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San Diego, CA 92108-2134
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(Contributed by Dr. Joseph Berger.)
Apr. 09, 2021
Stroke & Vascular Disorders
Prevention of stroke and transient ischemic attack includes blood pressure lowering, cholesterol reduction with statins, smoking cessation, and antiplatelet therapy, and more specific interventions, such as carotid revascularization or anticoagulation for atrial fibrillation.
Jul. 21, 2021
Acute spinal epidural abscess presents with severe focal pain, followed by radicular pain, followed by signs of spinal cord compression; whereas the most common presentation of chronic epidural abscess is that of a compressive lesion, sometimes with minimal pain. It consists of loculated infection within the fat-filled space that separates the spinal dura and arachnoid, and delay in diagnosis and treatment may result in death or profound, irreversible neurologic impairment.
Apr. 03, 2021
Meningococcemia presents abruptly with fever, chills, nausea, vomiting, headache, breathing difficulty, myalgias, malaise, prostration, and rash, which may rapidly progress to purpura fulminans, shock, and death. Outbreaks are particularly likely to occur in semiclosed communities with close quarters. Antibiotic therapy should be rapidly initiated when meningococcal disease is suspected.
Dec. 07, 2004
Generalized neuromyotonia is usually an autoimmune disease characterized by widespread muscle stiffness and delayed muscle relaxation after voluntary movement. It is accompanied by continuous muscle twitching known as myokymia. Both conditions are typically related to disorders of the voltage-gated potassium channel and caused by autoimmune, toxic, or genetic processes. Whereas neuromyotonia is specific to these disorders, myokymia can be seen in many neurologic conditions.
May. 03, 2021
Jul. 08, 2021
Endocannabinoid receptors are found throughout the CNS, with postsynaptic cannabinoid ligands that act presynaptically on endocannabinoid receptors, which appears to function as a negative feedback system. Multiple sclerosis has the most robust evidence for the efficacy of cannabis, and there is some research suggesting cannabis may suppress seizures in epilepsy, with some clinical trials suggesting benefit in specific pediatric epilepsy syndromes.
Oct. 12, 2020
Joubert syndrome is a malformation syndrome affecting brainstem and cerebellum, resulting in early hypotonia, subsequent truncal ataxia, delayed milestones, and, finally, cognitive impairment of varying degrees. Molar tooth sign is the diagnostic neuroimaging finding on axial cuts through the midbrain/hindbrain region. Some mutations (in particular NPHP1, C5orf42, autosomal recessive SUFU variants) tend to be associated with a mild molar tooth, which may be easily overlooked.
May. 21, 2021