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3. Global uncertainty in the diagnosis of neurological complications of SARS-CoV-2 infection by both neurologists and non-neurologists: An international inter-observer variability study

Author

Abbariao, Maritoni, Zaki, Shafiq Dexter Abou, Aleksic, Dejan, Aliling, Nicole, Rivas, Susana Arias, Artajos, Godard, Asukile, Melody, Atalar, Arife Çimen, Bae, Jong Seok, Banzrai, Chimeglkham, Bar, Michal, Barone, Valentina, Baykan, Betul, Beghi, Ettore, Berger, Thomas, Bilic, Ivica, Biller, Jose, Boskovic, Mateja, Cabreira, Verónica, Calado, Sofia, Canete, Maria Teresa, Celebisoy, Nese, Chen, Ike Leon, Chishimba, Lorraine, Chomba, Mashina, Constantino, Glenn Anthony, Cotelli, Maria Sofia, De Cauwer, Harald, Debroucker, Thomas, Orantes, Luis Del Carpio, Devaraj, Rashmi, D'Souza, Michelle, Ekizoglu, Esme, Elmali, Ayse Deniz, Fonseca, Ana Catarina, Furloni, Roberto, Gajre, Sunil, Azorin, David Garcia, Garfoot, Vanessa, Gasparic, Irena, Genç, Hamit, Glavica, Marinka, Guanaes, Luiz Gustavo, Gürsoy, Gizem, Hafiz, Nauman, Hasırcı, Buse, Helbok, Raimund, Hor, Chee Peng, Hughes, Stella, Hwang, Sungeun, Kaya, Irem Ilgezdi, Jakupi, Adi, Jamora, Roland Dominic, Kahwagi, Jamil, Kaprelyan, Ara, Kawatu, Nfwama, Kim, Manho, Kim, Hyunji, Kim, Hyun Kyung, Koffie, Desmond, Ladeira, Filipa, Lant, Suzannah, Lee, Woo-Jin, Lee, Sukyoon, Leonardo, Zerlyn, Lim, Christian Emmanuel, Lisak, Marijana, Loh, Hong Chuan, Loo, Lay Khoon, Huzjan, Arijana Lovrencic, Koh, Rosie Sue Luan Lu, Luabeya, Mesu'a Kabwa, Lugaresi, Alessandra, Macrohon, Bernadette, Majdak, Maja, Manalili, Sheryl, Manelli, Filippo, Mapoure, Yacouba Njankouo, Mascarella, Davide, Massano, João, Mataa, Mataa, Matibag, Jessica Leika, Matic-Gerodias, Alexandria, McMullen, Kate, Miranda, Miguel, Modequillo, Margaret, Shoab, Abul Kalam Mohammed, Motto, Cristina, Murphy, Sinead M., Mwendaweli, Naluca, Ng, Chen Fei, Ng, Rong Xiang, Ihsan, Mohd Khairul Nizam Nor, Nyein, Aye Myat, O'Connell, Karen, Oh, Seong-il, Ohnmar, Ohnmar, Özge, Aynur, Pajo, Azalea, Palavra, Filipe, Panteleienko, Larysa, Payne, Catherine, Pensato, Umberto, Peres, João, Peters, Steven, Polat, Burcu, Poljakovic, Zdravka, Punter, Martin Nicholas Michael, Quiles, Liz Edenberg, Ranieri, Angelo, Ratković, Marija, Renales, Maria Lina, Robles, Jose, Bedeković, Marina Roje, Rommer, Paulus, Šapina, Lidija, Sarac, Helena, Saylor, Deanna, Schmutzhard, Erich, Sharma, Anahita, Šimić, Aleksandra, Sipilä, Jussi O.T., Sokhi, Dilraj, Stagno, Mauro, Stancheva, Kristina, Stojsavljević, Marija, Subir, Ahamed, Surdhar, Sushee, Talabucon, Loreto, Jr, Tan, Hui Jan, Teoh, Sing Chiek, Vallejo, Dionis, Velioglu, Sibel K., Vukasović, Rafaela, Kit, Wong Wai, Welte, Tamara, Willekens, Barbara, Yesilot, Nilufer, Yu, Jeryl Ritzi T., Zaw, Moe Moe, Zhelyazkova, Sashka, Žitnik, Eva, Tamborska, A.A., Wood, G.K., Westenberg, E., Garcia-Azorin, D., Webb, G., Schiess, N., Netravathi, M., Baykan, B., Dervaj, R., Helbok, R., Lant, S., Özge, A., Padovani, A., Saylor, D., Schmutzhard, E., Easton, A., Lilleker, J.B., Jackson, T., Beghi, E., Ellul, M.A., Frontera, J.A., Pollak, T., Nicholson, T.R., Wood, N., Thakur, K.T., Solomon, T., Stark, R.J., Winkler, A.S., and Michael, B.D.

