Direction fixed nystagmus
Details about direction fixed and direction changing nystagmus have been included on the Cerebellar function page.
Neurology
Vertigo
The Vertigo page has been updated following the recent publication of the following article. Edlow, JA, Newman-Toker, D. Using the Physical Examination to Diagnose Patients with Acute Dizziness and Vertigo. Journal of Emergency Medicine. 2016;50(4):617-28.
Primary prevention of stroke
The Cerebrovascular disease page has been updated with additional information about the primary prevention of stroke. Steiger, N, Cifu, AS. Primary prevention of stroke. JAMA 2016;316(6):658-59.
sBP target for ICH is < 180mmHg
The Stroke management page has been revised to indicate that the target sBP value for the management of primary ICH is < 180mmHg and that reductions to 110-140mmHg appear to confer no additional benefit. Qureshi, AI, Palesch, YY, Barsan, WG, et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. N Engl J Med 2016.
Ticagrelor for stroke prevention
The Cerebrovascular disease page has been updated with information about the equivalence of ticagrelor and aspirin for the prevention of stroke. Johnston, SC, Amarenco, P, Albers, GW, et al. Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack. New England Journal of Medicine;2016.
Seizures in pregnancy
The Seizures page has been updated with a segment on seizures in pregnancy. Kinney, MO, Morrow, J. Epilepsy in pregnancy. BMJ 2016:i2880
Stiff person syndrome
A segment on Stiff person syndrome has been added to the Other movement disorders page.
Anticoagulation in AF and ESRF
The Cerebrovascular disease page has been updated with revised information about anticoagulation for patients with AF and end stage renal failure. Dahal, K, Kunwar, S, Rijal, J, et al. Stroke, Major Bleeding, and Mortality Outcomes in Warfarin Users With Atrial Fibrillation and Chronic Kidney Disease: A Meta-Analysis of Observational Studies. Chest 2016;149(4):951-59.
Aspirin for TIA
The Cerebrovascular disease page has been updated with revised information about the effectiveness of aspirin for stroke prevention in patients with TIA.
Seizures and driving
The segment on seizures and driving restrictions on the Management of isolated seizures page has been updated with reference to the Austroads: Assessing fitness to drive publication.
Low dose tPA for stroke
Some information about low dose (0.6mg/kg) IV tPA for the treatment of stroke has been added to the Thrombolytic therapy in stroke page. Anderson, CS, Robinson, T, Lindley, RI, et al. Low-Dose versus Standard-Dose Intravenous Alteplase in Acute Ischemic Stroke. N Engl J Med 2016.
ACEM position on thrombolysis in stroke
Information regarding the position on ACEM on tPA for the treatment of stroke has been updated on the Thrombolytic therapy in stroke page.
Don’t transfuse platelets to patients with ICH on antiplatelet agents
The Platelet transfusion and Stroke management pages have been updated with information from the PATCH RCT published in Lancet that demonstrated an increase in disability and mortality from platelet transfusion in patients with supratentorial ICH on mostly aspirin, clopidogrel and/or dipyridamole. The exact mechanism for this is unclear. Baharoglu, MI, Cordonnier, C, Salman, RA-S, et al. … Read more
Status epilepticus
The Status epilepticus page has been updated including new information about the relative efficacy of different anti-convulsant agents.
Deficit resolution in ICH
A statement about how approximately 0.5% of patients with ICH may have transient neurological deficits has been added to the Intracerebral haemorrhage page.
Hypomelanosis of Ito
The Phakomatoses page has been updated with a segment on Hypomelanosis of Ito.
Statin myopathy
A small segment on statin induced autoimmune myopathy has been added to the Neuropathies and myopathies page.
Deep brain stimulation
A short segment about deep brain stimulation and it’s potential adverse effects has been added to the Parkinson’s disease page.
CT in SAH – clarification
A statement on the Investigation of suspected subarachnoid haemorrhage page has been clarified. The statement ‘aneurysm may infrequently be seen if > 5 mm diameter’, in relation to CT head has been corrected to ‘aneurysm may occasionally seen if > 5 mm diameter’. Thanks to Raymund for picking this up.
Peripheral neuropathy
The Peripheral neuropathy page has been revised and updated following the recent JAMA article: Callaghan, BC, Price, RS, Feldman, EL. Distal Symmetric Polyneuropathy: A Review. JAMA 2015;314(20):2172-81.