scholarly journals Clinical spectrum and diagnostic pitfalls of neurologic syndromes with Ri antibodies

2020 ◽  
Vol 7 (3) ◽  
pp. e699 ◽  
Author(s):  
Claire Simard ◽  
Alberto Vogrig ◽  
Bastien Joubert ◽  
Sergio Muñiz-Castrillo ◽  
Géraldine Picard ◽  
...  

ObjectiveTo describe the main syndrome and clinical course in a large cohort of patients with anti–Ri-associated paraneoplastic neurologic syndrome (Ri-PNS).MethodsTwenty-year retrospective nationwide study and systematic review of the literature.ResultsThirty-six patients with complete clinical information were identified (median age 66 years, range: 47–87 years). In this French cohort, the majority were women (78%). At onset, 4 main patterns were observed: cerebellar syndrome (39%), isolated tremor (24%), oculomotor disturbances (17%), and other symptoms (19%). Course was multistep for 78% of cases. At the time the disease reached the plateau phase (median 12 weeks, range: 1–64 weeks; 28% >3 months), 24 (67%) showed an overt cerebellar syndrome, which was isolated in 3 patients, and was most frequently (21/24 cases) part of a multisystem neurologic disease. Patients manifested a variety of movement disorders, including myoclonus (33%), dystonia (17%), either cervical or oromandibular, and parkinsonism (17%). Most patients had cancer (92%), mainly breast cancer (n = 22). Misdiagnoses concerned 22% of patients (n = 8) and included atypical parkinsonism (n = 2), MS (n = 2), Bickerstaff encephalitis (n = 1), hyperekplexia (n = 1), vestibular neuritis (n = 1), and functional neurologic disorder (n = 1). Survival at 12 months was 73% (95% CI [0.54–0.85]), at 24 months 62% (95% CI [0.41–0.78]), and at 36 months 47% (95% CI [0.25–0.65]). There was no major clinical difference between cases retrieved from the systematic review of the literature (n = 55) and the French cohort.ConclusionsRi-PNS is a multisystem neurologic syndrome with prominent cerebellum/brainstem involvement. Opsoclonus-myoclonus is less common than expected, and the disorder can mimic neurodegenerative diseases.

2020 ◽  
Vol 5 (1) ◽  
pp. 326-338 ◽  
Author(s):  
Kristen Weidner ◽  
Joneen Lowman

Purpose We conducted a systematic review of the literature regarding adult telepractice services (screening, assessment, and treatment) from approximately 2014 to 2019. Method Thirty-one relevant studies were identified from a literature search, assessed for quality, and reported. Results Included studies illustrated feasibility, efficacy, diagnostic accuracy, and noninferiority of various speech-language pathology services across adult populations, including chronic aphasia, Parkinson's disease, dysphagia, and primary progressive aphasia. Technical aspects of the equipment and software used to deliver services were discussed. Some general themes were noted as areas for future research. Conclusion Overall, results of the review continue to support the use of telepractice as an appropriate service delivery model in speech-language pathology for adults. Strong research designs, including experimental control, across multiple well-described settings are still needed to definitively determine effectiveness of telepractice services.


VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.


2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.


Author(s):  
L. Kristjanson ◽  
E. Lobb ◽  
S. Aoun ◽  
L. Monterosso

2020 ◽  
Author(s):  
Ryan Hess ◽  
Ahmad Kareem Almekkawi ◽  
Karl R. Abi-Aad ◽  
Rudy J. Rahme ◽  
Devi P. Patra ◽  
...  

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