Archives of neurology
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Archives of neurology · Aug 2011
Review Meta AnalysisLack of evidence for the efficacy of memantine in mild Alzheimer disease.
We directly assessed the clinical trials' evidence for memantine's efficacy in mild Alzheimer disease (AD). Memantine is indicated in the United States and Europe for moderate to severe AD, which is diagnosed if a patient has a Mini-Mental State Examination (MMSE) score of less than 15 or less than 20, respectively. Yet memantine is very frequently prescribed for mild AD and mild cognitive impairment, and a manufacturer-sponsored meta-analysis claimed its efficacy in mild AD. ⋯ Despite its frequent off-label use, evidence is lacking for a benefit of memantine in mild AD, and there is meager evidence for its efficacy in moderate AD. Prospective trials are needed to further assess the potential for efficacy of memantine either alone or added to cholinesterase inhibitors in mild and moderate AD.
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Archives of neurology · May 2011
Case ReportsIn-flight seizures and fatal air embolism: the importance of a chest radiograph.
To describe for the first time, to our knowledge, a case of recurrent in-flight-dependent seizures related to commercial airline flight in which the patient experienced a fatal air embolism secondary to a giant bronchogenic cyst. ⋯ We propose minor air embolism as a cause of in-flight seizures. This type of seizure can signify the existence of a giant bronchogenic cyst. We believe that obtaining a chest radiograph can be useful in patients with a history of in-flight seizures to rule out the presence of a bronchogenic cyst and to prevent a possibly fatal air embolism.