-
The Neurohospitalist Jul 2024Anti-leucine rich glioma inactivated 1 (LGI-1) autoimmune encephalitis (AE) typically presents with cognitive impairment, faciobrachial dystonic seizures (FBDS) and...
Anti-leucine rich glioma inactivated 1 (LGI-1) autoimmune encephalitis (AE) typically presents with cognitive impairment, faciobrachial dystonic seizures (FBDS) and hyponatraemia. Reports are growing of neurological complications following coronavirus disease 2019 (COVID-19) vaccination. Here we describe a 50 year old man who developed anti-LGI-1 limbic encephalitis and autoimmune epilepsy 4 days following a dose of the mRNA Pfizer COVID-19 vaccine (of note, his first two vaccinations were viral vector ChAdOX1-S). He presented with focal aware seizures characterised by short-lived episodes of confusion, emotional distress and déjà vu associated with palpitations. He also reported subacute progressive amnesia. He responded well to high-dose steroid and subsequent immunoglobulin therapy. To our knowledge, this is the first reported case of anti-LGI-1 AE following a mixed COVID-19 vaccination regimen. We aim to complement the early literature on this post-COVID-19 vaccination phenomenon.
PubMed: 38895001
DOI: 10.1177/19418744241234100 -
Journal of Neurointerventional Surgery Apr 2024
PubMed: 38653523
DOI: 10.1136/jnis-2024-021484 -
Seizure May 2024Déjà vu (DV), a French term meaning "already seen," refers to inappropriate sensation of familiarity in the present moment, as if it had been experienced before... (Review)
Review
INTRODUCTION
Déjà vu (DV), a French term meaning "already seen," refers to inappropriate sensation of familiarity in the present moment, as if it had been experienced before without a specific recollection of when or where. Traditionally, DV has been closely associated with focal seizures originating from the medial temporal lobe. However, there are occasional reports of DV occurring in idiopathic generalized epilepsies (IGEs). The objective of our study was to assess the presence and frequency of DV in individuals with IGE.
METHODS
We used the Preferred Reporting Items for Systematic Review and Meta-Analysis for protocols (PRISMA-P) and searched PubMed and Embase from January 2000 to July 2022.
RESULTS
5 studies were included with a total of 1177 IGE and 1026 with temporal lobe epilepsy (TLE) patients. The frequency of DV in IGE ranged from 0 to 11 %, and the average was 3 %, compared to 19.6 % in TLE. Broadly, 40 % of patients with IGE reported some type of aura. EEG correlation of DV in IGE was not appropriately evaluated in the studies.
CONCLUSION
Clinicians should be aware that individuals with IGE may experience DV and other types of auras. Recognizing these auras is crucial in order to avoid misdiagnosing IGE as focal epilepsy. This is important to prevent unnecessary investigations and incorrect treatment decisions.
Topics: Humans; Epilepsy, Generalized; Deja Vu
PubMed: 38640571
DOI: 10.1016/j.seizure.2024.03.015 -
No Shinkei Geka. Neurological Surgery Mar 2024Preoperative simulation images creates an accurate visualization of a surgical field. The anatomical relationship of the cranial nerves, arteries, brainstem, and related...
Preoperative simulation images creates an accurate visualization of a surgical field. The anatomical relationship of the cranial nerves, arteries, brainstem, and related bony protrusions is important in skull base surgery. However, an operator's intention is unclear for a less experienced neurosurgeon. Three-dimensional(3D)fusion images of computed tomography and magnetic resonance imaging created using a workstation aids precise surgical planning and safety management. Since the simulation images allows to perform virtual surgery, a déjà vu effect for the surgeon can be obtained. Additionally, since 3D surgical images can be used for preoperative consideration and postoperative verification, discussion among the team members is effective from the perspective of surgical education for residents and medical students. Significance of preoperative simulation images will increase eventually.
