Current opinion in neurology
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Management of pain after spinal cord injury remains a difficult clinical problem. In particular, neuropathic spinal cord injury pain, like other forms of deafferentation pain in which there is loss or modification of normal afferent sensory inputs, is notoriously resistant to currently available modes of treatment. Although there have been some advances in our understanding of spinal cord injury pain, the mechanisms of neuropathic spinal cord injury pain remain largely unknown and treatment is often ineffective. This review presents findings from recent publications that deal with the mechanisms and management of spinal cord injury pain.
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Curr. Opin. Neurol. · Oct 1995
ReviewDiscordance between phenotype and genotype in malignant hyperthermia.
Eight mutations in the ryanodine receptor gene on human chromosome 19q13.1 have been linked to malignant hyperthermia. Although 50% of malignant hyperthermia families are not linked to the ryanodine receptor gene, only single malignant hyperthermia families have been linked to alternative loci on chromosome 7q21-22 and on chromosome 3q13.1. Problems in malignant hyperthermia linkage studies may arise from the inadequacy of the caffeine halothane contractures test for phenotypic diagnosis of malignant hyperthermia.
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Curr. Opin. Neurol. · Jun 1995
ReviewAcute disseminated encephalomyelitis and isolated central nervous system demyelinative syndromes.
The clinical and pathological characteristics of acute disseminated encephalomyelitis are briefly outlined. The possible relation between acute disseminated encephalomyelitis and other isolated monophasic inflammatory demyelinating episodes in the central nervous system, such as acute optic neuritis, transverse myelitis or brainstem lesions, is noted and the risk of progression to multiple sclerosis is examined. ⋯ Finally, the risk factors for the progression of demyelinating ther than optic neuritis to multiple sclerosis are explored. Further work to elucidate better the relationships between these pathological entities is suggested.
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A review of the literature dealing with patients presenting with headache caused by underlying disease reinforces the classic teaching that these headaches are hardly ever completely typical of benign syndromes such as migraine. More often than not they are accompanied by features, such as other symptoms or physical abnormalities, that suggest, to the careful clinician, the suspicion of a lesion and the need for investigation.
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Critical care neurology is a rapidly developing subspecialty of neurology. The neuro-intensivist is called upon to manage critically ill patients with stroke, neuromuscular disease, traumatic injury, increased intracranial pressure, and other disorders. Therapeutic and technologic advances are rapidly being incorporated into practice and will improve patient care and outcome.