tag:blogger.com,1999:blog-87078752936098840512024-03-12T20:02:39.978-07:00NeuroTV.netVisual contents from clinical cases, surgical procedures and research in neurology, neurosurgery and other neurosciences.Unknownnoreply@blogger.comBlogger65125tag:blogger.com,1999:blog-8707875293609884051.post-72774328740296838962013-04-30T08:08:00.001-07:002013-04-30T08:08:57.328-07:00Structural and molecular interrogation of intact biological systems<br />
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<br /><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-69852470030301101582013-04-21T00:30:00.000-07:002013-04-21T00:30:14.578-07:00Brain Control with Light<br /><div class="separator" style="clear: both; text-align: center;">
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<br /><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-47012853492962464702012-12-18T11:18:00.000-08:002012-12-18T11:18:20.382-08:00One Giant Bite: Woman with Quadriplegia Feeds Herself Chocolate Using Mind-Controlled Robot Arm <div class="separator" style="clear: both; text-align: center;">
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<br /><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-40126463963983411852012-10-14T01:36:00.000-07:002012-10-14T01:36:00.621-07:00 Alzheimer's Disease: A Guide for Patients and Families <div class="separator" style="clear: both; text-align: center;">
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<br /><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-34535800496131638412012-10-12T01:14:00.001-07:002012-10-12T01:14:03.866-07:00Biomarkers for Alzheimer: Movie showing the accumulation of amyloid plaques ...<a href="http://bioalz.blogspot.com/2012/10/movie-showing-accumulation-of-amyloid.html?spref=bl">Biomarkers for Alzheimer: Movie showing the accumulation of amyloid plaques ...</a>: Using Pittsburgh compound B based PET imaging, the following movie shows the accumulation of amyloid plaques in carriers of autosomal dom...<div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-41138190879247974612012-08-11T12:41:00.001-07:002012-08-11T12:41:19.192-07:00How I'm preparing to get Alzheimer's<object height="374" width="526"><param name="movie" value="http://video.ted.com/assets/player/swf/EmbedPlayer.swf"></param>
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Punding is defined as a constellation of complex, sterile and stereotyped behaviours including an intense fascination with repetitive manipulations of technical equipment, the continual handling, examining, and sorting of common objects, excessive grooming, hoarding, incessant fidgeting at clothes or oneself, pointless driving or walkabouts, and the engagement in extended monologues devoid of rational content.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1</a> It was first described in amphetamine and cocaine addicts in 1972,<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B2">2</a> and the term comes from the Swedish slang for "block-head" used by amphetamine addicts to describe their repetitive and pointless activities.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B3">3</a> Since Friedman’s first description of punding in an L-dopa treated patient in 1994, there has been increased interest in this largely unrecognised behavioural disorder leading to appreciable morbidity in Parkinson’s disease.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B4">4</a> It has also been attributed to the use of dopamine agonists,<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B5">5</a> and two cases of punding behaviours have been described after starting the antipsychotic quetiapine, although the patients were also on L-dopa.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B6">6</a> <br />
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<b>EPIDEMIOLOGY OF PUNDING IN PARKINSON’S DISEASE</b>In the only two published prevalence studies, punding was present in 1.4–14% of patients.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1,</a> <a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B7">7</a> There were no differences in gender, age or severity of disease between the punders and non-punders.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1</a> However, punding is almost certainly under-recognised because of a low awareness among physicians, and the reluctance of patients to divulge "irrelevant" or embarrassing details of their behaviour.<br />
<a _proxy_jslib_is_proxified="true" href="http://www.blogger.com/blogger.g?blogID=8707875293609884051#editor/target=post;postID=1167239268541885835" name="S4"></a><br />
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<b>PHENOMENOLOGY </b><br />
