Acute neurological conditions during pregnancy and their management: a review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Rubeena Maqbool ◽  
Mudasir Maqbool ◽  
Mehrukh Zehravi ◽  
Irfat Ara
Keyword(s):  
Neurological Disorders ◽  
Placental Abruption ◽  
Correct Diagnosis ◽  
Perinatal Outcomes ◽  
Physiological Changes ◽  
Systemic Blood ◽  
Peripheral Facial Palsy ◽  
Tunnel Syndrome ◽  
Neurological Conditions ◽  
Neurological Disturbance

Abstract Less vascular resistance, higher vascular permeability and improved cardiac output include anatomical and physiological changes related to pregnancy. These are needed to accommodate an increase in plasma volume and ensure significant organ infusion. Nevertheless, increases in oestrogen levels may lead to an increase in the risk of coagulation and thrombosis. Increased levels of progesterone increase the risk of thrombosis due to vasodilation, vascular stasis and edoema in these situations. The increased resistance in preeclampsia maternal systemic blood arteries can create high blood pressure that can interfere with blood flow in numerous organs (including liver, kidneys, brain and placenta). The risk of issues such as pulmonary edoema, placental abruption, pneumonia of aspiration, renal failure, hepatic failure and stroke in pregnant women is increased by Preeclampsia and eclampsia. Some peripheral neuropathies (carpal tunnel syndrome, peripheral facial palsy) and central neurological conditions (seizure, migraine, stroke, epilepsy) may become more common during pregnancy because of the exacerbation of the pre-existing neurologic condition or the onset of neurological disturbance caused by pregnancy physiological changes (such as headache or vascular disorders). During the three trimesters of pregnancy, neurological disorders are both peripheral and central. Therefore, an early and correct diagnosis is required to improve pregnancy care, treatment and perinatal outcomes. The aims of this paper are to identify, define and manage the most prevalent peripheral and centrally occurring neurological disorders in the pregnancy.

scholarly journals Acute Onset Neurological Disorders during Pregnancy: A Literature Review

2017 ◽  
Vol 39 (10) ◽  
pp. 560-568 ◽  
Author(s):  
Zita Ferraz ◽  
Joana Parra ◽  
Ana Areia ◽  
Elsa Vasco ◽  
Paulo Moura
Keyword(s):  
Neurological Disorders ◽  
Perinatal Outcomes ◽  
Neurological Complications ◽  
Clinical Findings ◽  
Acute Onset ◽  
Original Research ◽  
Peripheral Facial Palsy ◽  
Precise Diagnosis ◽  
Tunnel Syndrome

Objectives To characterize the most common peripheral and central neurological disorders during pregnancy. Methods Original research and review of the literature on neurological complications during pregnancy. We searched for keywords related to the topic on different databases. Results Pregnancy involves physiological changes that can trigger peripheral neurological and/or central nervous system pathologies, which can sometimes be associated with hypertensive disorders. A definitive diagnosis of neurological disorders can be made according to the trimester of pregnancy and the clinical findings. Carpal tunnel syndrome and peripheral facial palsy are common peripheral neurological disorders, more frequent in the second half of pregnancy. Central nervous disorders are more complex and a precise diagnosis must be made in order to improve perinatal outcomes, provide correct management and treatment and to prevent acute and long-term complications. Conclusions It is possible to achieve a precise diagnosis, management and treatment of neurological disorders during pregnancy, but these require a multidisciplinary approach, crucial to improve perinatal outcomes.

Acute neurological disorders in women during pregnancy and peurperium

2021 ◽  
Vol 12 (2) ◽  
pp. 58-64
Author(s):  
Akhil Kulkarni M ◽  
Keyword(s):  
Neurological Disorders ◽  
Physiological Mechanism ◽  
Postpartum Women ◽  
Physiological Changes ◽  
Imaging Findings ◽  
Posterior Reversible Encephalopathy ◽  
Increased Risk ◽  
Neurological Conditions ◽  
Reversible Encephalopathy ◽  
In Pregnancy

Neurological disorders in women during pregnancy and puerperium are a significant cause of morbidity and mortality in pregnancy. There are certain neurological conditions which are specifically related to physiological changes during this period (eg: eclampsia, Sheehan’s syndrome, posterior reversible encephalopathy syndrome) and some disorders which have increased risk but not specific to women in pregnancy and puerperium (eg: cerebral venous thrombosis, infarction). As radiologists, an understanding of the patho physiological mechanism and imaging findings associated with these various conditions is necessary in timely diagnosis and initiating therapy which in turn helps prevent complications to both them other and the fetus. Any prophylaxis against these events should be particularly targeted to postpartum women, indicating the need to better identify pregnant women at increased risk.