Published
2023
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9. Clinical review of cerebral venous thrombosis in the context of COVID-19 vaccinations: Evaluation, management, and scientific questions

Author

Thakur, Kiran T., Tamborska, Arina, Wood, Greta K., McNeill, Emily, Roh, David, Akpan, Imo J., Miller, Eliza C., Bautista, Alyssa, Claassen, Jan, Kim, Carla Y., Guekht, Alla, Pardo, Carlos A., Williams, Olajide, García-Azorín, David, Prasad, Kameshwar, Schmutzhard, Erich, Michael, Benedict D., Chou, Sherry H.-Y., Winkler, Andrea S., Solomon, Tom, and Elkind, Mitchell S.

Published
2021
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14. Frequency of Neurologic Manifestations in COVID-19: A Systematic Review and Meta-analysis

Author

Misra, Shubham, Kolappa, Kavitha, Prasad, Manya, Radhakrishnan, Divya, Thakur, Kiran T., Solomon, Tom, Michael, Benedict Daniel, Winkler, Andrea Sylvia, Beghi, Ettore, Guekht, Alla, Pardo, Carlos A., Wood, Greta Karen, Hsiang-Yi Chou, Sherry, Fink, Ericka L., Schmutzhard, Erich, Kheradmand, Amir, Hoo, Fan Kee, Kumar, Amit, Das, Animesh, Srivastava, Achal K., Agarwal, Ayush, Dua, Tarun, and Prasad, Kameshwar

Published
2021
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16. Clinical Trial Protocol: Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Efficacy, and Safety Study Comparing EG-1962 to Standard of Care Oral Nimodipine in Adults with Aneurysmal Subarachnoid Hemorrhage [NEWTON-2 (Nimodipine Microparticles to Enhance Recovery While Reducing TOxicity After SubarachNoid Hemorrhage)]

Author

Hänggi, Daniel, Etminan, Nima, Mayer, Stephan A., Aldrich, E. Francois, Diringer, Michael N., Schmutzhard, Erich, Faleck, Herbert J., Ng, David, Saville, Benjamin R., Macdonald, R. Loch, and for the NEWTON Investigators

Published
2019
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23. Epilepsy and nodding syndrome in association with an Onchocerca volvulus infection drive distinct immune profile patterns.

Author

Arndts, Kathrin, Kegele, Josua, Massarani, Alain S., Ritter, Manuel, Wagner, Thomas, Pfarr, Kenneth, Lämmer, Christine, Dörmann, Peter, Peisker, Helga, Menche, Dirk, Al-Bahra, Mazen, Prazeres da Costa, Clarissa, Schmutzhard, Erich, Matuja, William, Hoerauf, Achim, Layland-Heni, Laura E., and Winkler, Andrea S.

Subjects
ONCHOCERCA volvulus, EPILEPSY, NEUROLOGICAL disorders, BASIC proteins, FILARIASIS, SYNDROMES
Abstract

Previous studies have described the association of onchocerciasis (caused by Onchocerca volvulus) with epilepsy, including nodding syndrome, although a clear etiological link is still missing. Cases are found in different African countries (Tanzania, South Sudan, Uganda, Democratic Republic of the Congo, Central African Republic and Cameroon). In our study we investigated immunological parameters (cytokine, chemokine, immunoglobulin levels) in individuals from the Mahenge area, Tanzania, presenting with either epilepsy or nodding syndrome with or without O. volvulus infection and compared them to O. volvulus negative individuals from the same endemic area lacking neurological disorders. Additionally, cell differentiation was performed using blood smears and systemic levels of neurodegeneration markers, leiomodin-1 and N-acetyltyramine-O, β-glucuronide (NATOG) were determined. Our findings revealed that cytokines, most chemokines and neurodegeneration markers were comparable between both groups presenting with epilepsy or nodding syndrome. However, we observed elevated eosinophil percentages within the O. volvulus positive epilepsy/nodding syndrome patients accompanied with increased eosinophilic cationic protein (ECP) and antigen-specific IgG levels in comparison to those without an O. volvulus infection. Furthermore, highest levels of NATOG were found in O. volvulus positive nodding syndrome patients. These findings highlight that the detection of distinct biomarkers might be useful for a differential diagnosis of epilepsy and nodding syndrome in O. volvulus endemic areas. Trial-registration:NCT03653975. Author summary: A lot of epidemiological studies suggest that an infection with the filarial nematode Onchocerca volvulus is a risk factor for a certain form of epilepsy which includes the nodding syndrome. The seizures occur suddenly in previously healthy children between the ages of 3 and 18 years and the disease is an important public health problem in onchocerciasis-endemic regions with inadequate or lacking onchocerciasis elimination programmes. So far, no exact pathophysiological mechanisms were detected that shed light on how the parasite can trigger the seizures, although many factors have been investigated. However, most studies lack an accurate determination of an active/chronic O. volvulus infection; rather, they rely on the presence of circulating antibodies, which is only evidence of previous exposure to the parasite (and therefore positive in most people living in endemic areas. Within our study, we included participants from the Mahenge area, Tanzania, who were displaying epilepsy/nodding syndrome in absence or presence of a PCR-determined O. volvulus infection. We could show that the group of O. volvulus infected patients displayed higher levels of eosinophils, antigen-specific immunoglobulin levels as well as increased levels of a worm-related metabolic product (NATOG), which might be used as a potential diagnostic biomarker of the disease in future studies. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Neuropathological criteria of anti-IgLON5-related tauopathy

