Pontine ischaemic stroke syndromes.

Classic Raymond syndrome is a rare neurological presentation comprising ipsilateral abducens palsy, contralateral facial paresis and contralateral hemiparesis. We present a man in his late 60s who presented with diplopia, dysarthria and right-sided limb weakness. This syndrome is one of a group of 'crossed paralyses' of the caudal pons.

Bioinformatics-Based Identification of Expanded Repeats: A Non-reference Intronic Pentamer Expansion in RFC1 Causes CANVAS.

Genomic technologies such as next-generation sequencing (NGS) are revolutionizing molecular diagnostics and clinical medicine. However, these approaches have proven inefficient at identifying pathogenic repeat expansions. Here, we apply a collection of bioinformatics tools that can be utilized to identify either known or novel expanded repeat sequences in NGS data.

Decompressive hemicraniectomy after malignant middle cerebral artery infarction: does hospital of origin matter?

Decompressive hemicraniectomy (DHC) has been shown to reduce mortality in malignant middle cerebral artery (MCA) infarction. Our primary objective was to compare 1-year mortality between patients receiving DHC for malignant MCA infarction at our institution based on hospital of origin. We retrospectively reviewed the medical records of all patients treated for malignant MCA infarction with DHC at our institution over a 3-year period.

Impact and implementation of a sustainable regional telestroke network.

Background: Telestroke uses videoconferencing technology to allow off-site experts to provide stroke thrombolysis decision support to less experienced front line clinicians.

Aim: To assess the impact of a new telestroke service on thrombolysis rates and door-to-needle times in participating provincial hospitals and service resources to aid transition to a sustainable telestroke service.

Methods: This is a sequential comparison of 'pre' (December 2015 to May 2016) and 'post' (June 2016 to December 2016) implementation outcomes.

EpiNet as a way of involving more physicians and patients in epilepsy research: Validation study and accreditation process.

Objective: EpiNet was established to encourage epilepsy research. EpiNet is used for multicenter cohort studies and investigator-led trials. Physicians must be accredited to recruit patients into trials.

A case of botulism in New Zealand.

We describe the first case of food-borne botulism seen in New Zealand for 30 years. Botulism is an important diagnosis to consider in a patient with rapidly progressive descending paralysis and normal sensorium. Early recognition, timely institution of intensive care support and administration of botulism antitoxin are the most important aspects of management.

Inequities in provision of seizure care across the Wellington Region.

Aim: We wanted to determine whether adult patients presenting with a seizure to the emergency department (ED) of Wellington Hospital and Hutt Hospital, in the Wellington region, were equally likely to be referred for neurology input.

Methods: A retrospective review was conducted of 250 consecutive patients presenting with a seizure to the ED of each hospital. Patient electronic records were examined to determine the proportion of patients discussed with the inpatient neurology team and referred to neurology outpatient clinic.

Motor neurone disease in the greater Wellington region: an observational study.

Aims: This study investigated the demographic and disease characteristics of motor neurone disease (MND), as well as specific aspects of healthcare provision for MND patients in the greater Wellington region.

Methods: Data was collected from clinical records of all known patients with a diagnosis of Motor Neurone Disease MND in the Capital and Coast and Hutt Valley district health board catchment zones over a 12-month period. Survival data was collected at 2-year follow-up.

Drug-induced subacute cutaneous lupus erythematosus due to treatment with interferon beta-1a.

Drug-induced subacute cutaneous lupus is a very rare adverse reaction to medications. This case report describes onset of this condition caused by Interferon beta-1a, which has been rarely reported previously.

Use of postictal respiratory pattern to discriminate between convulsive psychogenic nonepileptic seizures and generalized tonic-clonic seizures.

Distinguishing between generalized tonic-clonic seizures (GTCSs) and convulsive psychogenic nonepileptic seizures (PNESs) can be difficult at the bedside, and this distinction has important implications for patient care. This study used a fully blinded method to examine postictal breathing parameters to identify features distinguishing between generalized tonic-clonic seizures (GTCSs) and convulsive psychogenic nonepileptic seizures (PNESs). Three blinded readers examined edited video recordings of the postictal phase of 72 convulsive seizure episodes recorded from 56 patients.

Clinical orientation program for new medical registrars--a qualitative evaluation.

We present a qualitative evaluation of a clinical orientation program for medical registrars within the Wellington region in New Zealand, designed and implemented by current advanced registrars. This program was intended to improve the transition from house officer to medical registrar. The program was qualitatively evaluated using focus groups comprising participants, presenters and senior nursing staff.

Brainstem lesions presenting with nausea and vomiting.

Positional vomiting is an important alerting sign for the presence of a brainstem central nervous system (CNS) lesion. Failure to identify another cause of protracted vomiting should prompt consideration of a CNS cause.