Possible Causally Effective Methods in Case of Multiple Sclerosis

It is wellknown that diagnosis and therapy of Multiple Sclerosis (MS) are not optimal so far, they need improvement. We present a diagnostic parameter and two therapeutic methods that offer a prospect of success without burdening the patient. They are the biomarker Nf-L for the evaluation of the status of the lesions of the neural axons and the application of two treatment methods of endogenous origin: PEA (N-Palm...

An Update on Targeting the Interlinked Epigenetic and Gut Microbiome Alterations in Autism through Diet and Pro/Prebiotics

Autism and Autism Spectrum Disorders (ASD) have complex etiologies as both genetic and environmental factors such as maternal infection, gut microbiome alterations, contaminants/toxins are involved in their pathogenesis and progression mainly through epigenetic modifications. Owing to the importance of gut microbiome in controlling the gut barrier permeability, reduced integrity of the gastrointestinal barrier and...

Case Report: Spindle Coma in a Girl with Cerebral Rabies Treated with the Milwaukee Rabies Protocol

Rabies has the highest case fatality rate of any human infectious disease. While there has been a recent increase in the incidence of rabies in the United States, detailed reports on cerebral rabies (CR) are rare. Since 2004, initiation of the Milwaukee Rabies Protocol (MRP) has enabled some patients to survive CR. The MRP requires placing the patient in an induced coma, necessitating continuous video electroencep...

The Incidence of Depression is one of the Neurological Manifestations in Patients with Brucellosis

Introduction: Brucellosis is a multi-aspect and complicated ailment that may present a wide range of clinical appearances. The main objective of this study was to determine depression as a neuropsychiatric sign in patients with brucellosis. One hundred with depression in the case group and 100 patients without depressive symptoms in the control group were selected and included. The Hamilton Depression Rating Scale...

Prospective Analysis of Application Reasons of Alzheimer's Patients Applying to the Emergency Department

Objective: The aim of this study is to analyze the reasons for admission of Alzheimer's patients who applied to the emergency services. Materials and Methods: The study was conducted prospectively on patients with Alzheimer's disease who applied to the emergency departments of Bursa Uludag University Health Application and Research Center, Health Sciences University Bursa Yüksek İhtisas Training and Research Hospi...

Management and Assessment of the Patient with Refractory Epilepsy: Some Considerations

Introduction: Pharmacological resistance in patients with epilepsy is a major problem, with devastating consequences, implying a poor prognosis, including mortality. In this article we will specify the conceptual aspects of refractoriness in epilepsy and the necessary considerations in the pre-surgical clinical evaluation of patients who may be candidates for surgery. Methods: For its elaboration, the Google Acade...

Unconventional Therapies in Super-Refractory Status Epilepticus

Status Epilepticus (SE) is a neurological emergency with high mortality and morbidity, despite having a well-defined initial therapeutic approach. In up to 40% of cases, SE is resistant to conventional therapy, namely antiseizure medications. This resistance to treatment can be to antiseizure medications alone, leading to Refractory Status Epilepticus (RSE), or to their combination with anesthesia in the case of S...

A Dancing and Rhythmic Epilepsy. A SEEG Case Report

Background: Recognizing ictal semiology is essential to identify the epileptogenic zone, particularly in refractory epilepsy where its correct identification is what determines the surgical prognosis. Dancing is a very unusual ictal semiology and its underlying neural networks remain somehow unclear since both the temporal and the frontal lobe have been implicated in its genesis. Methods: We present a 21-year-old...

On Childhood Vaccinations, Autism and Parental Opinion

Both genetic contributions and environmental factors are considered as being contributory to the etiology of autism spectrum disorder. Childhood vaccinations have for decades been blamed for causing autism, although in a very small number of children. The claim that vaccines against diphtheria and measles-mumps-rubella caused autism has been rejected outright. The last claim of vaccination being linked to autism w...

