Post prepared by Amanda Baker, Drexel University College of Medicine Class of 2014
A study recently published in the Journal of Neuroscience by Harvard researchers have linked casual marijuana use to structural changes in distinct areas of the brain.
These areas, the nucleus accumbens and amygdala, and are largely involved in recognition of reward, motivation, fear, and memory. In this study, the brain scans of 20 young adult casual marijuana users were compared to those of 20 young adult non-users.
While the results clearly demonstrated significant structural differences between the two groups, the structural changes have not been correlated with consequences in mental or physical functioning. In other words, researchers aren’t entirely sure of the impact of these brain changes.
The debate regarding the use of marijuana medically and recreationally is ongoing in the United States.
Although the Drug Enforcement Administration(DEA) categorizes this drug as Schedule I, “with currently no accepted medical use and a high potential for abuse”, many argue that there is, in fact, much benefit to medical marijuana, especially in comparison to other sedating pain medications.
This is reflected in 21 state laws which have legalized medical marijuana to varying degrees.
Last summer, Dr. Sanjay Gupta completed a documentary “Weed” highlighting the benefit of medical marijuana:
However, some states such as Washington and Colorado, have gone one step further by legalizing marijuana for both recreational and medical use.
Given the ongoing research on the effects of marijuana, perhaps this new study will call into question continued legalization of the most widely used recreational drug in America.
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Our first tremor patient treated with gamma knife radiosurgery recently came back, one year later, to have the other side treated.
He has essential tremor, which was affecting both arms.
He had undergone treatment to the left brain for right sided tremor last year.
He was so pleased with his results, he recently came to have the right brain treated to address the left sided tremor.
Here is his most recent video.
Note the action and postural tremor on the left (untreated) side, and the fact that he has almost not residual tremor on the right (treated) side.
Post prepared by Precious Ramirez-Arao, Monmouth Medical Center PGY3
A 60 year-old female was found lethargic lying in a pool of feces by roommate.
EMS was called and was immediately brought to the hospital.
In the emergency department she had a witnessed generalized tonic-clonic seizure.
Her roommate relates she had episodes of confusion and short-term memory loss over the past few weeks.
She remained lethargic over the next 72 hours in the hospital.
48-hour EEG monitoring showed diffuse 2 to 3 Hz delta slowing with periodic lateralized epileptiform discharges emanating from the left frontal temporal region.
T2 weighted image of the brain showed signal abnormality of the left mesial temporal lobe and the pulvinar with diffusion restriction in the left hippocampus consistent with limbic encephalitis.
Limbic encephalitis (LE) is a subacute syndrome of seizures, personality change and cognitive dysfunction, typically evolving over days to weeks.
Autoimmune and paraneoplastic forms have been described. The most common neoplasms associated with paraneoplastic LE are lung cancer (usually small cell), thymoma, ovarian or testicular teratoma, breast cancer and Hodgkin lymphoma. The associated autoantibody depends on the tumor type. Lung cancer and thymomas are associated with anti-VGKC while ovarian or testicular teratomas are associated with antiNMDA antibodies.
Neurologic symptoms can precede oncologic diagnosis for several months to years and initial CT scans are typically unrevealing.
Nevertheless, prompt and thorough evaluation for malignancy including PET and CT scan of the chest, abdomen and pelvis should be initiated. Symptomatic treatment includes corticosteroids, plasmapharesis and intravenous immune globulin.