Author

Gelpi, Ellen, Höftberger, Romana, Graus, Francesc, Ling, Helen, Holton, Janice L., Dawson, Timothy, Popovic, Mara, Pretnar-Oblak, Janja, Högl, Birgit, Schmutzhard, Erich, Poewe, Werner, Ricken, Gerda, Santamaria, Joan, Dalmau, Josep, Budka, Herbert, Revesz, Tamas, and Kovacs, Gabor G.

Published
2016
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29. Consensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy Patients

Author

Michael, Benedict D, Walton, Dean, Westenberg, Erica, García-Azorín, David, Singh, Bhagteshwar, Tamborska, Arina A, Netravathi, M, Chomba, Mashina, Wood, Greta K, Easton, Ava, Siddiqi, Omar K, Jackson, Thomas A, Pollak, Thomas A, Nicholson, Timothy R, Nair, Shalini, Breen, Gerome, Prasad, Kameshwar, Thakur, Kiran T, Chou, Sherry H-Y, Schmutzhard, Erich, Frontera, Jennifer A, Helbok, Raimund, Padovani, Alessandro, Menon, David K, Solomon, Tom, Winkler, Andrea S, and Global COVID-19 Neuro Research Coalition

Subjects
Psychiatry and Mental health, Neurology (clinical)
Abstract

Encephalopathy, a common condition among patients hospitalized with COVID-19, can be a challenge to manage and negatively affect prognosis. While encephalopathy may present clinically as delirium, subsyndromal delirium, or coma and may be a result of systemic causes such as hypoxia, COVID-19 has also been associated with more prolonged encephalopathy due to less common but nevertheless severe complications, such as inflammation of the brain parenchyma (with or without cerebrovascular involvement), demyelination, or seizures, which may be disproportionate to COVID-19 severity and require specific management. Given the large number of patients hospitalized with severe acute respiratory syndrome coronavirus-2 infection, even these relatively unlikely complications are increasingly recognized and are particularly important because they require specific management. Therefore, the aim of this review is to provide pragmatic guidance on the management of COVID-19 encephalopathy through consensus agreement of the Global COVID-19 Neuro Research Coalition. A systematic literature search of MEDLINE, medRxiv, and bioRxiv was conducted between January 1, 2020, and June 21, 2021, with additional review of references cited within the identified bibliographies. A modified Delphi approach was then undertaken to develop recommendations, along with a parallel approach to score the strength of both the recommendations and the supporting evidence. This review presents analysis of contemporaneous evidence for the definition, epidemiology, and pathophysiology of COVID-19 encephalopathy and practical guidance for clinical assessment, investigation, and both acute and long-term management.

