Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Mar 2008
Randomized Controlled TrialGabapentin for prevention of hypobaric hypoxia-induced headache: randomized double-blind clinical trial.
High-altitude headache (HAH) is a hypobaric hypoxia-induced symptom that is commonly experienced by newcomers to high-altitude areas. ⋯ Gabapentin was effective for the prevention of HAH and had satisfactory tolerability.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2008
Deep brain stimulation in 18 patients with severe Gilles de la Tourette syndrome refractory to treatment: the surgery and stimulation.
There have been several reports of successful deep brain stimulation (DBS) for the treatment of severe Gilles de la Tourette syndrome (GTS). ⋯ DBS is a useful and safe treatment for severe GTS. The results of ours and previous DBS reports suggest that the CM-Pfc and ventralis oralis complex of the thalamus may be a good DBS target for GTS.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2008
Case ReportsNon-length dependent small fibre neuropathy/ganglionopathy.
To describe the clinical and laboratory features of a painful non-length dependent, small fibre ganglionopathy (SFG). ⋯ The pattern of symmetric, non-length dependent neuropathic pain with face and trunk involvement suggests a selective disorder of the dorsal ganglia cells subserving small nerve fibres. It can be distinguished from distal SFN. A potential metabolic or immune process was detected in half of the cases and the disorder was often refractory to treatment.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2008
Serial yes/no reliability after traumatic brain injury: implications regarding the operational criteria for emergence from the minimally conscious state.
Published guidelines for defining the "minimally conscious state" (MCS) included behaviours that characterise emergence, specifically "reliable and consistent" functional interactive communication (accurate yes/no responding) and functional use of objects. Guidelines were developed by consensus because of the lack of empirical data to guide definitions. Criticism emerged that individuals with severely impaired cognition would have difficulty achieving the requisite threshold of accuracy and consistency proposed to demonstrate emergence from MCS. ⋯ Consistent yes/no accuracy is uncommon among responsive patients in early recovery from TBI. These results suggest that the operational threshold for yes/no response accuracy as a diagnostic criterion for emergence from MCS should be revisited.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2008
Irregularity distinguishes limb tremor in cervical dystonia from essential tremor.
Patients with cervical dystonia (CD) often have limb tremor that is clinically indistinguishable from essential tremor (ET). Whether a common central mechanism underlies the tremor in these conditions is unknown. We addressed this issue by quantifying limb tremor in 19 patients with CD and 35 patients with ET. ⋯ We propose that tremor in CD arises from oscillators with different dynamic characteristics, producing a more irregular output, whereas the tremor in ET arises from oscillators with similar dynamic characteristics, producing a more regular output. We suggest that variability of tremor is an important parameter for distinguishing tremor mechanisms. It is possible that changes in membrane kinetics based on the pattern of ion channel expression underlie the differences in tremor in some diseases.