General Aspects of Therapeutics in the Patient with Epilepsy

After the diagnosis of epilepsy, before defining the behaviour to follow, the doctor must take into account a series of general principles, which, if not fulfilled, will result in the control or not of the epileptic seizures, which is why it is significant importance that they are listed and known, with the aim of improving the quality of life of patients. These aspects include the objectives of drug treatment, pa...

Food Selectivity in Children on the Autism Spectrum: Evidencing the Effectiveness of Behavior Analytic Interventions

Food selectivity is a major cause for concern for many children on the autism spectrum, with some children’s diet restricted to one or two food sources only, such as a child only eating yoghurt or anther chid only eating potato chips. A systematic literature review was conducted to establish the effectiveness of behaviour analytic interventions that target introducing variety into the diet of these children. A tot...

Interaction of Contralateral Activation Maneuver and Dopaminergic Medication on Neural and Non-Neural Contributions to Parkinsonian Rigidity

Introduction: Rigidity is a cardinal symptom of Parkinson Disease (PD) and is defined as increased resistance to passive motion. Rigidity results from the interaction of exaggerated responses to passive stretch and shortening as well as changes to the intrinsic properties of muscle and connective tissues. A contralateral activation maneuver is used clinically to increase perceived rigidity to facilitate the diagno...

Vascular Epilepsy

Seizures can be a presenting feature of acute stroke. They may complicate its early clinical course or be a late complication or sequela. The incidence of combined “early” and “late” seizures after stroke has been reported to be approximately 10% and the prevalence is between 2-4%. Mechanisms leading to poststroke seizures and chronic epilepsy in both ischemic and hemorrhagic strokes are diverse. Focal slowing or...

Deep Brain Stimulation Improves Lower Extremity Coordination and Coordination Variability in Individuals with Parkinson’s Disease

Deep Brain Stimulation (DBS) is associated with vast improvements in the motor symptoms of Parkinson’s disease. Recent evidence has identified improvements in movement complexity during treadmill walking in response to DBS. However, the effects of DBS on intra-limb coordination during gait have not been well elucidated. This study investigated changes in intra-limb ankle and knee joint coordinative patterns during...

Social, Ethical and Economic Challenges in Managing Pediatric Epilepsy in Developing Countries

Epilepsy is one of the chronic disabling neurological disorder which significantly impact social, cultural, and economic aspects of the family and the society. The important challenges in the management of pediatric epilepsy include delayed diagnosis, costly treatment, weight-based drug dosage, consideration as a social stigma, and a need for regular follow-up visits. Although there has been significant improvemen...

Rodent Models of Neonatal Brain Oxygen Deprivation

The oxygen deprivation at birth leads to hypoxic-ischemic encephalopathy, a serious condition responsible for high mortality index and long-term disabilities in the survivors. There are not known efficient therapeutic strategies to prevent or minimize the sequelae, and there is need of reliable and replicable animal models those represent this condition in its molecular, cellular and behavioral particularities. He...

Approach to the Management of Refractory Epilepsy

Epilepsy is a global public health problem. It affects 1-2% of the population. Between 70-80% of all patients with epilepsy are controlled with medical treatment and 20- 30% are chronic refractory, which is considered refractory / drug-resistant epilepsy. 5-10% of these are candidates for surgery. Drug resistance is a major problem for the patient, with devastating consequences, which include persistence of seizur...

Integral Approach to the Management of the Patient with Epilepsy

Epilepsy is a disease considered as old as humanity itself and is for some the second neurological disease. The most frequent age of onset is childhood and adolescence and there are multiple treatments established to date. It is a disease associated with the psychological and social sphere of the patients who suffer from it, with a consequent stigmatization and discrimination against them. It is considered, in tur...

Natural Selection presupposes Autism

All of biology is based on natural selection. The latter in turn is based on the presence of autism. Only a single species has shed autism so far thereby losing its safe place in evolution: the human one. This fact raises the question of whether or not it is ethically allowed and advisable to kiss a member of a different species awake into the same emancipation from natural selection, by nudging her into becoming...

