JNS.jpgThe June issue of the Journal of the Neurological Sciences Vol 401 is now available online.

 

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Issue highlights

Hypnic headache: A review of 348 cases published from 1988 to 2018

Hypnic headache (HH) is a rare benign disorder described initially by Raskin in 1988. It is characterized by recurrent nocturnal episodes of headache that periodically awaken the sleeping patient and usually occur in the elderly. This review aimed to describe the clinical features of the HH cases published in the literature from 1988 to 2018.

  • HH predominates after 50 years of age but may occur in young adults and children
  • Autonomic manifestations may occur bilaterally, but do not meet diagnostic criteria for trigeminal-autonomic headaches.
  • Lithium, caffeine, indomethacin and melatonin are first choice drugs for prophylactic treatment of HH.

 


Can we stop the stuttering in stroke? Interventions in 40 patients with acute lacunes

Whether any treatment can stop fluctuations of stuttering lacunar syndromes (SLS) is unclear. Case reports have variably suggested effectiveness of intravenous thrombolysis, dual antiplatelet treatment, blood pressure augmentation and anticoagulation. We aim to describe our experience with different treatments used in patients presenting with SLS and their effect on clinical fluctuations and functional outcome.

  • Stuttering lacunar syndromes are infrequent.
  • Their complex clinical features and pathophysiology defy a uniform treatment.
  • Intravenous alteplase is the choice of treatment within 4.5-h window.
  • A loading dose of aspirin-clopidogrel may be an option when alteplase is not.
  • Blood pressure augmentation may benefit some patients with labile blood pressure.

 


Cervical spinal cord atrophy impact on quality of life in MS: A neuroimaging study

Multiple sclerosis (MS) is a progressive neurologic disease, which usually affects younger individuals and causes significant permanent disability. In the past two decades, the role of central nervous system (CNS) tissue atrophy has been emerging as a significant marker of disability in MS patients and substantial research efforts have been focused on the grey matter as well as white matter volume loss in the context of the neurodegenerative arm of this progressive neurologic disease.