Neurology
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A recent meta-analysis of randomized trials revealed that antiepileptic drugs (AEDs) as a class increase the risk of suicidal thoughts and behavior. We conducted an observational study with data from the United Kingdom General Practice Research Database to investigate if an increase in risk for different groups of AEDs is also evident in clinical practice. ⋯ Newer AEDs with a rather high frequency of depressive symptoms in clinical trials may also increase the risk of self-harm or suicidal behavior in clinical practice. For the most commonly used other groups of AEDs, no increase in risk was observed.
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The Vietnam Head Injury Study (VHIS) is a prospective, longitudinal follow-up of 1,221 Vietnam War veterans with mostly penetrating head injuries (PHIs). The high prevalence (45%-53%) of posttraumatic epilepsy (PTE) in this unique cohort makes it valuable for study. ⋯ Patients with PHI carry a high risk of PTE decades after their injury, and so require long-term medical follow-up. Lesion location, lesion size, and lesion type were predictors of PTE.
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The present retrospective cohort study compares the long-term functional outcome, improvement or deterioration, of patients considered in a vegetative state (VS) or a minimally conscious state (MCS) 1 year after coma onset, then yearly for up to 5 years. ⋯ In contrast to patients in VS, a third of patients in MCS improved more than 1 year after coma onset. This emphasizes the need to define reliable boundaries between VS and MCS using repeated clinical evaluations and all imaging and neurophysiologic tools available today.
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Historical Article
The "torpillage" neurologists of World War I: electric therapy to send hysterics back to the front.
The French neurologists and psychiatrists who were mobilized during the Great War were confronted with numerous soldiers with war neuroses, often with novel clinical manifestations such as camptocormia. They addressed hysteria and pithiatism according to concepts that had been formed before the war, and many doctors considered these soldiers to be malingerers. As a result, the use of aggressive therapies to enable their prompt return to the battlefront was advocated. ⋯ In January 1918, he too came up against soldiers refusing electric treatment. Following a new trial and an unfavorable press campaign, the psycho-faradic method gradually died out. These extreme medical practices developed to treat psychological trauma during the First World War subsequently led to the delineation of posttraumatic stress disorder in more recent wars.
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We aimed to study if age-related white matter changes (WMC) and vascular risk factors were predictors of cognitive decline in elderly subjects with WMC living independently. ⋯ WMC severity and diabetes are independent predictors of cognitive decline in an initially nondisabled elderly population. Vascular dementia is predicted by previous stroke and WMC, while AD is predicted only by MTA.