Complexities of Delirium in COVID-19: A Case Series

Since the onset of the COVID-19 pandemic in December 2019, the world is rapidly learning about the variable presentations of the novel coronavirus (SARS-CoV-2). While the initial focus was on respiratory symptoms and sequelae of the virus, there are now a growing number of reports that are describing neuropsychiatric complications of SARS-CoV-2, including delirium. The management, treatment, and complications of d...

Seizures Induces Hypoxia and Hypoxia Induces Seizures. A Perverse Relationship that Increases the Risk of SUDEP

“He uttered a cry and was seen to be rubbing his hands together. His pulse was immediately examined for but was not palpable” [1]. Hypoxia is a biological stimulus capable of promoting both rescue and survival mechanisms, as well as triggering a sequence of irreversible events that lead to death of cell, tissue and even individual. Brain and heart functions depend critically on adequate energy supply and they are...

Effects of Fluoxetine on Memory Processes in Rats with different Phenotypes of the Nervous System and different Levels of Biogenic Monoamines of the Brain

Background: Seizures formed in response to a sound in rats allows studying the mechanisms of both occurrence of pathological seizure activity and anti-seizure effects of new medications. Contemporary antidepressants are targeted at enhancing the level of the main neurotransmitters in the brain. One of the important biochemical factors forming mixed anxiety-depressive disorders is serotonin (5-HT). Deficiency of 5-...

Epilepsy in Children Diagnosed with Attention Deficit/Hyperactivity Disorder

Attention Deficit/Hyperactivity Disorder is one of the most common neurodevelopmental disorders seen in child and adolescent psychiatry practice. In addition to its negative effects on the psychological, academic and social development of the child, in case of a comorbidity, response to treatment and prognosis may be negatively affected. This study presents prevalence, clinical presentation and treatment options i...

A Case Report of Angelman Syndrome

We describe a case of a female pediatric patient showing recurrent seizures, socialization problems and speech development delay. She was born preterm, due to fetal heart rate alterations and spent a few days in neonatal intensive care. She has presented evolutionary global neurodevelopment delay and from the first year of life, she presented sleep disorders referred to as difficulties in initiating sleep and freq...

Anti-Seizure Effects of Fluoxetine on Rats with Susceptibility to Audiogenic Seizures

Background: Seizures formed in response to a sound in rats allows studying the mechanisms of both occurrence of pathological seizure activity and anti-seizure effects of new medications. Contemporary antidepressants are targeted at enhancing the level of the main neurotransmitters in the brain. One of the important biochemical factors forming mixed anxiety-depressive disorders is serotonin (5-HT). Deficiency of 5-...

Electroclinical Profile and Outcomes in Extratemporal Lobe Epilepsy Surgery Based on Intraoperative Electrocorticography

Objective: To present pre and postsurgical electroclinical profile in extratemporal lobe epilepsy patients (ExTLE). Thirty-one patients with pharmacoresistant Ex TLE underwent comprehensive presurgical evaluations including multimodal neuroimaging as well as surgical resective and/or disconnective procedures tailored by sequential intraoperative Electrocorticography (ECoG). Postsurgical electroclinical outcome ass...

Eye-of-the-Tiger-Sign Caused by Mixed Organic Solvents

A 68-year-old male presented to the neurology clinic with an extrapyramidal syndrome and cognitive complains years after exposure to mixed organic solvents. Exam showed parkinsonism and frontal lobe deficits. Extensive laboratory testing was unrevealing including gene sequencing for neurodegeneration with brain iron accumulation. Neuroimaging revealed symmetric lesions of the Globus pallidus consistent with Eye-of...

Kernohan’s Notch Syndrome in Acute Subdural Hematoma Secondary to Ruptured Middle Cerebral Artery Aneurysm

An 82 year old male was brought unconscious to the Emergency Department (ED). On examination, he was found to have a Glasgow Coma Scale (GCS) score of 6 (E1M4V1), with increased tone and hyperreflexia in the right arm and right leg. CT scan of the brain showed a large right sided Subdural Hematoma (SDH) and a Subarachnoid Hemorrhage (SAH) in the suprasellar cistern and Sylvian fissure. An aneurysm of the right mid...

