Journal of neurology
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There are established drugs for the treatment of status epilepticus (SE) but their potentially hazardous side-effects are well known. Levetiracetam (LEV) is a novel anticonvulsant available for intravenous (i.v.) application. It could be an alternative when standard drugs fail or should be avoided. ⋯ LEV could not terminate SE in seven patients. We documented nausea and emesis in one and elevation of liver enzymes in another patient that were likely to be attributed to LEV. LEV i.v. seems to be safe with relevant efficiency for the treatment of SE in elderly and multimorbid patients when comorbidity and respiratory insufficiency precludes high doses of benzodiazepines or phenytoin.
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Journal of neurology · Oct 2009
Letter Case ReportsA case of primary erythermalgia with encephalopathy.
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Journal of neurology · Sep 2009
Letter Case ReportsStroke in an adult with HIV infection due to carotid artery stenosis successfully treated with steroids: HIV-associated arteritis?
A 33-year-old Caucasian man with a 17-year history of HIV infection developed sudden right-sided hemiplegia, with the arm more affected than the leg, and aphasia. Magnetic resonance imaging of the brain showed hemodynamic watershed stroke between the anterior and middle cerebral artery territories and an ischemic stroke within the left posterior middle cerebral artery territory. Color-coded Duplex sonography and Doppler sonography revealed hypoechogenic stenosis of the left common carotid artery, the left internal carotid artery, left external carotid artery and right internal carotid artery. An extensive diagnostic workup led us to hypothesize that HIV-associated arteritis was the cause of the stroke, and following intravenous steroid therapy, the carotid artery stenoses vanished.
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Journal of neurology · Sep 2009
Case ReportsDe novo and rescue DBS leads for refractory Tourette syndrome patients with severe comorbid OCD: a multiple case report.
Invasive treatment for Gilles de la Tourette syndrome has shown interesting results in a number of published reports; it seems to be evolving into a promising therapeutic procedure for those patients demonstrating disabling clinical pictures who are refractory to conservative treatments. There are important issues concerning the stimulated brain target, with different nuclei currently under investigation. Our group asked in this pilot study whether Tourette syndrome could be treated by tailoring specific brain targets for specific symptoms. ⋯ Following two cases where rescue anterior limb of internal capsule/nucleus accumbens leads were employed, we performed two additional procedures (anterior limb of the internal capsule plus ventralis oralis/centromedianus-parafascicularis and anterior limb of the internal capsule alone) with some mild improvement of comorbid obsessive-compulsive disorder, although the number of observations in this case series was low. Overall, the effects observed with using the anterior limb of the internal capsule either alone or as a rescue were less than expected. In this report we detail our experience with this approach.