Journal of neurology
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Journal of neurology · Aug 2013
Review Meta AnalysisPsychiatric comorbidities of episodic and chronic migraine.
Migraine is a prevalent disabling neurological disorder associated with a wide range of medical and psychiatric comorbidities. Population- and clinic-based studies suggest that psychiatric comorbidities, particularly mood and anxiety disorders, are more common among persons with chronic migraine than among those with episodic migraine. Additional studies suggest that psychiatric comorbidities may be a risk factor for migraine chronification (i.e., progression from episodic to chronic migraine). ⋯ Here, we review the current literature on the rates of several psychiatric comorbidities, including depression, anxiety, and post-traumatic stress disorder, among persons with migraine in clinic- and population-based studies. We also review the link between physical, emotional, and substance abuse, psychiatric disorders, and migraine. Finally, we review the data on psychiatric risk factors for migraine chronification and explore theories and evidence underlying the comorbidity between migraine and these psychiatric disorders.
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Journal of neurology · Aug 2013
Observational StudyIntracerebral hemorrhage during anticoagulation with vitamin K antagonists: a consecutive observational study.
Intracerebral hemorrhage (ICH) is the most devastating complication of oral anticoagulation (OAC). As the number of patients on long-term OAC is expected to rise, the proportion of intracerebral hemorrhage related to OAC (OAC-ICH) in relation to spontaneous ICH (spont-ICH) is expected to increase as well. We determined the proportion of OAC-ICH in consecutive stroke patients and explored differences between OAC-ICH and spont-ICH regarding initial volume, hematoma expansion and outcome. ⋯ One-fourth of all ICH are related to OAC. Initial extension of ICH into the ventricles and primary IVH are more frequent in OAC-ICH. The rate of hematoma expansion in OAC-ICH patients is similar to non-anticoagulated ICH patients.
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Journal of neurology · Aug 2013
Initial cognitive dip after subthalamic deep brain stimulation in Parkinson disease.
Although many studies have shown no significant change in global cognitive function after subthalamic brain stimulation (STN DBS) in patients with Parkinson disease (PD) and have concluded that STN DBS is generally safe from a cognitive standpoint, some studies have reported a decline in global cognitive function after STN DBS. Interestingly, in some studies, the decline in cognitive function appears to be greater during the initial short period after surgery (within 6 or 12 months after surgery) than the decline thereafter. To this end, we examined whether the rate of change in global cognitive function during the initial 6 months after STN DBS was different from the mean 6-month change that occurred between 6 and 36 months after surgery. ⋯ Mean MMSE change during the first 6 months after surgery was significantly greater than the mean 6-month MMSE change between 6 to 36 months after surgery. The levodopa equivalent daily dose at baseline and the score for Stroop Color-word test at baseline were significantly associated with the decline in MMSE score during the first 6 months after surgery. Our result showed that decline in global cognitive function was faster in the first 6 months after surgery, compared with that after 6 months.
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Journal of neurology · Aug 2013
Stereotactic radiosurgery of cerebral arteriovenous malformations: long-term follow-up in 164 patients of a single institution.
This retrospective study aimed to investigate long-term outcome in patients with arteriovenous malformations (AVM) treated with stereotactic radiosurgery (SRS). Between 1998 and 2008, 164 patients with AVM received SRS. Median age was 36 years (range 7-69 years). ⋯ After SRS an improvement in epileptic episodes, headaches and motor-sensory deficits was found in 8.5, 14 and 15 % of patients, respectively. Our long-term follow-up data show that SRS is an effective treatment option in AVM with low toxicity and bleeding risk, depending on AVM size and Spetzler-Martin grade. An improvement of neurologic symptoms is achievable.
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Journal of neurology · Aug 2013
Longitudinal 7-year follow-up of chronic pain in persons with multiple sclerosis in the community.
The aim of this work is to examine the course and impact of chronic pain and pain-related disability in persons with multiple sclerosis (pwMS) over a 7-year period in the Australian community employing a longitudinal, cross-sectional study using structured interviews and validated measures. The intensity of chronic pain was assessed with the visual analogue scale (VAS); the chronic pain grade (CPG) classified pain severity using scores for both pain intensity and pain-related disability, and the assessment of quality of life (AQoL) questionnaire assessed impact on participatory domains. Of the 74 pwMS assessed at 7-year follow-up (T2), 53 (71.6 %) were female, with average age of 55.6 years, and median time since diagnosis of 16.5 years. ⋯ At T2, pwMS used less pharmacological medication but accessed more "other" therapy to cope with their chronic pain. This study provides longitudinal insight into the complex multidimensional chronic pain-related disability in pwMS over a longer period. Improved clinician understanding of the course of chronic pain, early intervention, and patient self-management may decrease pain-related disability and contribute to their overall well-being.