scholarly journals Neurogenic Dysphagia: A Systematic Review and Proposal of a Classification System

Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011350
Author(s):  
Tobias Warnecke ◽  
Bendix Labeit ◽  
Jens Schroeder ◽  
Alexander Reckels ◽  
Sigrid Ahring ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Underlying Disease ◽  
Qualitative Synthesis ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Chi Square ◽  
Brainstem Stroke ◽  
Unclear Etiology

Objective:Introduction and validation of a phenotypic classification of neurogenic dysphagia based on flexible endoscopic evaluation of swallowing (FEES).Methods:A systematic literature review was conducted, searching MEDLINE from inception to 05/2020 for FEES findings in neurological diseases of interest. Based on a retrospective analysis of FEES-videos in neurological diseases and considering the results from the review, a classification of neurogenic dysphagia was developed distinguishing different phenotypes. The classification was validated using 1012 randomly selected FEES-videos of patients with various neurological disorders. Chi-square-tests were used to compare the distribution of dysphagia phenotypes between the underlying neurological disorders.Results:159 articles were identified of which 59 were included in the qualitative synthesis. Seven dysphagia phenotypes were identified: (1) “Premature bolus spillage” and (2) “delayed swallowing reflex” occurred mainly in stroke patients, (3) “predominance of residue in the valleculae” was most common in Parkinson's disease, (4) “predominance of residue in the piriform sinus” occurred only in myositis, motoneuron disease and brainstem stroke patients, (5) “pharyngolaryngeal movement disorder” was found in atypical Parkinsonian syndromes and stroke patients, (6) “fatigable swallowing weakness” was common in patients with myasthenia gravis, and (7) “complex disorder” with a heterogeneous dysphagia pattern was the leading mechanism in amyotrophic later sclerosis. The interrater reliability showed a strong agreement (kappa = 0.84).Conclusion:Neurogenic dysphagia is not a mere symptom, but a multi-etiological syndrome with different phenotypic patterns depending on the underlying disease. Dysphagia phenotypes can facilitate differential diagnosis in patients with dysphagia of unclear etiology.

The Classification of Calcium Antagonists by the WHO Expert Committee: Relevance in Neurology

Cephalalgia ◽  
1988 ◽  
Vol 8 (8_suppl) ◽  
pp. 7-10 ◽  
Author(s):  
A Agnoli
Keyword(s):  
Calcium Antagonists ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Clinical Applications ◽  
Migraine Prophylaxis ◽  
Brain Cells ◽  
Expert Committee ◽  
New Classification ◽  
Classification Of Calcium Antagonists

A new classification of calcium antagonists has been developed by a WHO expert committee. Substances acting primarily via the inhibition of calcium entry into the cell have been divided into four distinct classes. The pharmacological characteristics of these classes that may be relevant for the use in various neurological disorders are highlighted in this paper. Some main differences concern the effects on vascular smooth muscle cells and brain cells. The well-documented clinical applications in neurology are still limited to migraine prophylaxis and vertigo. The evidence concerning the usefulness in cerebral vasospasm secondary to subarachnoid haemorrhage was regarded as reasonable, whereas several neurological indications should still be regarded as being under examination. There is little doubt that calcium antagonists will gain importance in the treatment of several neurological diseases.

scholarly journals Comparison of the mortality rate due to neurological diseases in Brazil: an epidemiological study from the last 5 years

2021 ◽  
Author(s):  
Diego Paixão Côrtes Aguiar ◽  
Daniela Witz Aquino ◽  
Elisa Kalil Vinholes
Keyword(s):  
Mortality Rate ◽  
Epidemiological Study ◽  
Neurological Disorders ◽  
Professional Training ◽  
Neurological Diseases ◽  
International Classification Of Diseases ◽  
National Average ◽  
Unified Health System ◽  
Classification Of Diseases

Background: In Brazil, about 9 thousand people die annually from nervous system (NS) diseases and its complications. Additionally, the neuropathology mortality rate (MR) is in eighth place, when considering the 21 chapters of the International Classification of Diseases. Objectives: To analyze the MRs of neurological disorders in the 5 regions of Brazil and to identify where professional training or increased investment may be necessary. Methods: Epidemiological study, whose statistics were taken from the Department of Informatics of the Brazilian Unified Health System (DATASUS). Results: The following MRs due to diseases of the NS were found for each region, in decreasing order: North (6.21%); Southeast (4.98%); Northeast (4.77%); South (3.96%); Midwest (3.93%). Also, the national average is expressed by a rate of 4.68%. It was also possible to observe that states in the same region have similar MRs, with some exceptions. Furthermore, the states with the highest MRs are Amazonas (9.42%); Acre (8.94%) and Rio de Janeiro (7.58%). Also, it was possible to notice that the states with the highest mortality, were those that invested less in patients with neurological disorders. However, the monetary factor is not the only determining aspect, since in some places that have similar investments, it is possible to identify a high difference between the MRs. Conclusions: Therefore, Brazil presents differences between the MRs due to diseases of the NS according to each region. It is evident that investments are fundamental, since states that invest less are, for the most part, those with the highest MRs.

