We are happy to report that Monmouth’s stoke program was well represented at the 2014 New Jersey Stroke Conference earlier this month.
Two department of medicine residents, Drs Amor and Chan, presented our TIA center data in the poster session:
Dr Holland gave a talk on the role of telemedicine in stroke rehabilitation.
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.
The device, which is similar to an electric toothbrush, consists of a detachable spoon, a motion-generating platform, a controller/sensor, and a rechargeable battery. It detects the frequency of the patient’s tremor, and then counteracts that motion, to keep the spoon stable.
Patients in the study still had tremor, but they were less likely to spill their food when eating with the spoon.
The device is now commercially available, and costs around $295.
We are trying to do a better job educating our patients about the warning signs of stroke, and that if they think they might be having a stroke they should act FAST and call 911 to get to the ER as soon as possible.
However, despite these efforts only 5% of US stroke patients get to the ER in time to receive clot busting therapy to treat their stroke. Furthermore, the quicker the drug is given, the better the outcome, TIME IS BRAIN!
We would like to see patients getting treated within one hour of the onset of their stroke, but because of the time it takes to get to the hospital and get evaluated in the ER this is rarely possible.
A pilot study in Texas is looking at getting stroke therapy administered faster by bringing the ER to the stroke patient.
The project brings a mobile CT scanner and a stroke neurologist (via telemedicine) to the patient in a specially equipped ambulance. The investigators hope to see stroke patients getting treated faster and improved outcomes.
How it this possible?
Well, the genetic code which is translated to from proteins “talks” in words made of three letters (base pairs).
A gene mutation that deletes only one or two base pairs, or worse still signals the end of the word (known a “premature stop codon”) will result it a very abnormal dysfunctional gene product, leading to complete deficiency of functioning dystrophin, and the more severe Duchenne Muscular Dystrophy.
However a gene mutation (deletion) that removes base pairs in a multiples of three is called an in-frame mutation, and causes a (sometimes only minor) qualitative change in the dystrophin protein, leading to the milder Becker’s muscular dystrophy.
Ataluren (also known as PTC124) is a small molecule designed to overcome premature stop codons.
Put simply, the idea is that it might convert some Duchenne boys in to a milder form (more like Becker’s) of muscular dystrophy by allowing them to produce some more normal dystrophin.
The drug can only help boys affected with premature stop codons confirmed by DNA testing.
Click here to find out more about one of the patients featured in this story.
Come to one of our trigeminal neuralgia support group meetings – check the Neuroscience Events Panel on the right side of the page.
(CNN) — Doctors and hospital officials from Novant Health Forsyth Medical Center in Winston-Salem, North Carolina, are notifying 18 neurosurgery patients that they might have been exposed to Creutzfeldt-Jakob disease, a serious and incurable neurological disorder.
“Today we are reaching out to 18 neurosurgery patients who were exposed to Creutzfeldt-Jakob disease over the last three weeks at Forsyth Medical Center,” said Jeff Lindsay, president of the center, according to CNN affiliate WGHP.
The hospital is in the process of contacting the 18 people, spokeswoman Jeanne Mayer said Tuesday. She was not sure how many had been reached.
According to the National Institute of Neurological Disorders and Stroke, CJD affects about one person in every 1 million people per year worldwide.
Gupta: Disease takes years to develop
“It is important to note that there are multiple variations of CJD and this case is not related to mad cow disease,” Novant Health said in a statement.
The hospital confirmed that on January 18, an operation was performed on a patient with CJD symptoms who later tested positive for the illness.
Even though the surgical instruments were sterilized by standard hospital procedures, they should have gone through enhanced sterilization procedures used when there are confirmed or suspected cases of CJD.
The original patient “had neurological symptoms that could have been attributed to CJD or another brain disease,” Novant Health said. “There were reasons to suspect that this patient might have had CJD. As such, the extra precautions should have been taken, but were not.”
The Centers for Disease Control and Prevention, as well as the World Health Organization, recommends that surgical equipment used on CJD patients be destroyed or decontaminated through an intense disinfecting process.
Although CJD can be transferred through surgical equipment, hospital officials say the likelihood of these patients contracting the disease is very low.
The CDC corroborates that assessment.
It says that no cases of the disease have been linked to the use of contaminated medical equipment since 1976.
But Lindsay made no excuses.
“On behalf of the entire team at Novant Health, I apologize to the patients and their families, for having caused this anxiety.”
CJD is a rare, degenerative and fatal brain disorder, according to the National Institutes of Health. It’s characterized by rapid, progressive dementia. Initial symptoms can include problems with muscular coordination, personality changes including impaired memory and thinking; and impaired vision.
CJD is believed to be caused by a type of protein called a prion. It can be sporadic, hereditary or acquired; the acquired type is the rarest form, according to the NIH, and seen in fewer than 1% of cases. It is not contagious through casual contact.
Asked whether the 18 people would be tested, Mayer said there is no quick test for CJD. The original patient underwent brain surgery and then the disease was found through a number of tests afterward, she said. In some cases, CJD can take years to show up, Mayer said.
The hospital has instituted the enhanced sterilization process on all surgical instruments used in brain surgery, Novant Health said.
In September, 13 patients received similar warnings from two hospitals in New Hampshire and Massachusetts, when a patient who had undergone neurosurgery was later suspected to have CJD.
The hospitals shared the specialized surgical equipment that was used to operate on the patient and continued to use it until the suspicion of exposure to the disease surfaced.