Acta neurologica Scandinavica
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Acta Neurol. Scand. · Oct 2010
Cognitive symptoms, cervical range of motion and pain as prognostic factors after whiplash trauma.
To evaluate pain, cervical range of motion (CROM) and cognitive symptoms as predictors for poor prognosis defined as sick leave 3 years later. ⋯ Initial pain and reduced CROM may be related to minor tissue damage which often heals while late functionality is more dependent on other factors such as cognitive dysfunction. For patients with whiplash-associated disorders two simple questions should be asked; 'Are you currently easily irritated?' and 'Are you currently easily distracted (e.g. is it difficult for you to follow a conversation if several people are talking in the room at the same time)?'. An affirmative answer to any of these questions indicates an increased risk for poor prognosis defined as sick leave 3 years later.
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Acta Neurol. Scand. · Sep 2010
Misdiagnosis of epileptic and non-epileptic seizures in a neurological intensive care unit.
The etiological misinterpretation of paroxysmal neurological symptoms frequently causes a delayed treatment or an inappropriate utilization of ICU-capacities. ⋯ In 13.9%, the emergency room diagnosis of epileptic seizures turned out to be incorrect, whereas in 15.6%, the final diagnosis of epileptic seizures was missed in the emergency room. Factors that were significantly correlated to missing the seizure diagnosis were (i) no prior history of epilepsy, (ii) old age, (iii) multi-morbidity, (iv) pathologic CT-scans demonstrating cerebrovascular lesions, (v) seizure description by non-professionals, (vi) predominantly negative seizure phenomena (aphasia, loss of consciousness, paresis), (vii) lack of tongue-bite lesions.
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Acta Neurol. Scand. · Sep 2010
ReviewThe value of conventional high-field MRI in MS in the light of the McDonald criteria: a literature review.
The diagnosis of MS is based on the revised McDonald criteria and is multidisciplinary. Both clinical and paraclinical measures are included. High-field magnetic resonance imaging (MRI) is becoming increasingly available and it is therefore necessary to clarify possible advantages of high-field MRI in MS. ⋯ The detection of more lesions at high-field strength did not seem to lead to earlier diagnosis of clinically definite multiple sclerosis. Further larger studies of patients with clinically isolated syndromes are needed to settle the question of a diagnostic consequence of high-field imaging in MS. We suggest that the next revision of the McDonald diagnostic criteria include a recommendation of field strength.
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Acta Neurol. Scand. · Jun 2010
Pulmonary function tests and diaphragmatic compound muscle action potential in patients with sporadic amyotrophic lateral sclerosis.
Respiratory failure is the primary cause of death in patients with amyotrophic lateral sclerosis (ALS). Diaphragmatic compound muscle action potentials (DCMAP) are valid parameters to assess the respiratory muscle innervation. ⋯ There is significant negative correlation between DCMAP latencies and PFTs suggesting early loss of myelinated fibres and diaphragmatic dysfunction. DCMAP latencies may be a good indicator of early respiratory muscle involvement and also of disease progression in ALS.
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Acta Neurol. Scand. · Jun 2010
Lacosamide as treatment of epileptic seizures - cost utility results for Sweden.
To calculate cost per additional quality-adjusted life-year (QALY) for lacosamide as adjunctive treatment for patients with uncontrolled partial-onset seizures as compared to no adjunctive treatment. ⋯ The estimated cost per QALY gained falls within the range of reported estimates of the willingness-to-pay for an additional QALY. The results imply that lacosamide is cost-effective in the treatment of uncontrolled partial-onset seizures (1 euro approximately 9.6 SEK).