scholarly journals Kinesiophobia in Stroke Patients, Multiple Sclerosis and Parkinson’s Disesase

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 796
Author(s):  
Dagmara Wasiuk-Zowada ◽  
Andrzej Knapik ◽  
Justyna Szefler-Derela ◽  
Anna Brzęk ◽  
Ewa Krzystanek
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Neurological Disorders ◽  
Functional Performance ◽  
Neurological Diseases ◽  
Neurological Impairment ◽  
Stroke Patients ◽  
Self Assessment ◽  
Sociodemographic Data ◽  
High Level

Background: Stroke (S), multiple sclerosis (MS), Parkinson’s disease (PD) are chronic neurological diseases that are a challange for public health and represent a real social problem. Physical activity (PA) improves functional performance, reduces various symptoms in PD and MS, in stroke- reduced neurological impairment of patients and provides a chance for independence. One of the main obstacles in successful rehabilitation is patients’ movement passivity. The reason might be the psychological aspects, in particular fear of movement—kinesiophobia. Aim: To determine how many patients with S, MS, and PD suffer from kinsiophobia and what factors influence this process. Methods: Fifty patients after stroke, eighty one MS patients and sixty one PD patients were consecutively recruited from hospital and outpatients clinics. The sociodemographic data, self- assesment of fitness, Visual Analogue Scale (VAS) for pain, Tampa Scale of Kinesiophobia (TSK) and The Modified Baecke Questionnarie for Older Adults for physical activity were collected. A score >37 was considered to indicate a high level of kinesiophobia according to the TSK. Results: High level of kinesiophobia was shown in 66.67% of the subjects. TSK medians in particular illnesses were above the cut-off score and amounted: S—42.50 points; MS—38 points; PD—42.00 points. Regression showed 15% of fluctuation of variance (R2 = 0.1498; p < 0.0001), where regression factor showed: for mobility self-assessment: b = −0.2137 and for the age b = 0.0065. Conclusions: Kinesiophobia among the patients suffering from S, MS and PD concerns most of the subjects. Predictors of kinesiophobia are: limitations connected with functioning and age. The meaning of kinesiophobia in neurological disorders requires further research.

Effect of Neuromuscular Electrical Stimulation on Swallowing Process in Stroke Patient with Neurogenic Dysphagia

1970 ◽  
Vol 1 (1) ◽  
pp. 44-53
Author(s):  
Ruth Ariyani ◽  
Widjajalaksmi ◽  
Luh K Wahyuni ◽  
Susyana Tamin ◽  
Saptawati Bardosono
Keyword(s):  
Electrical Stimulation ◽  
Voice Quality ◽  
Neuromuscular Electrical Stimulation ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Cough Reflex ◽  
Voluntary Cough ◽  
Pharyngeal Phase ◽  
Significant Difference ◽  
Quasi Experimental

Objective: The aim of this study to determine the therapeutic effect of Neuromuscular Electrical Stimulation (NMES) on pharyngeal phase of swallowing for stroke patients with neurogenic dysphagia,and to see the effect of NMES in reducing the incidence of standing secretion, residue, penetration and aspiration.Methods: It is a quasi-­experimental study design. 10 stroke patients with neurogenic dysphagia in Cipto Mangunkusumo hospital, Jakarta, 40-­80 years old with hemodynamically stable, cooperative and will be get NMES therapy for 4 weeks. Pre and Post treatment assessment caompared using a modified MASA test (The Mann Assessment of Swallowing Ability) and FEES examination (Flexible Endoscophic Evaluation of Swallowing). Analysis of change scores using Wilcoxon test.Results:The obtain average age of patients 59.80+9.705 years. Significant difference seen in the pharyngeal phase of swallowing increased score of gag reflex, velum elevation, cough reflex, voluntary cough, voice quality, pharynx response, pharyngeal constrictor contraction and vocal cord adduction (p<0.005).Also seen significant reduction in the incidence of standing secretion, residue and penetration (p<0.005), but not significantly in the incidence of aspiration (p=0083).Conclusions: NMES increased the pharyngeal phase of swallowing, reduced the incidence of standing secretion, residue and penetration of stroke patients with neurogenic dysphagia, but have not able to reduced aspiration.Keywords :Neuromuscular Electrical Stimulation (NEMS), neurogenic dysphagia, MASA test (The Mann Assessment of Swallow ing Ability), FEES examination (Flexible Endoscophic Evaluation of Swallowing), swallowing process.

