Neurology Alert
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Relationship Between Spikes and Seizures Using an Implantable Intracranial Detection Device
The authors report the preliminary findings for an implantable ambulatory intracranial recording device for seizure detection in 15 subjects. One of the primary findings was that spike rate significantly changed prior to seizures in nine of 15 subjects. Six of these subjects showed a significant decrease in spiking prior to ictal onset, whereas the remaining three showed a significant increase in spiking and these three subjects had the best seizure prediction results.
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Clinical Characterization of Inherited Erythromelalgia Due to Sodium Channel Mutations
A detailed non-interventional clinical study of patients with inherited erythromelalgia who carry gain-of-function mutations of voltage-gated sodium channel Nav1.7 further characterized pain phenotypes in this disorder and showed wide variability of pain symptoms.
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A Brief Report of Clinical Trials Results from the 2016 International Stroke Conference
This article provides an overview of the research presented at the 2016 International Stroke Conference.
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Hypoxia-induced Migraine
Hypoxia-induced migraine attacks with and without aura, in an experimental paradigm, were accompanied by dilation of cranial arteries in individuals who have migraine with aura, as well as in healthy control subjects.
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Predicting Seizure Recurrence with Routine EEG after First Unprovoked Seizure
The authors systematically reviewed prospective and retrospective studies of adults and children undergoing routine electroencephalography (EEG) after a first unprovoked seizure who were followed for at least 1 year. Using positive likelihood ratios, an adult and child with epileptiform discharges on EEG were estimated to have a 77% and 66% probability, respectively, of recurrent seizures.
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Pick Disease: Picking Away at the Pathology
The neuropathologic changes of Pick disease may sequentially progress through the brain in specified phases over time and may correlate with the progression of clinical symptoms.
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Thalamic Pain: Who Is Likely to Develop This Disorder?
In a careful anatomic and physiologic study of patients with thalamic stroke, the authors demonstrated that the combination of anterior pulvinar nucleus involvement with spinothalamic dysfunction predicts a “thalamic pain syndrome” with > 90% sensitivity.
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Peripheral Nerve Disorders After Cardiac Surgery
Following cardiac surgery, about 6% of patients will suffer a peripheral nerve injury, mostly due to compression, traction, or nerve ischemia. Proper patient positioning can prevent most of these injuries.
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Intracerebral Hemorrhages Associated with Non-vitamin K Oral Anticoagulants Appear to Be Smaller than Those Associated with Warfarin
This small prospective observational study suggests that warfarin-associated intracerebral hemorrhages may be larger and have worse clinical outcomes then hemorrhages associated with the newer anticoagulant agents.
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Symptomatic Carotid Artery Stenosis Requires Urgent Revascularization
Johansson et al identified a significant early risk of recurrent stroke in patients with symptomatic carotid artery stenosis, and advise a prospective randomized trial to determine when the optimal time for revascularization should take place.