Neurology Alert
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Overdiagnosis of Idiopathic Intracranial Hypertension
Idiopathic intracranial hypertension is over-diagnosed because of a lack of physician expertise in performing accurate ophthalmoscopy. When considering the diagnosis, referral to a neuro-ophthalmologist is strongly recommended.
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Isolated Dizziness and Vertigo Are Rarely Caused by Stroke
The rate of stroke in patients discharged from the ED with a diagnosis of peripheral vestibular disorder is extremely low, and unless there are associated neurological symptoms and signs, there is no need for extensive ED evaluation.
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Tranexamic Acid-associated Seizures: Features, Mechanisms, and Treatment
Tranexamic acid is a commonly used antifibrinolytic drug that has been associated with increased risk of postoperative seizures. The authors reviewed the incidence, risk factors, and clinical features of these seizures, as well as potential mechanisms. They also proposed treatments and interventions for preventing Tranexamic acid-related seizures.
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Does Rivastigmine Prevent Falls in Parkinson’s Disease?
A randomized, double-blind, placebo-controlled Phase II clinical trial of oral rivastigmine in 130 patients with moderate-stage Parkinson’s disease demonstrated improved gait stability as measured by accelerometry, and suggested an association with lower rate of falls.
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Intraoperative Neurophysiologic Monitoring: Does it Change the Outcome from Spinal Surgery?
In non-complex spine surgeries (spinal decompression and spinal fusion), intraoperative neurophysiologic monitoring improved clinical outcomes and reduced the risk of neurological complications by nearly one-half (49%).
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Sonographic Diagnosis of Inclusion Body Myositis
Inclusion body myositis has remained a clinical diagnosis assisted by a muscle biopsy, but now muscle ultrasound and biomarker identification may aid diagnosis.
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Optimal Antiplatelet Therapy for Secondary Prevention of Ischemic Stroke
This study strongly suggests that compared with maintaining patients on aspirin alone, switching to a different antiplatelet agent, or adding a second antiplatelet agent to aspirin may be better in preventing subsequent vascular events in patients who experienced a new ischemic stroke while taking aspirin.
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Treatment of AVM-related Epilepsy
There is insufficient evidence to recommend invasive AVM management to reduce epileptic seizure frequency, and this will have to be evaluated in a long-term randomized, controlled clinical trial.
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ICH May Clinically Mimic TIA
In a large retrospective review of 2137 patients with intracerebral hemorrhage, 34 had transient symptoms that could have been misclassified as “transient ischemic attack” if brain imaging had not been performed.
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Idiopathic Phrenic Neuropathy
Isolated phrenic neuropathy is a rare syndrome, often associated with a surgical procedure and diabetes mellitus, and has no proven, effective therapy other than respiratory support.