The prognostic value of resting-state EEG in acute post-traumatic unresponsive states.

Accurate early prognostication is vital for appropriate long-term care decisions after traumatic brain injury. While measures of resting-state EEG oscillations and their network properties, derived from graph theory, have been shown to provide clinically useful information regarding diagnosis and recovery in patients with chronic disorders of consciousness, little is known about the value of these network measures when calculated from a standard clinical low-density EEG in the acute phase post-injury. To investigate this link, we first validated a set of measures of oscillatory network features between high-density and low-density resting-state EEG in healthy individuals, thus ensuring accurate estimation of underlying cortical function in clinical recordings from patients.

Covert Speech Comprehension Predicts Recovery From Acute Unresponsive States.

Objective: Patients with traumatic brain injury who fail to obey commands after sedation-washout pose one of the most significant challenges for neurological prognostication. Reducing prognostic uncertainty will lead to more appropriate care decisions and ensure provision of limited rehabilitation resources to those most likely to benefit. Bedside markers of covert residual cognition, including speech comprehension, may reduce this uncertainty.

Can the early use of botulinum toxin in post stroke spasticity reduce contracture development? A randomised controlled trial.

Objective: Does early treatment of spasticity with botulinum-toxin (BoNTA), in (hyper)acute stroke patients without arm-function, reduce contractures and improve function.

Design: Randomised placebo-controlled-trial.

Setting: Specialised stroke-unit.

Human T-cell lymphotropic virus (HTLV)-associated encephalopathy: an under-recognised cause of acute encephalitis? Case series and literature review.

Human T-cell lymphotropic virus (HTLV)-1-associated myelopathy (HAM) is well described. Clinical features are predominantly consistent with cord pathology, though imaging and autopsy studies also demonstrate brain inflammation. In general, this is subclinical; however, six cases have previously been reported of encephalopathy in HTLV-1-infected patients, without alternative identified aetiology.

Dantrolene an unusual option for detrusor overactivity: observations of a patient with cerebral palsy.

We report a case of a 49-year-old female with cerebral palsy with spastic tri-plegia and lumbar spondyolisthesis diagnosed to have overactive neurogenic bladder, which improved on treatment with Dantrolene along with antimuscarinics. She was initially treated with antimuscarinics both transdermal and oral simultaneously and later received intravesical OnaBotulinum toxinA. Following lumbar spine fixation for spondylolisthesis, her bowel and bladder function deteriorated and she was commenced on Dantrolene for her spasticity, along with being on Oxybutinin and Mirabegron.

The early use of botulinum toxin in post-stroke spasticity: study protocol for a randomised controlled trial.

Background: Patients surviving stroke but who have significant impairment of function in the affected arm are at more risk of developing pain, stiffness and contractures. The abnormal muscle activity, associated with post-stroke spasticity, is thought to be causally associated with the development of these complications. Treatment of spasticity is currently delayed until a patient develops signs of these complications.

Heterozygosity at polymorphic codon 219 in variant creutzfeldt-jakob disease.

Background: Genetic variants of the prion protein gene (PRNP) strongly determine susceptibility to prion diseases. All tested patients with definite variant Creutzfeldt-Jakob disease (vCJD) are homozygous for methionine at a common polymorphism at codon 129. A further genetic polymorphism at codon 219, a common variant in several Asian populations, is considered protective against sporadic CJD.