eNeurologicalScieNeurologicalSci Vol 26

March 2022

Original Articles

Zonisamide improves axial symptoms in dementia with Lewy bodies with parkinsonism: Post hoc analysis of clinical trials

Yoshio Tsuboi, Kenji Kochi, Hidenori Maruyama, Yuji Matsumoto

  • Article 100384
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  • https://doi.org/10.1016/j.ensci.2021.100384
  • Abstract

    Patients with dementia with Lewy bodies (DLB) experience worsening axial symptoms with disease progression, which can negatively affect quality of life. Previous phase 2 and 3 clinical trials conducted in Japan showed that zonisamide improved parkinsonism in patients with DLB.

    In the present study, we performed a post hoc analysis of pooled data from the previous phase 2 and 3 trials to examine the effect of zonisamide on axial symptoms in this patient group. Our findings indicate that zonisamide may improve axial symptoms in DLB with parkinsonism and, thus, may potentially reduce the risk of falls and improve quality of life in this vulnerable patient population.

Predictors of high functional disability and mortality at 3 months in patients with status epilepticus

Dannys Rivero Rodríguez, Graham Pluck

  • Article 100389
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  • https://doi.org/10.1016/j.ensci.2021.100389
  • Abstract

    There are differences in epidemiology, etiology, and outcome in status epilepticus (SE) between developing and developed countries, which limits generalizability. We evaluated factors related to outcome at 3 months in SE patients in a developing country- Ecuador.

    Mortality rate at 3 months for SE patients was high. Glasgow Coma Scale, Charlson Index, and brain lesions were associated with unfavorable outcome, including mortality. Overall, the results were similar to those reported in more developed countries, but some differences, including overall higher mortality, prevalence of nonconvulsive SE, and lack of association of age with outcome were evident.

Demographic and institutional predictors of stroke hospitalization mortality among adults in the United States

Gabriel Neves, Travis Cole, Jeannie Lee, Tulio Bueso, ... Victor Montalvan

  • Article 100392
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  • https://doi.org/10.1016/j.ensci.2022.100392
  • Abstract

    Stroke remains a primary source of functional disability and inpatient mortality in the United States (US). Recent evidence reveals declining mortality associated with stroke hospitalizations in the US. However, data updating trends in inpatient mortality is lacking. This study aims to provide a renewed inpatient stroke mortality rate in a national sample and identify common predictors of inpatient stroke mortality.

    In this cross-sectional study, we analyzed data from a nationwide database between 2010 and 2017. We included patient encounters for both ischemic (ICD9 433–434, ICD10 I630–I639) and hemorrhagic stroke (ICD9 430–432, ICD10 I600–I629). We performed an annual comparison of in-hospital stroke mortality rates, and a cross-sectional analytic approach of multiple variables identified common predictors of inpatient stroke mortality.

    This study identified a continuous declining rate in in-hospital mortality due to stroke in the United States, and it also identified demographic and hospital predictors of inpatient stroke mortality.


Case Reports

A complex form of hereditary spastic paraplegia harboring a novel variant, p.W1515*, in the SPG11 gene

Kensuke Daida, Yosuke Nishioka, Yuanzhe Li, Hiroyo Yoshino, ... Kenya Nishioka

  • Article 100391
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  • https://doi.org/10.1016/j.ensci.2021.100391
  • Abstract

    Individuals with hereditary spastic paraplegia (HSP) are known to present with a variety of symptoms, including intellectual disability, cognitive decline, parkinsonism, and epilepsy. We report here our experience of treating a family with consanguinity, including three patients with HSP-related symptoms.

A case report of platypnea-orthodeoxia syndrome: A rare condition found during diagnostic workup of a patient with embolic stroke of undetermined sources

Keita Mizuma, Azusa Sugimoto, Yasuhide Mochizuki, Toshiro Shinke, Kenjiro Ono

  • Article 100393
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  • https://doi.org/10.1016/j.ensci.2022.100393
  • Abstract

    Platypnea-orthodeoxia syndrome (POS) is a rare condition wherein the magnitude of the interatrial shunt changes between the sitting and supine positions. We diagnosed POS in a case initially considered to be of embolic stroke of undetermined source and performed emergency foramen ovale closure as definitive management for the patient.

    In this case, additional risk factors for POS include spinal deformity, meandering of the aorta, and exclusion of the right atrium due to overextension. Transcranial color flow imaging is recommended for the diagnosis of POS because of its sensitivity, specificity, and non-invasiveness. Although POS is an important barrier to effective rehabilitation, early diagnosis and definitive management lead to dramatic clinical improvement.


Letters to the Editor

Vogt-Koyanagi-Harada disease – A diagnostic pitfall for neurologists

Minji Song, Seol-Hee Baek, Sun-Uk Lee, Sungwook Yu, Ji-Soo Kim

  • Article 100390
  • https://doi.org/10.1016/j.ensci.2021.100390
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