The Korsakov Syndrome in Spontaneous Subarachnoid Haemorrhage

1953 ◽  
Vol 99 (416) ◽  
pp. 521-530 ◽  
Author(s):  
John N. Walton
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Neurological Disorders ◽  
Review Of The Literature ◽  
Case Histories ◽  
Actual Case ◽  
Mental Symptoms ◽  
Symptom Complex ◽  
Excellent Description ◽  
The Subject ◽  
Neurological Conditions

The amnestic-confabulatory symptom-complex to which the eponymous title of Korsakov's syndrome is usually given was probably first described by the Swedish physician Magnus Huss (1807–90), who spent the greater part of his lifetime in the study of alcoholism. There is, however, no doubt that Korsakov's (1890) paper on the subject gave an excellent description of the syndrome, and stressed the fact that whereas it often developed in patients with alcoholism and polyneuritis, numerous other metabolic and neurological disorders could be complicated by the characteristic mental changes. Indeed, in Korsakov's (1890) own series of cases alcoholics were in the minority. One of the neurological conditions in which the syndrome has been described significantly often is spontaneous subarachnoid haemorrhage. The first reports of the association were probably those of Flatau (1918 and 1921), and it was discussed in some detail by Goldflam (1923) and Herman (1925 and 1926). Each of these authors described the mental symptoms exhaustively but gave no actual case-histories; the first fully documented cases in the literature were the two reported by Hall (1929). Single cases have since been described by Cubitt (1930), Popow (1930) and Kulkow (1935), and in 1939 Tarachow gave an extensive review of the literature and reported an additional 3 cases. It is remarkable that since 1939 the association has received little attention, although it has been mentioned by Sands (1941) and Meadows (1951).

scholarly journals IncobotulinumtoxinA (Xeomin)

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Neurological Disorders ◽  
Adult Patients ◽  
Swallowing Difficulties ◽  
Neurological Conditions ◽  
The Cost ◽  
Public Drug

CADTH recommends that Xeomin should be reimbursed by public drug plans for the treatment of chronic sialorrhea associated with neurological disorders if certain conditions are met. Xeomin should only be covered to treat adult patients with moderate to severe chronic troublesome sialorrhea who do not have swallowing difficulties. Xeomin should only be reimbursed if prescribed by a specialist with experience in managing neurological conditions, and the cost of Xeomin is reduced.

Simultaneous Compression of the Median and Ulnar Nerve at the Elbow: A Retrospective Study

2018 ◽  
Vol 23 (02) ◽  
pp. 198-204 ◽  
Author(s):  
Dimitrios Skouteris ◽  
Sofia Thoma ◽  
Georgios Andritsos ◽  
Nikolaos Tasios ◽  
Praxitelis Praxitelous ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ulnar Nerve ◽  
Correct Diagnosis ◽  
Sudden Onset ◽  
Cubital Tunnel Syndrome ◽  
Surgical Decompression ◽  
Cubital Tunnel ◽  
Tunnel Syndrome ◽  
Proximal Forearm

Background: Simultaneous compression of the median and ulnar nerve at the elbow region has not been sufficiently highlighted in the literature. The purposes of the present study are to report our experience regarding this entity, to elucidate the clinical features, and to describe the operative technique and findings as well as the results of simultaneous decompression performed through the same medial incision. Methods: We performed a retrospective study of thirteen elbows in thirteen patients -nine men and four women- with simultaneous compression of the median and ulnar nerve at the elbow region between 2000 and 2011. All were manual workers. Diagnosis was largely based on symptoms, patterns of paresthesia, and specific tests. Surgical decompression of both nerves at the same time was performed through a single anteromedial incision creating large flaps. Results: Patients were followed for a mean of thirty-eight months (range seven to ninety six). Resting pain in the proximal forearm as well as sudden onset of numbness in the ring and little fingers were reported by all patients. Nerve conduction studies were positive only for cubital tunnel syndrome. In all patients symptoms subsided following surgical decompression. At the time of final follow up there is no evidence of recurrence. Conclusions: Proximal median nerve compression can be seen in association with cubital tunnel syndrome. Careful evaluation of the reported symptoms as well as thorough clinical examination are the keystone of the correct diagnosis. Also, on the basis of this study, we believe that concurrent decompression can be performed through a single medial incision, though extensive dissection may be required.

Acupuncture in Neurological Disorders: An Evidence-Based Overview

2020 ◽  
pp. 449-494
Author(s):  
Alexandra Dimitrova
Keyword(s):  
Neurological Disorders ◽  
Large Scale ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Tunnel Syndrome ◽  
Meta Analyses ◽  
New Evidence ◽  
Common Misconceptions

Over the past 20 years acupuncture has been rapidly gaining in popularity both in clinical practice and in research. New evidence for the benefits of acupuncture in various disorders is emerging seemingly every week, and recent large-scale systematic reviews and meta-analyses have suggested that acupuncture’s benefits in pain conditions can be maintained long term. At present the strongest evidence for acupuncture in the treatment of neurological disorders is in the fields of migraine, tension headaches, diabetic neuropathy, carpal tunnel syndrome, and Bell’s palsy. Recent trials suggest that acupuncture may be used as an adjunct in stroke rehabilitation and in improving the quality of life in patients with Parkinson’s disease and dementia. Despite recent mechanistic research advances, much remains unknown about acupuncture’s mechanism of action and there are common misconceptions about the origins of modern-day acupuncture. As acupuncture is being rapidly integrated into mainstream medical practice and increasingly being sought by patients, healthcare providers and neurologists in particular need to be educated about its applications and benefits for various neurological disorders. Our hope is that this chapter will serve toward this educational goal.

