Neurology
-
Review Comparative Study
Cognitive outcomes and predictive factors in epilepsy.
Although most patients with epilepsy have normal cognitive abilities, they are at increased risk for cognitive deficits. Multiple factors contribute to this risk including antiepileptic drugs (AEDs), which not only reduce neuronal irritability but may also impair neuronal excitability. The major cognitive effects of AEDs are impaired attention, vigilance, and psychomotor speed, but secondary effects on other cognitive functions can be seen. ⋯ The cognitive profile of an AED is but one factor in the selection of therapeutic options. Ongoing seizures can be detrimental to both cognition and quality of life. Patients who are refractory or intolerant to AED therapy should be referred for video EEG monitoring to confirm the seizure diagnosis and determine if the patient is a candidate for epilepsy surgery.
-
Randomized Controlled Trial Clinical Trial
Ciguatera fish poisoning: a double-blind randomized trial of mannitol therapy.
Ciguatera poisoning (CP) is worldwide the most common fish-borne illness and one of the most common forms of nonbacterial food poisoning. IV mannitol is considered the treatment of choice for CP but has not been evaluated in a double-blind randomized trial. ⋯ Mannitol was not superior to normal saline in relieving symptoms and signs of CP at 24 hours in this study population but had more side effects. These results do not support single-dose mannitol as standard treatment for CP.
-
To investigate the presence of human polyomavirus JC virus genome and the expression of the viral oncoprotein T-antigen in neoplastic cells of a patient with MS and a glioblastoma multiforme. ⋯ These observations provide molecular and clinical evidence of the association of JC virus in the brain of a patient with concurrent glioblastoma multiforme and MS.
-
Transplanted striatal cells have been demonstrated to survive, grow, establish afferent and efferent connections, and improve behavioral signs in animal models of Huntington's disease (HD). ⋯ Transplantation of human fetal striatal cells is feasible and survival of transplanted cells was demonstrated. Patients with moderately advanced HD are at risk for SDH after transplantation surgery.