Published
2022

32. Approaches to Understanding COVID‐19 and its Neurological Associations

Author

Beghi, Ettore, Michael, Benedict D., Solomon, Tom, Westenberg, Erica, Winkler, Andrea S., Knauss, Samuel, Sejvar, Jim, Siddiqi, Omar, Netravathi, M., Charway‐Felli, Augustina, Abd‐Allah, Foad, Bassetti, Claudio, Ferreira, Maria Lúcia Brito, Chou, Sherry Hsiang‐Yi, Dalmau, Josep, Delgado‐García, Guillermo, Easton, Ava, Emmrich, Julius, Endres, Matthias, Fleury, Agnès, Frontera, Jennifer A., García‐Azorín, David, Guekht, Alla, Helbok, Raimund, Hellwig, Kerstin, Höglinger, Günter, Hoo, Fan Kee, Klein, Christine, Lant, Suzannah, McNett, Molly, Moro, Elena, Padovani, Alessandro, Pfausler, Bettina, Prasad, Kameshwar, Roman, Gustavo C., Sarfo, Fred S., Satishchandra, Parthasarathy, Saylor, Deanna, Spatola, Marianna, Spencer, Peter, Stark, Richard J., Synofzik, Matthis, Taba, Pille, Tagliavini, Fabrizio, Thakur, Kiran T., Umapathi, Thirugnanam, Vijayabala, Jeevagan, Weissenborn, Karin, Wijeratne, Tissa, Wood, Greta K., Carroll, William M., Oreja‐Guevara, Celia, Leonardi, Matilde, and Schmutzhard, Erich

Subjects
0301 basic medicine, medicine.medical_specialty, Study quality, Coronavirus disease 2019 (COVID-19), business.industry, Clinical study design, Comparability, Psychological intervention, MEDLINE, Clinical neurology, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Neurology Grand Rounds, Neurology, medicine, Pooled data, Neurology (clinical), Intensive care medicine, business, 030217 neurology & neurosurgery
Abstract

There is an accumulating volume of research into neurological manifestations of coronavirus disease 2019 (COVID‐19). However, inconsistent study designs, inadequate controls, poorly validated tests, and differing settings, interventions, and cultural norms weaken study quality and comparability, hence the understanding of the spectrum, burden, and pathophysiology of these complications. Therefore, a global COVID‐19 Neuro Research Coalition, together with the World Health Organization, has reviewed reports of COVID‐19 neurological complications and harmonized clinical measures for future research. This will facilitate well‐designed studies using precise, consistent case definitions of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and neurological complications, with standardized forms for pooled data analyses that nonspecialists can use, including those in low‐income settings. ANN NEUROL 2021;89:1059–1067

Published
2021

38. Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2)

Author

Lyden, Patrick, Hemmen, Thomas, Grotta, James, Rapp, Karen, Ernstrom, Karin, Rzesiewicz, Teresa, Parker, Stephanie, Concha, Mauricio, Hussain, Syed, Agarwal, Sachin, Meyer, Brett, Jurf, Julie, Altafullah, Irfan, Raman, Rema, Hess, Mary Jane, Mullin, Anthony, Jane Hess, Mary, Muranevici, Gabriela, Piantadosi, Bonnie, Jimenez-Maggiora, Gustavo, So, Jia-Shing, Jain, Sonia, Diringer, Michael, Derdeyn, Colin, Stern, Barney, Hamilton, Scott, Dietrich, Dalton, Becker, Kyra, Yenari, Midori, Dirnagl, Ulrich, Wijman, Christine, Chamorro, Ángel, Janis, Scott, Moy, Claudia, Lin, Felice, Song, Shlee, Schlick, Konrad, Khanolkar, Pooja, Edwards, Nancy J., Roldan, Ana, Wilson, Jeanette, Little, Amy, Lewis, Pam, Neil, William, Bruce, Nhu, Guzik, Amy, Sohdi, Ajeet, Herial, Nabeel, Ovbiagele, Bruce, Meyer, Dawn, Modir, Royya, Chavez, Ronelyn, Velazquez, Angela, Mayer, Stephan, Claassen, Jan, Falo, Cristina, Tafreshi, Gilda, Neil, William, Bruce, Nhu, Guzik, Amy, Modir, Royya, Kelly, Nancy, Chavez, Ronelyn, Ovbiagele, Bruce, Shell, Erin, Dugan, Guy, Kim, Elizabeth, Tanner, Amy, Michel, Patrik, Eskandari, Ashraf, Oddo, Mauro, Suys, Tamarah, Remillard, Suzette, Cordier, Maria, Brown, Robert, Jasak, Sara, McCullough, Louise, Brautigam, Robert, Alexandrov, Andrei, Sisson, April, Albright, Karen, Broessner, Gregor, Schmutzhard, Erich, Escioglou, Elissanet, Jones, William, Poisson, Sharon, Simpson, Jennifer, Shah, Qaisar, Jonczak, Karin, Bussinger, Patricia, Lewandowski, Christopher, Berry, Shannen, Lundell, AnneMarie, Miller, Joseph B., Cruz-Flores, Salvador, Holzer, Eve, Torretta, Susan, Brown, David, Heim, Laura, Smith, Carlos, Kelley, Chip, Greer, David, Marcolini, Evadne G., Gilmore, Emily J., Rutledge, Neil, McBee, Del, Khanna, Anna, Warren, Sonisha, Wilsom, Christina, Shushrutha Hedna, Vishnumurthy, Rosado, Christian, Kizza, Rosie, O’Phelan, Kristine, Escobar, Andrea, Merenda, Amedeo, Barcena, Juan Perez, and Malik., Amer

Published
2016
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41. Reply to Jung

Author

Helbok, Raimund, Dietmann, Anelia, Lackner, Peter, Schmutzhard, Erich, and Kremsner, Peter G.

