Neurology Alert – March 1, 2016
March 1, 2016
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Sonographic Diagnosis of Inclusion Body Myositis
Inclusion body myositis has remained a clinical diagnosis assisted by a muscle biopsy, but now muscle ultrasound and biomarker identification may aid diagnosis.
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Intraoperative Neurophysiologic Monitoring: Does it Change the Outcome from Spinal Surgery?
In non-complex spine surgeries (spinal decompression and spinal fusion), intraoperative neurophysiologic monitoring improved clinical outcomes and reduced the risk of neurological complications by nearly one-half (49%).
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Does Rivastigmine Prevent Falls in Parkinson’s Disease?
A randomized, double-blind, placebo-controlled Phase II clinical trial of oral rivastigmine in 130 patients with moderate-stage Parkinson’s disease demonstrated improved gait stability as measured by accelerometry, and suggested an association with lower rate of falls.
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Tranexamic Acid-associated Seizures: Features, Mechanisms, and Treatment
Tranexamic acid is a commonly used antifibrinolytic drug that has been associated with increased risk of postoperative seizures. The authors reviewed the incidence, risk factors, and clinical features of these seizures, as well as potential mechanisms. They also proposed treatments and interventions for preventing Tranexamic acid-related seizures.
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Overdiagnosis of Idiopathic Intracranial Hypertension
Idiopathic intracranial hypertension is over-diagnosed because of a lack of physician expertise in performing accurate ophthalmoscopy. When considering the diagnosis, referral to a neuro-ophthalmologist is strongly recommended.
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Symptomatic Carotid Artery Stenosis Requires Urgent Revascularization
Johansson et al identified a significant early risk of recurrent stroke in patients with symptomatic carotid artery stenosis, and advise a prospective randomized trial to determine when the optimal time for revascularization should take place.
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Intracerebral Hemorrhages Associated with Non-vitamin K Oral Anticoagulants Appear to Be Smaller than Those Associated with Warfarin
This small prospective observational study suggests that warfarin-associated intracerebral hemorrhages may be larger and have worse clinical outcomes then hemorrhages associated with the newer anticoagulant agents.
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Isolated Dizziness and Vertigo Are Rarely Caused by Stroke
The rate of stroke in patients discharged from the ED with a diagnosis of peripheral vestibular disorder is extremely low, and unless there are associated neurological symptoms and signs, there is no need for extensive ED evaluation.