Concurrent Paraspinous Myopathy and Myasthenia Gravis.

Paraspinous myopathy is a rare neuromuscular disorder characterized by selective involvement of the cervical, thoracic, or lumbar muscles. Leading clinical features include a bent spine or dropped head (antecollis). In myasthenia gravis (MG), patients may have camptocormia secondary to neuromuscular junction dysfunction of the paraspinal muscles, and this condition usually responds to acetylcholinesterase inhibitors or immunosuppressive treatments.

Long-Term Impact of Implementation of a Stroke Protocol on Door-to-Needle Time in the Administration of Intravenous Tissue Plasminogen Activator.

Background: This study aims to evaluate the effectiveness of implementing a stroke protocol (SP) in improving door-to-needle time (DTNT) and door-to-computed tomography (DTCT) time from 2010 to 2014. Published data from the Get With The Guidelines-Stroke (GWTGS) participating hospitals showed that median DTNT = 75 minutes with 26.6% of the patients achieving the recommended DTNT of 60 minutes or less.

Cranial Nerve-VI Palsy as the Main Clinical Manifestation of Neurosarcoidosis.

Introduction: Sarcoidosis is a chronic, systemic, inflammatory disorder that is characterized by the formation of noncaseating granulomas. Patients may present with cranial nerve palsy, paresthesia, paresis, pyramidal signs, progressive cognitive decline, urinary retention, seizures, or hypothalamic-pituitary syndrome. Although the diagnosis of neurosarcoidosis can be challenging, neurological manifestations of sarcoidosis occur more frequently than previously described.

Disorders of the Autonomic Nervous System after Hemispheric Cerebrovascular Disorders: An Update.

Autonomic and cardiac dysfunction may occur after vascular brain injury without any evidence of primary heart disease. During acute stroke, autonomic dysfunction, for example, elevated arterial blood pressure, arrhythmia, and ischemic cardiac damage, has been reported, which may hinder the prognosis. Autonomic dysfunction after a stroke may involve the cardiovascular, respiratory, sudomotor, and sexual systems, but the exact mechanism is not fully understood.

Trends in Outcome and Hospitalization Cost among Adult Patients with Acute Ischemic Stroke in the United States.

Introduction: New treatments for acute ischemic stroke (AIS) have been introduced and are expected to improve patients' overall outcomes. We assessed the impact of new therapeutic strategies on outcome and cost of hospitalization among adult patients with AIS in the United States.

Methods: Patients with AIS admitted in the United States in 1993-1994 and 2006-2007 were listed using the Nationwide Inpatient Survey database.

Serial heart rate variability testing for the evaluation of autonomic dysfunction after stroke.

Background And Purpose: Autonomic dysfunction has been described as a frequent complication of stroke that could involve the cardiac, respiratory, sudomotor, and sexual systems. Cardiac autonomic dysfunction after stroke is one of the most recognized and has been described to increase the rate of mortality and morbidity.

Methods: We report two cases of stroke-one hemorrhagic and one ischemic-and describe heart rate variability during the patients' hospitalizations with improvement reported for each patient several days after stroke onset.

Advanced neuroimaging in acute ischemic stroke: extending the time window for treatment.

Early treatment of ischemic stroke with thrombolytics is associated with improved outcomes, but few stroke patients receive thrombolytic treatment in part due to the 3-hour time window. Advances in neuroimaging may help to aid in the selection of patients who may still benefit from thrombolytic treatment beyond conventional time-based guidelines. In this article the authors review the available literature in support of using advanced neuroimaging to select patients for treatment beyond the 3-hour time window cutoff and explore potential applications and limitations of perfusion imaging in the treatment of acute ischemic stroke.