Microbiota-Immune System Interactions in Human Neurological Disorders

2020 ◽  
Vol 19 (7) ◽  
pp. 509-526
Author(s):  
Qin Huang ◽  
Fang Yu ◽  
Di Liao ◽  
Jian Xia
Keyword(s):  
Immune System ◽  
Gut Microbiota ◽  
Neurological Disorders ◽  
Brain Function ◽  
Neurological Diseases ◽  
Host Immune System ◽  
Gut Dysbiosis ◽  
Characteristic Features ◽  
Novel Therapeutic Strategies

: Recent studies implicate microbiota-brain communication as an essential factor for physiology and pathophysiology in brain function and neurodevelopment. One of the pivotal mechanisms about gut to brain communication is through the regulation and interaction of gut microbiota on the host immune system. In this review, we will discuss the role of microbiota-immune systeminteractions in human neurological disorders. The characteristic features in the development of neurological diseases include gut dysbiosis, the disturbed intestinal/Blood-Brain Barrier (BBB) permeability, the activated inflammatory response, and the changed microbial metabolites. Neurological disorders contribute to gut dysbiosis and some relevant metabolites in a top-down way. In turn, the activated immune system induced by the change of gut microbiota may deteriorate the development of neurological diseases through the disturbed gut/BBB barrier in a down-top way. Understanding the characterization and identification of microbiome-immune- brain signaling pathways will help us to yield novel therapeutic strategies by targeting the gut microbiome in neurological disease.

scholarly journals The Classification of Medicinal Plant Leaves Based on Multispectral and Texture Feature Using Machine Learning Approach

Agronomy ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 263
Author(s):  
Samreen Naeem ◽  
Aqib Ali ◽  
Christophe Chesneau ◽  
Muhammad H. Tahir ◽  
Farrukh Jamal ◽  
...  
Keyword(s):  
Machine Learning ◽  
Medicinal Plant ◽  
Texture Feature ◽  
Stevia Rebaudiana ◽  
Ocimum Sanctum ◽  
Multi Layer Perceptron ◽  
Plant Leaves ◽  
Chi Square ◽  
Lemon Balm

This study proposes the machine learning based classification of medical plant leaves. The total six varieties of medicinal plant leaves-based dataset are collected from the Department of Agriculture, The Islamia University of Bahawalpur, Pakistan. These plants are commonly named in English as (herbal) Tulsi, Peppermint, Bael, Lemon balm, Catnip, and Stevia and scientifically named in Latin as Ocimum sanctum, Mentha balsamea, Aegle marmelos, Melissa officinalis, Nepeta cataria, and Stevia rebaudiana, respectively. The multispectral and digital image dataset are collected via a computer vision laboratory setup. For the preprocessing step, we crop the region of the leaf and transform it into a gray level format. Secondly, we perform a seed intensity-based edge/line detection utilizing Sobel filter and draw five regions of observations. A total of 65 fused features dataset is extracted, being a combination of texture, run-length matrix, and multi-spectral features. For the feature optimization process, we employ a chi-square feature selection approach and select 14 optimized features. Finally, five machine learning classifiers named as a multi-layer perceptron, logit-boost, bagging, random forest, and simple logistic are deployed on an optimized medicinal plant leaves dataset, and it is observed that the multi-layer perceptron classifier shows a relatively promising accuracy of 99.01% as compared to the competition. The distinct classification accuracy by the multi-layer perceptron classifier on six medicinal plant leaves are 99.10% for Tulsi, 99.80% for Peppermint, 98.40% for Bael, 99.90% for Lemon balm, 98.40% for Catnip, and 99.20% for Stevia.

scholarly journals Diagnosis and treatment of neurogenic dysphagia – S1 guideline of the German Society of Neurology

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Rainer Dziewas ◽  
Hans-Dieter Allescher ◽  
Ilia Aroyo ◽  
Gudrun Bartolome ◽  
Ulrike Beilenhoff ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Treatment Options ◽  
German Society ◽  
Diagnosis And Treatment ◽  
Dietary Interventions ◽  
Neurogenic Dysphagia ◽  
Treatment Interventions ◽  
Term Care ◽  
High Resolution Manometry ◽  
Clinical Scenarios

