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Pearls & Oy-sters: Increased Visibility of Focal Cortical Dysplasia in Cerebral MRI During the First Year of Life.
Neurology
January 2025
Faculty of Medicine, University of Geneva, Switzerland.
Early detection of focal cortical dysplasia (FCD) using brain MRI in young children presenting with drug-resistant epilepsy may facilitate prompt surgical treatment, resulting in better control of seizures and decreased associated cognitive difficulties. Characteristics of FCD described in the literature are predominantly based on MRI findings in a fully myelinated brain; therefore, changes occurring during early brain maturation are not well known. In this case report, we describe distinct MRI features of a FCD visualized best before completion of myelination of the cortex and subcortical white matter.
View Article and Find Full Text PDFPearls and Oy-sters: A Patient on Lecanemab Newly Diagnosed With Atrial Fibrillation.
Neurology
December 2024
From the Department of Neurology (D.R., A.J.L.), Duke University School of Medicine, Durham; and Department of Surgery (B.A.Z.), Duke University, Durham, NC.
Article Synopsis
- * Her CHADS-VASc score of 6 indicates a high risk for stroke, typically necessitating anticoagulation treatment.
- * However, the use of anticoagulants is not recommended for patients on lecanemab, leading to a management dilemma that requires careful consideration and potential alternative solutions.
Pearls & Oy-sters: Breaking Bad CIDP: Recognition of Anti-NF155 Autoimmune Nodopathy in Refractory CIDP.
Neurology
November 2024
From the Rutgers New Jersey Medical School (R.S., N.J.B., W.G.H., J.H.P.), Newark; East Orange Veterans Hospital (W.G.H., J.H.P.), NJ; University of Pennsylvania (E.L., M.S.), Philadelphia; and Philadelphia VA Medical Center (E.L.), PA.
Pearls & Oy-sters: Neurologic Involvement in Shiga Toxin-Associated Hemolytic Uremic Syndrome.
Neurology
November 2024
From the Department of Neurology (T.A.F., C.B.), and Department of Biomedical Imaging and Image-guided Therapy (M.T.S.), Medical University of Vienna, Austria.
Article Synopsis
- Shiga toxin-producing E. coli (STEC) is a key cause of bacterial enteritis and can lead to severe complications like hemolytic uremic syndrome (HUS), characterized by hemolytic anemia, low platelet count, and kidney dysfunction.
- HUS primarily damages small blood vessels, particularly in the kidneys and brain, with rare neurologic symptoms such as altered consciousness and seizures primarily observed in adults.
- A case report of a 52-year-old woman revealed multiple craniocervical dissections linked to STEC-HUS-encephalopathy, suggesting that Shiga toxin damage may extend beyond small vessels to larger blood vessels as well.
Pearls & Oy-sters: Vocal Cord Palsy as the Presenting Manifestation of Neurosarcoidosis.
Neurology
November 2024
From the Department of Neurology, University of Pittsburgh Medical Center, PA.
Article Synopsis
- - The case discusses a 64-year-old woman with a complex set of symptoms including difficulty speaking and swallowing, which led to the consideration of various potential diagnoses, including neurosarcoidosis.
- - Diagnostic procedures revealed cranial nerve palsies; while MRI was inconclusive, CT scans indicated vocal cord paralysis, and lab tests showed elevated CSF biomarker levels, supporting the diagnosis of neurosarcoidosis.
- - Treatment with steroids and infliximab showed significant improvement in her symptoms and highlights the importance of CSF sIL-2R as a useful biomarker while also promoting the use of steroid-sparing therapies in managing the condition.
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