Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Feb 2004
Interrater agreement of the diagnosis and classification of a first seizure in childhood. The Dutch Study of Epilepsy in Childhood.
To assess the interrater agreement of the diagnosis and the classification of a first paroxysmal event in childhood. ⋯ The interrater agreement on the diagnosis of a first seizure in childhood is just moderate. This phenomenon hampers the interpretation of studies on first seizures in which the diagnosis is only made by one observer. The use of a panel increased the interrater agreement considerably. This approach is recommended at least for research purposes. Classification into clinically relevant syndromes is possible only in a very small minority of children with a single seizure.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2004
Clinical TrialThe use of contact lenses to treat visually symptomatic congenital nystagmus.
It has been suggested that contact lens wear improves the visual function of patients with visual loss from congenital nystagmus. In this study, four patients with congenital nystagmus had two evaluations separated by at least one week (one with spectacles, one with contact lenses) including visual acuity, contrast sensitivity, oscillopsia scale, quality of life questionnaire (NEI VFQ-25), and eye movement recording with an infrared tracking system. ⋯ Several parameters of nystagmus showed no change in two patients, worsening in one patient and improvement in one patient. This suggests that much of the clinical improvement observed in our patients may result from a better optical correction of their refractive error with contact lenses than with spectacles, rather than from a true damping effect of the nystagmus by contact lenses.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2004
Rate and correlates of weight change in Huntington's disease.
To determine the rate and correlates of weight change in a large, well characterised sample of patients with Huntington's disease followed at 44 sites by the Huntington Study Group. ⋯ Weight loss following symptom onset is not a consistent feature of Huntington's disease. The mechanisms contributing to weight change in this condition are unclear and probably multifactorial. Future studies examining asymptomatic carriers of the mutation could be helpful in identifying incipience of low body weight and may be better suited for identifying clinical correlates of weight loss than studies in symptomatic patients.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2004
Case ReportsThe importance of suspecting superficial siderosis of the central nervous system in clinical practice.
Once the central nervous system surface is greatly encrusted with haemosiderin, even removing the source of bleeding will have little effect on the progression of clinical deterioration. Superficial siderosis of the central nervous system is rare and insidious, but magnetic resonance imaging has turned a previously late, mainly autoptical diagnosis into an easy, specific, in vivo, and possibly early one. Avoiding long diagnostic delay will be very important in those cases susceptible of causal treatment.
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J. Neurol. Neurosurg. Psychiatr. · Feb 2004
Vascular endothelial growth factor (VEGF) is increased in serum, but not in cerebrospinal fluid in HIV associated CNS diseases.
Vascular endothelial growth factor (VEGF) is a potent angiogenic and mitogenic peptide, which also induces several mediators that may play a role in HIV induced CNS damage. VEGF levels were determined in cerebrospinal fluid (CSF) and serum samples from patients with (n = 8) and without (n = 19) directly HIV associated CNS disorders and HIV negative control patients (n = 18). VEGF serum but not CSF levels were significantly increased in HIV infected patients with (381.1 (78.9) pg/ml) HIV associated CNS diseases compared with those without (120.8 (13.1) pg/ml) and HIV negative control patients (133.1(14.8) pg/ml). ⋯ A relevant increase of serum VEGF was not observed in patients without HIVE though high HI viral load. We conclude that HIVE is associated with increased serum VEGF levels. Further studies are warranted to elucidate the role of VEGF in HIVE.