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The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
After surgery, she demonstrates good walking (even demonstrates walking backward and tests her own reflexes). When her brain tumor recurs, it presents as diminished vision (“getting dark,” hence the title), becoming blind. It all happens within minutes. She says goodbye to her dogs, unsteadily climbs the stairs, goes to bed, and dies peacefully. Dark Victory contains scenes in which doctors give misleading information and a highly unusual clinical presentation. Nothing can even be attributed to the Zeitgeist of the times. From a historical perspective, Dark Victory conjures several important issues, which make it potentially interesting for neurologists. Bette Davis’ cinematic portrayal of the vicissitudes of living with a brain tumor (and not knowing it) is close to the reality of denial and a persistent hope for a cure. Her pressured speech may signal the general anxiety she feels. Dark Victory depicts progressive, rapidly fatal neurologic disease but also depicts a doctor withholding information from the patient. The film was included at #32 in AFI’s 100 Years … 100 Passions80 and considered by many critics to be a major poignant work at the time. It is a prime example of how the interpretation of a film—the neurology message and cinematic message—can be so different.
Remediating Brain Instabilities in a Neurology Practice
Published in Hanno W. Kirk, Restoring the Brain, 2020
The physical and neurological exam provide further clues on how to target the training. An elevated blood pressure and pressured speech indicate the need for parietal calming. Non-smooth pursuit in the eye exam, excessive involuntary motions, and seizures point to instabilities. Easy distractibility, left–right confusion, apraxias, and speech dysfluency, as well as overt focal deficits, all inform the neurofeedback clinician on how to prescribe the brain training protocol. Again, these findings are clearly listed in the initial assessment.
Psychiatric Emergencies in Medical Conditions
Published in R. Thara, Lakshmi Vijayakumar, Emergencies in Psychiatry in Low- and Middle-Income Countries, 2017
Anju Kuruvilla, Anoop Raveendran, K.S. Jacob
Patients with mania may be irritable or elated, expansive in mood, with pressured speech and hyperactivity which is goal-directed. Depressed individuals may report sadness, anxiety and feelings of guilt, worthlessness, hopelessness, and helplessness. Both these mood states may occur secondary to an organic etiology.
Recurrent Optic Neuritis in Paediatric Anti-N-Methyl-D-Aspartate Receptor (Anti-NMDAR) Encephalitis: Case Report and Literature Review
Published in Neuro-Ophthalmology, 2022
Jinn Shian Chan, Masnon Nurul-Ain, Nor Fadhilah Mohamad, Wan Hazabbah Wan Hitam, Lakana Kumar Thavaratnam
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an immune-mediated encephalitis that commonly presents with neuropsychiatric features. The disease was first described in 2007. It is a rare clinical phenomenon that is frequently misdiagnosed as a psychiatric illness, as patients may show signs of psychosis, memory deficit, language disintegration, and even a state of unresponsiveness with catatonic features.1A definitive diagnosis of anti-NMDAR encephalitis can be made in the presence of one or more of the six major symptoms and positive NMDAR antibodies after reasonable exclusion of other disorders.2 The six major symptoms consist of: abnormal behaviour or cognitive dysfunction; speech dysfunction including pressured speech, verbal reduction, or mutism; seizures; movement disorder including dyskinesias, rigidity, or abnormal postures; decreased level of consciousness; autonomic dysfunction and central hypoventilation. There is a recognised association of overlapping antibody-associated demyelinating syndromes due to myelin oligodendrocyte glycoprotein (MOG) antibodies or aquaporin-4 (AQP4) antibodies, and autoimmune encephalitis mediated by anti-NMDAR antibodies.3 Nonetheless, this condition is treatable and potentially reversible.
Treatment of pemphigus vulgaris: part 1 – current therapies
Published in Expert Review of Clinical Immunology, 2019
Rebecca L. Yanovsky, Michael McLeod, A. Razzaque Ahmed
Steroid psychosis does not have a uniform presentation. Most common symptoms include anxiety, emotional lability, pressured speech, insomnia, mutism, and memory impairment. Symptoms can also mimic schizophrenia with delusions, visual or auditory hallucinations and disorganized speech and behavior [10].