1,483 results match your criteria Confusional States and Acute Memory Disorders


Assessment of Instruments for Measurement of Delirium Severity: A Systematic Review.

JAMA Intern Med 2018 Dec 17. Epub 2018 Dec 17.

Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts.

Importance: Measurement of delirium severity has been recognized as highly important for tracking prognosis, monitoring response to treatment, and estimating burden of care for patients both during and after hospitalization. Rather than simply rating delirium as present or absent, the ability to quantify its severity would enable development and monitoring of more effective treatment approaches for the condition.

Objectives: To present a comprehensive review of delirium severity instruments, conduct a methodologic quality rating of the original validation study of the most commonly used instruments, and select a group of top-rated instruments. Read More

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December 2018

The neurophysiological and neurochemical effects of alcohol on the brain are inconsistent with current evidence based models of sleepwalking.

Authors:
Mark R Pressman

Sleep Med Rev 2018 Nov 10;43:92-95. Epub 2018 Nov 10.

Sleep Medicine Services, Lankenau Medical Center, Wynnewood, PA, USA; Lankenau Institute for Medical Research, Wynnewood, PA, USA; Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA; Charles Widger School of Law, Villanova University, Villanova, PA, USA. Electronic address:

The DSM-5 and ICSD-3 have removed alcohol from the list of potential triggers for sleepwalking due to the lack of empirical evidence. Recent imaging and EEG based studies of sleepwalking and confusional arousals have provided a more data-based method of examining if alcohol is compatible with what is known about the neurophysiology and neurochemistry of sleepwalking. These studies have demonstrated a deactivation of the frontal areas of the brain, while the cingulate or motor cortex remains active and characterized activation in the form of beta EEG. Read More

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November 2018
2 Reads

De novo absence status epilepticus in three paediatric patients: a new idiopathic epilepsy syndrome?

Epileptic Disord 2018 Dec 10. Epub 2018 Dec 10.

Hospital de Pediatría "La madre y el Niño", Formosa, Argentina.

Absence status epilepticus (ASE) is a prolonged generalized absence seizure that usually lasts for hours and can even last for days. The main symptom is the altered content of consciousness while the patient may be alert and partly responsive. We describe the electroclinical features, treatment, and evolution of three paediatric patients with de novo ASE with an excellent response to valproic acid (VPA). Read More

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December 2018

Atypical MRI presentation of posterior reversible encephalopathy syndrome with predominant brainstem involvement.

Acta Neurol Belg 2018 Nov 29. Epub 2018 Nov 29.

Department of Neurology, Rouen University Hospital and University of Rouen, 76031, Rouen Cedex, France.

We report here the case of a 80-year-old woman for the assessment of an acute confusional state since 2 days asssociated with diffuse and gradual headache. Brain MRI disclosed isolated hyperintense signal on fluid-attenuated inversion recovery sequence involving the medulla and the right inferior cerebellar peduncle with moderate swelling, consistent with vasogenic oedema, without abnormalities on diffusion-weighted imaging sequence. PRES diagnosis was suspected and antihypertensive therapy was introduced to achieve a blood pressure goal < 140/90 mmHg, allowing a quickly favourable clinical course. Read More

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November 2018
2 Reads

Limbic encephalitis: Experience of a moroccan center.

Brain Behav 2018 Nov 25:e01177. Epub 2018 Nov 25.

Department of Neurology, Hassan II University Teaching Hospital, Fez, Morocco.

Objectives: Histologically defined as an inflammation-degeneration of limbic structures, limbic encephalitis (LE) is a rare disease and often difficult to diagnose particularly in institutions with limited access to laboratory tests such as antineuronal antibodies or HSV-PCR, and functional imaging. We aimed to describe the demographic, clinical, paraclinical, and etiological features of LE, as well as its medium-term prognosis in Moroccan patients.

Materials And Methods: We collected retrospectively all patients diagnosed with LE in the Department of Neurology of the University Hospital Hassan II of Fez (Morocco) between September 2008 and December 2016. Read More

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November 2018
5 Reads

Sleep-related Eating Disorder in a Patient with Parkinson's Disease.

Cureus 2018 Sep 22;10(9):e3345. Epub 2018 Sep 22.

