Journal of Neurology 

About: Journal of Neurology is an academic journal published by Springer Science+Business Media. The journal publishes majorly in the area(s): Neuroradiology & Medicine. It has an ISSN identifier of 0340-5354. Over the lifetime, 16666 publications have been published receiving 399868 citations. The journal is also known as: Zeitschrift für Neurologie (1974).

The Rivermead Post Concussion Symptoms Questionnaire: a measure of symptoms commonly experienced after head injury and its reliability

Abstract: After head injuries, particularly mild or moderate ones, a range of post-concussion symptoms (PCS) are often reported by patients. Such symptoms may significantly affect patients' psychosocial functioning. To date, no measure of the severity of PCS has been developed. This study presents the Rivermead Post Concussion Symptoms Questionnaire (RPQ) as such a measure, derived from published material, and investigates its reliability. The RPQ's reliability was investigated under two experimental conditions. Study 1 examined its test-retest reliability when used as a self-report questionnaire at 7–10 days after injury. Forty-one head-injured patients completed an RPQ at 7–10 days following their head injury and again approximately 24 h later. Study 2 examined the questionnaire's inter-rater reliability when used as a measure administered by two separate investigators. Forty-six head-injured patients had an RPQ administered by an investigator at 6 months after injury. A second investigator readministered the questionnaire approximately 7 days later. Spearman rank correlation coefficients were calculated for ratings on the total symptom scores, and for individual items. High reliability was found for the total PCS scores under both experimental conditions (R s = +0.91 in study 1 andR S = +0.87 in study 2). Good reliability was also found for individual PCS items generally, although with some variation between different symptoms. The results are discussed in relation to the major difficulties involved when looking for appropriate experimental criteria against which measures of PCS can be validated.

Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature.

Abstract: In this review of the acquired immunodeficiency syndrome (AIDS) the authors have evaluated a total of 352 homosexual patients with AIDS or generalized lymphadenopathy managed at the University of California San Francisco (UCSF) between 1979 and 1984. Of an initial unselected group of 318 patients 124 (39%) were neurologically symptomatic and 1/3 already had their neurological complaints at the time of presentation. An additional 210 AIDS patients with neurological symptoms have been reported in the literature. Thus a total of 366 neurologically symptomatic patients with AIDS or lymphadenopathy are reviewed. Central nervous system (CNS) complications encountered in 315 patients included the following viral syndromes: subacute encephalitis (54) atypical aseptic meningitis (21) herpes simplex encephalitis (9) progressive multifocal leukoencephalopathy (6) viral myelitis (3) and varicella-zoster encephalitis (1). Non-viral infections were caused by Toxoplasma gondii (103) Cryptococcus neoformans (41) Candida albicans (6) Mycobacteria (6) Treponema pallidum (2) coccidiodomycosis (1) Mycobacterium tuberculosis (1) Aspergillus fumigatus (1) and Escherichia coli (1). Neoplasms included primary CNS lymphoma (15) systemic lymphoma with CNS involvement (12) and metastatic Kaposis sarcoma (3). Cerebrovascular complications were seen in 4 patients with hemorrhage and 5 with infarction. 5 patients in the UCSF series had multiple intracranial pathologies including 2 cases of simultaneous Toxoplasma gondii infections and primary CNS lymphoma 2 cases of coexistent Toxoplasma gondii and viral infections and 1 case of combined Toxoplasma gondii and atypical mycobacterial infection. Cranial or peripheral nerve complications seen in 51 patients included cranial nerve syndromes secondary to chronic inflammatory polyneuropathy (5) lymphoma (5) and Bells palsy (5). Peripheral nerve syndromes included chronic inflammatory polyneuropathy (5) distal symmetrical neuropathy (13) herpes zoster radiculitis (6) persistent myaligias (2) myopathy (2) and polymyositis (1). In light of the protean behavior of AIDS and the problems related to the clinical and radiological and serological diagnosis of the unusual and varied associated nervous system diseases patients with AIDS and neurological complaints require a rigorous and detailed evaluation. The authors experience suggests that biopsy of all CNS space-occupying lesions should be performed for tissue diagnosis prior to the institution of other therapies. (authors)

Cognitive deficits in Parkinson’s disease

Abstract: Neuropsychological investigations of patients with Parkinson's disease have shown specific impairments even in the early stages of the disease, which include deficit of behavioural regulation in sorting or planning tasks, defective use of memory stores, and impaired manipulation of internal representation of visuospatial stimuli. These deficits, reported in a disease which predominantly involves subcortical structures, have drawn attention to a potential role of the basal ganglia in cognitive processes. Given the modulatory role of the basal ganglia, these disorders might result from more fundamental deficits concerning the allocation of attentional resources, the temporal organization of behaviour, the maintenance of representations in working memory or the self-elaboration of internal strategies, all of which resemble dysfunctions of processes that are commonly considered to be controlled by the frontal lobes. This suggests a functional continuity or complementarity between the basal ganglia and association areas of the prefrontal cortex. The recent description in primates of segregated loops that interconnect discrete regions of the caudate nucleus to the dorsolateral and orbitofrontal regions of the prefrontal cortex via the thalamus may give some support to this hypothesis. Alternatively, degeneration of the ascending cholinergic and catecholaminergic neuronal systems may contribute, at least in part, to the occurrence of this frontal-lobe-like symptomatology associated with Parkinson's disease.

Chemotherapy-induced peripheral neuropathy.

Abstract: The induction of peripheral neuropathy is a common factor in limiting therapy with chemotherapeutic drugs. Little is known about the mechanisms responsible for the development of neuropathy. Depending on the substance used, a pure sensory and painful neuropathy (with cisplatin, oxaliplatin, carboplatin) or a mixed sensorimotor neuropathy with or without involvement of the autonomic nervous system (with vincristine, taxol, suramin) can ensue. Neurotoxicity depends on the total cumulative dose and the type of drug used. In individual cases neuropathy can evolve even after a single drug application. A general predisposition for developing a chemotherapy-induced neuropathy has been observed in nerves previously damaged by diabetes mellitus, alcohol or inherited neuropathy. The recovery from symptoms is often incomplete and a long period of regeneration is required to restore function. Up to now, no drug is available to reliably prevent or cure chemotherapy-induced neuropathy.

Prospective assessment of falls in Parkinson's disease

Abstract: We studied prospectively the epidemiology, clinical impact and prediction of falls in 59 moderately affected patients with Parkinson's disease (PD) (mean UPDRS motor score 31.5; mean age 61 years) and 55 controls (mean age 60 years). At baseline, balance and gait were evaluated extensively. The retropulsion test (response to sudden shoulder pull) was executed first unexpectedly and five more times following prior warning. All persons used standardised scoring forms to document their falls during six months. Thirty patients (50.8 %) and eight controls (14.5%) fell at least once (relative risk [RR] 6.1; 95% confidence interval [CI] 2.5-15.1, p or = 2) falls occurred in 15 patients (25.4%), but in only two controls (RR 9.0; 95 % CI 2.0-41.7; p=0.001). Recurrent falls were more common among persons taking benzodiazepines (RR 5.0; 95% CI 1.6-15.5; p 100; 95% CI 3.1-585) and asking for prior falls (RR 5.0; 95% CI 1.2-20.9). We conclude that falls are common and disabling, even in relatively early stage PD. Recurrent fallers were best predicted by disease severity and presence of prior falls. Strategies to prevent falls in PD should particularly focus at intrinsic (patient-related) factors, such as minimising the use of benzodiazepines.