Journal of neurology
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Journal of neurology · Mar 2007
Comparative StudyClinical-diffusion mismatch defined by NIHSS and ASPECTS in non-lacunar anterior circulation infarction.
Instead of the mismatch in MRI between the perfusion-weighted imaging (PWI) lesion and the smaller diffusion-weighted imaging (DWI) lesion (PWI-DWI mismatch), clinical-DWI mismatch (CDM) has been proposed as a new diagnostic marker of brain tissue at risk of infarction in acute ischemic stroke. The Alberta Stroke Program Early CT Score (ASPECTS) has recently been applied to detect early ischemic change of acute ischemic stroke. The present study applies the CDM concept to DWI data and investigated the utility of the CDM defined by the NIH Stroke Scale (NIHSS) and ASPECTS in patients with non-lacunar anterior circulation infarction. ⋯ Patients with CDM had high rate of early neurological deterioration and lesion growth. CDM defined as NIHSS>or=8 and DWI-ASPECTS>or=8 can be another marker for detecting patients with tissue at risk of infarction, but more work is needed to clarify whether this CDM method is useful in acute stroke management.
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Journal of neurology · Mar 2007
Randomized Controlled Trial Clinical TrialNeck pain in chronic whiplash syndrome treated with botulinum toxin. A double-blind, placebo-controlled clinical trial.
Neck pain in chronic whiplash syndrome is a major burden for patients, healthcare providers and insurance companies. Randomized data on treatment of botulinum toxin in chronic whiplash syndrome are scarce. We conducted a randomized, placebo-controlled clinical trial to prove efficacy of botulinum toxin for neck pain in chronic whiplash syndrome. ⋯ Botulinum toxin was not proven effective in treatment of neck pain in chronic whiplash syndrome. Increased muscle tenderness alone might not be the major cause of neck pain in whiplash syndrome.
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Journal of neurology · Feb 2007
Clinical TrialTremor reduction by subthalamic nucleus stimulation and medication in advanced Parkinson's disease.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has proved to be effective for tremor in Parkinson's disease (PD). Most of the recent studies used only clinical data to analyse tremor reduction. The objective of our study was to quantify tremor reduction by STN DBS and antiparkinsonian medication in elderly PD patients using an objective measuring system. ⋯ Thus, with regard to the advanced impact on the other parkinsonian symptoms, STN DBS can replace thalamic stimulation in this cohort of patients. Nevertheless, medication was still effective postoperatively and may act synergistically. The significantly superior efficacy of STN DBS on tremor amplitude and its impact on tremor frequency in contrast to medication might be explained by the influence of STN DBS on additional neural circuits independent from dopaminergic neurotransmission.
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Journal of neurology · Feb 2007
Randomized Controlled Trial Multicenter Study Clinical TrialPatient preference in migraine therapy. A randomized, open-label, crossover clinical trial of acute treatment of migraine with oral almotriptan and rizatriptan.
To assess patient preference for almotriptan 12.5 mg vs rizatriptan 10 mg for the acute treatment of migraine. ⋯ Physicians should use information from meta-analyses and preference studies like this one to aid in the selection of a triptan with a high likelihood of providing rapid, sustained relief from pain coupled with an absence of AEs. About 55% of patients recording a preference in this trial preferred almotriptan, perhaps because of its combination of good efficacy and lower incidence of triptan-associated AEs.