Effects of systemic arterial blood pressure on the contractile force of a human hand muscle

2000 ◽  
Vol 88 (4) ◽  
pp. 1390-1396 ◽  
Author(s):  
Julie R. Wright ◽  
D. I. McCloskey ◽  
Richard C. Fitzpatrick
Keyword(s):  
Blood Pressure ◽  
Muscular Activity ◽  
Systemic Blood Pressure ◽  
Muscle Performance ◽  
Knee Extensors ◽  
Human Hand ◽  
Physiological Changes ◽  
Force Output ◽  
Systemic Blood ◽  
Arterial Blood

The effect of physiological changes in systemic blood pressure on the force output of working abductor pollicis (AP) muscle was studied in six normal subjects. Supramaximal tetanic stimulation at the ulnar nerve produced repeated isometric contractions at 1-s intervals. Force output declined gradually with time. During the train of contractions, subjects voluntarily contracted the knee extensors for 1 min; this raised systemic blood pressure by 29%. Force output from AP rose in parallel with blood pressure so that 18% of the contraction force lost through fatigue was recovered for each 10% increase in blood pressure. When blood pressure in the hand was kept constant despite the increased systemic pressure, force output did not rise. The results show that muscle performance is strongly affected by physiological changes in central blood pressure and suggest that sensory input concerning the adequacy of muscle performance exerts a feedback control over the increase in systemic blood pressure during muscular activity.

Polysomnography

2017 ◽  
Author(s):  
Sudhansu Chokroverty ◽  
Roberto Vertugno
Keyword(s):  
Neurological Disorders ◽  
Clinical Presentation ◽  
Sleep Latency ◽  
Clinical Aspects ◽  
Physiological Changes ◽  
Functional Neuroanatomy ◽  
Maintenance Of Wakefulness Test ◽  
Laboratory Procedures ◽  
Clinical Considerations ◽  
Multiple Sleep Latency

This chapter covers the technical and clinical aspects of polysomnography (PSG). Section 1 includes a brief review of the historical milestones, functional neuroanatomy of sleep, physiological changes (emphasizing those pertinent to overnight PSG interpretation) and clinical relevance as well as homeostatic and circadian factors, and functions of sleep. Section 2 deals with laboratory procedures, including PSG recording and scoring techniques, indications for PSG, video-PSG, ambulatory and computerized PSG, artifacts during PSG recording, and pitfalls of PSG. Section 3 includes clinical considerations, briefly describing the clinical presentation, diagnosis, and treatment but mainly focusing on PSG findings in common sleep disorders as well as sleep-related movement disorders, neurological disorders, and sleep-related epilepsies. Section 4 addresses related laboratory procedures for the assessment of sleep, including the multiple sleep latency test, the maintenance-of-wakefulness test, and actigraphy.

Mitochondrial CHCHD2 and CHCHD10: Roles in Neurological Diseases and Therapeutic Implications

2019 ◽  
Vol 26 (2) ◽  
pp. 170-184
Author(s):  
Wei Zhou ◽  
Dongrui Ma ◽  
Eng-King Tan
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Mitochondrial Gene ◽  
Experimental Models ◽  
Loss Of Function ◽  
Motor Neuron Diseases ◽  
Therapeutic Implications ◽  
Mitochondrial Inner Membrane ◽  
Mitochondrial Defects ◽  
Neurological Conditions

CHCHD2 mutations have been identified in various neurological diseases such as Parkinson’s disease (PD), frontotemporal dementia (FTD), and Alzheimer’s disease (AD). It is also the first mitochondrial gene whose mutations lead to PD. CHCHD10 is a homolog of CHCHD2; similar to CHCHD2, various mutations of CHCHD10 have been identified in a broad spectrum of neurological disorders, including FTD and AD, with a high frequency of CHCHD10 mutations found in motor neuron diseases. Functionally, CHCHD2 and CHCHD10 have been demonstrated to interact with each other in mitochondria. Recent studies link the biological functions of CHCHD2 to the MICOS complex (mitochondrial inner membrane organizing system). Multiple experimental models suggest that CHCHD2 maintains mitochondrial cristae and disease-associated CHCHD2 mutations function in a loss-of-function manner. However, both CHCHD2 and CHCHD10 knockout mouse models appear phenotypically normal, with no obvious mitochondrial defects. Strategies to maintain or enhance mitochondria cristae could provide opportunities to correct the associated cellular defects in disease state and unravel potential novel targets for CHCHD2-linked neurological conditions.

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