Journal of neurology
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Journal of neurology · Nov 2008
Pain and motor function in carpal tunnel syndrome: a clinical, neurophysiological and psychophysical study.
Patients with carpal tunnel syndrome (CTS) complain of motor symptoms. The study is aimed to understand which features are associated with the presence of motor symptoms in CTS. ⋯ Motor symptoms may be found in approximately half of CTS hands. Clinical and neurographic signs of median nerve motor damage appear to be poorly correlated to motor symptoms. The factor that can help reconcile the discrepancy between motor symptoms and motor signs is pain. Pain modulation on motor function may take place at various anatomical levels in CTS. Nociceptive C-fibers may be involved in pain-motor interactions finally leading to motor symptoms.
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Journal of neurology · Nov 2008
ReviewNosocomial ventriculitis and meningitis in neurocritical care patients.
External ventricular drainage (EVD) is frequently necessary in neurological and neurosurgical intensive care patients. A major complication of this procedure is an EVD-related venticulitis or meningitis. The purpose of this review is (1) to address the magnitude of the problem in the neurocritical care patient population, (2) to discuss the difficulties in providing an appropriate and timely diagnosis of this disease entity and (3) to propose an algorithm for both rapid diagnosis and appropriate therapy. ⋯ Nosocomial EVD-related ventriculitis is a significant cause of morbidity and mortality in critically ill neurological patients. Rapid diagnosis and prompt initiation of appropriate antimicrobial therapy is needed. A stepwise algorithm for the management of EVD-related ventriculitis is proposed.
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Journal of neurology · Nov 2008
Telemedicine in acute stroke: remote video-examination compared to simple telephone consultation.
Telemedicine is increasingly being used in acute stroke care. Some of the first studies and network projects are already applying remote audiovisual communication for patient evaluation. Formerly the telephone was the method of choice to contact experts for case discussion. We compared remote video-examination and telephone consultation in acute stroke care. ⋯ Creating a network improves stroke care by establishing cooperation between hospitals. Telephone consultation could be a simple method of telemedicine to support cooperation as it is easy and widely available. However, outcome parameters like mortality indicate that remote video examination is superior to TC. Therefore, full-scale audiovisual communication is recommended for remote consultation in acute stroke care.