Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
ReviewFunctional (conversion) neurological symptoms: research since the millennium.
Functional neurological symptoms (FNS) are commonly encountered but have engendered remarkably little academic interest. 'UK-Functional Neurological Symptoms (UK-FNS)' was an informal inaugural meeting of UK based clinicians in March 2011 with a variety of research and clinical interests in the field. This narrative review reflects the content of the meeting, and our opinion of key findings in the field since the turn of the millennium.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
ReviewEffort, exaggeration and malingering after concussion.
Although most individuals who suffer a mild traumatic brain injury have complete recovery, a number experience persistent symptoms that appear inconsistent with the severity of the injury. Symptoms may be ascribed to malingering, exaggeration or poor effort on cognitive testing. The purpose of this paper is to propose that previously unconsidered factors, informed by social psychology and behavioural economics, can appear as 'symptom magnification' or 'poor effort', which are incorrectly interpreted as the result of a conscious process. These are complex and multi-determined behaviours with a unique differential diagnosis which have important implications for research, evaluation and treatment.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
Randomized Controlled TrialClonazepam quiets tinnitus: a randomised crossover study with Ginkgo biloba.
To assess the effect of Ginkgo biloba and clonazepam, a γ-aminobutyric acid (GABA)-receptor agonist, upon tinnitus. ⋯ Clonazepam is effective in treating tinnitus; G biloba is ineffective.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
Randomized Controlled TrialAssessing the risk of subsequent tonic-clonic seizures in patients with a history of simple or complex partial seizures.
Patients who present with only simple or complex partial seizures have a poorly documented prognosis. Treatment may be advocated to prevent future secondary generalised seizures, reduce the frequency of further simple or complex partial seizures or a combination of both. ⋯ Patients presenting with a history of only partial seizures are at low risk of subsequent tonic-clonic seizures in the period of time to which therapeutic decisions are relevant. The effects of the antiepileptic drugs used in the MESS study are greater for tonic-clonic seizures than they are for partial seizures.
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J. Neurol. Neurosurg. Psychiatr. · Aug 2012
Increased risk of multiple sclerosis relapse after in vitro fertilisation.
Exogenous sexual steroids together with pregnancy have been shown to influence the risk of relapses in multiple sclerosis (MS). Treatments used during assisted reproductive techniques may consequently influence the short term evolution of MS by modifying the hormonal status of the patient. The objective of this study was to determine if there was an increased risk of developing exacerbations in women with MS after in vitro fertilisation (IVF). ⋯ An increased relapse rate was observed in this study after IVF in patients with MS and may be partly related both to IVF failure and the use of GnRH agonists.