Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Dec 2015
Review Historical ArticleBell's palsy: aetiology, clinical features and multidisciplinary care.
Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis along with in vitro studies of virus-axon interactions. ⋯ For those with longstanding sequaelae from incomplete recovery, aesthetic, functional (nasal patency, eye closure, speech and swallowing) and psychological considerations need to be addressed by the treating team. Increasingly, multidisciplinary collaboration between interested clinicians from a wide variety of subspecialties has proven effective. A patient centred approach utilising physiotherapy, targeted botulinum toxin injection and selective surgical intervention has reduced the burden of long-term disability in facial palsy.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2015
ReviewThe corpus callosum in the diagnosis of multiple sclerosis and other CNS demyelinating and inflammatory diseases.
Lesions in the corpus callosum (CC) are important radiological clues to the diagnosis of multiple sclerosis (MS), but may also occur in other neuroinflammatory and non-neuroinflammatory conditions. In this article, we discuss the radiological features of lesions within the CC in MS and other central nervous system inflammatory and acquired demyelinating diseases. An understanding of the appearance and location of lesions in the CC is important not only for accurate diagnosis and treatment of these various conditions, but as it also provides insights into pathogenesis.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2015
Selective peripheral denervation for cervical dystonia: long-term follow-up.
61 procedures with selective peripheral denervation for cervical dystonia were retrospectively analysed concerning surgical results, pain, quality of life (QoL) and recurrences. ⋯ Selective peripheral denervation remains a surgical option in the treatment of cervical dystonia when conservative measures fail. Although the majority of patients experience a significant relief of symptoms, there is a substantial risk of reinnervation and/or change in the pattern of the cervical dystonia.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2015
Bethlem myopathy: long-term follow-up identifies COL6 mutations predicting severe clinical evolution.
Mutations in one of the 3 genes encoding collagen VI (COLVI) are responsible for a group of heterogeneous phenotypes of which Bethlem myopathy (BM) represents the milder end of the spectrum. Genotype-phenotype correlations and long-term follow-up description in BM remain scarce. ⋯ Long-term follow-up identified important phenotypic variability in this cohort of 35 BM patients. However, worsening of the functional disability appeared typically after the age of 40 in 47% of our patients, and was frequently associated with COL6A1 exon 14 skipping.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2015
Diagnosis of dementias by high-field 1H MRS of cerebrospinal fluid.
To test whether the information obtained from cerebrospinal fluid (CSF) and analysed with high-field proton ((1)H) MR spectroscopy (MRS) would help the diagnosis of most common forms of dementia. ⋯ The results indicate that the composition of CSF contains enough information of the neurological state of a given patient with a given dementia to be diagnosed with extremely high accuracy. This approach might provide potentially a very powerful diagnostic tool to help the diagnostic process of dementias.