Orthostatic hypotension, meaning a fall in blood pressure with standing, is an underrecognized cause of faints and falls in the elderly. Risk of traumatic brain injury and hip fracture is substantial and can increase mortality. Parkinsonism and diuretics used for hypertension or heart failure predispose. Midlife hypertension is a powerful risk factor for ischemic and… Read more »
Whether alcohol promotes or prevents dementia has been studied for years but results are conflicting. A new study tries to resolve the issue by looking at 3000 people (median age 78 and a 6-year follow-up), and separating them into two groups, with or without baseline mild cognitive impairment. For the cognitively unimpaired group, no amount… Read more »
In neurology, vitamin D is important in two settings: epilepsy and multiple sclerosis. The older enzyme-inducing anti-epileptic medications, such as phenytoin (Dilantin) and phenobarbital, are no longer widely used in the US. They increase metabolism of vitamin D, resulting in lower levels and thereby increase bone density loss (osteopenia) which increases risk of fractures, especially… Read more »
There is no reliable device to diagnose concussion on the sidelines, despite extensive research. This is the conclusion of the US Food and Drug administration (FDA), outlined in an April 10, 2019 warning letter to parents, coaches, and trainers. Devices currently in use or development include smartphone apps, portable devices that check eye movements and… Read more »
Even though good scientific evidence may be lacking, many migraine sufferers take supplements. Placebo responses are high (nothing wrong with that) but there are occasional safety concerns, especially regarding butterbur. Widely used are magnesium, feverfew, and riboflavin. A new study seems to explain why some but not all patients respond to riboflavin and supports the… Read more »
This is an important advance as it can dramatically reduce the use of CT scans after concussions. Not only do unnecessary CT scans waste health care dollars but they also expose young athletes to unnecessary radiation. Children and teens, compared to adults, are several times more susceptible to the effects of radiation. Emergency room personnel… Read more »
Dermatomal herpes zoster (shingles) has a lifetime risk of over 30% and carries a high risk of post-herpetic neuralgia which can be excruciating and even permanent. Rarely, the virus can disseminate (spread) and may even result in stroke. Further, recent studies have shown that the virus may be the trigger for giant cell arteritis, a… Read more »
Readers of a review article by Giacoppo and others in Multiple Sclerosis and Related Disorders, 2017, pages 22-31, will probably agree with this statement. Sativex is a branded oromucosal spray containing tetrahydrocannabinol and cannabidiol in a 1:1 ratio. It has been available for years in Canada and has been approved in several European countries since… Read more »
A new device provides noninvasive electrical stimulation of the vagus nerve in the neck to treat episodic cluster headaches. It is call gammaCore and was recently approved by the FDA and will probably be available by prescription in the United States in fall 2017. It is about the size of a cell phone, handheld, applied… Read more »
A practice guideline, prepared by the American Academy of Neurology, was published recently in Neurology. SUDEP stands for sudden unexpected death in epilepsy. This has been recognized for many years but the specific risk has not been consistently established. People with epilepsy can die during a seizure, presumably from post- ictal respiratory depression. SUDEP, according… Read more »
Recent Comments