Neurology
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Immunoreactivity of sera from patients with Rasmussen encephalitis (RE) and patients with partial epilepsy (PE) was analyzed by immunohistoblot on rat brain sections and the staining pattern compared with that obtained with antibodies to a-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid and NMDA receptors. Staining for anti-glutamate receptor 3 (GluR3) was found in 82% of patients with RE and 64% of patients with PE. Histoblot analysis showed a positive staining in GluR3- and NMDA-specific regions of rat brain, providing a comprehensive CNS immunolocalization.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomized, double-blind, placebo-controlled trial of a glycine antagonist in neuropathic pain.
Nerve injury results in increases in spinal glutamate, which opens the NMDA ionophore channel, causing an influx of calcium. A glycine-binding site must be occupied for the channel to open. GV196771 is a selective antagonist of the glycine-binding site of the NMDA ionophore. ⋯ Although the glycine antagonists show anti-hyperalgesic action in animal models of neuropathic pain, GV196771 does not appear to be an effective treatment in subjects with chronic neuropathic pain. This may be due to insufficient penetration of GV196771 to central sites of action, differences between the human and animal glycine receptors, or differences between neuropathic pain in animal models and humans.
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Clinical Trial
Global and domain-specific cognitive impairment and outcome after subarachnoid hemorrhage.
Cognitive dysfunction is the most common form of neurologic impairment after subarachnoid hemorrhage (SAH). ⋯ Cognitive impairment impacts broadly on functional status, emotional health, and QOL after SAH. The TICS may be a useful alternative to more detailed neuropsychological testing for detecting clinically relevant global cognitive impairment after SAH.
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The authors report the findings of a prospectively collected database of stroke and TIA recorded from 1998 through 1999 by the 178 family physicians of the Belgian sentinel network. The yearly age-adjusted attack rate per 100,000 men was estimated as 109 (95% CI = 86 to 137) for left motor deficit and 75 (95% CI = 56 to 99) for right motor deficit (p = 0.011). This difference was not observed among women nor in the entire sample population. The authors suggest that handedness should be systematically recorded and compared to both sex and the side of the event.
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Epilepsy affects 80% of patients with Sturge-Weber syndrome; the majority of seizures begin before the age of 1. When seizures are intractable to medications and unihemispheric, hemispherectomy is often advised. ⋯ Children undergoing hemispherectomy presented at a young age and had frequent seizures for approximately 1 year but are now mostly seizure-free. Age at surgery did not have an adverse effect on either seizure or cognitive outcomes.