Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Jun 2009
Use of antidepressants and the risk of Parkinson's disease: a prospective study.
Individuals with depression have a higher risk of Parkinson's disease (PD) but the timing of the association is unknown. Therefore, the relationship between initiation of antidepressant therapy and PD risk was assessed in a large population based database from the UK and the timing of this association was explored. ⋯ Initiation of any antidepressant therapy was associated with a higher risk of PD in the 2 years after the start of treatment, which suggests that depressive symptoms could be an early manifestation of PD, preceding motor dysfunction.
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J. Neurol. Neurosurg. Psychiatr. · Jun 2009
Cognitive visual perceptual deficits in patients with delirium.
Delirium is a neuropsychiatric disorder characterised by severe cognitive impairment, but the specific neuropsychological profile of this condition has not yet been clearly delineated. Psychiatric symptoms of perceptual disturbance--such as hallucinations, illusions and misperceptions--are common in delirium, suggesting that patients may have deficits in the cognitive systems underlying visual perception. ⋯ Patients with delirium have specific visual perceptual deficits that cannot be accounted for by general cognitive impairment. These novel findings provide insights into the neural mechanisms underling delirium and might help to improve clinical detection and management of the disorder. The results also support previous suggestions that cognitive perceptual deficits play a causal role in eliciting psychiatric symptoms of perceptual disturbance.
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J. Neurol. Neurosurg. Psychiatr. · Jun 2009
Intravenous levetiracetam: a new treatment alternative for refractory status epilepticus.
The purpose of this study was to investigate the safety and efficacy of intravenous levetiracetam (LEV-iv) in refractory status epilepticus (SE). A retrospective chart review was performed on patients who received LEV-iv for treatment of SE (n = 36) and had failed at least one other antiepileptic drug. LEV-iv (median 3000 mg/day; range 1000-9000) was administered as a bolus loading (500-2000 mg per 30-60 min, n = 30) or as a continuous pump infusion (n = 6). ⋯ Two patients experienced nausea and vomiting during LEV-iv loading, leading to aspiration pneumonia in one. This study suggests that LEV-iv may be a safe and efficacious treatment of SE. Prospective and controlled trials are imperative to confirm these preliminary findings.
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Randomized Controlled TrialEfficacy of methylphenidate in the rehabilitation of attention following traumatic brain injury: a randomised, crossover, double blind, placebo controlled inpatient trial.
Most previous studies evaluating the use of methylphenidate following traumatic brain injury (TBI) have been conducted many years post-injury. This study evaluated the efficacy of methylphenidate in facilitating cognitive function in the inpatient rehabilitation phase. ⋯ Methylphenidate enhances information processing speed in the inpatient rehabilitation phase following TBI. This trial is registered with the Australian New Zealand Clinical Trials Registry (12607000503426).
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J. Neurol. Neurosurg. Psychiatr. · May 2009
Prospective study of chemical exposures and amyotrophic lateral sclerosis.
Although environmental toxins, including pesticides, are suspected of contributing to the risk of amyotrophic lateral sclerosis (ALS), no data exist from large prospective investigations. This study assessed the association between exposure to chemicals and risk of ALS in a prospective cohort study. ⋯ There was little evidence for any association between pesticides/herbicide exposure and ALS. In contrast, evidence was found, suggesting an increased risk of ALS with formaldehyde exposure. Because of the longitudinal design, this result is unlikely to be due to bias, but it should nevertheless be interpreted cautiously and needs to be verified independently.