Positive signs from the history as an aid for early diagnosis in functional movement disorders: The prospective TASMAN study.

Background And Purpose: There has been a concerted move in recent times to shift from an exclusionary to a positive diagnosis of functional movement disorders (FMDs). To date, most of the focus has been on defining positive physical signs. Here the focus was on the diagnostic specificity of specific symptoms and patient characteristics.

A Rare Case of Meningitis in an Immunocompetent Patient: A Successful Outcome with a Short Course of Antibiotics.

Introduction: is a Gram-negative bacterium found in the oral flora of dogs and cats, transmitted to humans through bites, licks, or scratches. Infections can lead to severe manifestations, including meningitis, particularly in immunocompromised individuals.

Case Presentation: A 46-year-old immunocompetent man presented with somnolence, headache, and fever after being licked by his dog.

Lived experience of driving in individuals with functional neurological disorder.

Background: Functional neurological disorder (FND) is a common neurological diagnosis that encapsulates a range of incapacitating clinical presentations. These include functional seizures, movement disorders, and sensory disturbances. Safe driving requires both cognitive skills and physical abilities, which may be impacted by FND symptoms.

A Critical Appraisal of the Whack-a-Mole and Swivel Chair Signs in the Diagnosis of Functional Movement Disorders.

Background: The demonstration of positive signs during neurological examination is a cornerstone of the diagnosis of functional movement disorders, however, the available data supporting the diagnostic value of some of these signs is limited.

Objectives: To determine the diagnostic value (sensitivity and specificity) of the "whack-a-mole" (WAM) and "swivel chair" (SC) tests in patients with functional movement disorders (FMD).

Methods: We enrolled patients with functional and organic movements in the WAM test if they exhibited tremor, dystonia, myoclonus, chorea, or tics.

[Severe hypomagnesemia in a man with alcohol dependence: a forgotten electrolyte in a neglected population].

Background: Symptoms of acute alcohol withdrawal like tremors, seizures and delirium are commonly treated with benzodiazepines and vitamins. When complaints are not reacting to this treatment, an alternative diagnosis must be considered. Although hypomagnesemia is present in at least 30 percent of the patients with alcohol dependence, it can provoke and maintain these complaints.

Health Care Utilization in Functional Neurologic Disorders: Impact of Explaining the Diagnosis of Functional Seizures on Health Care Costs.

Background And Objective: The objectives of this study were to investigate health care utilization costs of patients with video-electroencephalography (VEEG)-confirmed functional seizures (FS), determine whether patients who received a satisfactory functional neurologic disorder (FND) diagnosis explanation had reduced health care utilization compared with those with a poor explanation; and to quantify the overall health care costs 2 years prediagnosis and postdiagnosis for those receiving a different explanation.

Methods: Patients with VEEG-confirmed pure FS (pFS) or mixed (functional seizure plus epileptic seizures) diagnosis between July 1, 2017, and July 1, 2019, were evaluated. Explanation of the diagnosis was determined "unsatisfactory" or "satisfactory" using self-developed criteria, and health care utilization data were collected using an itemized list.

Hazard Perception Skill and Driver Behavior in Patients With Functional Neurologic Disorders.

Background And Objectives: Driving in patients with functional neurologic disorders (FND) is a major concern, but current guidelines (where they exist) are based on expert consensus only due to a lack of relevant empirical evidence. This study aimed to provide such evidence by comparing drivers with FND with healthy controls on aspects of driving performance and behavior important to crash risk, including hazard perception skill.

Methods: Participants completed validated self-report questionnaires of driving behaviors (assessing lapses, errors, violations, and attentional issues) and 2 computer-based measures of hazard perception skill (both known to be associated with crash risk).

'Tricked' sensory trick: a geste antagoniste in functional dystonia.

A sensory trick, or geste antagoniste, is a manoeuvre used by patients with dystonia to ameliorate their dystonic movements or posturing. Typically, a sensory trick is a confirmatory clue indicating an organic nature of the dystonia. In this report, we present an extremely rare case of a sensory trick in a patient with functional dystonia.

A novel diagnostic approach for patients with adult-onset dystonia.

Adult-onset dystonia can be acquired, inherited or idiopathic. The dystonia is usually focal or segmental and for a limited number of cases causal treatment is available. In recent years, rapid developments in neuroimmunology have led to increased knowledge on autoantibody-related dystonias.

Tremor Drugs in the Crosshairs.

Background: Alopecia areata is a rare but debilitating adverse effect of drugs used in the treatment of tremors. Recurrent hair loss after different types of tremor medications has never been described before.

Case Report: We herein report the case of a 56-year-old tremor patient who we diagnosed with tremor-dominant Parkinson's disease.

Locked-In Syndrome after Traumatic Basilar Artery Entrapment within a Clivus Fracture: A Case Report and Review of the Literature.

We report the case of a 58-year-old male with a rare vascular complication after traumatic head injury: entrapment of the basilar artery into a fracture of the clivus, ultimately leading to a locked-in syndrome due to brainstem infarction. Review of the literature revealed 19 earlier published cases of basilar artery entrapment within traumatic longitudinal clival fractures. In the majority of these patients there is an unfavorable neurological outcome.

Rare functional missense variants in CACNA1H: What can we learn from Writer's cramp?

Writer's cramp (WC) is a task-specific focal dystonia that occurs selectively in the hand and arm during writing. Previous studies have shown a role for genetics in the pathology of task-specific focal dystonia. However, to date, no causal gene has been reported for task-specific focal dystonia, including WC.

A Pyramidal Cause of a Cerebellar Ataxia: HSP-7.

A 43-year-old man presented with a slowly progressive fatigue and coordination problems, coupled with a radiological appearance of diffuse atrophy, especially in the cerebellar hemispheres. The diagnostic process was challenging because initially the additional investigations were focused on a cerebellar ataxia. In the following months, his ataxic gait developed in a more spastic pattern and whole exome sequencing revealed mutations in the SPG7 gene, confirming a diagnosis of hereditary spastic paraplegia.

Late relapse myoclonus in a case of Lance-Adams syndrome.

A 66-year-old man had a history of an anterior myocardial infarction followed by a successful cardiopulmonary resuscitation and a posthypoxic myoclonus, also known as Lance-Adams syndrome (LAS). Eight years ago, he was admitted to the emergency department with the same myoclonic jerks during an intercurrent respiratory infection. After treatment with clonazepam and resolution of the infection, the myoclonus promptly disappeared.

A clinical decision model identifies patients at risk for delayed diagnosed injuries after high-energy trauma.

Objective: Tertiary trauma survey is widely implemented in trauma care to identify all injuries in trauma patients. However, various studies consistently show that some trauma patients have missed injuries. In this study, we developed a clinical decision model to identify patients who are at risk for delayed diagnosed injuries.