Neurology, University of Missouri, Columbia, USA.

Sleep disorders constitute a major aspect of the non-motor symptoms of Parkinson's disease (PD). Rapid eye movement (REM) behavior disorders are the most frequently experienced parasomnias in patients with PD. Non-REM sleep disorders like confusional arousals, sleep terrors, sleepwalking, and sleep-related eating disorder (SRED) are also associated with PD. Read More

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September 2018
4 Reads

Elevation of serum anti-glucose-regulated protein 78 antibodies in neuropsychiatric systemic lupus erythematosus.

Lupus Sci Med 2018 10;5(1):e000281. Epub 2018 Oct 10.

Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Sagamihara, Japan.

Objective: Recent studies have demonstrated that autoantibodies directed against glucose-regulated protein 78 (GRP78) on endothelial cells promote blood-brain barrier (BBB) damages. The present study examined whether serum anti-GRP78 antibodies might be involved in the pathogenesis of neuropsychiatric SLE (NPSLE).

Methods: Serum samples were obtained from 129 patients with SLE (58 patients with diffuse psychiatric/neuropsychological syndromes of NPSLE (diffuse NPSLE), 30 with neurological syndromes (focal NPSLE), 21 with lupus nephritis (LN), 20 without NPSLE or LN (SLE alone)), from 35 patients with non-SLE rheumatic diseases (non-SLE RD) and from 24 healthy controls (HC). Read More

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October 2018
4 Reads

Confusional state in a pregnant woman: A case of NMDA receptor encephalitis during pregnancy.

J Neuroimmunol 2018 Dec 19;325:29-31. Epub 2018 Oct 19.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

We report the case of a pregnant female presenting with behavioral change and hallucinations followed by focal seizures with impaired awareness. EEG revealed generalized slowing interspersed with extreme delta-brush pattern and MRI brain was normal. Both Serum and CSF anti-N-methyl-d-aspartate receptor (NMDAR) antibodies were positive. Read More

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December 2018
4 Reads
2.470 Impact Factor

Peri-lead edema after deep brain stimulation surgery for Parkinson's disease: a prospective magnetic resonance imaging study.

Eur J Neurol 2018 Oct 25. Epub 2018 Oct 25.

U.O. Neurofisiopatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.

Background And Purpose: The aim of this study was to define the prevalence and characteristics of peri-electrode edema in a prospective cohort of patients undergoing deep brain stimulation (DBS) surgery and to correlate it with clinical findings.

Methods: We performed brain magnetic resonance imaging (MRI) between 7 and 20 days after surgery in 19 consecutive patients undergoing DBS surgery for Parkinson's disease. The T2-weighted hyperintensity surrounding DBS leads was characterized and quantified. Read More

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October 2018
8 Reads

Video polysomnographic findings in non-rapid eye movement parasomnia.

J Sleep Res 2018 Oct 8:e12772. Epub 2018 Oct 8.

Sleep Disorders Centre, Guy's Hospital, London, UK.

Although video polysomnography (vPSG) is not routinely recommended for the evaluation of typical cases of non-rapid eye movement (NREM) parasomnias, it can aid diagnosis of unusual cases, other sleep disorders and complicated cases with REM behaviour disorder (RBD), and in differentiating parasomnias from epilepsy. In this study, we aimed to assess vPSG findings in consecutive patients with a clinical diagnosis of NREM-parasomnia covering the whole phenotypic spectrum. Five hundred and twelve patients with a final diagnosis of NREM parasomnia who had undergone vPSG were retrospectively identified. Read More

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October 2018
2 Reads

180-day risk of mortality in older patients admitted to short-stay units: the 6-Month Short-Stay Unit (6M UCE) Score.

Emergencias 2018 10;30(5):315-320

Coordinación del Grupo URGUCE SEMES.

Objectives: To develop a multidimensional score to assess risk of death for patients of advanced age 180 days after their admission to short-stay units (SSUs).

Material And Methods: Prospective, multicenter, observational and analytical study of a cohort of patients aged 75 years or older who were admitted to 5 Spanish SSUs between February 1 and April 30, 2014. We recorded demographic and clinical data as well as geriatric assessment scores. Read More

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October 2018
1 Read

Atypical development of neurosyphilis mimicking limbic encephalitis.

