Management of Chronic Migraine and Occipital Neuralgia in Post 9/11 Combat Veterans.

Introduction: The rate of chronic migraine (CM) has been shown to be 20% or greater in the post 9/11 combat veteran population with a history of traumatic brain injury, while the rate is much lower at 3-5% in the general population. Studies have shown that medications such as oral topiramate or intramuscular injections of onabotulinum toxin A (Botox) have been used for CM prevention, and occipital blocks have been shown to be helpful in treating occipital neuralgia and short-term relief of CM. However, there are no known studies that have specifically evaluated the use of Botox and occipital blocks for reducing headache frequency in the US veteran population.

A 62-year-old man with fluctuating neurological deficits and skin lesions.

A 62-year-old man with no significant medical history experienced fatigue, night sweats, hoarseness of voice, and dry cough, which were followed by vision disturbances in his left eye. He lost about 4.5 kg (10 lb) in just over a month.

A novel autoantibody to a 155-kd protein is associated with dermatomyositis.

Objective: In polymyositis and dermatomyositis (DM), identified autoantibodies occur in <50% of adult patients and in a smaller proportion of children. This study was undertaken as part of a larger effort to define novel autoantibodies that assist in the clinical evaluation of myositis.

Methods: Sera from children and adults satisfying criteria for idiopathic inflammatory myopathies and from patients with other connective tissue diseases (CTDs), patients with noninflammatory myopathies, and healthy individuals were tested for autoantibodies by immunoprecipitation (IP).

Modern therapeutic approach for high grade astrocytoma: intracranial Ir-192 brachytherapy.

Prognosis of high-grade astrocytoma has been extremely disappointing and the median survival of patients with this tumor is less than 10 months at best. The most common cause of failure is local persistence of the tumor. Many neuro-oncologists have now turned to an alternative therapeutic approach involving brain brachytherapy (interstitial implantation) for the treatment of high-grade astrocytomas because in this manner a higher dose can be delivered to the tumor bed without excessively irradiating the surrounding normal brain tissue.

Environmental influence on altered receptor function in a genetic disease: insulin and glucose affect insulin receptors in myotonic dystrophy.

Insulin action in vivo and insulin binding to monocytes in vitro were correlated in patients with myotonic dystrophy (MyD) and compared with healthy controls. Confirming our previous studies and those of others, the present results show that the glucose infusion rate (DR), an estimate of in vivo insulin sensitivity, was significantly diminished in MyD. At the same per cent of ideal body weight DR in MyD patients was considerably less than controls suggesting that obesity could not solely account for decreased insulin sensitivity in MyD.

Reduction in insulin receptors in amyotrophic lateral sclerosis correlates with reduced insulin sensitivity.

Abnormal glucose and insulin metabolism have often been reported in patients with amyotrophic lateral sclerosis. Recently, we have demonstrated reduced insulin sensitivity in this disease and suggested that muscle wasting was not the principal determinant of this reduction. In the current studies, insulin binding to circulating mononuclear leukocytes from 10 amyotrophic lateral sclerosis patients and 16 controls were compared.

Inclusion body myositis associated with systemic sarcoidosis.

We report an autopsy study of a 64-year-old female with systemic sarcoidosis. In addition many muscles showed typical light and electron microscopic features of inclusion body myositis. To our knowledge this association has not been previously reported.

Insulin resistance in amyotrophic lateral sclerosis.

Over the last 30 years glucose intolerance has been reported in a significant percentage of patients with amyotrophic lateral sclerosis (ALS). Currently, a controversy exists in determining whether the carbohydrate abnormality is disease-specific or secondary to decreased glucose utilization due to muscle atrophy. A reduction in glucose receptor space had been postulated for a number of neuromuscular diseases including ALS.

Inclusion body myositis. A corticosteroid-resistant idiopathic inflammatory myopathy.

In seven patients with slowly progressive muscle weakness, inclusion body myositis (IBM) was diagnosed on biopsy. None had stigmata of collagen-vascular disease or malignancy. Serum creatine kinase levels were mildly or moderately increased.

Lysophospholipase activity in rabbit skeletal muscle.

Skeletal muscle contains appreciable lysophospholipase activity which is differentiated by muscle type with red muscle subcellular fractions having greater activity than the corresponding white ones.