Puzzling New Neurological Syndrome Investigated

A new neurological syndrome has been described in early December 2007 and is presenting a challenge not only to the affected patients but also to the health professionals. The illness is characterized by pain, sensory symptoms, weakness and fatigue. Abnormal lab tests and MRI scan results were also present. The syndrome has affected at east two dozen workers who are working in pig slaughterhouses in three states of the U.S. Researchers have now a somewhat clearer picture of the mysterious illness, but Dr. Daniel Lachance, assistant professor of neurology at the Mayo Clinic in Rochester, Minnesota, describes the illness as one of the kind that has “defied explanation and a name”. At this point investigators have called it “progressive inflammatory neuropathy” (PIN), but the term is merely descriptive but not accurate enough. Dr. Lachance described the clinical picture based on findings on 18 patients from Minnesota who have been investigated in the most comprehensive manner.

The course of their illness was marked by pain, decreased sensation and tingling along with weakness and fatigue which far exceeded the findings of physical examinations. All of the affected individuals had abnormal MRI’s and abnormal results of the labs of their cerebrospinal fluid. Various tests of reflexes or quantitative sensory testing also showed abnormalities, and nerve conduction studies were abnormal in most of the patients. All of them had a new IgG auto-antibody biomarker. The findings point to an immune-mediated phenomenon which translates into a neurological illness. The workers affected all were exposed to aerosolized brain particles from slaughtered pigs.

All workers worked in the “warm room” where pigs were slaughtered and the brain extracted in a technique in which compressed air is shot into a dead pig’s foramen magnum. This blast of compressed air not only emulsifies the brain, but some of it becomes aerosolized and airborne. Symptoms seem to start within days or weeks of exposure, after which the course of the disease is chronic.

Puzzling New Neurological Syndrome InvestigatedProgressive inflammatory neuropathy caused by aerosolized brain particles from slaughtered pigs

Treatment has been symptomatic in those most severely affected with the medications of choice being methylprednisolone and/or intravenous treatment with immune globulin. Researchers have tested early on for human and porcine pathogens, but no infectious agent has been found. The precise mechanism by which the illness is occurring is not fully understood, but the syndrome does not seem to be food borne or transmissible from person to person.

Reference: The Medical Post, May 13, 2008, page 14, 15.

Last edited December 4, 2012


When Kids Are Migraine Sufferers

It is often assumed that migraine headaches are reserved for people with a family history of migraines and that those who are afflicted by those disabling headaches are usually adults. When a child has the symptoms of migraine headaches it is usually a source of grave concern to the parents. Dr. Lewis reported about his findings at a meeting which was sponsored by Rady Children’s Hospital. He has seen many young persons who suffer of headaches and pointed out that the greatest fear of the patient and the parents, is the thought of a developing brain tumor. If a patient has been having headaches for half a year or two years and has had an entirely normal neurological exam, Dr. Lewis can reassure the patient that there is no brain tumor. Breaking the vicious cycle of fear by reassurance often lifts a load of the patient’s back and things may settle down. About 11% of children in the age group of 5 to 15 years have migraine type headaches. The incidence has a peak at 12 years in boys and at 14 years in girls. Migraines have different criteria than headaches: there are at least 5 lifetime attacks that have a least two of the following symptoms: severe aches on both sides of the head, the front or on one side only, throbbing aches, moderate to severe pain that gets worse with activity. At least one symptom of the following has to be present: either light sensitivity, sensitivity to noise, nausea and vomiting. Dr. Lewis reports that proper sleep habits can make a difference. Too little, too much or inconsistent sleep is closely associated with the frequency of migraines. He cited the example of a sixteen year old who started having migraines after school ended at the end of June. She stayed up late and slept till noon. Once she returned to a regular sleep cycle she did a lot better. Eating patterns can play a role too. One of the common stories is the student skipping lunch and developing a headache about an hour later. Other migraine triggers can be sensitivities to certain foods, altitude changes, weather, motion sickness on a trip, excitement, dehydration and learning problems. Dr. Lewis reported that many of the very young patients age 4 to 5 with migraines may have attention-deficit hyperactivity disorder. If the performance problems are addressed headaches will resolve in 80 to 90% of the time. Headaches can also be linked to emotional aspects, peer problems at school, family problems or depression.

