Twitter Digest for June 22, 2020

Spotlight on Disequilibrium

In this article, Dr. Douglas Lanska of the University of Wisconsin School of Medicine and Public Health, the Medical College of Wisconsin, and IM Sechenov First Moscow State Medical University explains the clinical presentation, pathophysiology, diagnostic work-up, and management of disequilibrium.

Vestibular vertigo is a common problem, particularly in the elderly. Careful history and detailed examination, including focused evaluation of proprioception, vestibular function, directional bias of postural sway, ability to maintain stance with eyes open and closed (Romberg test), ability to maintain stance despite perturbations (eg, pull test), and gait will allow distinction of the major categories of disequilibrium in most cases and will often allow a specific etiologic diagnosis as well.

To view the complete article, click here and log in.

Twitter Digest for June 19, 2020

Twitter Digest for June 18, 2020

Spotlight on Hexacarbon neuropathy

Hexacarbons are present in many solvents and glues, and exposure is most commonly occupational. The neuropathy associated with hexacarbon exposure results in giant axonal swellings and distal slowing of conduction velocity. Hexacarbon neuropathy may continue to worsen for some time after cessation of exposure (coasting).

In this article, Dr. Michael Pulley of the University of Florida, Jacksonville reviews the clinical features of this interesting toxic neuropathy, which was fairly common in the past, related to recreational glue sniffing, but is primarily occupational currently. The axonal swellings seen in hexacarbon neuropathy are similar to those seen in carbon disulfide and acrylamide neuropathy.

To view the complete article, click here and log in.

Twitter Digest for June 17, 2020

Twitter Digest for June 15, 2020

Spotlight on Coma due to supratentorial and cerebellar lesions

Coma is characterized by the absence of arousal (wakefulness, vigilance) and awareness of self and environment, lasting for more than 1 hour. Comatose patients have closed eyes, do not communicate, and do not arouse to verbal, tactile, or noxious stimuli. The terminology and etiologies of coma have not changed historically since the seminal work by Plum and Posner. Current work-up starts with imaging to delineate anatomic from physiologic causes, which drives the ensuing investigation and treatment.

In this article, Dr. Richard Jackson of University of Vermont addresses the clinical manifestations, biological basis, and management of coma due to supratentorial and cerebellar lesions.

To view the complete article, click here and log in.