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Obesity surgery is being increasingly performed in the United States. A systematic review by Singh and Kumar highlights the unique neurologic features of Wernicke encephalopathy after obesity surgery. Wernicke encephalopathy occurs more commonly among young women with vomiting 4 to 12 weeks after surgery. This review also highlights several atypical features of this unique neurologic entity.
see page 807
The DLB and PDD border zone: Dx, Rx, mechanisms, and markers
Lippa et al. iterate conclusions of an international group of scientists from a variety of backgrounds. The group defined areas of consensus and controversy regarding the clinical and biologic relationship between a patient with PD dementia (PDD) and one with dementia with Lewy bodies (DLB).
see page 812
Hippocampal and entorhinal atrophy predict conversion to AD
Devanand et al. followed 139 patients with mild cognitive impairment and 63 healthy control subjects. In patients, smaller baseline MRI hippocampal and entorhinal cortex volumes each predicted conversion to AD and added to the prediction obtained by demographic and clinical measures. MRI volumetric assessment improves the early diagnosis of AD.
see page 828
IVIG in MG: A randomized, masked, controlled trial
Zinman et al. compared placebo to IVIg, 2 g/kg, in patients with worsening myasthenic weakness. IVIg treatment decreased the quantitative myasthenia gravis score (QMGS) significantly, with greater effect in patients with moderate to severe MG defined as QMGS >10.5/39.
see page 837
There is an accompanying editorial by Matthew N. Meriggioli.
see page 803
Men have better functional outcomes after stroke thrombolysis
Elkind et al. found that among 333 patients with ischemic stroke treated with IV thrombolytic therapy within 3 hours, men were approximately three times more likely to have a good functional outcome than women (47.5% of men vs 30.3% of women had a Barthel Index 
95).
see page 842
Loss of CX32 function in CMT1X
CMT1X is caused by mutations in the GJB1 gene that encodes connexin 32 (Cx32). Shy et al. demonstrated that CMT1X results from a loss of Cx32 function compared with CMT1A or CMT1B which resulted from an abnormal gain of function from mutated PMP22 or MPZ. The loss of function phenotype suggests that CMT1X may prove amenable to gene replacement strategies.
see page 849
Stenting of intracranial vertebrobasilar stenosis
Jiang et al. studied the long-term outcome of 79 consecutive patients with symptomatic intracranial vertebrobasilar stenosis following elective stenting. They revealed a 4.6% annual stroke rate in the vertebrobasilar territory including any stroke and death within 30 days which compares favorably with medical therapy.
see page 856
There is an accompanying editorial by Kevin M. Barrett and Karen C. Johnston.
see page 805
Stroke and myocardial injury in stem cell transplants
Chen-Plotkin et al. describe two cases of autologous stem cell transplantation complicated by transient profound encephalopathy, cerebral infarction, and myocardial injury. They postulate that the stem cell carrier DMSO may be responsible.
see page 859
Motor impersistence due to callosal disconnection
Seo et al. identified a novel disconnection sign in a patient with an infarction involving the anterior part of the corpus callosum and right superior frontal lobe. When asked to raise both hands, the patient's healthy right arm showed a motor impersistence, which was substantiated by experiments using a finger dynamometer.
see page 862
A marker for axonal damage in neuromyelitis optica
Miyazawa et al. measured neurofilament heavy chain (NfHSMI35), a biomarker of axonal damage in the CSF. Significantly high levels were found in 25% of the patients with neuromyelitis optica but none with MS, suggesting that axonal damage is more severe in neuromyelitis optica.
see page 865
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