The International journal of neuroscience
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Cervical artery dissection (CAD) is a common cause of stroke in young individuals. Risk factors, treatment, and outcome of CAD are not well established. Our aim is to identify risk factors, outcome, and discuss treatment of CAD. ⋯ Hypertension and hypercholesterolemia were risk factors in spontaneous dissections, speaking for vascular wall abnormalities as potential contributors to pathophysiology of CAD. There was no evidence supporting one type of treatment over the other. A large ongoing prospective study should quell this controversy.
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Randomized Controlled Trial Multicenter Study Comparative Study
Immediate versus delayed switch from levodopa/carbidopa to levodopa/carbidopa/entacapone: effects on motor function and quality of life in patients with Parkinson's disease with end-of-dose wearing off.
Assess motor function and quality of life (QoL) in Parkinson's disease (PD) subjects with end-of-dose wearing off (EODWO), comparing immediate and delayed switch (IS, DEL) to levodopa/carbidopa/entacapone (LCE). ⋯ The IS provided greater motor improvement at week 4 and improved QoL at week 8.
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Comparative Study
Retrospective chart review of duloxetine and pregabalin in the treatment of painful neuropathy.
The primary aims of our study were to compare pregabalin and duloxetine in a neuromuscular clinic for diabetic neuropathic pain (DPN) and to study the effect of these medications in cryptogenic sensory polyneuropathy. We performed a retrospective chart review of 143 patients who were started on pregabalin or duloxetine during a 10-month period in a tertiary neuromuscular outpatient center for neuropathic pain. Duloxetine and pregabalin were started in 103 and 91 patients, respectively. ⋯ However, these differences between pregabalin and duloxetine were not statistically significant. Despite the study's limitations of retrospective design, these findings suggest that both pregabalin and duloxetine are probably effective for neuropathic pain, secondary to diabetes or cryptogenic sensory peripheral neuropathy in a tertiary care academic neuromuscular center. Prospective randomized controlled comparative effectiveness studies are required for both drugs in the treatment of neuropathic pain.
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A 24-year-old male presented with features of progressively worsening spastic quadriparesis of 5 years' duration with similar milder features in the younger brother. His neuroradiological investigations revealed diffuse thickening of posterior longitudinal ligament, ligamentum flavum, and duramater in the cervical spine causing severe canal stenosis with secondary ischemic cord changes. As both brothers had dysmorphic facial features, further work-up suggested the diagnosis of a rare familial form of myelopathy due to mucopolysaccharidosis VI.
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Comparative Study
Meloxicam exerts neuroprotection on spinal cord trauma in rats.
Traumatic injury to the central nervous system results in the delayed dysfunction and neuronal death. Impaired mitochondrial function, generation of reactive oxygen species (ROS), and lipid peroxidation occur soon after traumatic spinal cord injury (SCI), while the activation of compensatory molecules that neutralize ROS occurs at later time points. The aim of the current study was to investigate the putative neuroprotective effect of the COX2 inhibitor meloxicam in a rat model of SCI. ⋯ On the other hand, meloxicam treatment reversed all these biochemical parameters as well as SCI-induced histopathological alterations. Furthermore, impairment of the neurological functions due to SCI was improved by meloxicam treatment. The present study suggests that meloxicam, reduces SCI-induced oxidative stress and exerts neuroprotection by inhibiting lipid peroxidation, GSH depletion, and DNA fragmentation.