eNeurologicalScieNeurologicalSci Vol 2

March 2016 | Pages 1-30

Review Article

Prevention, management, and rehabilitation of stroke in low- and middle-income countries

Lijing L. Yan, Chaoyun Li, Jie Chen, J. Jaime Miranda, Rong Luo, Janet Bettger, Yishan Zhu, Valery Feigin, Martin O'Donnell, Dong Zhao, Yangfeng Wu

Although stroke incidence in high-income countries (HICs) decreased over the past four decades, it increased dramatically in low- and middle-income countries (LMICs). In this review, we describe the current status of primary prevention, treatment, and management of acute stroke and secondary prevention of and rehabilitation after stroke in LMICs. Although surveillance, screening, and accurate diagnosis are important for stroke prevention, LMICs face challenges in these areas due to lack of resources, awareness, and technical capacity.


Original Articles

Computed tomography scanning and stroke mortality in an urban medical unit in Cameroon

Alain Lekoubou, Clovis Nkoke, Anastase Dudzie, Andre Pascal Kengne

Despite the increasing availability of head computerized tomography (CT) in resource-limited settings, it is unclear if brain-imaging-based diagnosis of stroke affects the outcomes in the absence of dedicated structures for acute stroke management

MPV17-related hepatocerebral mitochondrial DNA depletion syndrome (MPV17-NNH) revisited

Clifford Qualls, Mario Kornfeld, Nancy Joste, Abdul-Mehdi Ali, Otto Appenzeller

MPV17-related hepatocerebral mitochondrial DNA depletion syndrome (previously known as Navajo neurohepatopathy) was discovered in children in the Four Corner's region of New Mexico approximately 40 years ago. This disease is associated with a single missense mutation in exon 2 in the MPV17 gene. The syndrome has now been recognized world-wide. We find that huge quantities of neurotoxins were present in archived nervous tissues from such patients. Arsenic was increased 18 ×, cadmium ~ 10 ×, cobalt 2.5 × and manganese 2.3 ×; the largest increase was in mercury content 16,000 × compared to contemporaneous fresh-frozen normal nervous tissues.

Testing cranial nerve VII: It is all in the wording

Caroline Freilinger, Eva Auffenberg, Christina Lipski, Tobias Freilinger

During our practice of clinical neurological examination we frequently observed that patients, upon testing of cranial nerve VII, when instructed to "wrinkle their forehead" (to evaluate the innervation of the M. frontalis), seem to falsely "frown" (i.e. innervate the corrugator supercilii). Here, we set out to prospectively evaluate prevalence and characteristics of this phenomenon. Using a semi-structured questionnaire, we show that the majority of colleagues at our center shared our observation.

Late-onset myasthenia gravis is predisposed to become generalized in the elderly

Waka Sakai, Naoko Matsui, Mitsuyo Ishida, Takahiro Furukawa, Yoshimichi Miyazaki, Koji Fujita, Ryosuke Miyamoto, Nobuaki Yamamoto, Wataru Sako, Kenta Sato, Kazuya Kondo, Yoshihiko Nishida, Takao Mitsui, Yuishin Izumi, Ryuji Kaji

The continuous increase in the number of patients presenting with late-onset myasthenia gravis (LOMG) underscores the need for a better understanding of the clinical course and the establishment of an optimal therapeutic strategy. We aimed to clarify factors associated with clinical outcomes in LOMG.


Letters to the Editor

Dalfampridine is associated with de novo occurrence or reoccurrence of positive sensory symptoms in MS

C. Solaro, E. Trabucco, M. Messmer Uccelli

Oral extended release dalfampridine (FA) is a recently approved medication that blocks voltage-dependent potassium channels inhibiting functioning of axonal membranes. It results in improved conduction affecting ambulation in a subgroup of patients with multiple sclerosis (MS) [1–2].