Journal of the neurological sciences
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Spontaneous intracerebral hemorrhage (ICH) is a devastating subtype of stroke that results in significant rates of mortality and morbidities. The initial hematoma volume, hematoma expansion (HE), blood pressure (BP), and coagulopathy are considered strong predictors of clinical outcomes and mortality. Low serum magnesium (Mg++) levels have been shown to be associated with larger initial hematoma and greater HE. ⋯ However, randomized clinical trials administering intravenous Mg++ have shown no benefit over placebo in ICH patients. The confounding effect of hypocalcemia and a delay in Mg++ trafficking across the blood-brain barrier might explain the futile results for intravenous Mg++ therapy. In the current review, we will discuss the evidence regarding the possible role of low serum Mg++ level on HE in acute ICH.
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Imaging studies have revealed cortical thinning and subcortical atrophy occurring in Parkinson's disease (PD); however, the topographical distribution and clinical associations related to advancing stages of PD remains unclear. ⋯ In conclusion, in more severe disease stages PD patients exhibit progressive cortical thinning and subcortical volume loss which could have relevance to the development of cognitive impairment.
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The prevalence and diagnostic values of myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) in dermatomyositis/polymyositis (DM/PM) were studied. ⋯ MSAs and MAAs serve as biomarkers for differentiating DM/PM from other CTDs as well as distinguishing DM/PM with ILD from DM/PM without ILD.
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Intravenous immunoglobulins (IVIg) are an efficacious treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN). IVIg is considered in patients who have a high suspicion of an inflammatory neuropathy, but do not meet diagnostic criteria. The objective of this retrospective study was to assess which diagnostic results led to the decision to administer IVIg and to determine the rate of improvement. ⋯ There was no association between the presence of the EFNS/PNS supportive criteria, including nerve hypertrophy on ultrasound, and treatment response. In conclusion, enlarged nerves on ultrasound and elevated CSF protein were the main reasons to start IVIg treatment in our study, although findings did not correlate with treatment response. In tertiary referral clinics, IVIg treatment could be considered in selected patients with a high suspicion of an inflammatory neuropathy, especially in those suspected of CIDP.