Neurology
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Randomized Controlled Trial
Hyperdopaminergic crises in familial dysautonomia: a randomized trial of carbidopa.
The purpose of this study was to determine whether carbidopa (Lodosyn), an inhibitor of dopa-decarboxylase that blocks the synthesis of dopamine outside the brain, is an effective antiemetic in patients with familial dysautonomia (FD) and hyperdopaminergic nausea/retching/vomiting attacks. ⋯ This study provides Class II evidence that carbidopa is effective in reducing nausea/retching/vomiting in patients with FD.
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Case Reports
Teaching NeuroImages: Comatose patient with bilateral thalamic infarct due to internal carotid artery occlusion.
An 88-year-old woman with a medical history of diabetes, hypertension, and atrial fibrillation presented to the emergency room after being found unresponsive with a NIH Stroke Scale score of 23 and Glasgow Coma Scale score of 3. She was unresponsive to painful stimuli. Noncontrast CT demonstrated bilateral thalamic infarcts (figure 1A).
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Education research: changing practice. Residents' adoption of the atraumatic lumbar puncture needle.
The atraumatic needle is recommended over the cutting needle to prevent complications related to lumbar puncture and to reduce costs to the health care system. However, very few practicing neurologists use the atraumatic needle, which in turn limits the teaching of its use to neurology residents. Despite this, neurology residents may be able to adopt the atraumatic needle for lumbar punctures. ⋯ Neurology residents can successfully adopt the atraumatic needle as standard of care for lumbar punctures.
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To evaluate the sensitivity of contact heat evoked potentials (CHEPs) compared with dermatomal somatosensory evoked potentials (dSSEPs) and clinical sensory testing in myelopathic spinal cord disorders (SCDs). ⋯ Assessment of spinothalamic pathways with CHEPs is reliable and revealed the highest sensitivity in all SCDs. Specifically in incomplete lesions that spare dorsal pathways, CHEPs are sensitive to complement the clinical diagnosis.