Punding is characterised by repetitive pointless behaviours that are carried out for long periods of time at the expense of all other activities. They have a compulsive flavour to them and any interruption or disruption of the activity from an outside source frequently leads to irritation, anxiety and frustration. The behaviour is irresistible but rarely considered to be pleasurable. It is often carried out overnight leading to sleep deprivation. The chosen behaviour is frequently related to the individual’s previous occupation, hobbies and pastimes. One of our patients who was a musician wrote thousands of musical lyrics over a short period, while a retired carpenter occupied himself with unnecessary joinery projects in his home. A retired seamstress spent hours cataloguing and sorting her large collection of buttons. One patient spent many hours pointlessly drawing (<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#NNP07060397F01">fig 1</a>) while another spent most of the day on his computer cataloguing all types of data, including excessive detailing of medications and sleeping patterns, which he emailed to his doctor every month (<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#NNP07060397F02">fig 2</a>). A feature of the behaviour is that it is never ending, it is disorganised and frequently leaves chaos in its wake. Most patients concede its pointlessness and often acknowledge its ultimate self-destructiveness. Punding can cause social avoidance, severe sleep deprivation, and disintegration of family relationships.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1</a> In most cases it is the family members who describe the full social and functional impact of these behaviours on the patients’ lives.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B7">7</a><br />
Punding is often associated with the dopamine dysregulation syndrome/impulse control disorders such as hypersexuality, pathological gambling and L-dopa-induced dyskinesias <a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1,</a> <a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B8">8</a> Evans and colleagues showed that punders were taking higher daily amounts of dopaminergic medications than non-punders.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1</a> Punding behaviours may be homologous to amphetamine-induced stereotypies in animals, suggesting that punding is related to plastic changes in the ventral and dorsal striatal structures, including the nucleus accumbens.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B8">8</a><br />
In contrast to obsessional compulsive disorder, intrusive fears and thoughts causing distress are not an associated feature in punding, and the motor behaviours are quite different.<a _proxy_jslib_is_proxified="true" href="http://www.infodoctor.net/cgi-bin/nph-sen.cgi/001000A/http/pn.bmj.com/cgi/content/full/7/6/397#B1">1</a> Punding also differs from mania and hypomania because punders do not demonstrate features such as excessive talking or pressured speech, racing thoughts or flight of ideas and grandiosity. Mania is often associated with an indiscriminate enthusiasm for multiple tasks, unlike punding where the focus usually remains on a single prolonged and repetitive motor activity. <br />
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<a _proxy_jslib_is_proxified="true" href="http://www.blogger.com/blogger.g?blogID=8707875293609884051#editor/target=post;postID=1167239268541885835" name="S5"></a><b>IDENTIFICATION AND TREATMENT OF PUNDING IN PARKINSON’S DISEASE</b>A high index of suspicion is required if punding is to be detected early. Family members may need to be interviewed separately. Some specific questions may help to tease out the possibility of punding<br />
Management can be difficult but the gradual reduction of dopaminergic treatment with the help of the family is often effective and the discontinuation of rescue doses of treatment should be enforced. Treatment of insomnia may need to be addressed independently by a combination of patient- and family-enforced restrictions of nocturnal activities, often in addition to short-term prescription of hypnotics. A trial of low dose quetiapine (12.5–50 mg at night) may be indicated if these measures are ineffective, and any associated psychotic or depressive symptoms should be treated appropriately. <br />
<br />
<br />
