Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Oct 2007
Proxy and self-report agreement on the Stroke and Aphasia Quality of Life Scale-39.
Health related quality of life outcomes are increasingly used to measure the effectiveness of stroke interventions. People with severe aphasia after stroke may be unable to self-report on such measures, necessitating the use of proxy respondents. We explored the level of agreement between people with aphasia (PWA) and their proxies on the Stroke and Aphasia Quality of Life Scale (SAQOL-39) and whether this agreement is influenced by demographic variables and proxy levels of depression and carer strain. ⋯ For group comparisons, proxy respondents who are in frequent contact with people with chronic aphasia can reliably report on their health related quality of life, using the SAQOL-39. Although there are significant differences between PWA and proxy responses, the magnitude of this difference is small to moderate.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2007
T2 hyperintensities in children with neurofibromatosis type 1 and their relationship to cognitive functioning.
Neurofibromatosis type 1 (NF1) is a single gene disorder associated with a high frequency of cognitive deficits and a complex cognitive phenotype. These cognitive deficits have been associated with focal areas of high signal intensity on T2 weighted MRI images but the relationship remains controversial. ⋯ T2H cannot be used in general as a radiological marker for cognitive deficits in children with NF1; however, lesions in the thalamus are strongly associated with cognitive impairment. It is possible that lesions in the thalamus in conjunction with more general thalamic hypometabolism may compound the level of thalamic dysfunction, resulting in cognitive deficits well beyond those produced by T2H in other regions.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2007
Case ReportsRemission of alcohol dependency following deep brain stimulation of the nucleus accumbens: valuable therapeutic implications?
Chronic consumption of alcohol represents one of the greatest health and socioeconomic problems worldwide. We report on a 54-year-old patient with a severe anxiety disorder and secondary depressive disorder in whom bilateral deep brain stimulation (DBS) of the nucleus accumbens was carried out. Despite the absence of desired improvement in his primary disorder, we observed a remarkable although not primarily intended alleviation of the patient's comorbid alcohol dependency. Our case report demonstrates the extremely effective treatment of alcohol dependency by means of DBS of the nucleus accumbens and may reveal new prospects in overcoming therapy resistance in dependencies in general.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2007
How generalised are secondarily "generalised" tonic clonic seizures?
In clinical practice, epileptic seizures with focal onset and subsequent generalised motor involvement are referred to as secondarily generalised seizures. The purpose of this study was to investigate the degree of electrophysiological generalisation in seizures that are clinically secondarily generalised. ⋯ Our results demonstrate that seizures that are secondarily generalised clinically are not always generalised electrophysiologically. This may have therapeutic implications.
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J. Neurol. Neurosurg. Psychiatr. · Sep 2007
Case ReportsLateral medullary ischaemic events in young adults with hypoplastic vertebral artery.
To present three cases of young adults with lateral medullary ischaemic events associated with a hypoplastic vertebral artery (VA). All three patients had two additional atherosclerotic or non-atherosclerotic risk factors for stroke. ⋯ Hypoplasia of VA is not considered a risk factor for stroke as it is a common variant in up to 75% of the general population. However, in our patients, hypoplastic VA coexisted with two risk factors and resulted in stroke. Thus although a hypoplastic VA may not be an uncommon asymptomatic finding, it may contribute to stroke if additional risk factors are present.