Acta neurologica Belgica
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Acta neurologica Belgica · Sep 2008
ReviewThe Glasgow Coma Scale--a brief review. Past, present, future.
The Glasgow Coma Scale (GCS) was introduced in 1974 aiming at standardizing assessment of level of consciousness in head injured patients. It has been used mainly in evaluating prognosis, comparing different groups of patients and monitoring the neurological status. However its use expanded beyond the original intention of the scale and certain limitations were identified. ⋯ Moreover, future trends and implications are considered. The key concept in all articles reviewed is that even though GCS is not a perfect tool and other coma scales have been proposed, it seems destined to be incorporated in clinical decisions regarding coma for many years to come. Nonetheless, deep knowledge of its proper applications on one hand and limitation of its misuse on the other is essential to benefit both health care professionals and their patients.
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Acta neurologica Belgica · Mar 2008
Case ReportsExcellent outcome after prolonged status epilepticus due to non-paraneoplastic limbic encephalitis.
Limbic encephalitis (LE) is frequently associated with malignancy. Non-paraneoplastic LE is less common and in this form, voltage-gated potassium channel (VGKC) antibodies are usually found. ⋯ Here we describe a further patient in whom extensive diagnostic procedures suggested non-paraneoplastic antibody-negative limbic encephalitis. Although this woman had prolonged status epilepticus during seven weeks, her outcome was excellent.
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Acta neurologica Belgica · Dec 2007
Randomized Controlled TrialLevetiracetam and bleeding disorders.
Six studies were conducted in healthy male volunteers to evaluate the effect of levetiracetam on bleeding time. In three open-label studies, a single dose of levetiracetam (250, 500, or 1000 mg, respectively) was administered 12 hours after acetylsalicylic acid (aspirin). Bleeding time increased by 3.5% to 30% relative to baseline, but the effect was not dose-related and not clinically relevant. ⋯ Except for two subjects in a crossover study, one of whom received placebo, no absolute bleeding time value was above the normal range of 4-8 minutes. These results indicate that levetiracetam does not produce clinically significant increases in bleeding time in healthy male volunteers. Further a review of clinical trials suggests that levetiracetam does not appear to cause clinically significant or relevant hematological adverse events suggestive of underlying hematological disorders.
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Acta neurologica Belgica · Mar 2007
Case ReportsStroke as the first manifestation of Takayasu arteritis.
Takayasu arteritis (TA) is an uncommon disease of young women, characterized by granulomatous vasculitis of medium and large arteries. In addition to constitutional symptoms, it causes various clinical morbidities, such as arm claudication, decreased arterial pulses, carotidynia and hypertension. The incidence rate of TA has wide variation in different geographical areas. ⋯ We present clinical, laboratory and imaging findings of a 50 years old lady with TA, who was initially presented by clinical manifestations mimicking a stroke. Of particular importance is the occurrence of intracranial arterial stenosis in the patient, which is a relatively rare condition. The rarity of the disease and especially such a presentation can cause considerable delay in the diagnosis and treatment.
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Acta neurologica Belgica · Mar 2007
Case ReportsNeurodegeneration with brain iron accumulation: clinical, radiographic and genetic heterogeneity and corresponding therapeutic options.
Neurodegeneration with brain iron accumulation (NBIA), formerly known as Hallervorden-Spatz syndrome, is a heterogeneous group of disorders with different treatment options. ⋯ The clinical, radiographic and genetic heterogeneity of NBIA has to be underlined.