Neurology
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Randomized Controlled Trial Clinical Trial
Riluzole in cerebellar ataxia: a randomized, double-blind, placebo-controlled pilot trial.
The pleiotropic effects of riluzole may antagonize common mechanisms underlying chronic cerebellar ataxia, a debilitating and untreatable consequence of various diseases. ⋯ This study provides Class I evidence that riluzole reduces, by at least 5 points, the ICARS score in patients with a wide range of disorders that cause cerebellar ataxia (risk difference 63.2%, 95% CI 33.5%-79.9%).
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Patient nonattendance in neurology and other subspecialty clinics is closely linked to longer waiting times for appointments. We developed a new scheduling system for residents' clinic that reduced average waiting times from >4 months to < or =3 weeks. The purpose of this study was to compare nonattendance for clinics scheduled using the new model (termed "rapid access") vs those scheduled using the traditional system. ⋯ A new scheduling system that minimizes waiting times for new patient appointments has been effective in substantially reducing nonattendance in our neurology residents' clinic. This rapid access system should be considered for implementation and will likely enhance the outpatient educational experience for trainees in neurology.
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To investigate the risk of stroke development following a diagnosis of herpes zoster ophthalmicus (HZO). ⋯ Herpes zoster ophthalmicus may represent a marker of increased risk of stroke development during the 1-year follow-up period.
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Randomized Controlled Trial
Cognitive effects of pregabalin in healthy volunteers: a double-blind, placebo-controlled trial.
Antiepileptic drugs (AEDs) can be associated with neurotoxic side effects including cognitive dysfunction, a problem of considerable importance given the usual long-term course of treatment. Pregabalin is a relatively new AED widely used for the treatment of seizures and some types of chronic pain including fibromyalgia. We measured the cognitive effects of 12 weeks of pregabalin in healthy volunteers. ⋯ At conventional doses and titration, pregabalin induced mild negative cognitive effects and neurotoxicity complaints in healthy volunteers. These effects are one factor to be considered in the selection and monitoring of chronic AED therapy. Class of Evidence: This study provides Class I evidence that pregabalin 300 mg BID negatively impacts cognition on some tasks in healthy volunteers.
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To study rapid-onset central motor plasticity, and its relationship to motor impairment and CNS injury in patients with multiple sclerosis (MS). ⋯ Despite motor impairment and CNS injury in patients with multiple sclerosis (MS), rapid-onset motor plasticity is comparable to that in healthy subjects. Compensation of MS-related CNS injury is unlikely to be constrained by insufficient rapid-onset neuroplasticity.