Neurology
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Eleven patients with primary thunderclap headache (TCH) were treated with oral nimodipine 30 to 60 mg every 4 hours or IV nimodipine 0.5 to 2 mg/h if the oral regimen failed or images showed cerebral vasospasm. With oral nimodipine, headache did not recur in the nine patients without vasospasm. ⋯ Nimodipine may be effective for TCH. Vasospasm may warrant IV nimodipine.
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Clinical Trial Controlled Clinical Trial
Stiff-person syndromes: motor cortex hyperexcitability correlates with anti-GAD autoimmunity.
S: To investigate whether motor cortex excitability is enhanced in both stiff-person syndrome (SPS) and its "plus" variant, progressive encephalomyelitis with rigidity (PER), and related to autoimmunity against glutamic acid decarboxylase (GAD). ⋯ The motor cortex is hyperexcitable in SPS and PER patients. However, hyperexcitability is partly masked by GABAmimetic treatment. Correlation of elevated GAD antibody levels with enhanced ICF suggests that motor cortex hyperexcitability in SPS and PER is related to anti-GAD autoimmunity.
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To analyze the prevalence and demography of chronic daily headache (CDH) with analgesic overuse. ⋯ CDH with analgesic overuse is a common disorder in the general population, mainly in women in their fifties, in whom 5% meet its diagnostic criteria.
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Antiplatelet drugs (APD) are widely used in the prevention of ischemic cardio- and cerebrovascular diseases. The authors studied the frequency of stroke occurring after APD discontinuation, the cause of discontinuation, and the delay between APD disruption and stroke. Only 4.49% of strokes were related to a recent APD discontinuation, but all cases occurred between 6 and 10 days after drug discontinuation (p < 0.0001). This temporal pattern has biologic plausibility because the inhibited platelets circulate in the blood for about 10 days.