When Kids Are Migraine Sufferers

When Kids Are Migraine Sufferers

There is no drug that is officially approved for migraines in children. The medication that has been studied most closely is ibuprofen. A controlled trial of 7.5 mg/kg showed a response of 76 %. Acetaminophen with a dose of 15 mg/kg was studied in patients aged 4 to 16 years. The response was 54%. Neither of those two medications showed any adverse side effect. Sumatriptan nasal spray was well tolerated, showed a 1 hour response of 58%, had no side effects, but a bitter aftertaste. It was also pointed out that in a study oral sumatriptan and placebo scored the same. It is obviously most important to get to the root of the problem and eliminate the triggering factors after which medication can be used. The general consensus is to treat the attacks rapidly and consistently, get the patient back to his or her daily functioning, minimize backup medications and make sure that there are minimal or no adverse side effects.

More information about:

1. Attention-deficit hyperactivity disorder: http://nethealthbook.com/mental-illness-mental-disorders/developmental-disorders/attention-deficithyperactivity-disorder/

2. Migraine headaches: http://nethealthbook.com/neurology-neurological-disease/common-causes-headaches/migraine-headache/

Reference: Presentation at Annual Advances in the Practice of Pediatrics: San Diego 2008; Feb. 22-24, Hilton La Jolla

Last edited November 3, 2014


Autism Not Linked to MMR Vaccine

The fear that there could be a connection between the measles-mumps-rubella (MMR) vaccine and the development of autism (PDD or pervasive developmental disorder) has stopped many concerned parents to have their children vaccinated against these common childhood diseases.
Canadian research found out that a different picture emerged. Dr. Fombonne and his team from Montreal calculated that PDD prevalence increased by about 10 % every year. The MMR coverage decreased by about 4%. From these figures it is clear that the MMR-autism connection has been a myth. The consequences of the scare however, have been severe after the 1998 scare that came from an article in the Lancet. MMR vaccination has dropped from 95% to 85%, and the UK is currently experiencing its worst measles outbreak in 20 years. Measles is not a “harmless” disease that affects small kids. People have to remember that measles are a disease that kills, and not just in developing countries.
The next item was the hypothesis that mercury exposure from vaccines could pose a problem. Mercury exposure however has dropped to nil ever since a compound called thimerosal that was used as a preservative has been discontinued and eliminated from vaccines in 1996.
Autism (PDD) and its increase still keep researchers busy. The vaccination myth has been debunked as the culprit for autism.

Autism Not Linked to MMR Vaccine

Dr. Fombonne explains that there is increasing evidence for genetic factors giving rise to the disorder, but there could be contributing environmental factors.

Reference: National Review Of Medicine, July 30, 2006, page 3

Link to chapter on autism in my Net Health Book with more info about autism: http://www.nethealthbook.com/articles/autism.php

Last edited December 6, 2012


Do Not Mix Migraine Medications With Antidepressants

Headache medications that are available over the counter in the local drugstore are ineffective when it comes to a migraine headache, and migraine sufferers have received great help from medications that are targeting a migraine attack. They are non-narcotic prescription drugs, some of which have to be injected. They are available under names like Amerge, Axert, Frova, Imitrex, Maxalt, Relpax or Zomic, and the medication group is known in pharmacists’ language as “triptans”.
The medications are generally well tolerated, but the FDA has issued a warning.
In combination with another medication group, life threatening side effects can occur.
Any patient who is receiving medication for the treatment of depression in the form of a Selective Serotonin Reuptake Inhibitor (SSRI’s) is strongly warned, not to take any of those listed triptans for migraine. The anti depressive drugs are Celexa, Fluvoxamin, Paxil, Prozac and Zoloft. Two other medications, namely Effexor and Cymbalta are Selective Serotonin/Norepinephrin Reuptake Inhibitors (SSNRI’s), and they carry the same risk when taken in combination with the triptans.
The combination of the two medications can lead to a dangerous condition known as Serotonin syndrome. It occurs when the body has too much serotonin, a chemical found in the nervous system. Serotonin syndrome symptoms may include restlessness, hallucinations, loss of coordination, fast heartbeat, and rapid changes in blood pressure, increased body temperature, overactive reflexes, nausea, vomiting, and diarrhea. Serotonin syndrome may be more likely to occur when starting or increasing the dose of a triptan, SSRI or SNRI.

Do Not Mix Migraine Medications With Antidepressants

Do Not Mix Migraine Medications With Antidepressants

It is up to the prescribing physician to carefully weigh the advantages against the serious side effects, and it can be a difficult choice, as both conditions, migraine as well as depression, need to be treated effectively. Any patient who has to take both medications has to be closely watched. The patient also has to be alert to any side effect.

