Dr Panayiotopoulos has written this monograph cum swan song about the syndrome that he has put on the diagnostic map and to which his name has been attached. This childhood syndrome certainly breaks many “epilepsy rules”. The seizures usually start with autonomic symptoms nausea, retching, or vomiting and evolve to altered awareness usually only after several minutes. Tonic deviation of …

https://jnnp.bmj.com/content/jnnp/73/5/605.3.full.pdf

Panayiotopoulos syndrome, a common and benign childhood epileptic syndrome

Defining a conversion ratio between Botox and Dysport mouse units to compare their therapeutic potencies has puzzled neurologists for years: initial studies used inadequate clinical models, such as blepharospasm, hemifacial spasm, or spasmodic dysphonia, which are extremely dose insensitive with respect to their therapeutic outcome and side effects. A later study used cervical dystonia as a more sensitive model, but referred to independent patient groups, thus provoking criticism because of vast interinvidual cervical dystonia differences. By using cervical dystonia and applying a crossover design, the study by Ranoux and colleagues1 certainly has methodological advantages over previous ones. However, it has its own flaws: with durations of action in the Dysport 1:4 group ranging from 0 to 491 days and a substantially larger standard deviation in this than in any other group, the Dysport 1:4 group obviously contains at least one, if not more, patients with clearly abnormal and unusual responses, thus erroneously overestimating this group’s duration of action. The Dysport 1:3 group with a normal range of durations of action, was not significantly different from the Botox group. The meaning of a duration of action of 0 days in the Botox group and in the Dysport 1:3 group remains unclear. With the pain score in the Botox group being substantially lower …

https://jnnp.bmj.com/content/jnnp/73/5/604.1.full.pdf

Dysport produces intrinsically more swallowing problems than Botox: unexpected results from a conversion factor study in cervical dystonia

Pseudoaneurysms of the superficial temporal artery are mostly traumatic in origin. Here, a case of a superficial temporal artery aneurysm that emerged following a recraniotomy is presented. A 59-year-old woman was admitted with subarachnoid hemorrhage. She underwent a pterional craniotomy and clipping of a saccular aneurysm of middle cerebral artery bifurcation. A control digital subtraction angiography on the 3rd postoperative day revealed partial filling of the aneurysm and a revision was performed. The second control digital subtraction angiography on the 4th postoperative day of the revision showed a pseudoaneurysm of the left superficial temporal artery. The pseudoaneurysm was excised successfully under local anesthesia. In conclusion, pseudoaneurysm of the superficial temporal artery should be considered among the early postoperative complications of the surgical procedures at the superficial temporal artery territory. Although some conservative approaches are used, excision of the aneurysm is recommended for treatment.

/pdf/pseudoaneurysm-of-the-superficial-temporal-artery-following-5cgc05v5pr.pdf

Pseudoaneurysm of the superficial temporal artery following revision of a middle cerebral artery aneurysm clipping: case report and review of the literature.

As the editor of this book says, at one time those who reported psychometric testing data in relationship to a particular lesion location or disease process were considered more experimental and scientific, where rehabilitators were perceived as seeking a therapeutic effect from atheoretical and non-experimental approaches. Although this attitude is still prevalent in some …

https://jnnp.bmj.com/content/jnnp/73/5/605.4.full.pdf

Neuropsychological interventions, clinical research and practice.

I read the interesting paper by Vroomen and colleagues1 concerning the utility of clinical evaluation in patients with sciatica and suspected lumbosacral nerve root compression. While the study appears generally well done, I am concerned about several aspects of the calculations and the interpretation of some of the results. Firstly, the reported odds ratio for “male sex” appears to have been inverted; from the information presented it should …

https://jnnp.bmj.com/content/jnnp/73/5/604.2.full.pdf

Diagnostic value of history and physical examination in patients suspected of lumbosacral nerve root compression.

Postoperative aneurysm of the superficial temporal artery

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Postoperative aneurysm of the superficial temporal artery