关键词： Post-acute sequelae of COVID   Post-COVID syndrome   Long-hauler   Long-COVID   COVID-19   SARS-CoV-2   Outcomes   Cognitive   Quality of life   Readmission   Neurologic   Brain   Function   Anxiety   Depression   Fatigue   Sleep  

摘要： Background: Little is known regarding long-term outcomes of patients hospitalized with COVID-19. Methods: We conducted a prospective study of 6-month outcomes of hospitalized COVID-19 patients. Patients with new neurological complications during hospitalization who survived were propensity score-matched to COVID-19 survivors without neurological complications hospitalized during the same period. The primary 6month outcome was multivariable ordinal analysis of the modified Rankin Scale(mRS) comparing patients with or without neurological complications. Secondary outcomes included: activities of daily living (ADLs;Barthel Index), telephone Montreal Cognitive Assessment and Neuro-QoL batteries for anxiety, depression, fatigue and sleep. Results: Of 606 COVID-19 patients with neurological complications, 395 survived hospitalization and were matched to 395 controls;N = 196 neurological patients and N = 186 controls completed follow-up. Overall, 346/ 382 (91%) patients had at least one abnormal outcome: 56% had limited ADLs, 50% impaired cognition, 47% could not return to work and 62% scored worse than average on >= 1 Neuro-QoL scale (worse anxiety 46%, sleep 38%, fatigue 36%, and depression 25%). In multivariable analysis, patients with neurological complications had worse 6-month mRS (median 4 vs. 3 among controls, adjusted OR 1.98, 95%CI 1.23-3.48, P = 0.02), worse ADLs (aOR 0.38, 95%CI 0.29-0.74, P = 0.01) and were less likely to return to work than controls (41% versus 64%, P = 0.04). Cognitive and Neuro-QOL metrics were similar between groups. Conclusions: Abnormalities in functional outcomes, ADLs, anxiety, depression and sleep occurred in over 90% of patients 6-months after hospitalization for COVID-19. In multivariable analysis, patients with neurological complications during index hospitalization had significantly worse 6-month functional outcomes than those without.

关键词： Telemedicine   Education   Resource-limited setting  

关键词： Behcet's syndrome   Parenchymal Neuro-Behcet syndrome   Cerebral venous sinus thrombosis   Differential diagnosis   Multiple sclerosis   Neuromyelitis optica spectrum disorders   Bagel sign   Neuropathology  

摘要： Behcet's Syndrome (BS) may present with different neurological problems, related either directly (primary) or indirectly (secondary) to BS. Primary neurological involvement is named as neuro-Behcet's syndrome (NBS), and its two major subtypes that are classified mainly on the clinical and MRI findings are (1) Parenchymal-NBS (pNBS) and (2) Extra parenchymal neuro-vascular involvement mostly seen as cerebral dural venous sinus thrombosis (CVST). The less commonly seen forms of NBS are cognitive and behavioral syndromes and peripheral nervous system involvement. Parenchymal-NBS is the most common clinical neurological presentation of BS. It is a rare disease with distinct MRI features and is often included in the differential diagnosis of neuro-vascular and neuro-inflammatory disorders. The most commonly affected neuro-anatomical site in p-NBS is the meso-diencephalic junction (MDJ), followed by the ponto-bulbar and thalamic regions, the basal ganglia, and the spinal cord. These varied locations may explain to a certain extent why BS is considered in the differential of so many neurological disorders. The other relatively common form of NBS that results in CVST may also be confused with other conditions resulting in CVST, especially when the systemic clinical features suggestive of BS are missed.