Partial Human Kluver-Bucy Syndrome Secondary to Right Frontal Arterio-Venous Malformation (AVM) Resection

A 67-year-old right-handed male developed apathy, alcohol abuse, episodes of indecent exposure and visual agnosia after right frontal AVM resection. Neuropsychological testing revealed frontal lobe dysfunction. MRI FLAIR imaging revealed signal attenuation in the right frontal lobe (Figures 1A-C). EEG showed no seizure activity. Kluver-Bucy syndrome is a constellation of neuropsychiatric symptoms, classically asso...

Radiotherapy of Skull Base Meningioma: Radiological Efficacy and Tumor Volume Kinetic

Purpose: To compare 4 methods of quantitative measurements of the radiological response after irradiation of skull base meningiomas. Methods and Materials: Radiological and clinical data from 35 patients treated between January 2009and 2014were reviewed. Most of the lesions were localized in the cavernous sinus (60%). Patients were treated either with fractionated stereotactic radiation therapy (54%) or helicoïdal...

Pathology of Early Guillain-Barré Syndrome

Guillain-Barré Syndrome (GBS) is an acute-onset, immune-mediated disorder of the peripheral nervous system, which includes at least four disease patterns: Acute Inflammatory Demyelinating Polyneuropathy (AIDP), acute motor axonal neuropathy, acute motor-sensory axonal neuropathy, and Fisher’s syndrome. The aim of this paper was to analyze the pathologic background of early GBS, arbitrarily established up to 10 day...

Ion Channel Dysfunction and Altered Motoneuron Excitability in ALS

Dysregulated excitability is a hallmark of Amyotrophic Lateral Sclerosis (ALS) pathology both in ALS research models and in clinical settings. This primarily results from the dysfunction of Na+, K+, and Ca2+ ion channels responsible for maintaining neuronal thresholds and executing signal transduction or synaptic transmission. The exact dysfunction that each of these ion channel currents display in ALS pathology c...

Dietary Patterns in Mexican Patients With Multiple Sclerosis A Study of Cases and Controls

Introduction: Multiple sclerosis is a demyelinating disease of the central nervous system. Various nutritional factors appear to be involved in the incidence and progression of the disease. Objective: Identify dietary patterns in patients with multiple sclerosis. Methods: An analysis of cases and controls was performed in the study "Risk factors associated with multiple sclerosis in Mexico: multicenter study" cond...

Increasing Physical Activity in Youth with Autism and Other Developmental Disabilities in Physical Education

Youth with Developmental Disabilities (DD) are less active and more sedentary than their typically developing peers.The purpose of this study was to investigate differences in time spent sedentary and in moderate-to-vigorous physical activity (MVPA) in youth with DD during Physical Education (PE) versus the Fitness Fun zone (FFZ)®. Twenty-three children (8-17 years) were observed during PE and FFZ on 20 non-consec...

Status Epilepticus Complicating Anti-Ma2 Antibody Associated Paraneoplastic Autoimmune Encephalitis

Anti-Ma2 antibody associated paraneoplastic autoimmune encephalitis is a rare condition characterized by a clinical syndrome of neuropsychiatric deficits and seizures. We describe a patient with this condition who despite delay in initial diagnosis, was successfully treated with immunotherapy and removal of a testicular seminoma, but unusually developed status epilepticus after a period of remission. This case hig...

Challenges in Sensory Integration and Processing in the Child with Wolf-Hirschhorn Syndrome

Challenges in sensory integration and processing occur when the central nervous system is not able to adequately detect, interpret and respond to sensory information captured by the various sense organs. Difficulty integrating and processing sensory information adequately, impacts environmental interaction and the capacity to respond effectively to external stimuli and sensory input from one's own body. The presen...