Int J STD AIDS 2018 Sep 26:956462418797873. Epub 2018 Sep 26.

1 Brain Research Laboratory, Department of Neurology, Ziv Medical Center, Safed, Israel.

A previously healthy 35-year-old man suffering from behavioral and mental deterioration for three months was referred to our facility. On admission, the patient was dysphasic and had tonic-clonic seizures. Neurological examination showed mental confusion, euphoric mood, mania, paranoia, and mild motor dysphasia. Read More

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September 2018
10 Reads

Neurologic adverse events in patients with relapsed/refractory acute lymphoblastic leukemia treated with blinatumomab: management and mitigating factors.

Ann Hematol 2018 Sep 20. Epub 2018 Sep 20.

Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany.

Neurologic events (NEs) have been reported during treatment with blinatumomab, a bispecific T cell engager (BiTE®) construct. We evaluated the occurrence, severity, and management of NEs; the relationship between NEs and blinatumomab dose; and the potential clinical risk factors in an open-label, single-arm, phase 2 study (N = 189). Patients had Philadelphia chromosome-negative, relapsed/refractory acute lymphoblastic leukemia (ALL) and ≥ 10% bone marrow blasts. Read More

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September 2018
6 Reads

Increase in Risk of Acute Confusional State in Dementia Patients.

Authors:
Torsten Kratz

Dtsch Arztebl Int 2018 Sep;115(35-36):594

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September 2018
1 Read

Parasomnia versus epilepsy: An affair of the heart?

Neurophysiol Clin 2018 Oct 15;48(5):277-286. Epub 2018 Sep 15.

NeuroPain Team, Inserm U 1028/CNRS, UMR 5292, University of Lyon, Lyon Neuroscience Research Centre (CRNL), 69677 Bron, France.

Objective: Differential diagnosis between sleep-related epileptic seizures and NREM parasomnia remains challenging. Pathophysiological markers to differentiate both conditions are needed. Activation of autonomic system is present in arousal reactions and epileptic seizures. Read More

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October 2018
1 Read

The Co-Occurrence of Sexsomnia, Sleep Bruxism and Other Sleep Disorders.

J Clin Med 2018 Aug 23;7(9). Epub 2018 Aug 23.

Department of Experimental Dentistry, Wroclaw Medical University, 50-367 Wroclaw, Poland.

Background: Sleep sex also known as sexsomnia or somnambulistic sexual behavior is proposed to be classified as NREM (non-rapid eye movement) parasomnia (as a clinical subtype of disorders of arousal from NREM sleep-primarily confusional arousals or less commonly sleepwalking), but it has also been described in relation to REM (rapid eye movement) parasomnias.

Methods: The authors searched the PubMed database to identify relevant publications and present the co-occurrence of sexsomnia and other sleep disorders as a non-systematic review with case series.

Results: In the available literature the comorbidity of sexsomnia and other sleep disorders were reported mainly in case reports and less in case series. Read More

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August 2018
16 Reads

Restoration of Balance and Unilateral Hearing Using Alternating and Filtering Auditory Training in Shunt-Treated Hydrocephalus Following Subarachnoid Hemorrhage: A Case Report.

Am J Case Rep 2018 Aug 10;19:935-940. Epub 2018 Aug 10.

Department of Neurology, Neurorehabilitation Unit, South Paris University Hospital, Le Kremlin Bicêtre, France.

BACKGROUND Although rehabilitation for balance disorders is commonly undertaken following a stroke, hearing dysfunction is rarely investigated, even though hearing loss affects the ability to maintain balance. This report presents a case of restoration of balance and unilateral hearing using an alternating and filtering auditory training (AFAT) protocol in a patient with subarachnoid hemorrhage (SAH) and shunt-treated hydrocephalus. CASE REPORT A 54-year-old woman with a five-month history of SAH due to a ruptured aneurysm in the anterior communicating artery and hydrocephalus treated with a shunt was admitted to our unit for neurorehabilitation. Read More

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August 2018
1 Read

Confusional arousals during non-rapid eye movement sleep: evidence from intracerebral recordings.

