Spotlight on Genital herpes: neurologic complications

Dr. Marylou Solbrig of the University of Manitoba reviews the neurologic complications of genital herpes and herpes simplex virus type 2 (HSV-2) infections in adults and neonates and summarizes the recommendations for acute and suppressive treatments from the International Herpes Management Forum (IHMF). Illustrative cases of HSV-2 lumbosacral radiculomyelitis in an immunocompromised patient and HSV-2 meningoencephalitis in a child are presented. In this update, the changing epidemiology of genital herpes with the growing proportion of HSV-1 and rare cases of varicella zoster virus infection is presented, along with an expanded discussion of herpes simplex virus in CNS autoimmune disorders and lessons from neonatal herpes generalizable to clinical and research approaches to Zika virus congenital infections..

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Twitter Digest for July 12, 2019

Twitter Digest for July 11, 2019

Spotlight on Cervical disc disease

Neck pain, with or without radiating arm pain and associated root distribution paraesthesias, numbness, and motor deficit, is the classic presenting feature of cervical disc disease. Degenerative changes in the cervical disc are an inevitable result of aging, and rupture of disc material through the annulus frequently presents as an irritative mass against the centrally positioned spinal cord or laterally positioned root. Along with historical features, physical examination findings help to establish the diagnosis of cervical disc rupture and to distinguish between other causes of pain in the upper extremity, such as shoulder impingement or myofascial pain syndromes.

In this article, Dr. Saul Schwarz of the University of Colorado Health Sciences describes the fundamentals in diagnosis and treatment of cervical disc disease. A historical overview is provided as well as some of the newest concepts in diagnostic imaging and surgical repair. Case studies with imaging and intraoperative photographs are reviewed.

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Twitter Digest for July 10, 2019

Twitter Digest for July 9, 2019

Twitter Digest for July 8, 2019

Spotlight on Uremic neuropathy

Uremic neuropathy is a distal sensorimotor polyneuropathy caused by uremic toxins. Symptoms are insidious in onset. Paresthesias are usually the earliest symptoms; weakness and atrophy will follow the sensory symptoms. The pathologic features are severe axonal degeneration in the most distal nerve trunks with secondary segmental demyelination. Chronic dialysis may prevent neuropathy in some patients, especially if begun early. Renal transplantation is generally the most successful method to prevent neuropathy.

In this article, Dr. Yi Pan of St. Louis University and Dr. Florian Thomas of Hackensack University Medical Center summarize the clinical, electrophysiological, and pathological features of uremic neuropathy.

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Twitter Digest for July 5, 2019

Twitter Digest for July 3, 2019