Neurology
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Case Reports Comparative Study
Neurologic immune reconstitution inflammatory syndrome in HIV/AIDS: outcome and epidemiology.
To characterize the immune reconstitution inflammatory syndrome in the nervous system (NeuroIRIS) among patients with HIV/AIDS. ⋯ Immune reconstitution inflammatory syndrome in the nervous system (NeuroIRIS) remains an uncommon complication of combination antiretroviral therapy (cART) but with a potentially poor outcome. Initiation of cART in very immunosuppressed patients requires close monitoring to manage NeuroIRIS in an expedient manner.
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Intracortical inhibition in the motor cortex may be measured with short interval intracortical inhibition (SICI), likely mediated by GABA(A) receptors, and long interval intracortical inhibition (LICI), likely mediated by GABA(B) receptors. Separate neuronal populations mediate SICI and LICI, and LICI inhibits SICI, likely through GABA(B) mediated presynaptic inhibition. The purpose of this study was to test the hypothesis that cortical presynaptic inhibition in Parkinson disease (PD) is impaired. ⋯ The inhibitory effect of long interval intracortical inhibition on short interval intracortical inhibition, likely representing presynpatic inhibition in the motor cortex, is decreased in Parkinson disease and may be a nondopaminergic feature of the disease.
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Postanoxic status epilepticus (PSE) is considered a predictor of fatal outcome and therefore not intensively treated; however, some patients have had favorable outcomes. The aim of this study was to identify favorable predictors for awakening beyond vegetative state in PSE. ⋯ Patients with postanoxic status epilepticus and preserved brainstem reactions, somatosensory evoked potentials, and EEG reactivity may have a favorable outcome if their condition is treated as status epilepticus.
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Meta Analysis Comparative Study
Impact of cardiac complications on outcome after aneurysmal subarachnoid hemorrhage: a meta-analysis.
Impact of cardiac complications after aneurysmal subarachnoid hemorrhage (SAH) remains controversial. We performed a meta-analysis to assess whether EKG changes, myocardial damage, or echocardiographic wall motion abnormalities (WMAs) are related to death, poor outcome (death or dependency), or delayed cerebral ischemia (DCI) after SAH. ⋯ Markers for cardiac damage and dysfunction are associated with an increased risk of death, poor outcome, and delayed cerebral ischemia after subarachnoid hemorrhage. Future research should establish whether these cardiac abnormalities are independent prognosticators and should be directed toward pathophysiologic mechanisms and potential treatment options.