关键词： Underrepresented in medicine (UIM)   Neurology leadership   Biases   Diversity   Equity and inclusion   Leadership   Nudges  

摘要： Underrepresented in medicine (UIM) academic physicians are poorly represented among medical school faculty when compared with their proportion in the US population, receive NIH research awards less frequently, are promoted less often, indicate lower career satisfaction, and report higher social isolation, than faculty who are not under-represented. Supporting a successful and sustainable workforce of UIM academic physicians is essential in neurology, because such neurologists are more likely to engage in research to reduce disparities in neurological outcomes that affect underserved and/or low-income communities, and help improve the paucity of diverse race-ethnic participation in clinical trials. Having more diverse academic neurologists serve in such roles could bolster their careers and model possibilities for others who share similar cultures and backgrounds. Beyond leading/joining diversity affairs committees, more UIM are needed in mainstream leadership roles. In this work, we explore self-application vs. appointment/nomination opportunities and how this play a role in leadership opportunities. In addition to considering appropriate weighing of self-applications vs. appointments based opportunities, we highlight approaches and introduce the concept of nudging. Nudging, which refers to purposely increasing the visibility and appeal of particular items with the goal of boosting the odds of selecting those items, has been shown to successfully influence the process of selection, and may help level the leadership playing field for UIM in neurology.

摘要： Background End-stage renal disease (ESRD) patients on haemodialysis (HD) suffer from several peripheral and central neurological complications. They are at high risk for developing silent neurological lesions (SNL) that may be detected accidentally by magnetic resonance imaging (MRI). Many factors are implicated in the development of neurological deficits in ESRD patients on HD. Aim of the Work Evaluation of SNL in young ESRD patients by using MRI and assessing its correlation with hyperparathyroidism. Methods The study involved 48 young ESRD patients (mean age of 19.6 +/- 6 years) with HD and do not have any apparent abnormalities in the neurological examination. Laboratory investigations and conventional brain MRI were done on all. Results 79.2% have SBI and 45.8% have white matter lesions. Regression analysis revealed that calcium level and duration of dialysis were independent predictor factors for the presence of silent brain MRI lesions (P = .034 & 0.045 respectively). ROC curve showed that parathyroid hormone (PTH) level >585 pg/mL, duration of dialysis >2 years, and calcium level >7.5 mg/dL predicted the presence of SNL. Conclusion The duration of HD and hyperparathyroidism (HPT) were independent predictors for the presence of SNL. MRI brain is considered as a mandatory affordable tool for HD patients >2 years and has HPT for early detection of SNL to help early intervention and avoid neurological complications and disabilities.

关键词： White-Sutton syndrome   POGZ   POGZ mutation   Epilepsy   Paroxysmal not-epileptic events   EEG abnormalities   Cognitive profile   Autism   Case report  

摘要： Background White-Sutton (WHSUS) is a recently recognized syndrome caused by mutations of the POGZ gene. Approximately 70 patients have been reported to date. Intellectual disability, hypotonia, behavioral abnormalities, autism, and typical facial dysmorphisms are recognized as WHSUS features;however, still few patients receive a comprehensive psychometric, behavioral and neurological examination. In this report, we describe the pediatric, dysmorphological, neurological, psychometric and behavioral phenotype in a new WHSUS patient due to a novel heterozygous POGZ mutation, highlighting the distinctive epileptic phenotype and the cognitive pattern. Case presentation The patient, an 8 years-old girl, presented history of hypotonia, motor and speech delay, and distinctive facial features. The diagnosis of WHSUS followed the identification of the de novo variant ***828GlyfsTer36 (c.2482dupG) in the POGZ gene. The patient showed a distinctive neurological phenotype with the occurrence of both paroxysmal not-epileptic events in the first 6 months of age and EEG abnormalities without evidence of clinical seizures after the first year of age. Psychological and behavioral testing highlighted moderate intellectual and communication deficit, mild autism spectrum and visual-motor integration deficit. Conclusions This is the first described case of WHSUS with a co-existence of paroxysmal not-epileptic events and abnormal EEG without seizures in the same patient. Together with the available literature data, this observation suggests that paroxysmal not-epileptic events could be more frequent than expected and that this feature belongs to the WHSUS phenotypic spectrum. Autism is a known comorbidity of WHSUS but is still poorly investigated. Specific clinical testing could help detect also mild autistic phenotypes and better define autism prevalence in POGZ-related syndrome. Special attention should be given to symptoms such as stereotypies, social withdrawal, and hyperactivity th