Sleep 2018 Oct;41(10)

Department of Clinical Neurophysiology, Lille University Hospital, Lille, France.

Study Objectives: Confusional arousals (CA) are characterized by the association of behavioral awakening with persistent slow-wave electroencephalographic (EEG) activity during non-rapid eye movement (NREM) sleep-suggesting that sensorimotor areas are "awake" while non-sensorimotor areas are still "asleep." In the present work, we aimed to study the precise temporo-spatial dynamics of EEG changes in cortical areas during CA using intracerebral recordings.

Methods: Nineteen episodes of CA were selected in five drug-resistant epileptic patients suffering incidentally from arousal disorders. Read More

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October 2018
4 Reads

Delirium and Psychotic Symptoms Associated with Hyperglycemia in a Patient with Poorly controlled Type 2 Diabetes Mellitus.

Innov Clin Neurosci 2018 Jun;15(5-6):30-33

Dr. Lopes is with the Faculty of Medicine at the University of Porto in Porto, Portugal.

Delirium, acute confusional states, and secondary psychosis have been associated with several medical conditions, including endocrine disorders. In the context of diabetes mellitus (DM), it has been mostly related to hypoglycemia and rarely occurs in association with hyperglycemia, outside of the context of a hyperglycemic hyperosmolar state or diabetic ketoacidosis. Here, we describe a case of delirium and psychotic symptoms associated with hyperglycemia in a patient with poorly controlled Type 2 DM as an attempt to alert clinicians to this rare association. Read More

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June 2018
19 Reads

NREM sleep parasomnias as disorders of sleep-state dissociation.

Nat Rev Neurol 2018 Aug;14(8):470-481

Reference National Center for Narcolepsy-Hypersomnia, Sleep Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.

Non-rapid eye movement (NREM) sleep parasomnias (or NREM parasomnias) are fascinating disorders with mysterious neurobiological substrates. These conditions are common and often severe, with social, personal and forensic implications. The NREM parasomnias include sleepwalking, sleep terrors and confusional arousals - collectively termed disorders of arousal (DOAs) - as well as less well-known entities such as sleep-related sexual behaviours and eating disorders. Read More

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August 2018
4 Reads

Insomnia and Mild Cognitive Impairment.

Gerontol Geriatr Med 2018 Jan-Dec;4:2333721418778421. Epub 2018 Jun 1.

East Tennessee State University, Johnson City, TN, USA.

Insomnia is a common problem in older people, especially in patients with mild cognitive impairment (MCI) whose circadian rhythm is often compromised. Insomnia exerts such a toll on caregivers that it is frequently the primary reason for seeking to institutionalize their loved ones. Three different types of insomnia are recognized: sleep-onset or initial insomnia, sleep maintenance or middle insomnia, and early morning awakening or late insomnia. Read More

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June 2018
2 Reads

Driving and Patients With Dementia.

Gerontol Geriatr Med 2018 Jan-Dec;4:2333721418777085. Epub 2018 May 31.

East Tennessee State University, Johnson City, TN, USA.

Driving is a symbol of autonomy and independence, eagerly awaited during adolescence, cherished during adulthood and reluctantly rescinded during old age. It is nevertheless an individual's privilege, not right, especially as driving may affect other drivers and pedestrians on the road. It is therefore not only the individual patient who is at stake but essentially the entire community. Read More

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May 2018
2 Reads

Particulate wear debris osteolysis, acute urinary retention and delirium as late complications of hip arthroplasty.

Age Ageing 2018 Sep;47(5):756-757

Ageing and Complex Medicine Directorate, Salford Royal NHS Foundation Trust, Salford Hospital, Manchester, UK.

Intrapelvic mass formation as a result of particulate wear debris induced osteolysis is a recognised late complication of cementless total hip arthroplasty. Clinical presentation typically involves hip and/or leg pain resulting in functional impairment, and obstructive urinary symptoms developing 3-20 years after surgery. An acute confusional state has never been described in this scenario. Read More

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September 2018
12 Reads

Visual Hallucinations and Paranoid Delusions.