Topics: Humans; Skull Base; Imaging, Three-Dimensional; Skull Base Neoplasms; Tomography, X-Ray Computed; Neurosurgical Procedures; Magnetic Resonance Imaging
PubMed: 38514121
DOI: 10.11477/mf.1436204916 -
European Heart Journal Mar 2024
Topics: Humans; Transcatheter Aortic Valve Replacement; Deja Vu; Length of Stay; Aortic Valve Stenosis; Postoperative Complications; Aortic Valve
PubMed: 38437639
DOI: 10.1093/eurheartj/ehae096 -
Schizophrenia Research Apr 2024We aimed to investigate as to whether psychotic-like experiences (PLEs) predict the perceived intent to seek treatment. Our secondary aim was to explore which PLEs...
We aimed to investigate as to whether psychotic-like experiences (PLEs) predict the perceived intent to seek treatment. Our secondary aim was to explore which PLEs predict the perceived need to seek treatment using a network analysis. The study was based on a community sample of individuals with a negative history of psychiatric treatment. At baseline, they completed questionnaires recording the presence of PLEs, depressive, and anxiety symptoms. After 6-7 months, they were reassessed with respect to the perceived intent to seek treatment. A total of 1100 individuals were assessed at baseline (aged 27.1 ± 5.1 years, 48.6 % males). The follow-up assessment was completed by 581 individuals (52.8 %). Higher baseline levels of PLEs were associated with a greater intent to seek treatment at the follow-up before (Beta = 0.289, p < 0.001) and after adjustment for sociodemographic characteristics, depressive and anxiety symptoms (Beta = 0.128, p = 0.004). A network analysis demonstrated that the intent to seek treatment was connected to five nodes of PLEs including "déjà vu experiences" (weight = 0.046), "problems in differentiating reality and imagination" (weight = 0.103), "a lack of control over own ideas or thoughts" (weight = 0.077), "being distracted by distant sounds" (weight = 0.105), and "paranoid thoughts" (weight = 0.145). Findings from the present study indicate that PLEs might contribute to help-seeking behaviors regardless of co-occurring depressive and anxiety symptoms. However, specific PLEs may differ with respect to their effects on the perceived intent to seek treatment.
Topics: Male; Humans; Female; Psychotic Disorders; Depression; Anxiety; Surveys and Questionnaires; Psychotherapy
PubMed: 38387252
DOI: 10.1016/j.schres.2024.02.033 -
Continuum (Minneapolis, Minn.) Dec 2023Progress is ongoing in understanding paraneoplastic neurologic disorders, with new syndromes and antibodies being described and more detailed evidence available to guide...
OBJECTIVE
Progress is ongoing in understanding paraneoplastic neurologic disorders, with new syndromes and antibodies being described and more detailed evidence available to guide workup for diagnosis and treatment to improve outcomes. Many excellent reviews have summarized the molecular features of different antibodies, but this article emphasizes the clinical features of each syndrome that may help guide initial diagnosis and treatment, which often should occur before an antibody or cancer is found to confirm the diagnosis.
LATEST DEVELOPMENTS
Recent findings include updated diagnostic criteria with validated sensitivity and specificity, discovery of novel antibodies, and clinical findings that increase the likelihood of an underlying paraneoplastic disorder. Suggestive syndromes that have been recently identified include faciobrachial dystonic seizures and pilomotor auras in anti-leucine-rich glioma inactivated protein 1 encephalitis, extreme delta brush on EEG in N-methyl-d-aspartate (NMDA)-receptor encephalitis, déjà vu aura in anti-glutamic acid decarboxylase 65 (GAD65) encephalitis, and sleep disturbances in several disorders. In addition, there is confirmed utility of brain positron emission tomography (PET) and CSF markers, including carcinoembryonic antigen and oligoclonal bands, as well as improved tests for the presence of leptomeningeal cancer cells in CSF. Associations of cancer immunotherapies with paraneoplastic syndromes and herpes simplex virus encephalitis (and COVID-19) with NMDA-receptor encephalitis have been described.
ESSENTIAL POINTS
All neurologists should be aware of advances regarding paraneoplastic neurologic syndromes, as patients can present with a wide variety of neurologic symptoms and earlier diagnosis and treatment can improve outcomes.
