Neurology Alert – April 1, 2004
April 1, 2004
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An Epidemic of Bell’s Palsy
This paper examined the risk of Bells palsy after introduction of an inactivated intranasal influenza vaccine in Switzerland. Mutsch and associates used a matched case-control study and a case-series analysis. -
Fascicular Phenomena
How does one physiologically explain ulnar neuropathies at the elbow that clinically localize to the wrist? Why do proximal sciatic neuropathies sometimes masquerade clinically as peroneal neuropathies at the knee? In this lucid, well-articulated review, Stewart thoroughly and evenhandedly comments on the literature going back to 1913, convincingly arguing that nerve fibers do not randomly intertwine as they progress distally in nerve bundles. -
Age Has a Crucial Effect on Outcome After Hemicraniectomy
Approximately 10% of all patients with middle cerebral artery (MCA) territory cerebral infarction suffer progressive deterioration due to cerebral edema, increased intracranial pressure, and brain herniation. In these patients with malignant MCA territory infarction aggressive decompressive craniectomy has been reported to improve overall prognosis. -
Diligent Dental Flossing May Help Prevent Stroke
Chronic inflammation is now a well-recognized cause of atherosclerotic vascular disease, including coronary artery disease and stroke. Asymptomatic individuals harboring the common bacterium Chlamydia pneumoniae have been shown to have an elevated incidence of plaque in both the coronary and carotid arteries. -
Cerebral Sinus Thrombosis
Cerebral sinus thrombosis most commonly affects the superior sagittal sinus (up to 80%) or the transverse and sigmoid sinuses (70%), with concomitant involvement of the cortical veins in up to 40% of cases. Women are more commonly affected, reflecting their unique risk factors, including pregnancy, the puerperium, and oral contraceptive medication. Other risk factors include surgery, head and neck infections, head injury, malignancy, dehydration, and connective tissue diseases. -
Huntington’s Disease: A Sweet New Treatment
Huntingtons disease is a progressive neurodegenerative disease with onset generally in midlife. Insoluble huntingtin protein aggregates have been seen in vitro in mammalian cells, as well as in transgenic mouse models and in brain tissues from patients with Huntingtons disease. The relationship between the presence of the insoluble protein aggregates and Huntingtons disease pathogenesis has been controversial. -
Alzheimer Brain Atrophy Rate Measured by Serial MRIs
Techniques for accurately measuring the rates of brain atrophy from serial MRI images have improved significantly in recent years. A few of these techniques have been implemented in a partially or fully automated fashion, which is arguably a necessary precondition to their being applied clinically. -
More Food for Thought?
As discussed previously in Neurology Alert, there is increasing evidence that a number of dietary manipulations may significantly affect the risk of dementia and Alzheimers disease (AD). Three studies in 2002 indicated that dietary intake of vitamins E and C lowered the risk of getting AD. However, there appeared to be no association with intake from dietary supplements. This is an important point since it is much easier to take dietary supplements than to increase ones dietary intake of antioxidant vitamins. -
Correction
Correction -
Pharmacology Watch: Estrogen Found to Not Affect Heart Disease, Breast Cancer
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Clinical Briefs in Primary Care Supplement