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The image illustrates substrate synthesis inhibition therapy as an approach to lysosomal storage diseases. (Contributed by Dr. John Barranger.)
Neuropharmacology & Neurotherapeutics
Apr. 18, 2021
Neurologic complications of infective endocarditis are due to septic embolism to cerebral arteries, which may result in embolic stroke, infection of vessel walls with mycotic aneurysm or vascular rupture, and extension outside the affected vessel to cause meningitis or brain abscess. Rapid diagnosis and early antibiotic intervention remain the mainstays to avoid neurologic complications.
Aug. 19, 2020
Acute pandysautonomia is characterized by acute onset of severe and disabling autonomic failure affecting sympathetic, parasympathetic, and enteric functions. Other portions of the nervous system may be involved less frequently: brain, somatic sensory, and rarer motor nerve fibers. Initial nonspecific symptoms of lethargy and fatigue are followed by autonomic symptoms: orthostatic lightheadedness and orthostatic hypotension leading to vasovagal syncope, blurring of vision, abdominal distension, pain, and dryness of eyes, voiding difficulty with or without nocturia or urinary retention, and various degrees of anhidrosis may coexist.
Nov. 09, 2020
Neurogastroenterology is defined as the neurology of the gastrointestinal tract, liver, gallbladder, and pancreas and encompasses control of digestion through the enteric nervous system, the central nervous system, and integrative centers in sympathetic ganglia. It primarily covers diseases of the intrinsic enteric nervous system, "brain of the gut," which is a part of the nervous system and controls motility, endocrine secretions, and microcirculation of the gastrointestinal system.
Nov. 10, 2020
Neuro-Ophthalmology & Neuro-Otology
Headaches, transient visual obscurations, and pulsatile tinnitus are the most frequent early manifestations of idiopathic intracranial hypertension (IIH) in adults. Untreated, it can result in optic nerve injury, visual field defects, and blindness. The manifestations of IIH in children differ from those in adults and include asymptomatic papilledema, prominent neck or back pain, diplopia, torticollis, and other focal neurologic signs.
Sep. 02, 2019
HTLV-1 associated myelopathy is a progressive inflammatory myelopathy that typically evolves over decades. Typical features include spastic paraparesis typified by early bladder dysfunction, neuritic pains in the low back and legs, and frequent subtle lower motor neuron findings. Brain and cord MRI with serology and PCR will make the diagnosis. There is only symptomatic treatment for inflammation and spasticity, but no specific etiologic treatment.
Oct. 15, 2020
Swallow syncope is caused by stimulation, irritation, or dysfunction of the afferent origin of a vagovagal reflex (eg, the distal esophagus), the vagus nerve itself, or the efferent target of the vagovagal reflex (ie, the heart). It is frequently triggered by liquids, particularly cold, carbonated beverages, and may occur within 3 to 5 seconds of swallowing. Many bouts result only in presyncope, with associated visual greyout or tunnel vision.
Oct. 21, 2020
Patients with new spinal cord injuries have unique challenges that are best addressed in an inpatient rehabilitation setting. The patient’s functional goals should be based on their level of injury. There are multiple medical issues the physician should evaluate and patients should familiarize themselves with, including pain, spasticity, neurogenic bowel or bladder, pressure injuries, autonomic dysreflexia, and pulmonary compromise.
Jun. 14, 2021