Neurology
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American Heart Association Urges Improvement in Stroke Care
In a scientific statement, the group offered tactics to eliminate the racial and ethnic inequities that exist in stroke incidence, prevalence, treatment, and outcomes.
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The Effect of Peripheral Neuropathy in Parkinson’s Disease on Gait and Balance
In this cohort study of 99 patients with Parkinson’s disease (PD), 40% were found to have peripheral neuropathy, with most meeting criteria for small fiber neuropathy. Gait and balance were worse in PD patients with neuropathy compared to those without.
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Neurologists Try to Predict Cognitive Impairment Earlier
Researchers used easy memory tests among healthy participants to determine who might be more likely to need closer monitoring.
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Malpractice Lawsuits Allege ED Missed Intracranial Aneurysms
Failure to image patients is a relatively frequent cause of litigation, but it should be seen in context. It is not so much incorrect interpretations of imaging studies; rather, failure to consider the possibility of an aneurysm, resulting in an inadequate workup, is a more common allegation.
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Stroke and a Wide QRS
The ECG in the figure is from an older man who presented with an acute stroke. He denied chest pain. Why is there QRS widening? What might be the clinical implications?
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Is It Safe and Effective to Use Low-Dose Opioids Long Term to Treat Refractory RLS?
A review of two-year longitudinal data regarding efficacy and dose stability in refractory restless legs syndrome (RLS) patients treated with low-dose opioids shows that patients do not escalate their opiate dosage and that there is clinical and therapeutic stability in treating RLS with this therapeutic regimen.
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Viral Exposure and the Risk of Developing Neurodegenerative Disease
In two national European biobanks, researchers identified and replicated 22 pairs of viral exposures associated with a higher risk of neurodegenerative diseases.
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Subcutaneous IVIG for Treatment of Myasthenia Gravis
A Phase II trial comparing subcutaneous (SC) administration of pooled immunoglobulin to intravenous (IV) administration of immunoglobulin in 23 patients with seropositive myasthenia gravis demonstrated a stable course after transition from IV to SC.
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Inclusion Body Myositis: Variability and Clinical Subsets
Inclusion body myositis (IBM) is a progressive myopathy characterized by prominent finger flexor and quadriceps involvement. Black patients with IBM have more prominent proximal weakness, in addition to finger flexion and quadriceps weakness. Female patients have less prominent finger flexion and quadriceps weakness and slower progression, whereas younger patients had a greater delay in diagnosis. There are variability and distinct clinical subsets among IBM patients, which can have implications in terms of timely diagnosis and possibly response to treatments.
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The Neural Pathways of Pain Treatment Response in Small-Fiber Neuropathy
Pain in peripheral neuropathy, referred to as neuropathic pain, is thought to result from overexpression of pain receptors, regeneration of hypersensitive nerve sprouts, and denervation hypersensitivity of neurons in the sensory ganglia. Additionally, activation of the pain pathways appears to induce secondary structural and functional changes in the brain that contribute to pain perception, persistence, and response.