Cost Effectiveness of ADHD Treatment from Childhood to Adulthood

There are well known behavioral complications of ADHD at childhood adolescence and adulthood, among them are: learning difficulties resulting in lower education attainments, increased rate of car and other accidents, increased prevalence of substance abuse, misconduct and imprisonment. These complications can be prevented or alleviated by early diagnosis of ADHD and effective treatment. In this mini-review we desc...

Ethical and Legal Issues in Deep Brain Stimulation: An Overview

As a treatment approved and certified for certain neurological diseases, Deep Brain Stimulation (DBS) sometimes produces spectacular results quickly. It is also a powerful research tool in neurology and psychiatry. It combines a highly technical surgical procedure with a complex active medical device that acts on the brain, the substratum of human thought and identity. It raises several ethical and legal questions...

Identification of Responders for Pain Treatments: Did we find the Holy Grail?

Recent focus in pain research is to phenotype and genotype patients with the aim to better target therapies. Until now, no major breakthroughs are presented in this field. The pathophysiology of pain due to polyneuropathy partly may reside in the skin. Polyneuropathy is usually symmetrical, and the same holds true for pain intensity in both feet. Therefore, topical analgesics present an interesting treatment optio...

Endocrine Disruptors and Autism Spectrum Disorder in Pregnancy: A Review of the Epidemiological Evidence

Exposure to environmental contaminants during pregnancy has been linked to adverse health outcomes later in life. Notable among these pollutants are the endocrine disruptors chemicals (EDCs), which are ubiquitously present in the environment and have been measured and quantified in the fetus. In this systematic review, our objective was to summarize the epidemiological research on potential association between pre...

Gender, Psychiatric and Cognitive Status Related to Experiential Auras in Patients with Temporal Lobe Epilepsy

Objective: To determine whether the experiential auras in patients with temporal lobe epilepsy (TLE) are related to gender, psychiatric comorbidity, material-specific memory impairment, lateralization by video-EEG and structural neuroimaging abnormalities. Material and methods: Retrospective review (1998-2015) of clinical charts and video-EEG of patients with TLE and experiential auras followed at the JM Ramos Mej...

Neurofibromatosis Type-1 and Diffuse Intracranial Dolichoectasia

Dolichoectasia implies abnormal elongation, dilation and tortuosity of arteries, and in the cranial vasculature the vertebrobasilar circulation is predominately affected. Neurofibromatosis type1 (NF-1) predisposes to dolichoectasia. We describe a patient with NF-1 and a unique pattern of symptomatic dolichoectasia involving the intracranial internal carotid, middle cerebral, vertebral and basilar arteries.

Klippel-Feil Syndrome and Thoracic Outlet Syndrome

Klippel–Feil Syndrome (KFS) is a rare disease that was firstly described in 1912 by Maurice Klippel and Andre Feil. It is a bone disorder recognized by the abnormal fusion of two or more spinal bones, it seem in the cervical vertebrae. It has three major features which are short neck, limited age of motion in the cervical spine and low hairline at the beck [1]. We report the case of a 26-year-old male patient was...

Neurogenic Speech Disorders Rehabilitation: A Dosage Quest

In neurospeech rehabilitation, compensation for loss of function takes place through reorganization and renovation of neural connections over repeated practice. Rehabilitation of motor speech skill lost to brain damage entails neuroplasticity, the brain’s capacity to remodel itself as a response to training. A critical point in neurospeech treatment protocol involves exercising quantification, translated as freque...

Automated Prescription and Reconstruction of Brain MR Spectroscopy Data for Rapid Integration into the Clinical Workflow

Objectives: To implement and evaluate a fast, automated, end-to-end brain MR Spectroscopy workflow for rapid integration of metabolic parameters into clinical care. Materials and methods: An automated and reproducible atlas-based prescription for single and multi-voxel MR spectroscopy (MRS) data has been developed and combined with an online reconstruction that enables DICOM MRS results to be generated and sent to...