关键词： 神经精神疾病   全国性学术会议   精神病学   临床荟萃   神经内科   精神科   神经病学   被引频次  

摘要： 由国家教育部主管、中山大学主办的《中国神经精神疾病杂志》创刊于1975年,是国内神经病学、精神病学领域内具有重要影响力的专业学术性核心期刊,被引频次及影响因子居临床医学期刊前列。我刊主要报道我国神经内科、神经外科、精神科临床和基础研究的新成果,介绍相关领域研究的新进展,推广先进的诊疗技术,组织专题学术讨论和召开全国性学术会议。辟有包括专家论坛、论著、短著述、研究简报、临床荟萃、讲座、综述、疑难病例讨论等诸多栏目,全面、实时地反映最新的学术思想和临床经验,其从基础到临床的广阔领域给致力于神经科学发展的研究者们提供了博大的舞台。

关键词： 高血压   高半胱氨酸   脑梗死   神经病学表现  

摘要： 目的探讨H型高血压与大动脉粥样硬化(LAA)型急性脑梗死早期神经功能缺损严重程度的关系。方法LAA型急性脑梗死患者270例,详细记录患者一般资料,24小时内检测患者空腹血清同型半胱氨酸(Hcy)水平,根据患者有无高血压及血清Hcy水平将患者分为H型高血压组(患有高血压伴Hcy≥10μmol/L),单纯高血压组(仅患有高血压),单纯高Hcy组(仅Hcy≥10μmol/L),对照组(既无高血压又无Hcy升高);按照美国国立卫生院卒中量表(NIHSS)评定患者入院时神经功能缺损严重程度(轻度NIHSS≤5分,中重度NIHSS>5分)。分析H型高血压与LAA型急性脑梗死早期神经功能缺损严重程度的相关性。结果中重度急性脑梗死患者H型高血压发生率高于轻度急性脑梗死患者(P<0.01);高血压与高Hcy对神经功能缺损严重程度交互作用指数(S)>1,有正交互作用。结论H型高血压可能是LAA型急性脑梗死早期神经功能恶化的危险因素,并且高血压、高Hcy对神经功能恶化存在协同作用。

关键词： 柳叶刀   正常脑组织   缺血性中风患者   神经病学   血管内   时间窗   快速识别   组织转化  

摘要： “中风120”的普及能够使公众快速识别中风,在有效的时间窗内送达有条件的医院,及时进行溶栓或血管内取栓,使血流再通,脑缺血半暗带组织转化为正常脑组织,患者得到成功救治.美国宾夕法尼亚大学刘仁玉教授和复旦大学附属闵行医院赵静教授结合中国国情,提出中文版中风快速识别口诀“中风120”口诀,并于2016年10月29日“世界卒中日”在《柳叶刀神经病学》杂志向全球发布。

关键词： 重庆医科大学   医药卫生事业   副主任医师   神经病学   博士毕业   奋斗终生   博士生导师   人类身心健康  

摘要： "健康所系,性命相托……我决心竭尽全力除人类之病痛,为祖国医药卫生事业的发展和人类身心健康奋斗终生。"医学生誓言铿锵有力,他从选择医学这条道路开始,就决定用一生的热情去对待。22岁时以年级第一的成绩考入重庆医科大学研究生院;24岁获得美国神经病学会Travel Scholarship,在国际会议上作报告;27岁获得美国神经病学会国际学者奖(International Scholarship Award);博士毕业前多次受邀赴美国、加拿大、澳大利亚、欧洲国际会议做报告;32岁被评为副主任医师;35岁破格成为重庆医科大学当时最年轻的博士生导师;37岁晋升主任医师,他就是李琦。