A summary of recently published articles in the Neurology® Resident & Fellow Section
February 4, 2020, issue
This issue starts with an Education Research piece that discusses teaching and assessing communication and professionalism in neurology residency with simulation. Next, a Clinical Reasoning case illustrates a 58-year-old woman who presented with progressive memory deficits, odd behavior, and falls. The Teaching Video NeuroImage presents a case of stroke presenting with isolated superior branch of cranial nerve III palsy.
Education Research: Teaching and assessing communication and professionalism in neurology residency with simulation
The Accreditation Council for Graduate Medical Education mandates that residents become proficient in interpersonal communication and professionalism, but the ideal methods to achieve these milestones are unclear. The authors sought to understand resident and faculty perceptions about teaching these competencies, and to determine the potential role of simulation in resident education of these topics.
Page 229
Clinical Reasoning: A 58-year-old woman presents with progressive memory deficits, odd behavior, and falls
This case displays the importance of the temporal history of symptoms for diagnosis of neurologic disorders. It also illustrates the importance of maintaining a wide differential and reassessing the differential when additional information is collected or in the event of clinical developments.
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Teaching Video NeuroImages: Stroke presenting with isolated superior branch of cranial nerve III palsy
The authors show the rare manifestation of partial third nerve palsy caused by a stroke.
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February 11, 2020, issue
This issue starts with an Emerging Subspecialties in Neurology article about sleep medicine fellowship after child neurology residency. A Clinical Reasoning case discusses a 70-year-old man with rapid, stepwise paraparesis and sensory loss. The issue also includes a Teaching Video NeuroImages case that describes tardive diaphragmatic tremor.
Emerging Subspecialties in Neurology: Sleep medicine fellowship after child neurology residency
This article discusses the opportunity in clinical, academics, and research to encourage additional child neurology residents to consider sleep medicine for subspecialty training.
Page 278
Clinical Reasoning: A 70-year-old man with rapid stepwise paraparesis and sensory loss
This case highlights the importance of pursuing specific myelopathy diagnoses when initial testing is nondiagnostic, idiopathic transverse myelitis criteria are not met, and empiric treatment does not lead to sustained improvement.
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Teaching Video NeuroImages: Tardive diaphragmatic tremor
A 75-year-old woman was prescribed pimozide 2 mg twice a day around 4 years previously for paranoid behavior. The patient developed involuntary movements in her abdomen following abrupt discontinuation of pimozide.
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February 18, 2020, issue
The Child Neurology article in this issue reports a case of a young child with an undiagnosed case of dystonia responsive to l-dopa. The Clinical Reasoning case discusses a young woman with painful ophthalmoplegia. A Pearls & Oy-sters piece discusses a rare presentation of Whipple disease. The Teaching NeuroImage featured this issue describes the pathology and thromboembolism of carotid web.
Child Neurology: A young child with an undiagnosed case of dystonia responsive to l-dopa
The authors present a case of a child with an l-dopa-responsive dystonia with a negative causative workup including whole exome sequencing whose treatment with l-dopa would likely have been delayed or not attempted without a diagnostic therapeutic trial of l-dopa early in his disease course.
Page 326
Clinical Reasoning: Young woman with orbital pain and diplopia
The authors describe the case of a 27-year-old woman presenting with acute painful ophthalmoplegia, discussing the possible differential diagnosis. Our case highlights the importance of timely recognition of idiopathic orbital myositis, given the usually rapid and dramatic response to adequate corticosteroid therapy.
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Pearls & Oy-sters: A rare presentation of Whipple disease: Still waters run deep
In this case report, a rare presentation of Whipple disease is described. The authors summarize the history, etiology, epidemiology, clinical characteristics, diagnosis, treatment, and prognosis of Whipple disease, and focus on characteristics of neuro-Whipple to improve recognition and to illustrate the multiple diagnostic methods needed in any suspected cases to establish the diagnosis.
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Teaching NeuroImages: Pathology and thromboembolism of carotid web
The authors describe a young woman with acute middle cerebral artery occlusion due to embolization from carotid web. Her pathologic results and spontaneous recanalization in middle cerebral artery were typical for carotid web and supposed embolization theory.
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February 25, 2020, issue
The Clinical Reasoning case in this issue presents a case of a 7-year-old girl with progressive gait difficulties. This issue also features a Pearls & Oy-sters article that discusses chemotherapy-associated hyperammonemic encephalopathy. The Teaching NeuroImage describes the dentate sign in subacute cerebellar ataxia: metronidazole neurotoxicity.
Clinical Reasoning: Seven-year-old girl with progressive gait difficulties
The authors present a 7-year-old girl who presented with progressive gait difficulties due to generalized dystonia and a strong family history suggestive of autosomal recessive inheritance.
Page 364
Pearls & Oy-sters: Chemotherapy-associated hyperammonemic encephalopathy
The authors present the case of a 55-year-old woman who developed severe idiopathic hyperammonemic encephalopathy (HE) following a course of chemotherapy. This case will be of benefit to neurologists and trainees, since idiopathic chemotherapy-associated HE is a rare and lethal condition requiring prompt recognition and neurocritical care.
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Teaching NeuroImages: The dentate sign in subacute cerebellar ataxia: Metronidazole neurotoxicity
A 79-year-old woman developed infectious periaortitis after an abdominal aortic aneurysm repair.
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Footnotes
Editor's Blog: NPub.org/rfblog
Neurology Podcast: NPub.org/rf
Resident & Fellow Clinical Reasoning Book: NPub.org/crb
Resident & Fellow ePearls: NPub.org/epearls
- © 2020 American Academy of Neurology
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