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Objective To examine potential differences in language function among nonepileptic seizures (NES) and epilepsy patients. Method Data were acquired via IRB approved retrospective chart review. Subjects were 60 patients who completed an inpatient stay in the Epilepsy Monitoring Unit of a southwestern hospital. 33 were diagnosed with NES, 13 were diagnosed with epilepsy originating in right hemisphere (ER), and 14 were diagnosed with epilepsy originating in the left hemisphere (EL). Patients were 65.9 % female, with a mean age of 40.5 (SD = 13.7). As part of a standard inpatient neuropsychological test battery, participants completed language tests that consisted of verbal fluency (FAS and Animals), Boston Naming Test, Wechsler Test of Adult Reading (WTAR), and Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2) Similarities and Vocabulary subtests. Results ANOVA testing revealed significant between group differences in scores on the Animals verbal fluency test (F = 7.72, p =.008 for linear trend). Other measures did not achieve significance. NES participants had the highest Animal fluency scores (mean T = 49.28), followed by ER (47.73) then EL patients (43.27). WTAR score did not moderate this effect. Gender did moderate the effect, with male ER and EL subjects demonstrating lower Animal naming scores than their female counterparts (p =.037). Conclusion Animal naming was the only language-based variable found to differ in this sample of NES and epilepsy patients. Those with EL had the lowest scores on this measure, consistent with prior research that has found language deficits in this population. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to explore if symptom factors are related to cognitive outcomes. Prior studies have examined the relationship of individual symptoms to cognition. However, the relation between empirically-derived symptom factors and cognitive outcomes has yet to be explored. Methods Data were extracted via retrospective chart review of 691 patients (aged 10–24, mean: 14.99±2.63). Participants completed ImPACT and the PCSS within 14 days of injury (mean: 9.27±3.37). Predictors were PCSS factor scores of Cognitive-Fatigue-Migraine (CFM), Affective (AFF), Somatic (SOM), and Sleep (SLP) (Kontos et al. 2012). Outcomes examined were ImPACT composite scores. Univariate analyses were performed and values with p < 0.10 were entered into stepwise linear regression (LR) models. Retained predictors in each LR model had p values <.05. Results Verbal memory was predicted by CFM, SOM, age, and gender. Visual memory was predicted by CFM and SOM. Visual motor speed was predicted by age, gender, CFM, SOM, and AFF. Reaction time was best predicted by SOM, CFM, and age. The variance explained was fairly small (0.08 to 0.21). SLP was not a significant predictor in any LR. Conclusion CFM and SOM factors were most predictive of lower cognitive performance, similar to prior studies linking dizziness to longer recovery and post-traumatic migraine to worse cognitive performance. These findings underscore the clinical importance of diverse symptom assessment and injury education. Higher CFM and SOM scores may also serve as proxy for injury severity, which we would expect to be associated with worse cognitive performance. [ABSTRACT FROM AUTHOR]

Acute esophageal food impaction (AEFI) occurs frequently. Few data are published describing the use of effervescent agents (EAs) for treatment of AEFI. We aimed to evaluate the effectiveness, cost, and safety of EAs in the treatment of AEFI. We retrospectively identified patients aged 18 years and older who were seen in the emergency department of 2 hospitals in 1 metropolitan area from January 1, 2011, through April 4, 2016, who had a clinical diagnosis of AEFI. We collected and analyzed data on outcomes and cost associated with the use of EAs, glucagon, and no pharmacologic therapy. During the study period, 239 patients with AEFI met the inclusion criteria. Of the 45 patients who received EA monotherapy, 25 (55.6%) responded successfully, compared with 11 of 62 (17.7%) who received glucagon monotherapy (P  < .001) and 16 of 93 (17.2%) who had no therapy (P  < .001). Ten of 39 patients (25.6%) who were given both glucagon and EA responded successfully. The other 177 patients had endoscopy, which was successful in all cases. Median hospitalization charges for patients who responded successfully to EA alone were $1,136, compared with $2,602 for responders to glucagon alone (P  < .001) and $1,194 for those who cleared their bolus spontaneously (P  < .001). All patients who received EA monotherapy had lower median hospitalization costs ($2,384) than all patients who received glucagon monotherapy ($9,289; P  = .03) and all patients who received neither ($8,386; P  = .02). Effervescent agents are a safe, effective, and cost-saving initial strategy in the treatment of acute esophageal food impaction. [ABSTRACT FROM AUTHOR]