Pain-Related Vertex Evoked Potentials. Comparison of Surface Electrical to Heat Stimulation.

Introduction: Demonstration of nociceptive fiber abnormality is important for diagnosing neuropathic pain and small fiber neuropathies. This is usually assessed by brief heat pulses using lasers, contact heat, or special electrodes. We hypothesized that pain-related evoked potentials to conventional surface electrical stimulation (PREPse) can index Aδ afferences despite tactile Aß fibers coactivation.

Navigating migraine care through the COVID-19 pandemic: an update.

The worldwide treatment gap for migraine before COVID-19 inevitably widens as attention focuses on an international emergency. Migraine hits people particularly in their early and middle years, potentially reduces quality of life and productivity, and remains a common emergency presentation. This article examines the impact of COVID-19 on migraine, and changing aspects of migraine care during and after the pandemic.

Spinal cord infarction with ipsilateral segmental neuropathic pain and flaccid paralysis. A functional role for human afferent ventral root small sensory fibres.

This paper illustrates the cases of two patients with an acute onset of right brachial neuropathic pain, flaccid paralysis and contralateral thermal and thermal pain hypoesthesia, without posterior column impairment nor pyramidal signs below the segmental lesion. MRI showed right sided spinal cord infarction, in the anterior spinal artery territory between C1 and C5 in one patient and between C3 and C7 in the other. Contact Heat Evoked Potentials and Quantitative Thermal Sensory testing are consistent with contralateral, but not ipsilateral, spinothalamic tract involvement.

Familial limb pain and migraine: 8-year follow-up of four generations.

Background Migraine limb pain may be under-recognized in adults and children. There is little information about familial forms of this disorder. Objectives To describe the clinical and inheritance patterns of familial migraine limb pain over four generations and to review the evidence for limb pain as a manifestation of migraine.

Syncope and Raynaud's disease.

Objective: To investigate an association between syncope and Raynaud's disease (RD), its clinical features, and the effect of treatment with nifedipine.

Design: One-year prospective study of new outpatients after 3 initial clinical observations.

Setting: Neurology clinics at Chelsea and Westminster, Royal Free, Barnet, and Edgware Hospitals.

SCA3 presenting as an isolated axonal polyneuropathy.

Objectives: To highlight an unexpected clinical presentation and to review the associated polyneuropathy phenotypes of SCA3.

Design: Clinical follow-up.

Setting: Neurological referral center.

Dysarthria in amyotrophic lateral sclerosis: A review.

Dysarthria is a motor disorder of speech characterized by abnormalities of the articulation and intelligibility of speech. Phonation and the rate of facial movements may also be affected. Understanding the nature and course of dysarthria in amyotrophic lateral sclerosis (ALS) is important because loss of communication prevents patients from participating in many activities, may lead to social isolation, and reduces the quality of life.

Amyotrophic lateral sclerosis and ocular flutter.

A previously unreported association of amyotrophic lateral sclerosis and ocular flutter is presented. It is hypothesized that initial loss of brainstem inhibitory interneurons resulted in disinhibition of burst interneurons and that the ocular flutter subsequently disappeared as burst interneurons also became affected by the disease process. The association adds clinical evidence of involvement of brainstem interneurons to other evidence of involvement of neurons other than motor neurons in the disease process.

Nineteen-year follow-up of Waldenström's-associated neuropathy and Bing-Neel syndrome.

We describe the follow-up of a patient with Waldenström's macroglobulinemia who developed mild predominantly sensory peripheral neuropathy, Bing-Neel syndrome, and, after 17 years, acute mononeuropathy multiplex associated with increasing paraprotein levels. Nerve biopsy demonstrated deposition of IgM in the endoneurium and perineurium. Magnetic resonance imaging showed extension of the cerebral white-matter abnormality.

Widespread loss of neuronal populations in the spinal ventral horn in sporadic motor neuron disease. A morphometric study.

The cytopathology and loss of neurons was studied in 7670 neurons from the ventral horn of the third lumbar segment of the spinal cord of six sporadic motor neuron disease (MND) patients compared with 7568 neurons in seven age matched control subjects. A modified Tomlinson et al. [Tomlinson BE, Irving D, Rebeiz JJ.

Limitations of inferences from observational databases in amyotrophic lateral sclerosis: all that glitters is not gold.

Data from three observational databases have suggested that survival in patients with ALS who take riluzole is far greater than that reported in randomized controlled studies. This editorial discusses why therapeutic efficacy cannot be inferred from observational databases. Data in these databases cannot control for biases in treatment assignment or for differences in intensity of follow-up or supportive care.