Published
2008
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45. Characteristics of people with epilepsy and Neurocysticercosis in three eastern African countries–A pooled analysis.

Author

Stelzle, Dominik, Schmidt, Veronika, Keller, Luise, Ngowi, Bernard J., Matuja, William, Escheu, Gabrielle, Hauke, Peter, Richter, Vivien, Ovuga, Emilio, Pfausler, Bettina, Schmutzhard, Erich, Amos, Action, Harrison, Wendy, Kaducu, Joyce, and Winkler, Andrea S.

Subjects
NEUROCYSTICERCOSIS, PEOPLE with epilepsy, SEIZURES (Medicine), TAENIA solium, EPILEPSY, ZOONOSES
Abstract

Background: Neurocysticercosis (NCC), a zoonotic disease caused by the pork tapeworm T. solium, represents one of the most common causes of secondary epilepsy but remains often undiagnosed due to lack of awareness and diagnostic facilities. Methodology: We pooled data from four cross-sectional studies on epilepsy and NCC in eastern Africa. Study sites were in Uganda, Malawi and in Tanzania (Dar es Salaam and Haydom). The study in Uganda and Malawi were community-based, the two studies in Tanzania were hospital-based. The same questionnaire was used for assessment of clinical characteristics of patients with epilepsy. Computed tomography (CT) scans and serological testing were performed in order to diagnose NCC. Results: Overall, 1,179 people with epilepsy were included in our analysis. Of those, 941 PWE underwent CT scanning and were pooled for NCC analysis. Seventy patients were diagnosed with NCC, but NCC prevalence differed considerably between sites ranging from 2.0% (95%CI 0.4% to 3.6%) in Dar es Salaam to 17.5% (95%CI 12.4% to 22.6%) in Haydom. NCC prevalence did not show any association with sex but increased with age and was higher in rural than urban settings. In addition, being a farmer, non-Muslim, eating pork and living with pigs close by was associated with a higher NCC prevalence. PWE with NCC experienced their first epileptic seizure around 3 years later in life compared to PWE without NCC and their epileptic seizures seemed to be better controlled (p<0.001). There was no difference between focal onset seizures and focal signs on neurological examination in both groups (p = 0.49 and p = 0.92, respectively). The rT24H-EITB had a sensitivity for the detection of NCC of 70% (95% confidence interval [CI] 51 to 84%), the LLGP of 76% (95%CI 58 to 89%) and the antigen ELISA of 36% (95% CI 20 to 55%). Conclusions: NCC is prevalent among PWE in eastern Africa, although it may not be as common as previously stated. Demographic characteristics of PWE with NCC differed from those without NCC, but semiological characteristics and results on neurological examination did not differ compared to PWE without NCC. Interestingly, seizures seemed to be less frequent in PWE with NCC. Being aware of those differences and similarities may help triaging PWE for neuroimaging in order to establish a diagnosis of NCC. Author summary: Neurocysticercosis is a neglected zoonotic disease caused by the pork tapeworm Taenia solium. Patients with neurocysticercosis show a wide range of symptoms, from asymptomatic to severely affected by epileptic seizures, progressive headache or focal neurological deficits. Epileptic seizures are particularly common and up to 30% of people with epilepsy have neurocysticercosis in areas endemic for Taenia solium. The disease is often undiagnosed in Africa because of a lack of diagnostic opportunities (serological tests and neuroimaging). Furthermore, symptoms are too unspecific to diagnose patients solely based on clinical characteristics. Moreover, radiological features of neurocysticercosis differ between continents and have not been described yet for African populations. In this study, for the first time, we describe radiological but also clinical features of patients with epilepsy and neurocysticercosis in eastern Africa. We found that in Tanzania, Malawi and Uganda, neurocysticercosis is common in people with epilepsy although less common than previously reported. Also, most patients with neurocysticercosis have multiple parenchymal lesions and clinical features of people with epilepsy and neurocysticercosis do not differ substantially from people with epilepsy without neurocysticercosis. [ABSTRACT FROM AUTHOR]

Published
2022
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