Gerontol Geriatr Med 2018 Jan-Dec;4:2333721418777086. Epub 2018 May 30.

East Tennessee State University, Johnson City, TN, USA.

Visual well-formed hallucinations, fluctuations in the level of cognition, and alertness and extrapyramidal signs are core features of dementia with Lewy bodies. Some patients realize that what they are seeing or hearing are just hallucinations and learn to accept them. Others, however experience these hallucinations as quite real and cannot be dissuaded from the firm belief that they are. Read More

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May 2018
2 Reads

Functional networks reemerge during recovery of consciousness after acute severe traumatic brain injury.

Cortex 2018 Sep 12;106:299-308. Epub 2018 May 12.

Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA. Electronic address:

Integrity of the default mode network (DMN) is believed to be essential for human consciousness. However, the effects of acute severe traumatic brain injury (TBI) on DMN functional connectivity are poorly understood. Furthermore, the temporal dynamics of DMN reemergence during recovery of consciousness have not been studied longitudinally in patients with acute severe TBI. Read More

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September 2018
3 Reads

Transient Central Sleep Apnea Runs Triggered by Disorder of Arousal in a Child.

J Clin Sleep Med 2018 Jun 15;14(6):1075-1078. Epub 2018 Jun 15.

Sleep Research Centre, Oasi Research Institute-IRCCS, Troina, Italy.

Abstract: We report the case of a 5-year-old girl with frequent nocturnal episodes of disorder of arousal (confusional arousals, sleep terrors, and sleep walking), occurring at the end of periods of slow wave sleep, followed by return to sleep accompanied by the occurrence of periodic breathing with a run of approximately 10 to 20 central events. The duration of the central events and oxyhemoglobin desaturation were both maximum at the beginning of each run and became progressively less prominent with the development of the sequences. Night episodes disappeared with bedtime clonazepam but behavioral problems occurred as a paradoxical response; thus, clonazepam was stopped. Read More

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June 2018
14 Reads

Role of serum autoantibodies in blood brain barrier damages in neuropsychiatric systemic lupus erythematosus.

Clin Exp Rheumatol 2018 Nov-Dec;36(6):1003-1007. Epub 2018 May 24.

Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.

Objectives: The present study was carried out to elucidate the roles of serum autoantibodies in the development of blood-brain barrier (BBB) damages in neuropsychiatric systemic lupus erythematosus (NPSLE).

Methods: Paired serum and CSF samples were obtained from 101 SLE patients when they presented active neuropsychiatric manifestations (69 patients with diffuse psychiatric/neuropsychological syndromes [diffuse NPSLE] and 32 patients with neurologic syndromes or peripheral neuropathy [focal NPSLE]). IgG anti-NR2 subunit of NMDA receptor (anti-NR2), anti-Sm, anti-ribosomal P and IgG anti-cardiolipin in sera and albumin in CSF and sera were measured by ELISA. Read More

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May 2018
4 Reads

Delusional misidentifications in a procrustean bed.

Psychiatriki 2018 Jan-Mar;29(1):15-18

Consultant Psychiatrist, Department of Psychological Medicine, Honorary Clinical Associate Professor, University of Nottingham, UK.

The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally fused functions of perception and recognition. The classical sub-types are: the syndromes of Capgras, Fregoli,Intermetamorphosis (mentioned in 3) and Subjective doubles. These syndromes occur in a clear sensorium and shouldbe differentiated from the banal transient misidentifications occurring in confusional states and in mania and from thenon-delusional misidentifications (e. Read More

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October 2018
1 Read

Phase 1 study of seviteronel, a selective CYP17 lyase and androgen receptor inhibitor, in women with estrogen receptor-positive or triple-negative breast cancer.

Breast Cancer Res Treat 2018 May 9. Epub 2018 May 9.

Breast Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Purpose: Seviteronel (INO-464) is an oral, selective cytochrome P450c17a (CYP17) 17,20-lyase (lyase) and androgen receptor inhibitor with in vitro and in vivo anti-tumor activity. This open-label phase 1 clinical study evaluated safety, tolerability, pharmacokinetics (PK), and activity of once-daily (QD) seviteronel in women with locally advanced or metastatic TNBC or ER+ breast cancer.