Topics: Humans; N-Methylaspartate; Paraneoplastic Syndromes, Nervous System; Encephalitis; Autoantibodies; Epilepsy; Receptors, N-Methyl-D-Aspartate
PubMed: 38085898
DOI: 10.1212/CON.0000000000001357 -
Acta Neuropathologica Communications Dec 2023Gene fusion events have been linked to oncogenesis in many cancers. However, gene fusions in meningioma are understudied compared to somatic mutations, chromosomal...
Gene fusion events have been linked to oncogenesis in many cancers. However, gene fusions in meningioma are understudied compared to somatic mutations, chromosomal gains/losses, and epigenetic changes. Fusions involving B-raf proto-oncogene, serine/threonine kinase (BRAF) are subtypes of oncogenic BRAF genetic abnormalities that have been reported in certain cases of brain tumors, such as pilocytic astrocytomas. However, BRAF fusions have not been recognized in meningioma. We present the case of an adult female presenting with episodic partial seizures characterized by déjà vu, confusion, and cognitive changes. Brain imaging revealed a cavernous sinus and sphenoid wing mass and she underwent resection. Histopathology revealed a World Health Organization (WHO) grade 1 meningioma. Genetic profiling with next generation sequencing and microarray analysis revealed an in-frame BRAF::PTPRN2 fusion affecting the BRAF kinase domain as well as chromothripsis of chromosome 7q resulting in multiple segmental gains and losses including amplifications of cyclin dependent kinase 6 (CDK6), tyrosine protein-kinase Met (MET), and smoothened (SMO). Elevated pERK staining in tumor cells provided evidence of activated mitogen-activated protein kinase (MAPK) signaling. This report raises the possibility that gene fusion events may be involved in meningioma pathogenesis and warrant further investigation.
Topics: Adult; Female; Humans; Meningeal Neoplasms; Meningioma; Oncogene Proteins, Fusion; Proto-Oncogene Proteins B-raf; Receptor-Like Protein Tyrosine Phosphatases, Class 8
PubMed: 38066633
DOI: 10.1186/s40478-023-01668-w -
Neuroscience and Biobehavioral Reviews Dec 2023Déjà vu can be defined as conflict between a subjective evaluation of familiarity and a concurrent evaluation of novelty. Accounts of the déjà vu experience have not... (Review)
Review
Déjà vu can be defined as conflict between a subjective evaluation of familiarity and a concurrent evaluation of novelty. Accounts of the déjà vu experience have not explicitly referred to a "conflict account of déjà vu" despite the acceptance of conflict-based definitions of déjà vu and relatively recent neuroimaging work that has implicated brain areas associated with conflict as underpinning the experience. Conflict monitoring functioning follows a similar age-related trajectory to déjà vu with a peak in young adulthood and a subsequent age-related decline. In this narrative review of the literature to date, we consider how déjà vu is defined and how this has influenced the understanding of déjà vu. We also review how déjà vu can be understood within theories of recognition memory and cognitive control. Finally, we summarise the conflict account of déjà vu and propose that this account of the experience may provide a coherent explanation as to why déjà vu experiences tend to decrease with age in the non-clinical population.
Topics: Humans; Young Adult; Adult; Motivation; Recognition, Psychology; Brain; Neuroimaging
PubMed: 37979736
DOI: 10.1016/j.neubiorev.2023.105467 -
The Behavioral and Brain Sciences Nov 2023On Barzykowski and Moulin's continuum hypothesis, déjà vu and involuntary autobiographical memories (IAMs) share their underpinning neurocognitive processes. A...
On Barzykowski and Moulin's continuum hypothesis, déjà vu and involuntary autobiographical memories (IAMs) share their underpinning neurocognitive processes. A discontinuity issue for them is that familiarity and episodic recollection exhibit different neurocognitive signatures. This issue can be overcome, I say, provided the authors are ready to distinguish a déjà vécu/episodic IAM continuity and a déjà vu/semantic IAM continuity.
Topics: Humans; Recognition, Psychology; Memory, Episodic; Semantics
PubMed: 37961835
DOI: 10.1017/S0140525X23000225