Neurology
-
A subset of patients with dura mater graft-associated Creutzfeldt-Jakob disease (dCJD) demonstrates atypical clinical features and plaque formation in the brain (plaque type). ⋯ The frequency of the plaque type in dura mater graft-associated Creutzfeldt-Jakob disease is apparently higher than previously recognized. For the clinical diagnosis of the plaque type dura mater graft-associated Creutzfeldt-Jakob disease, MRI and CSF markers would be useful, in addition to the core features, i.e., onset with ataxic gait disturbance, relatively slow progression, and no or late occurrence of periodic sharp-wave complexes on EEG.
-
Prognosis of status epilepticus (SE) depends on its cause, but there is uncertainty as to whether SE represents an independent outcome predictor for a given etiology. Cerebral anoxia is a relatively homogenous severe encephalopathy. Postanoxic SE is associated to a nearly 100% mortality in this setting; however, it is still unclear whether this is a severity marker of the underlying encephalopathy, or an independent factor influencing outcome. The goal of this study was to assess if postanoxic SE is independently associated with mortality after cerebral anoxia. ⋯ In this hospital-based cohort, postanoxic status epilepticus (SE) seems to be independently related to death in cardiac arrest survivors, suggesting that SE might determine a bad prognosis for a given etiology. Confirmation of these results in a prospective assessment is needed.
-
Randomized Controlled Trial Multicenter Study
Risk factors for somnolence, edema, and hallucinations in early Parkinson disease.
The CALM-PD trial evaluated the development of motor complications in subjects with early Parkinson disease (PD) randomized to initial treatment with either pramipexole or levodopa. A secondary finding of the trial was a higher than anticipated development or worsening of somnolence and edema and development of hallucinations. ⋯ Comorbid illnesses are important and overlooked risk factors for the development of somnolence, edema, and hallucinations. When initiating therapy with pramipexole, patients should be counseled about and monitored for somnolence and edema. Slight decrements in cognitive function and older age are associated with an increased risk of hallucinations.