<span style="font-size: 85%;"><b>References</b><br />Evans AH, Katzenschlager R, Paviour D, et al. Punding in Parkinson’s disease: its relation to the dopamine dysregulation syndrome. Mov Disord 2004; 19: 397–405.</span><span style="font-size: 85%;"><br />Rylander G. Psychoses and the punding and choreiform syndromes in addiction to central stimulant drugs. Psychiatr Neurol Neurochir 1972; 75: 203–12.</span><span style="font-size: 85%;"><br />Schiorring E. Psychopathology induced by "speed drugs". Pharmacol Biochem Behav 1981; 14(Suppl 1): 109–22.</span><span style="font-size: 85%;"><br />Friedman JH. Punding on levodopa. Biol Psychiatry 1994; 36: 350–1.</span><span style="font-size: 85%;"><br />Nirenberg MJ, Waters C. Compulsive eating and weight gain related to dopamine agonist use. Mov Disord 2006; 21: 524–9.</span><span style="font-size: 85%;"><br />Miwa H, Morita S, Nakanishi I, et al. Stereotyped behaviors or punding after quetiapine administration in Parkinson’s disease. Parkinsonism Relat Disord 2004; 10: 177–80.</span><span style="font-size: 85%;"><br />Miyasaki JM, Al Hassan K, Lang AE, et al. Punding prevalence in Parkinson’s disease. Mov Disord 2007; 22: 1179–81.</span><span style="font-size: 85%;"><br />Silveira-Moriyama L, Evans AH, Katzenschlager R, et al. Punding and dyskinesias. Mov Disord 2006; 21: 2214–17.</span><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-32275930670681019092011-12-27T09:08:00.001-08:002011-12-27T09:08:29.873-08:00Mirror movements in parkinsonism: evaluation of a new clinical signRepresentative examples of the four UPDRS-motor tasks used in the assessment of mirror movements: finger tapping (item 23), hand movement (item 24), forearm pronation-supination (item 25), and foot tapping (item 26). The MM scores determined during blinded rating for these selected cases are shown prior to each task<br /><br />
<object class="BLOG_video_class" contentid="f18e4bad59541c79" height="266"<div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-55039575532120449912011-12-27T08:59:00.002-08:002011-12-27T09:00:06.057-08:00Steppage gait<object height="355" width="425"><param name="movie" value="http://www.youtube.com/v/ny0b_Audmak&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/ny0b_Audmak&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-73137904502414959242011-12-27T08:59:00.000-08:002011-12-27T08:59:06.616-08:00Cerebellar gait: trying to do tandem walk<object height="355" width="425"><param name="movie" value="http://www.youtube.com/v/5Dj827uCP3g&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/5Dj827uCP3g&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object><a class="cssButton" href="javascript:void(0)" id="publishButton" onclick="if (this.className.indexOf("ubtn-disabled") == -1) {var e = document['postingForm'].publish;(e.length) ? e[0].click() : e.click(); if (window.event) window.event.cancelBubble = true; return false;}" target=""></a><br />
<div class="cssButtonOuter"><div class="cssButtonMiddle"><div class="cssButtonInner"><a class="cssButton" href="javascript:void(0)" id="publishButton" onclick="if (this.className.indexOf("ubtn-disabled") == -1) {var e = document['postingForm'].publish;(e.length) ? e[0].click() : e.click(); if (window.event) window.event.cancelBubble = true; return false;}" target="">Publicar entrada</a></div></div></div><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-6370268064440162242011-12-27T08:58:00.001-08:002011-12-27T08:58:13.358-08:00Hemiballismus<object height="355" width="425"><param name="movie" value="http://www.youtube.com/v/BsBFxhdGl0Q&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/BsBFxhdGl0Q&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-11207660316555192252011-12-27T08:57:00.001-08:002011-12-27T08:57:48.181-08:00Cerebellar disease examination<object height="355" width="425"><param name="movie" value="http://www.youtube.com/v/NLqFiIVchbg&rel=1"></param><param name="wmode" value="transparent"></param><embed src="http://www.youtube.com/v/NLqFiIVchbg&rel=1" type="application/x-shockwave-flash" wmode="transparent" width="425" height="355"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-19187642594400976492011-12-08T00:46:00.000-08:002011-12-08T00:46:25.467-08:00Internal-Carotid-Artery Dissection and Cranial-Nerve Palsies<div class="mediaRef"></div><div style="text-align: justify;">A 45-year-old woman presented to the emergency department 3 days after the acute onset of severe dysphagia, breathy dysphonia, and earache and pulsatile tinnitus in the left ear. Her medical history was unremarkable. Physical examination revealed leftward deviation of the protruded tongue that was consistent with a lesion in cranial nerve XII, hypernasal speech and rightward deviation of the soft palate on phonation that was consistent with lesions in cranial nerves IX and X, and a paralyzed left vocal cord detected on laryngoscopic examination that was consistent with a lesion in cranial nerve X (see <a class="viewType-Layer viewClass-WiderLayer" href="http://www.nejm.org/action/showMediaPlayer?doi=10.1056%2FNEJMicm1009319&aid=NEJMicm1009319_attach_1&area=" target="_blank">video</a>). Axial magnetic resonance images of the head and neck were obtained and showed an extracranial dissection of the left internal carotid artery (see <a class="viewType-Layer viewClass-WiderLayer" href="http://www.nejm.org/action/showMediaPlayer?doi=10.1056%2FNEJMicm1009319&aid=NEJMicm1009319_attach_1&area=" target="_blank">video</a>), with delayed perfusion of the left hemisphere but no evidence of ischemic stroke. The acute onset of cranial-nerve palsies accompanied by pain in the head, neck, or ear should prompt physicians to consider a diagnosis of internal-carotid-artery dissection. Most peripheral palsies are associated with cranial nerves IX through XII. This patient was treated conservatively and showed complete neurologic recovery at a 6-month follow-up examination.</div><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-90246414950232873532011-10-20T10:34:00.000-07:002012-12-06T01:45:10.373-08:00Movement Disorders on YouTube — Caveat Spectator<div style="text-align: justify;">
