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Cefepime Neurotoxicity

Naoum P. Issa MD PhD — Tue, 05 Dec 2017 02:06:46 +0000

Cefepime is a cephalosporin antibiotic typically used when broad spectrum coverage including Pseudomonas aerigonsa is needed. However, it can produce cefepime neurotoxicity with encephalopathy, myoclonus, reversible aphasia, and/or convulsive or subclinical seizures. Risk factors for cefepime neurotoxicity Retrospective studies have shown neurotoxicity is most likely when the cefepime dose is insufficiently corrected for renal function, […]

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Juvenile Myoclonic Epilepsy

Naoum P. Issa MD PhD — Sun, 02 Jul 2017 22:17:35 +0000

Juvenile myoclonic epilepsy (JME) is one of the most common generalized epilepsy syndromes and typically presents in the teen years. Like absence epilepsy, it is considered a primary generalized epilepsy, rather than a localization-related epilepsy. Clinical Presentation of JME JME accounts for about 25% of all primary generalized epilepsy syndromes. It presents in patients between […]

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How to prepare for the neurology board exam

Naoum P. Issa MD PhD — Sun, 02 Jul 2017 03:48:29 +0000

Whether you’re taking the initial certification or a maintenance of certification neurology exam there are several good ways to prepare. Three complementary routes are available. 1. Lecture-based course. These can be either live or online courses, taught by well-respected academic neurologists. The Oakstone Comprehensive Neurology Review contains 44 lectures (43 CME credits) and consists of […]

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Absence Epilepsy

Naoum P. Issa MD PhD — Sat, 01 Jul 2017 20:15:15 +0000

Absence epilepsy is a type of primary generalized epilepsy in children, and usually presents as staring spells. Clinical Presentation of Absence Epilepsy Childhood absence epilepsy develops in children, with a peak onset of 6 years old. Development of these seizures at an age of 10-12 is more consistent with the juvenile subtype or juvenile myoclonic […]

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Carnitine palmitoyltransferase (CPT) deficiency

Naoum P. Issa MD PhD — Sun, 12 Oct 2014 21:20:33 +0000

Carnitine palmitoyltransferase II (CPT) deficiency is the most common inherited lipid-metabolism disorder in skeletal muscle. The adult form causes exercise-induced myalgias, myoglobinuria (myoglobin excretion into the urine) with rhabdomyolysis and myopathy. Triggers include fever, illness, and a high-fat dietary load. In severe cases with complete loss of enzyme function, the disease is fatal in infancy. […]

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McArdle Disease

Naoum P. Issa MD PhD — Sun, 12 Oct 2014 15:25:30 +0000

McArdle disease is a glycogen storage disease in which the enzyme muscle myophosphorylase is deficient. It is commonly known as glycogen storage disease V. The disorder is characterized by exercise-induced muscle pain, myoglobinuria and elevated serum CK sometimes to the degree of clinical rhabdomyolysis with renal dysfunction. Patients have a “second-wind” phenomenon once non-glycogen dependent […]

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Mitochondrial myopathy

Naoum P. Issa MD PhD — Sun, 12 Oct 2014 12:43:58 +0000

Mitochondrial myopathy can be caused by metabolic abnormalities related to mutations in the mitochondrial genome or mutations in the somatic genome that produce abnormal mitochondrial proteins. Pathologic findings in mitochondrial myopathy The classic findings of a mitochondrial myopathy on muscle biopsy are shown in the images below. These include: Ragged red fibers. This appearance is […]

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USMLE tutoring for neuro

Naoum P. Issa MD PhD — Fri, 10 Oct 2014 20:06:04 +0000

This is a 1-hour small-group tutoring session for neuro topics that are covered on USMLE step 1. There can be up to 5 students per session, and the session will be conducted over Google Hangouts. The session is taught by Naoum Issa, MD, PhD, an award-winning neurobiology professor and author. Each session will cover a […]

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Conductive aphasia

Naoum P. Issa MD PhD — Mon, 15 Sep 2014 01:12:56 +0000

Conductive aphasia is defined as the inability to repeat a spoken phrase, even when comprehension is intact and speech production is otherwise normal. Conductive aphasia is classically caused by lesions to the arcuate fasciculus (usually on the left). The arcuate fasciculus is a curved bundle of axons that projects from Wernicke’s area to Broca’s area. […]

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Expressive aphasia

Naoum P. Issa MD PhD — Mon, 15 Sep 2014 00:48:33 +0000

Patients with expressive aphasia have difficultly speaking fluently, although they can understand what other people say when they are spoken to. On exam this manifests as: Patients can follow commands (as long as that does not require speaking). Depending on the severity of the aphasia, patients have difficulty producing speech ranging from some word finding […]

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