Abstract Introduction Neurogenic dysphagia defines swallowing disorders caused by diseases of the central and peripheral nervous system, neuromuscular transmission, or muscles. Neurogenic dysphagia is one of the most common and at the same time most dangerous symptoms of many neurological diseases. Its most important sequelae include aspiration pneumonia, malnutrition and dehydration, and affected patients more often require long-term care and are exposed to an increased mortality. Based on a systematic pubmed research of related original papers, review articles, international guidelines and surveys about the diagnostics and treatment of neurogenic dysphagia, a consensus process was initiated, which included dysphagia experts from 27 medical societies. Recommendations This guideline consists of 53 recommendations covering in its first part the whole diagnostic spectrum from the dysphagia specific medical history, initial dysphagia screening and clinical assessment, to more refined instrumental procedures, such as flexible endoscopic evaluation of swallowing, the videofluoroscopic swallowing study and high-resolution manometry. In addition, specific clinical scenarios are captured, among others the management of patients with nasogastric and tracheotomy tubes. The second part of this guideline is dedicated to the treatment of neurogenic dysphagia. Apart from dietary interventions and behavioral swallowing treatment, interventions to improve oral hygiene, pharmacological treatment options, different modalities of neurostimulation as well as minimally invasive and surgical therapies are dealt with. Conclusions The diagnosis and treatment of neurogenic dysphagia is challenging and requires a joined effort of different medical professions. While the evidence supporting the implementation of dysphagia screening is rather convincing, further trials are needed to improve the quality of evidence for more refined methods of dysphagia diagnostics and, in particular, the different treatment options of neurogenic dysphagia. The present article is an abridged and translated version of the guideline recently published online (https://www.awmf.org/uploads/tx_szleitlinien/030-111l_Neurogene-Dysphagie_2020-05.pdf).

Trend of Hospital Admission and Outcome Study of Patients Admitted in a Neurology Unit at a Tertiary Care Neuroscience Hospital in Bangladesh

2018 ◽  
Vol 4 (2) ◽  
pp. 69-74
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Choudhury ◽  
KM Ahasan Ahmed ◽  
Mohammad Sadekur Rahman Sarkar ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Total Death ◽  
Neurological Patients ◽  
Study Population ◽  
The Mean ◽  
Day By Day

Background: Neurological disorders is becoming a growing concern both for developed and developing countries. Magnitude of the problem is increasing day by day. Among all neurological disorders, stroke is the leading cause of morbidity and mortality globally.Objectives: The purpose of the study was to see the trend of admission of patients with neurological diseases and to study the outcome of patients at referral neurology hospital in Bangladesh.Methodology: This retrospective chart review was conducted in the blue unit of the Department of Neurology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from 1st January to 31st December 2016 for a period of one (01) year. All the admitted patients with both sexes were selected as study population. The outcome was observed among the study population.Result: A total number of 1044 patients were admitted during the study period. Majority of the patients were in the age group of the 41 to 50 years which was 417(39.9%) cases. Both male and female were in highest number in the month of May which was 63 and 48 cases respectively. The total death of the study population was 146(14.0%) cases. The mean length of hospital stay was 8.4±2.31 days.Conclusion: Middle aged male is the main bulk of the neurological patients, admitted in a referral neurology hospital in Bangladesh. Highest admission and mortality was observed in stroke patients.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 69-74

scholarly journals Overview of Dual-Acting Drug Methotrexate in Different Neurological Diseases, Autoimmune Pathologies and Cancers

2020 ◽  
Vol 21 (10) ◽  
pp. 3483 ◽  
Author(s):  
Przemysław Koźmiński ◽  
Paweł Krzysztof Halik ◽  
Raphael Chesori ◽  
Ewa Gniazdowska
Keyword(s):  
Folic Acid ◽  
Combination Therapy ◽  
Autoimmune Diseases ◽  
Myasthenia Gravis ◽  
Neurological Disorders ◽  
Chemotherapeutic Agent ◽  
Neurological Diseases ◽  
Immunosuppressive Drug ◽  
Structural Analogue ◽  
Potential Benefits

Methotrexate, a structural analogue of folic acid, is one of the most effective and extensively used drugs for treating many kinds of cancer or severe and resistant forms of autoimmune diseases. In this paper, we take an overview of the present state of knowledge with regards to complex mechanisms of methotrexate action and its applications as immunosuppressive drug or chemotherapeutic agent in oncological combination therapy. In addition, the issue of the potential benefits of methotrexate in the development of neurological disorders in Alzheimer’s disease or myasthenia gravis will be discussed.

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