For many patients and their families, the Internet has become the
primary resource for medical information, in addition to providing a
forum for patients to share their personal experiences. Movement
disorders, which include Parkinson's disease, dystonia, and tremor, are
common neurologic conditions that readily lend themselves to
demonstration by video. We were recently alerted by our patients to
content regarding movement disorders. <br />
<br />
<a name='more'></a><br /><br />
However, a brief search revealed that many of the videos seemed to us
to be atypical for the specific form of movement disorder the person in
the video was purported to have. In fact, some of the videos showed
movements characteristic of psychogenic movement disorders, the
movement-disorder counterpart of conversion disorder (i.e., symptoms
that are not attributable to a medical disorder or to feigning and are
judged to be associated with psychological factors). We therefore asked seven neurologists who were experts in movement
disorders to independently evaluate the most frequently viewed YouTube
videos of patients purported to have a movement disorder and to judge
whether the movement disorder depicted appeared to be psychogenic or
organic.</div>
<div style="text-align: justify;">
Using the keywords dystonia, Parkinson's, chorea,
myoclonus, tics, and tremor, we searched YouTube in January 2011 and
selected videos from the top 3% of the most often viewed videos in each
category that were uploaded by patients and were of sufficient quality.
Although a proper diagnosis of organic or psychogenic movement disorder
relies on the results obtained from the patient's history and
standardized examinations (which were not available to the raters),
movement disorders by their nature can be seen and evaluated without
special examination techniques. We asked the raters to base their
judgments on published diagnostic criteria for psychogenic movement
disorders<span class="ref"><a class="showRefLayer" href="http://www.nejm.org/doi/full/10.1056/NEJMc1107673#ref2" rel="#refLayer">2</a></span> that are related to aspects of the movement disorder apparent on simple observation.</div>
<div style="text-align: justify;">
Of
29 videos showing people with movement disorders, 66% were rated as
psychogenic and 34% as organic, with excellent interrater agreement.
The accompanying comments on the site recommended specific treatments
in 53% of the videos considered to show a psychogenic movement disorder
but in only 20% of those considered to show an organic movement
disorder.</div>
<div style="text-align: justify;">
For patients with a movement disorder, the information
available on YouTube may be misleading and may provide an inaccurate
impression of the disorder and its treatment. One video described as
showing facial dystonia showed different patterns of facial spasm that
appeared to be triggered by an electrical stimulator, and it suggested
that dystonia could be alleviated if the patient wore cotton clothes and
avoided radiation. Other recommendations were potentially more serious,
proposing the use of immunosuppressive agents or invasive or expensive
diagnostic tests, and some videos claimed that profound benefit could be
had from interventions such as craniosacral massage and herbal remedies
prescribed by health care providers.</div>
<div style="text-align: justify;">
The fact that such a large
number of videos showing psychogenic movement disorders are available on
the Internet highlights an underlying problem that affects virtually
every medical specialty, and the information these videos provide can
interfere with the effective recognition and care of patients with a
movement disorder. Physicians should caution their patients to be wary
of relying on information from potentially unreliable Web sources and
should also help to make reliable medical information freely available
to those with either organic or psychogenic disorders.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: right;">
Taken from <span class="citation">N Engl J Med 2011; 365:1160-1161</span> </div>
<div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-21174503779568725482011-10-12T10:28:00.000-07:002011-10-12T10:28:53.378-07:00Benedikt syndrome with cerebellar syndome<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dww0V-7klLOSwz2y_zVfzfBO9emiY1a2FZSoKQ74UDlKQO6574mrAc6fccopSKMfqQ8tyIQr8-dJoHrDu1G' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div>