Reference: FDA/Center for Drug Evaluation and Research, July 19, 2006

Link to chapter on migraines in Net Health Book: http://nethealthbook.com/neurology-neurological-disease/common-causes-headaches/migraine-headache/

Last edited Nov. 1, 2014


Better Recovery From Strokes Through Early CT Scans


You can have a better recovery from strokes through early CT scans. This was published in the September 2001 issue of the American Journal of Neuroradiology (Am J Neuroradiol – 01-SEP-2001; 22(8): 1534-42). A group of clinicians from the Foothills Hospital in Calgary/Alberta published an article with a scoring system for CT scans. These scans were done on every patient with a stroke. By utilizing early CT scans and this scoring system an ischemic stroke (due to a blood vessel that closed off in the brain) could be rapidly assessed.

Early CT scan helps to decide whether clot-busting drugs help the patient

Within 3 hours of the beginning of the stroke the treating physician would know whether the patient would benefit from clot-busting drugs (TPA or tissue plasminogen activator) or not. Dr. Pexman and co-workers had noted that patients with an Alberta Stroke Program Early CT Score (ASPECTS) of less than 7 had a poor survival rate or an outcome with high dependency on caregivers. Patients with a score of 7 to 10 had a much better survival chance and were ideal candidates for the clot-busting therapy. The radiologist who reads the CT scan of the brain of the stroke patient divides th CT scan into 10 regions. Researchers evaluate the findings systematically and obtain an ASPECTS score.

Ischemic strokes treated early

Dr. Michael Hill, an assistant professor at the University of Calgary, and one of the co-workers of this initial study has now completed a further follow-up study together with Dr. A.Buchan, director of the Calgary Stroke Program. The authors published the results of the study in the August 2003 issue of the medical journal “Stroke”. They found that ischemic strokes (from clots in the middle cerebral artery) have the best outcome when detected by CT scan early (within 3 hours of the beginning of the stroke) and if thrombolysis therapy with TPA, the clot-busting drug, is done before 6 hours after the beginning of the stroke.

Better Recovery From Strokes Through Early CAT Scans

CT Scan of Ischemic Stroke

Stroke in the middle cerebral artery diagnosed early

The lack of blood circulation from a stroke, which closed the middle cerebral artery, is shown in this link. What does that mean in practical terms? Let us assume a patient is suddenly losing all of the strength and movement in one arm and losing speech as well. In this case the physician orders an emergency CT scan right away. This helps to determine that the patient had a stroke in the middle cerebral artery region. Let us say that the ASPECTS score was between 7 and 10. This patient’s physicians would likely treat the stroke with the clot-busting medicine mentioned being confident that there likely will be a good outcome.

Less permanent palsies with early intervention 

Before this therapy was available, many of these patients ended up with a permanent arm palsy without much function. They likely also sustained a permanent speech deficit as well. After the clot-busting therapy many of these patients have a much better outlook. Now they have a considerably better return of function in their arm and regain their speech as well. Unfortunately, the opposite is true as well.

Those with an ASPECTS score below 7 do poorly with their stroke

Those with a poor ASPECTS score below 7 will not be candidates for the clot-busting therapy. They tend to do poorly. Several countries use this scoring system of early CT scans already to investigate the severity of strokes (ASPECTS). Among those are Canada, the US, Australia and Europe.  Dr. A.Buchan said: “Early detection and intervention in stroke is critical to achieve a positive outcome”. He is the director of the Calgary Stroke Program. In addition, he is also a professor in the department of clinical neurosciences of the University of Calgary/Alberta. Here is a link for more background on strokes.


Folic Acid In Cereal Reduces Abnormalities Of The Brain and Spine In The Unborn Child

In 1998 the Canadian government approved the mandatory addition of folic acid in cereal products as studies in the past had shown that pregnant women did not always take their prenatal folic acid supplements to prevent neural tube defects (abnormalities in brain and spine formation).

A total of 336,963 children of women who were either pregnant before or after the 1998 folic acid fortification program was institued, were screened for open neural tube defects. The result was that prior to the legislation there were 113 cases per 100,000 pregnancies. After 1998 there were only 58 per 100,000 pregnancies found.

Dr. Joel G. Ray from the Sunnybrook and Women’s College Health Sciences Center in Toronto who was the lead researcher stated that a food fortification program with folic acid in addition to the regular prenatal folic acid tablet supplementation is essential. To a large extent this will prevent these devastating congenital malformations that cause disabilities or death.

Folic Acid In Cereal Reduces Abnormalities Of The Brain In The Unborn Child

Folic Acid In Cereal Reduces Abnormalities Of The Brain In The Unborn Child

Based on: Lancet 2002;360:2047-2048.

Comments: It is also important for women to know that folic acid tablets need to be taken already before, around and after conception to be most effective with regard to preventing brain and spinal malformations. The nervous tissue is one of the fastest growing tissues in the first few weeks of pregnancy. Any deficiency of cell differentiation, for which folic acid is an essential ingredient, has devastating longterm consequences for the child.

Last edited December 10, 2012