Ginkgo biloba and Cerebral Bleeding A Case Report and Critical Review

Ginkgo biloba is a herbal medication that is often used worldwide. Although side effects are uncommon, G. biloba has been associated with serious bleeding complications, especially intracranial hemorrhage. We report the case of a young woman who made chronic use of G. biloba and suffered from cerebral bleeding without any structural abnormalities. Several studies have pointed to the association between G. biloba and intracranial hemorrhage.Universidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, São Paulo, BrazilWeb of Scienc

Hepatitis C virus: A rare manifestation - Remitting relapsing central and peripheral demyelination

The most frequent neurologic manifestations of hepatitis C virus infection include peripheral neuropathy axonal type and central nervous system (CNS) vasculitis. Affected patients usually have cryoglobulinemia and other signs of vasculitis. Demyelinating lesions, both central and peripheral are rarely described. We present a case of simultaneous peripheral nervous system and CNS demyelination that comes in relapsing episodes, with negative cryoglobulins.Universidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Neuromuscular Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Neuromuscular Dis, São Paulo, BrazilWeb of Scienc

Unusual movement disorders in spinocerebellar ataxias

Universidade Federal de São Paulo, Dept Neurol, Div Gen Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Ataxia Unit, São Paulo, BrazilHosp Clin Porto Alegre, Dept Biochem, Porto Alegre, RS, BrazilHosp Clin Porto Alegre, Med Genet Serv, Porto Alegre, RS, BrazilHosp Clin Porto Alegre, Dept Internal Med, Porto Alegre, RS, BrazilUniv Fed Minas Gerais, Dept Internal Med, Div Neurol, Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Dept Neurol, Div Gen Neurol, São Paulo, BrazilUniversidade Federal de São Paulo, Ataxia Unit, São Paulo, BrazilWeb of Scienc

MUNIX: Reproducibility and clinical correlations in Amyotrophic Lateral Sclerosis

Objective: To study the reproducibility, diagnostic yield to detect denervation, and clinical correlations of the Motor Unit Number Index (MUNIX) in subjects with Amyotrophic Lateral Sclerosis (ALS). Methods: MUNIX evaluation was performed in three muscles twice on the same day to assess reproducibility. Cut-off values for the MUNIX were based on data from 51 healthy subjects (controls) to evaluate the sensitivity of the technique to detect denervation in 30 subjects with ALS. Results: The method had good reproducibility. The variability was greater in the ALS group. In 23 ALS subjects (77%), low MUNIX values were detected. Most of the muscles with low MUNIX had also low compound muscle action potential (CMAP) and strength, but these parameters were normal in 9% of muscles. According to ROC curve analysis, MUNIX was generally accurate (AUC = 0.9504) for discriminating between healthy individuals and subjects with at least one denervated muscle. Conclusions: MUNIX variability was higher in the ALS group. The method showed good diagnostic performance for the detection of denervation in a sample of patients with ALS. Significance: This study demonstrated that in addition to being a quantitative tool MUNIX can detect denervation in subjects with ALS. (C) 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.Univ Fed Sao Paulo, Dept Neurol, Sao Paulo, SP, BrazilUniv Sao Paulo, Sch Med FMUSP, Div Mol Med, Dept Med, BR-05508 Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Neurol, Sao Paulo, SP, BrazilWeb of Scienc