Methods: Seviteronel was administered in de-escalating 750, 600, and 450 mg QD 6-subject cohorts. Read More

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May 2018
6 Reads

Disseminated herpes simplex virus: a case of eczema herpeticum causing viral encephalitis.

Authors:
C Finlow J Thomas

J R Coll Physicians Edinb 2018 Mar;48(1):36-39

C Finlow, Noble's Hospital, Strang, Douglas IM4 4RJ, Isle of Man, Email:

Eczema herpeticum is a dermatological emergency causing a mortality of up to 10% if untreated. It frequently presents in a localised form and rarely disseminates via haematogenous spread with pulmonary, hepatic, ocular and neurological manifestations. Although it commonly appears on a background of atopic dermatitis, many other dermatological conditions have been described preceding this disease. Read More

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March 2018
10 Reads

Impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure.

Emergencias 2018 06;30(3):149-155

Área de Urgencias, Hospital Clínic, Institut de Recerca Biomédica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, España.

Objetive: To study the impact of geriatric assessment variables on 30-day mortality among older patients with acute heart failure (AHF).

Methods: Retrospective analysis of cases in the OAK Registry (Older Acute Heart Failure Key Data), a prospectively compiled database of consecutive patients aged 65 years or older treated for AHF in 3 Spanish emergency departments over a 4-month period (November-December 2011 and January-February 2014). The patients underwent a geriatric assessment adapted for emergency department use on weekdays between 8 AM and 10 PM. Read More

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June 2018
5 Reads
2.900 Impact Factor

Prevalence, risk factors and adverse outcomes of anticholinergic burden in patients with advanced chronic conditions at hospital admission.

Geriatr Gerontol Int 2018 Aug 11;18(8):1159-1165. Epub 2018 Apr 11.

Pharmacy Department, Vic University Hospital - Vic Hospital Consortium; Hospital of Santa Creu of Vic (Barcelona), Spain.

Aim: To evaluate the anticholinergic burden (ACB), the risk factors associated with its onset and the clinical consequences for patients with advanced chronic conditions.

Methods: A 10-month cross-sectional study was carried out in an acute hospital care geriatric unit. Patients with advanced chronic conditions were identified by the NECessity of PALliative care (NECPAL) test. Read More

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August 2018
2 Reads

Impulsive, Disinhibited Behavior-Dining in a Restaurant.

Gerontol Geriatr Med 2018 Jan-Dec;4:2333721418756994. Epub 2018 Mar 14.

East Tennessee State University, Johnson City, TN, USA.

Dining in a restaurant with a loved one who has dementia can be an ordeal, especially if the expectations of the caregiver do not match those of the patient and the restaurant environment is not suitable for patients with dementia. The size of the dining area, lighting, background music or noise, décor of the room, number of customers, variety of the items on the menu, number of plates and cutlery on the table, in addition to flowers, candles, and other decorations on the table are all potent distractors. There are so many stimuli; the patient can be overwhelmed with information overload and not able to focus on the main purpose of the event: have dinner and especially enjoy the other person's company. Read More

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March 2018
2 Reads

[Status epilepticus: Recent advances].

Presse Med 2018 Mar 9;47(3):266-277. Epub 2018 Mar 9.

Fondation ophtalmologique Rothschild, service d'anesthésie-réanimation, 75019 Paris, France.

About half of status epilepticus (SE) occur in patients without epilepsy. An EEG has to be performed quickly in any patient who remains unconscious after the end of convulsions with the aim to detect a subtle status. An EEG should be performed as soon as possible in case of suspicion of non-convulsive status epilepticus, or in case of a confusional state whose origin remains unknown. Read More

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March 2018
4 Reads

Repetitive Questioning II.

Gerontol Geriatr Med 2018 Jan-Dec;4:2333721417740190. Epub 2018 Feb 13.

East Tennessee State University, Johnson City, TN,USA.

Repetitive questioning is a major problem for caregivers, particularly taxing if they are unable to recognize and understand the reasons why their loved one keeps asking the same question over and over again. Caregivers may be tempted to believe that the patient does not even try to remember the answer given or is just getting obnoxious. This is incorrect. Read More

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February 2018
1 Read

Paciente inmunocompetente con criptococosis cerebral: reporte de un caso.

