Neurology
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Randomized Controlled Trial
Structural changes in patients with primary generalized tonic and clonic seizures.
We conducted MR volumetry and voxel-based morphometry in 19 patients who had idiopathic generalized epilepsy (IGE) with tonic clonic seizures as the only seizure type and 52 control subjects. Patients exhibited elevated frontal lobe fraction of CSF and reduced fraction of gray matter in the frontal, parietal, temporal cortex, thalamus, and cerebellum. The thalamus and cerebellum also showed reduced volumes, as did the caudate and putamen. Contrary to current diagnostic criteria, regional tissue abnormalities may be present in IGE.
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To systematically review outcomes in comatose survivors after cardiac arrest and cardiopulmonary resuscitation (CPR). ⋯ Pupillary light response, corneal reflexes, motor responses to pain, myoclonus status epilepticus, serum neuron-specific enolase, and somatosensory evoked potential studies can reliably assist in accurately predicting poor outcome in comatose patients after cardiopulmonary resuscitation for cardiac arrest.
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Randomized Controlled Trial Comparative Study
Sodium valproate vs phenytoin in status epilepticus: a pilot study.
Sixty-eight patients with convulsive status epilepticus (SE) were randomly assigned to two groups to study the efficacy of sodium valproate (VPA) and phenytoin (PHT). Seizures were aborted in 66% in the VPA group and 42% in the PHT group. ⋯ The side effects in the two groups did not differ. Sodium valproate may be preferred in convulsive SE because of its higher efficacy.
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Randomized Controlled Trial
A double-blind, controlled study of botulinum toxin A in chronic myofascial pain.
Recent studies have reported a potential analgesic effect of botulinum toxin A (BTXA) in musculoskeletal pain. The present double-blind, randomized, placebo-controlled, parallel clinical trial studied the effect of BTXA on pain from muscle trigger points and on EMG activity at rest and during voluntary contraction. ⋯ The results do not support a specific antinociceptive and analgesic effect of botulinum toxin A.