Twitter Digest for May 17, 2019

Twitter Digest for May 16, 2019

Spotlight on Rett syndrome

In this article, Dr. Anita Datta of the University of British Columbia describes Rett syndrome, a rare genetic neurologic disorder of the grey matter of the brain that primarily affects females but has also been found in male patients. The clinical features include deceleration of the rate of head growth and a period of regression followed by stagnation or stabilization. Repetitive and stereotyped hand movements, such as wringing, are seen. There is usually loss of expressive language. Those affected with Rett syndrome require multidisciplinary care as many systems can be involved. Up to 80% of individuals with Rett syndrome will have seizures. Scoliosis, growth failure, and constipation are very common and can be problematic.

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Twitter Digest for May 15, 2019

Twitter Digest for May 14, 2019

Twitter Digest for May 13, 2019

Spotlight on Organophosphate neuropathy

In this article, Dr. Michael Pulley of the University of Florida, Jacksonville details the clinical manifestations resulting from organophosphate poisoning. Although there has been great concern about the effects of “nerve gas,” definite exposure to these chemicals in combat has been limited, and the manifestations have not been well studied. This article focuses on the clinical features of acute and intermediate syndromes of organophosphate poisoning and on organophosphate-induced delayed polyneuropathy, which develops only after exposure to certain specific chemicals.

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Twitter Digest for May 10, 2019

Twitter Digest for May 9, 2019

Spotlight on Disorders of consciousness

Clinical disorders of consciousness have attracted extensive scientific and media attention. The persistent vegetative state (also known as unresponsive wakefulness syndrome) and the minimally conscious state are being reconsidered and redefined since their original descriptions in 1972 (persistent vegetative state) and 2002 (minimally conscious state). The results of functional neuroimaging and electrophysiological studies suggest that some degree of consciousness or awareness that has not been or could not be determined by behavioral evaluations alone may be present in some of these patients. This raises multiple therapeutic and ethical questions, such as:

  1. Do the findings of these research evaluations truly represent consciousness, and if they are present on fMRI, PET, or EEG in a patient who cannot otherwise demonstrate conscious behavior, are they adequate and appropriate neural correlates?
  2. Do these patients appreciate pain?
  3. Should the usual duration of aggressive rehabilitation therapies be extended given the multiple reports of continued improvement of patients in persistent vegetative state well past the standard estimates of permanency of 3 months for nontraumatic and 12 months for traumatic etiologies?
  4. Should end-of-life or right-to-life issues be reconsidered given the aforementioned concerns?

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