Gac Med Mex 2017;153(7):911-914

Departamento de Investigación Clínica, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Ciudad de México. México.

A 14-year-old female, presenting sudden and progressive holocraneal headache along with incoercible vomiting arrived to emergency room. Acute confusional state and meningoencephalitis syndrome where identified. Brain computed tomography-scan with normal results was performed. Read More

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January 2017
1 Read

Acute Confusional Migraine: Distinct Clinical Entity or Spectrum of Migraine Biology?

Brain Sci 2018 Feb 7;8(2). Epub 2018 Feb 7.

Department of Neurology-Headache Division, University of Miami, Miller School of Medicine, Miami, FL 33136, USA.

The goal of this review is to explore the literature reports of acute confusional migraine (ACM) including patient characteristics, migraine symptomatology, and proposed diagnostic criteria. A literature review was conducted using PubMed, Scopus and Web of Science using the terms "confusional migraine" and "confusional state in migraine". All the relevant articles from 1970 to 2016 were included. Read More

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February 2018
3 Reads

[Four-year follow-up of a neurosyphilis case presenting psychiatric symptoms].

Orv Hetil 2018 Feb;159(6):234-238

Pszichiátriai és Pszichoterápiás Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Balassa u. 6., 1083.

The authors present a case of neurosyphilis associated with predominant psychiatric symptoms. The elderly man was admitted because of confused behavior, maniform state, lack of critical judgement and grandiose delusions. On admission, right central facial nerve paresis, hand tremor and parkinsonism were also found. Read More

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February 2018
3 Reads

Neurological variability in chemotherapy-induced posterior reversible encephalopathy syndrome associated with thrombotic microangiopathy: Case reports and literature review.

Mol Clin Oncol 2018 Jan 2;8(1):178-182. Epub 2017 Nov 2.

Department of Oncology and Neurology, Leslie and Michael Gaffin Center for Neuro-Oncology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel.

Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome characterized by headaches, seizures, a confusional state and visual disturbances associated with transient predominantly bilateral posterior white mater magnetic resonance imaging lesions. It is primarily reported in the setting of hypertension, acute renal failure, peripartum eclampsia, autoimmune disease, immunosuppression and chemotherapy. Thrombotic microangiopathy (TMA), including hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) has also been reported as potential PRES inducer. Read More

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January 2018
7 Reads

Controlled pre-post, mixed-methods study to determine the effectiveness of a national delirium clinical care standard to improve the diagnosis and care of patients with delirium in Australian hospitals: a protocol.

BMJ Open 2018 01 24;8(1):e019423. Epub 2018 Jan 24.

Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.

Introduction: Delirium, an acute confusional state, affects up to 29% of acute inpatients aged 65 years and over. The Australian Delirium Clinical Care Standard (the Standard) contains evidence-based, multicomponent interventions, to identify and reduce delirium. This study aims to: (1) conduct a controlled, before-and-after study to assess the clinical effectiveness of the Standard to improve diagnosis and treatment of delirium; (2) conduct a cost-effectiveness study of implementing the Standard and (3) evaluate the implementation process. Read More

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January 2018
2 Reads

An overview of exposure to ethanol-containing substances and ethanol intoxication in children based on three illustrated cases.

Drugs Context 2018 9;7:212512. Epub 2018 Jan 9.

Department of Neurology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.

Alcohol addiction and intoxication are major health problems worldwide. Acute alcohol intoxication is well reported in adults and adolescents but less frequently reported in children of younger ages. We report three anonymized cases of pediatric ethanol exposure and illustrate the different mechanisms of intoxication. Read More

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January 2018
3 Reads

Acute confusional syndrome as an onset form of aortic dissection.

Med Clin (Barc) 2018 Oct 29;151(8):e45-e46. Epub 2017 Dec 29.

Servicio de Medicina de Familia y Comunitaria, Hospital Juan Ramón Jiménez, Huelva, España.

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October 2018
2 Reads

Differential serum cytokine profile in patients with systemic lupus erythematosus and posterior reversible encephalopathy syndrome.

