Neurology Alert
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Pattern of Atrial Fibrillation Is Associated with Outcomes After Stroke
In a Japanese stroke registry, permanent as opposed to paroxysmal atrial fibrillation was associated with higher in-hospital mortality after stroke.
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Blood Pressure Lowering After Acute Stroke: Can It Kill You?
Patients with chronically elevated blood pressure are at increased risk of all-cause and cardiovascular death, with a particularly increased risk of ischemic and hemorrhagic stroke. Treatment to lower systolic BP decreases stroke risk, without an apparent lower threshold down to 120 mmHg. However, lowered SBP (≤ 120 mmHg) in the 5 years after a stroke may be associated with increased mortality. Lower SBP over a shorter period of time after a stroke in chronically hypertensive patients could potentially increase mortality as well.
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Incidental Cerebral Microbleeds and Cerebral Blood Flow in Elderly Individuals
Cerebral microbleeds in non-demented elderly people are associated with a global reduction in cerebral blood flow and a high prevalence of beta-amyloid deposition in the brain.
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Idarucizumab: A Promising New Drug that Reverses the Anticoagulant Effects of Dabigatran
A recent study found that idarucizumab rapidly reverses the effects of dabigatran and is likely to have important clinical benefits for patients with intracerebral hemorrhage and other disease processes in which reversal of anticoagulation is important.
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Nerve Biopsy for Asymptomatic Vasculitic Neuropathy
Nerve biopsy is a safe and highly sensitive definitive diagnostic test for systemic vasculitis, even without symptoms of peripheral neuropathy, when electrodiagnostic tests indicate an axonal neuropathy.
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Migraine and Cognitive Dysfunction
During an attack of migraine without aura, patients may experience transient cognitive impairment, with predominant involvement of verbal processing speed, learning, and memory, due to reversible cortical dysfunction.
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RYR1-related Myopathies
Ryanodine receptor gene mutations are among the most common genetic disorders found in a variety of congenital myopathies, both mild and severe.
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A Modern Epidemiologic View of Status Epilepticus in the United States
In this retrospective review of mortality and hospitalization related to status epilepticus from 1999 to 2010, the authors found that overall mortality remained relatively stable, whereas the rate of related hospitalizations significantly increased, particularly in patients who were intubated and in whom status epilepticus was not the primary diagnosis.
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Scrub Typhus and the Brain
Scrub typhus infections involve the nervous system in a majority of cases and should be suspected in patients who live in, or are returning from, endemic regions with a compatible clinical syndrome.
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GAD Antibody Syndromes: When to Dig Deeper
This retrospective case series identifies the clinical and immunologic features of GAD antibody-positive patients who should be screened for an underlying cancer.