Twitter Digest for June 25, 2020

Spotlight on Primary CNS angiitis

Diffuse inflammation of small- and medium-sized blood vessels confined exclusively to the brain, meninges, or spinal cord is called primary angiitis of the central nervous system (PACNS). There have been significant advances in the understanding of this disorder due to the identification of pathological and clinical subsets, along with advances in the imaging modality of vessel wall abnormalities. A considerable gap still exists, however, particularly with respect to its pathophysiological mechanisms. Although various laboratory and neuroimaging findings may support the diagnosis of primary CNS angiitis, they are not highly specific, and neurologists often face a substantial challenge when diagnosing this disorder because they need to rule out a vast array of nonvasculitic conditions and secondary causes of central nervous system vasculitis. Therefore, a correct and timely diagnosis of primary CNS angiitis requires a high degree of suspicion coupled with knowledge of other diseases that can masquerade as primary CNS vasculitis.

In this article, Dr. Jorge Moncayo-Gaete of the International University of Ecuador and Dr. Julien Bogousslavsky of the Genolier Swiss Medical Network focus on the clinical and pathological findings, diagnostic work-up, differential diagnosis, and current therapeutic options of this still enigmatic and complex entity.

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Twitter Digest for June 24, 2020

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.

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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.

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