Clin Exp Immunol 2018 May 16;192(2):165-170. Epub 2018 Jan 16.

Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Systemic lupus erythematosus (SLE) patients are susceptible to the development of posterior reversible encephalopathy syndrome (PRES). The main theory concerning the physiopathology of PRES suggests that there is brain-blood barrier damage, which is associated with endothelial dysfunction, and characterized by vasogenic oedema. However, current evidence regarding its physiopathogenic mechanisms is quite scant. Read More

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May 2018
5 Reads

Subacute Encephalopathy With Seizures in Alcoholics (SESA) Presenting as Focal Nonconvulsive Status Epilepticus.

Clin EEG Neurosci 2018 Nov 20;49(6):414-416. Epub 2017 Dec 20.

3 Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain.

Purpose: To acquaint readers with the underrecognized subacute encephalopathy with seizures in chronic alcoholics (SESA) that has more recently been associated with different types of status epilepticus.

Methods: Case reports and review of the literature on SESA and nonconvulsive status epilepticus (NCSE).

Results: Two cases: one with alternating bifrontoparietal NCSE, and one with focal, confusional NCSE, with imaging and EEG correlates. Read More

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November 2018
13 Reads

Patients with Dementia Are Easily Distracted.

Gerontol Geriatr Med 2017 Jan-Dec;3:2333721417735938. Epub 2017 Dec 7.

East Tennessee State University, Johnson City, TN, USA.

Mild cognitive impairment (MCI) is the middle ground between normal, age-appropriate memory impairment, and dementia. Whereas patients with MCI are able to cope with the memory deficit, those with dementia are not: Their memory impairment and other cognitive deficits are of sufficient magnitude to interfere with the patients' ability to cope independently with daily activities. In both MCI and dementia, there is evidence of declining cognitive functions from a previously higher level of functioning. Read More

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December 2017
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Neuropsychiatric manifestations are not uncommon in Indian lupus patients and negatively affect quality of life.

Lupus 2018 Apr 14;27(4):688-693. Epub 2017 Dec 14.

1 Department of Internal Medicine, 29751 Postgraduate Institute of Medical Education and Research , Chandigarh, India.

Objectives The objectives of this paper are to look at the prevalence of neuropsychiatric manifestations and assess their impact on quality of life in North Indian lupus patients. Methods The study included consecutive patients with systemic lupus erythematosus (SLE) who were older than 18 years and met the SLICC 2012 criteria. A diagnosis of a neuropsychiatric syndrome was made as per ACR 1999 definitions. Read More

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April 2018
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Horner Syndrome as the Only Focal Neurologic Manifestation of Hypothalamic Hemorrhage.

J Neuroophthalmol 2018 Jun;38(2):192-194

Departments of Ophthalmology, Neurology, and Radiology (Neuroradiology), Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.

A 70-year-old woman suffered an anterior dorsal hypothalamic hemorrhage that caused an ipsilateral Horner syndrome (HS) as the only focal neurologic manifestation. This is only the second reported case of hypothalamic hemorrhage producing HS. Because HS was the sole focal neurologic manifestation, its confirmation with topical apraclonidine drops was a valuable clue toward prompt localization of the patient's confusional state. Read More

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June 2018
3 Reads

Syndrome of Transient Headache and Neurologic Deficits With Cerebrospinal Fluid Lymphocitosis Should Be Considered in Children Presenting With Acute Confusional State.

Headache 2018 Mar 2;58(3):438-442. Epub 2017 Dec 2.

Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital, Headache Center, IRCCS, Rome, Italy.

Background: Transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL) is benign and self-limited, with neurologic deficits including sensory disturbance of one body side, aphasia, nausea/vomiting, weakness, decreased vision, homonymous hemianopsia, photophobia. Acute confusional state can rarely occur. Papilledema and intracranial hypertension have also been described. Read More

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March 2018
17 Reads

[Pharmacologic monitoring of acute confusional state in Spanish hospital emergency departments].

Emergencias 2017 Dic;29(6):427-428

Coordinador Servicio de Urgencias, Hospital Príncipe de Asturias. Comunidad de Madrid, España.

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November 2018
3 Reads