Neurology

Gradual onset of left-sided temporal headache and ptosis

, Dakshinamurty Gullapalli, MD; Chintan Shah, MD; Eric McGraw, MD April 12, 2012

Glaucoma limited this patient's vision, but new symptoms limited to his left side had more to do with his ocular muscles.
 

Updated guidelines for the diagnosis of Alzheimer disease: A clinical review

April 05, 2012

The goal of the 2011 diagnostic guidelines is to make earlier identification of Alzheimer 
disease possible, which in turn will help patients and families to better prepare and plan.
 

Seizures induced by hot water in an 
otherwise healthy 18-month-old boy

February 13, 2012

Over several days, ordinary bathing causes a child to go limp and develop periorbital 
and lip cyanosis that resolves when he is removed from the water.
 

Phenytoin: An old friend that 
still confuses us

February 07, 2012

Dosing of phenytoin is complicated by its unique properties: it is highly lipophilic, highly protein-bound, and undergoes capacity-limited pharmacokinetics at therapeutic levels.
 

Management of migraine headache: An overview of current practice

February 02, 2012

Using both pharmacologic and nonpharmacologic therapies for acute treatment and as 
preventive therapy can help patients with migraine to avoid debilitating symptoms.
 

A different kind of headache in a patient with migraines

, January 19, 2012

Magnetic resonance venography is the definitive imaging modality for this unusual condition, but MRI is also performed to identify other abnormalities in the brain.
 

State-of-the-art interventions in acute large-vessel ischemic stroke

January 05, 2012

The treatments for large-vessel ischemic stroke include IV rtPA, IA rtPA, and mechanical clot retrieval. All must be used soon after symptom onset for the best outcome.
 

A Day in the Life: Kaatje van der Gaarden, PA-C

December 13, 2011

A PA specializing in rehabilitation medicine finds reward in caring for patients with debilitating injuries.
 

How soon can I play after a concussion?

, Gretchen Fox, PA-C, MMSc, DFAAPA November 30, 2011

Second-impact brain injuries that occur before the first injury has healed can cause cardiac and respiratory collapse and even death.
 

Sudden onset of confusion and visual disturbances

, , Urvi R. Shah, MD November 22, 2011

An advanced MRI technique clinches the diagnosis after it detects cerebral lesions not seen on conventional MRI.
 

Fusobacterium otitis causes a case of 
hydrocephalus and fatal meningitis

Erin N. Arrington; M. Michael Behnia, MD November 15, 2011

A delay in the administration of antimicrobial therapy resulted in lethal complications. To reduce the high morbidity and mortality rates, clinicians must begin early treatment.
 

Impaired vision along with a headache in an elderly man

, Taral R. Sharma, MD, MBA; Dennis G. Duncan; Urvi R. Shah, MD October 28, 2011

An otherwise healthy man with a history of otitis media presents with a worsening headache and visual disturbances for the past week.
 

The use of corticosteroids for spinal cord injuries: Where are we now?

October 17, 2011

Clinicians have long been confused about how to best treat SCIs. Research on the topic is limited, and existing study designs remain flawed. This article reviews the literature.
 

Evaluating the patient with vertigo: A complex complaint made simple

, October 04, 2011

It's a truism that the history alone can often lead to an accurate diagnosis, and asking the right questions can be especially helpful when assessing the patient with dizziness.
 

Cauda equina syndrome and acute respiratory distress syndrome

, Peter Sandor, MHS, PA-C, RRT September 27, 2011

This article reviews the general features, clinical assessment, diagnosis, and treatment of acute respiratory distress syndrome and cauda equina syndrome.
 

A case of confabulation and abnormal eye movements

, Bush Kavuru, MD; Joseph W. Iskandar, DO; Ashley Coffman; Kelly Johnson September 23, 2011

An emergency department team works to determine the cause of this patient's recurrent nausea, vomiting, and failure to thrive.
 

What's new in multiple sclerosis treatment: 
First oral drug, new antibody therapies

, Megan Orchard, PA-C; Paula Hardeman, PA-C; Daniel L. O’Donoghue, PA-C, PhD August 18, 2011

A number of revolutionary new treatments for multiple sclerosis—including the first oral treatment, antibody therapies, and agents that may be able to regulate immune function—are currently being developed.
 

Progressive weakness and inability to walk in a healthy 28-year-old male

July 11, 2011

The weakness was so severe that the patient could not get out of bed despite having intact sensation in his feet, and friends had to help transport him to the emergency department.
 

Trigeminal neuralgia: Diagnosis and medical and surgical management

, David Piepgras, MD; Douglas Chyatte, MD; Denise Rizzolo, PhD, PA-C July 06, 2011

Trigeminal neuralgia is an exceedingly painful condition that leaves patients desperate for symptomatic relief. Fortunately, good medical and operative treatments exist.
 

An effective tool in establishing the diagnosis of sport-related concussion

Jonathan Thomas Baird, MPAS, PA-C, ATC June 20, 2011

An objective assessment of concussion will benefit the athlete as well as aid clinicians in 
accurately describing the injury to parents, coaches, and the athletes themselves.
 

Transverse myelopathy mimicking conus medullaris syndrome

, Michael Roscoe, PhD, MPAS, PA-C June 07, 2011

A generally healthy man with a history of migraine headaches and diplopia awakens with sudden onset of numbness below the waist, erectile dysfunction, and difficulty urinating.
 

Intermittent headaches relieved by lying down

, Mark Casteel, MD; Peter White, MD April 29, 2011

The patient was growing depressed that attempts at pain relief, including therapy for migraine headache and chiropractic care, failed to relieve her month-long symptoms.
 

A rare but serious cause of spinal cord compression in an adolescent female

, Eddy Garrido, MD, FRCS, FACS April 25, 2011

A young woman presents for evaluation after falling down the stairs a few times and developing midthoracic back pain.
 

Tingling and swelling on the left side of a patient's neck

, Urvi R. Shah, MD; Sandeep K. Puri March 22, 2011

In this unusual case, a patient with a history significant for trauma to the neck and upper extremities presents with progressive swelling of the neck and tingling in the left upper limb.
 

Miller Fisher variant of Guillain-Barré syndrome in an HIV-infected patient

, Miguel Valdes-Sueiras, MD; Pam Jongthavorn, NP; Shilpa Sayana, MD; Homayoon Khanlou, MD March 07, 2011

Symptom overlap makes Miller Fisher syndrome hard to distinguish, but the presence of antiganglioside antibodies can verify a diagnosis.
 

Identifying the most common causes of reversible dementias: A review

, Samuel L. Gurevitz, PharmD, CGP March 01, 2011

Many dementia syndromes can be reversed if caught early. Prompt diagnosis can spare patients an otherwise very challenging life.
 

Swelling of the eye and light sensitivity in a patient struck in the face by a wakeboard

, Michael Suprenant; Barbara Piccirillo, MS, RPA-C, DFAAPA February 25, 2011

The patient brushed off the mishap until friends noted ocular swelling and drooping of the right eyelid.
 

Deep brain stimulation: A review of the procedure and the complications

, February 14, 2011

DBS is no longer experimental, and this treatment is becoming more common. PAs should be prepared to care for these implant patients.
 

Carpal tunel syndrome and pulmonary embolus

, January 20, 2011

Clinical features, diagnosis, and treatment of carpal tunnel syndrome and pulmonary embolus are discussed.
 

Sensory loss and complex joint pain in an adult male

, Dakshinamurty Gullapali, MD December 21, 2010

This patient's imaging test results and symptoms, including complicated pain throughout multiple joints and numbness below nipple level, led to a diagnosis.
 

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