<div style="text-align: right;">
<br /></div><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-44253987957498406352011-10-12T10:26:00.001-07:002011-10-12T10:26:41.932-07:00Alien hand syndrome. Visual grasp<div class="separator" style="clear: both; text-align: center;">
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<br /><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Carlos Vázquezhttp://www.blogger.com/profile/09266699098392968330noreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-87441190977603156272010-12-13T14:22:00.000-08:002010-12-13T14:22:19.309-08:00Complex partial seizure evolving into a psychogenic nonepileptic seizure<div style="text-align: justify;">An 11-year-old, right-handed girl was admitted for video-EEG monitoring of nocturnal paroxysms consisting of eye opening, groans, right arm shaking, and altered consciousness (see video on the Neurology® Web site at www.neurology.org). Ictal video-EEG suggested a left frontal seizure; subsequent behavioral disturbances including dysrhythmic right arm shaking and confusion continued without electrographic correlate (figure). Although epileptic and nonepileptic seizures frequently coexist, this case illustrates the rare direct evolution of a complex partial epileptic seizure into a nonepileptic seizure and highlights the importance of video-EEG monitoring in discerning epileptic from nonepileptic events.1 Ictal activation or disinhibition of emotional neural circuitry is one proposed mechanism for this phenomenon. </div><br />
<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dzsuEqgs4VZF28peLcVBicyGZbgsuXxRSQtt1-LoJ-FicLBBMHHNlP09JKNGkALIsd7QIv4P4F3VhIFAww86Q' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><div style="text-align: justify;"><span lang="EN-US" style="font-family: "Times New Roman", "serif"; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">The initial episode of eye opening out of sleep with vocalization, right arm shaking and impaired consciousness correlated with a left frontal electrographic seizure; continued dysrythmic right arm movements and confusion occurred without EEG correlation. </span></div><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://www.neurology.org/content/75/24/e98/F1.medium.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="286" n4="true" src="http://www.neurology.org/content/75/24/e98/F1.medium.gif" width="400" /></a></div><div style="text-align: justify;">Figure EEG recording (A) Left frontal electrographic seizure with right arm clonic activity (see arrow). (B) No further electrographic seizure activity during continued right arm dysrhythmic jerking movements. Sensitivity 10 μV/mm.</div><br />
<div style="text-align: right;">Taken from: Neurology December 13, 2010 vol. 75 no. 24 e98 </div><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-37988798770567285092010-04-05T08:07:00.000-07:002011-12-27T09:06:37.596-08:00Cycling for Freezing of GaitA 58-year-old man with a 10-year history of idiopathic Parkinson's disease presented with an incapacitating freezing of gait (Panel A,<a href="http://content.nejm.org/cgi/content/full/362/13/e46/DC1"> Video 1</a>). The patient had severe difficulties initiating gait and was able to take only a few shuffling steps when provided with a visual cue (the examiner's foot placed in front of the patient). Attempts to walk evolved rapidly into forward festination and ultimately a fall to the ground. Axial turning was impossible. However, the patient's ability to ride a bicycle was remarkably preserved (Panel B, <a href="http://content.nejm.org/cgi/content/full/362/13/e46/DC1">Video 2</a>). Gait freezing recurred instantaneously after he dismounted the bicycle. This striking kinesia paradoxica may be explained by the bicycle's rotating pedals, which may act as an external pacing cue. Alternatively, the motor-control mechanisms involved in gait as compared with other activities engaging the legs, such as cycling, could be affected differentially in Parkinson's disease. Cycling may offer a useful approach for exercise training in patients with Parkinson's who are "grounded" by severe freezing of gait. (Editor's note: In Video 2, the patient is not wearing a safety helmet because in the Netherlands, unlike the United States, wearing a safety helmet is neither required by law nor customary.)<div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-52407838444434846162010-03-30T08:56:00.000-07:002010-03-30T08:56:08.964-07:00Fourth ventricle epidermoid cys tumor in a 45 year male. Complete Surgical excision<object width="480" height="385"><param name="movie" value="http://www.youtube.com/v/5qa2ltDL4F8&hl=es_ES&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/5qa2ltDL4F8&hl=es_ES&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="480" height="385"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-66368845486772931002010-01-27T13:54:00.000-08:002010-01-27T13:54:37.232-08:00El derrame cerebral de iluminación<object width="560" height="340"><param name="movie" value="http://www.youtube.com/v/wsvlhmdFulU&hl=es_ES&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/wsvlhmdFulU&hl=es_ES&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="560" height="340"></embed></object><br />
