The Experts below are selected from a list of 831 Experts worldwide ranked by ideXlab platform
Sashank Prasad - One of the best experts on this subject based on the ideXlab platform.
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historical trends in the diagnosis of peduncular hallucinosis
Journal of Neuro-ophthalmology, 2017Co-Authors: Kristin M Galetta, Sashank PrasadAbstract:BACKGROUND: Peduncular hallucinosis (PH) describes the clinical syndrome of Vivid, Dream-like visual hallucinations that intrude on normal wakefulness. Additional clinical deficits, especially ophthalmoparesis, have historically been an important part of the diagnosis and localization of this syndrome. We examined how modern neuroimaging has impacted the diagnosis of PH. METHODS: We reviewed all available cases of PH, including 3 of ours and all previously reported in the literature. We determined whether other eye movement abnormalities were part of the clinical presentation and whether a neuroimaging study was performed to make the diagnosis. RESULTS: A total of 85 cases were identified and evaluated. Eye movement abnormalities were present in 12/15 (80%) without a neuroimaging study but in only 24/70 (34%) of cases in which a neuroimaging study was performed (P = 0.001). CONCLUSIONS: Although eye movement abnormalities historically have been considered a key localizing clinical feature supporting the diagnosis of PH, we found that in the era of modern neuroimaging, co-occurring eye movement abnormalities are far less frequent and are not a requisite feature of the diagnosis.
Kristin M Galetta - One of the best experts on this subject based on the ideXlab platform.
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historical trends in the diagnosis of peduncular hallucinosis
Journal of Neuro-ophthalmology, 2017Co-Authors: Kristin M Galetta, Sashank PrasadAbstract:BACKGROUND: Peduncular hallucinosis (PH) describes the clinical syndrome of Vivid, Dream-like visual hallucinations that intrude on normal wakefulness. Additional clinical deficits, especially ophthalmoparesis, have historically been an important part of the diagnosis and localization of this syndrome. We examined how modern neuroimaging has impacted the diagnosis of PH. METHODS: We reviewed all available cases of PH, including 3 of ours and all previously reported in the literature. We determined whether other eye movement abnormalities were part of the clinical presentation and whether a neuroimaging study was performed to make the diagnosis. RESULTS: A total of 85 cases were identified and evaluated. Eye movement abnormalities were present in 12/15 (80%) without a neuroimaging study but in only 24/70 (34%) of cases in which a neuroimaging study was performed (P = 0.001). CONCLUSIONS: Although eye movement abnormalities historically have been considered a key localizing clinical feature supporting the diagnosis of PH, we found that in the era of modern neuroimaging, co-occurring eye movement abnormalities are far less frequent and are not a requisite feature of the diagnosis.
Ajaz Sheikh - One of the best experts on this subject based on the ideXlab platform.
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a case of focal rem sleep epilepsy originating from the occipital lobe p3 278
Neurology, 2018Co-Authors: Umar Shuaib, Mohammad Humayun, Sharjeel Panjwani, Ajaz SheikhAbstract:Objective: NA Background: Seizures occur during various stages of sleep with different propensity. REM sleep has been found in particular to play a seizure-protective role, and therefore seizures during this phase are a rare phenomenon. Multiple pathways have been postulated that makes REM sleep relatively immune to seizures, when compared to other stages of sleep as well as the awake state. We present a case of focal occipital lobe epilepsy in REM sleep. Design/Methods: Case report Results: 36-year-old right-handed legally blind gentleman who presented with seizures reportedly beginning at 6 months of age. Seizure semiology progressed from generalized tonic clonic convulsions to ultimately become almost exclusively related to experiencing a Vivid Dream. We admitted him for video-EEG monitoring. Anti-seizure drugs (ASD) include Levetiracetam 300 mg daily, Topiramate 300mg twice daily, and Zonisamide 200 mg daily. Patient had frequent right interictal occipital spike-and-wave discharges which were seen exclusively during REM sleep. After weaning ASD, patient had a clinical event described as a Dream experience of being pursued and in distress, followed by a brief period of wakefulness and subsequent loss of consciousness. Electrographically, this was associated with seizure onset during REM sleep and was 7-minute-long in duration, originating from right occipital region that subsequently generalized. There was no clear clinical correlate aside from brief leg stiffening 5 minutes into the seizure. Conclusions: Seizures during REM sleep are seldom seen and are usually reported in temporal and frontal lobe epilepsy; REM sleep seizures emanating from occipital lobe is a rare entity. Vivid Dream at seizure onset during REM sleep is of particular interest in this case. The mechanism for the seizure-protective effect of REM sleep is not entirely clear, but is postulated to be due to factors including increased cholinergic output, asynchronous discharges that result in reduced opportunity for spatial and temporal summation, and emergence of regional antiepileptic microrhythms. Disclosure: Dr. Shuaib has nothing to disclose. Dr. Humayun has nothing to disclose. Dr Panjwani has nothing to disclose. Dr. Sheikh has nothing to disclose.
