Journal of neurology
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Journal of neurology · Sep 2008
Treatment wish of individuals with known and unknown restless legs syndrome in the community.
Restless legs syndrome (RLS) is a frequent sleep disorder with a prevalence of 5% to 15% in Caucasian populations. Dopaminergic treatment is known to reduce sensorimotor RLS symptoms and is approved for RLS, but not all patients ask for treatment. About 2% to 3% of patients presenting to a primary care physician require RLS-specific treatment. The overall treatment preference of RLS sufferers, however, is still unknown. The aim of this study was to assess the prevalence and treatment preference in patients with previously diagnosed and those with yet undiagnosed RLS in a population-based survey in Germany. ⋯ About every fourth RLS case knows about the diagnosis and overall every fifth RLS case wishes medication to effectively reduce symptoms, corresponding to 1.6% of the whole study population.
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The cardinal motor manifestation of Parkinson's disease (PD) is being treated with greater and greater efficacy with both newer medications as well as both subthalamic nucleus (STN) and globus pallidus internus (GPI) deep brain stimulation (DBS). The burden of disease is shifting towards the non-dopaminergic disease manifestations including gait and posture. Based on evidence in the literature and in animal models, recent trials are underway to examine the effects of pedunculopontine nucleus DBS on the treatment of parkinsonian gait disorder. We review the rationale behind this treatment and the status of the current trials.
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Journal of neurology · Aug 2008
Clinical TrialMechanisms of unilateral STN-DBS in patients with Parkinson's disease : a PET study.
Bilateral symptoms and signs of Parkinson's disease (PD) are often improved by unilateral subthalamic nucleus deep brain stimulation (STN-DBS). However, the mechanism for such bilateral effects is unknown. This study was intended to examine effects of unilateral STN-DBS using positron emission computed tomography (PET) and to elucidate mechanisms for bilateral improvement achieved by unilateral stimulation. ⋯ Ipsilateral thalamic activation might induce ipsilateral motor cortical activation, which explains the improvement of contralateral limb symptoms. Furthermore, deactivation of the contralateral GPi might disinhibit the thalamus and contralateral motor cortex, which explains reduction of ipsilateral limb symptoms. These results suggest the mechanisms for bilateral improvement achieved by unilateral DBS.
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Journal of neurology · Jun 2008
Randomized Controlled Trial Multicenter StudyEvaluating the efficacy of acupuncture in defined aspects of stroke recovery: a randomised, placebo controlled single blind study.
To investigate the efficacy of acupuncture on stroke recovery compared to an inert placebo. ⋯ Acupuncture did not demonstrate specific efficacy over placebo and both groups did as well as normally expected with this condition.
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Journal of neurology · Jun 2008
Lipid profile, statin use, and outcome after intravenous thrombolysis for acute ischaemic stroke.
Low cholesterol levels have been associated with an increased risk of haemorrhagic stroke. This study investigated whether lipid levels or prior statin use influence outcome in patients with acute ischaemic stroke treated with IV thrombolysis. ⋯ High admission triglyceride levels were independently associated with a higher risk of sICH, but were not associated with a reduced chance of a favourable functional outcome at 3 months. Total cholesterol levels, LDL levels and statin use had no influence on both the occurrence of sICH or functional outcome.