La Dra. Jill Bolte Taylor es una neuroanatomista estadounidense que a finales de 1996 sufrió un derrame cerebral del cual tardó en recuperarse 8 años.<br />
<br />
En esta fascinante y espectacular conferencia explica las diferencias entre los hemisferios del cerebro humano y nos invita a percibir al mundo de una manera diferente.<div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-66801445886363401652010-01-17T01:47:00.001-08:002010-01-17T01:47:24.295-08:00Myotonic "Fainting" Goats<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/j5kKoBOfPJk&hl=es_ES&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/j5kKoBOfPJk&hl=es_ES&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-4512919589860444152010-01-17T01:40:00.001-08:002010-01-17T01:40:58.518-08:00Vilayanur Ramachandran: A journey to the center of your mind<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/Rl2LwnaUA-k&hl=es_ES&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/Rl2LwnaUA-k&hl=es_ES&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-15334993145971738692010-01-17T01:04:00.000-08:002010-01-17T01:04:14.862-08:00Movement Disorders Mime Video<object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/R-efPKM5_7k&hl=es_ES&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/R-efPKM5_7k&hl=es_ES&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-20517105423117609772009-11-01T02:47:00.001-08:002009-11-01T02:48:53.649-08:00Abduction palsy<p><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dzmjeTdwr7Xzt8HIkHy9cs1brWAqHGieLrJuf-EBms4T4G7Cag3QKAiJVXfie-P8zAE2ApPtSL-lCDOhQqfMw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></p><p></p><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dxgRmkOLxG0NFbPnjp8PGHM4Ypf3iah8QqQoWAMAeDEaLhj5eYlGWliAywU9IFd74QuOpQ6Vjf2BnAUjEP4mw' class='b-hbp-video b-uploaded' frameborder='0'></iframe><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-8707875293609884051.post-45464887982812150102009-03-08T00:30:00.000-08:002009-03-08T00:47:39.183-08:00Pendular Nystagmus and Palatomyoclonus from Hypertrophic Olivary Degeneration<a href="http://content.nejm.org/content/vol360/issue9/images/large/12f1.jpeg"><img style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 371px; CURSOR: hand; HEIGHT: 219px; TEXT-ALIGN: center" alt="" src="http://content.nejm.org/content/vol360/issue9/images/large/12f1.jpeg" border="0" /></a> <div></div><div></div><div align="justify">A 50-year-old woman with hypertension had an acute pontine hemorrhage, as seen on computed tomography (Panel A, arrow), which resulted in quadriplegia. Thirty months later, she reported having difficulty reading because of oscillopsia. The physical examination revealed pendular nystagmus (two cycles per second) with a predominantly vertical component and some horizontal and torsional eye movements (<a href="http://content.nejm.org/cgi/content/full/360/9/e12/DC1">Video 1</a>). She also had palatomyoclonus, seen as rhythmic, involuntary contractions of the soft palate and pharyngopalatine arch (one to two cycles per second) (<a href="http://content.nejm.org/cgi/content/full/360/9/e12/DC1">Video 2</a>). T2-weighted magnetic resonance imaging of the brain showed hyperintensity and enlargement of the inferior olivary nuclei, findings that were compatible with a diagnosis of hypertrophic olivary degeneration (Panel B, arrowheads). The condition, which may be caused by trauma, infection, demyelination, neoplasm, or vascular injury in the components of the dentatorubroolivary pathway, results in olivary hypertrophy rather than atrophy. Myoclonic contractions of the soft palate and nystagmus represent the effects of transsynaptic degeneration of the inferior olivary nuclei. After treatment with trihexyphenidyl, there was some improvement in the patient's visual symptoms.</div><div align="justify"></div><div align="justify"><span style="font-size:85%;"><strong>References:</strong></span></div><div align="justify"><span style="font-size:85%;">Lim CC</span><span style="font-size:85%;">, </span><span style="font-size:85%;">Lim SA</span><span style="font-size:85%;">. Pendular nystagmus and palatomyoclonus from hypertrophic olivary degeneration. </span><span style="font-size:85%;">N Engl J Med.</span><span style="font-size:85%;"> 2009 Feb 26;360(9):e12.</span></div><div class="blogger-post-footer">Neuroteka belongs to iMedPub.</div>Unknownnoreply@blogger.com0