Umar Shuaib - One of the best experts on this subject based on the ideXlab platform.
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a case of focal rem sleep epilepsy originating from the occipital lobe p3 278
Neurology, 2018Co-Authors: Umar Shuaib, Mohammad Humayun, Sharjeel Panjwani, Ajaz SheikhAbstract:Objective: NA Background: Seizures occur during various stages of sleep with different propensity. REM sleep has been found in particular to play a seizure-protective role, and therefore seizures during this phase are a rare phenomenon. Multiple pathways have been postulated that makes REM sleep relatively immune to seizures, when compared to other stages of sleep as well as the awake state. We present a case of focal occipital lobe epilepsy in REM sleep. Design/Methods: Case report Results: 36-year-old right-handed legally blind gentleman who presented with seizures reportedly beginning at 6 months of age. Seizure semiology progressed from generalized tonic clonic convulsions to ultimately become almost exclusively related to experiencing a Vivid Dream. We admitted him for video-EEG monitoring. Anti-seizure drugs (ASD) include Levetiracetam 300 mg daily, Topiramate 300mg twice daily, and Zonisamide 200 mg daily. Patient had frequent right interictal occipital spike-and-wave discharges which were seen exclusively during REM sleep. After weaning ASD, patient had a clinical event described as a Dream experience of being pursued and in distress, followed by a brief period of wakefulness and subsequent loss of consciousness. Electrographically, this was associated with seizure onset during REM sleep and was 7-minute-long in duration, originating from right occipital region that subsequently generalized. There was no clear clinical correlate aside from brief leg stiffening 5 minutes into the seizure. Conclusions: Seizures during REM sleep are seldom seen and are usually reported in temporal and frontal lobe epilepsy; REM sleep seizures emanating from occipital lobe is a rare entity. Vivid Dream at seizure onset during REM sleep is of particular interest in this case. The mechanism for the seizure-protective effect of REM sleep is not entirely clear, but is postulated to be due to factors including increased cholinergic output, asynchronous discharges that result in reduced opportunity for spatial and temporal summation, and emergence of regional antiepileptic microrhythms. Disclosure: Dr. Shuaib has nothing to disclose. Dr. Humayun has nothing to disclose. Dr Panjwani has nothing to disclose. Dr. Sheikh has nothing to disclose.
Kristin Galetta, Sashank M. Prasad - One of the best experts on this subject based on the ideXlab platform.
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Historical Trends in the Diagnosis of Peduncular Hallucinosis
Lippincott Williams & Wilkins, 2018Co-Authors: Kristin Galetta, Sashank M. PrasadAbstract:Peduncular hallucinosis (PH) describes the clinical syndrome of Vivid, Dream-like visual hallucinations that intrude on normal wakefulness. Additional clinical deficits, especially ophthalmoparesis, have historically been an important part of the diagnosis and localization of this syndrome. We examined how modern neuroimaging has impacted the diagnosis of PH. We reviewed all available cases of PH, including 3 of ours and all previously reported in the literature. We determined whether other eye movement abnormalities were part of the clinical presentation and whether a neuroimaging study was performed to make the diagnosis. A total of 85 cases were identified and evaluated. Eye movement abnormalities were present in 12/15 (80%) without a neuroimaging study but in only 24/70 (34%) of cases in which a neuroimaging study was performed (P = 0.001). Although eye movement abnormalities historically have been considered a key localizing clinical feature supporting the diagnosis of PH, we found that in the era of modern neuroimaging, co-occurring eye movement abnormalities are far less frequent and are not a requisite feature of the diagnosis
