorder extensively examined antibody correlates of clinical features. Anti-GAD65 antibodies were highly associated with typical stiff-person syndrome, and anti-GlyR antibodies with SPS-plus. However, presence of anti-GAD antibodies predicted worse outcome than presence of antiGlyR antibodies, independent of clinical subtype.