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Word of the Week


BEST PRACTICES
the use of care concepts, interventions, and techniques that are grounded in research and know to promote higher quality of care. Hospitals use best practices to support their clinical protocols and standards of care.
 
INTRANIDAL
being within the nidus or aggregate of nerve cells; intranidal aneurysms are found with the nucleus of an arteriovenous malformation (AVM)
 
ANHEDONIA
one of the main symptoms of major depressive disorder and is defined as the inability to experience pleasure from activities usually found enjoyable such as exercise, hobbies, music, friends…
 
PHARMACORESISTANT EPILEPSY (PRE)
failure to achieve seizure freedom following adequate trials of two tolerated and appropriately chosen antiepileptic drugs (AEDs). The complexity of PRE reflects the dynamic nature of the underlying disease biology and the multiplicity of mechanisms of drug resistance.
 
METAMORPHOPSIA
type of distorted vision in which a grid of straight lines appears wavy and parts of the grid may appear blank. It is mainly associated with macular degeneration.
 
TAU PROTEINS
proteins that stabilize microtubules and are abundant in neurons of the central nervous system and less common elsewhere. Defective tau proteins are found in Alzheimer’s disease. High levels  of tau protein in fluid bathing the brain are linked to poor recovery after head trauma.
 
DOOSE SYNDROME
Myoclonic-Astatic Epilepsy (MAE) atonic, drop attack, idiopathic generalized epilepsy, an epilepsy syndrome of early childhood that is often resistant to medication.
 
PURE ALEXIA
is a reading disorder that occurs in literate individuals secondary to a lesion in the left occipito-temporal region. The hallmark of this deficit is the word-length effect: the naming latencies of patients increase dramatically with increasing numbers of letters in the word. Pure alexia is also known as letter-by-letter reading, spelling dyslexia, alexia without agraphia, verbal dyslexia, word blindness or letter-by-letter dyslexia.
 
NERNST POTENTIAL EQUATION
calculates the equilibrium potential for an ion based on temperature, the ion’s valence (charge), and its concentration gradient across the membrane.
 
MINI MENTAL STATE EXAMINATION (MMSE)
most commonly used instrument for screening for cognitive function. It is a brief 30-point questionnaire. The MMSE can be used to help diagnose dementia and to help assess its progression and severity.
 
BORBORYGMUS
rumbling or gurgling noise that occurs from the movements of fluid and gas in the intestines.
 
SYNAPTOGENESIS
formation of synapses between neurons that occurs throughout a person’s lifespan. Exuberant synaptogenesis is an explosion of synapse formation that occurs during early brain development.
 
MILD COGNITIVE IMPAIRMENT (MCI)
a measurable cognitive problem that does not lead to problems with activities of daily living. MCI had been associated with a risk for developing Alzheimer’s disease.
 
AEROPHOBIA
an abnormal fear or sensitivity to air or the movement of air. Aerophobia is a symptom of rabies.
 
HYPNAGOGIC HALLUCINATIONS
Vivid dream-like experiences that occur during the transitions between wake and sleep
 
ELECTRODECREMENTAL ICTAL ACTIVITY
characterized by nearly flat or ill-defined low voltage initiation, commonly followed by voltage increase with spike activity, rhythmical and gradually slowing. Most commonly involved the frontal lobe.
 
SACRAL ALA

the “wings” of the sacrum. The sacral ala are an important part of the connection between the sacrum and the pelvis. They are often used during spinal surgery as a point of attachment for instrumentation that helps to stabilize the lumbosacral junction.

TALL MAN LETTERING

FDA and Institute for Safe Medication Practices recommends TALL Man lettering which is the practice of writing part of a drug’s name in upper case letters to help distinguish sound-alike, look-alike drugs from one another to avoid medication errors. Example: DOBUTamine vs DOPamine.

SEMANTIC DEMENTIA
progressive loss of the ability to remember the meaning of words, faces, and objects which results from shrinkage of the temporal lobes of the brain. Patients often present with the complaint of word-finding difficulties. As the disease progresses, behavioral and personality changes are often seen.
 
BUILD-UP
Colloquialism. Frequently employed to describe progressive increase in voltage of the EEG or appearance of waves of increasing amplitude, frequently associated with decrease in frequency during hyperventilation. Sometimes applied to hyperventilation or seizure discharges (use discouraged).
 
TRANSVERSE MYELITIS
a neurological condition in which the spinal cord is inflamed. This inflammation damages nerve fibers, and causes them to lose their myelin coating, thereby leading to decreased electrical conductivity in the nervous system.
 
INTELLECTUAL DISABILITY
formerly called “mental retardation”; is characterized by significant limitations both in intelligence and in adaptive behavior affect many everyday social and practical skills.
 
CHIARI MALFORMATION
the downward (caudal) displacement of part of the cerebellum or brainstem below the foramen magnum. May cause hydrocephalus.
 
ENCOCHES FRONTAL

This pattern is intimately related to anterior dysrhythmia and the two are often seen admixed over the frontal regions. Encoches frontales consist of 50-100 µV pp broad diphasic transients (0.5-0.75 sec) with a small initial negative deflection and a larger positive deflection. Overall, they are typically synchronous and symmetric, often present in transitional sleep and most abundant in the transition from active to quiet sleep.

HYPSAR RHYTHMIA

Pattern consisting of diffuse high voltage (.300 mV) irregular slow waves interspersed with multiregional spikes and sharp waves over both hemispheres.

CHAGAS DISEASE
also known as American Trypanosomiasis is caused by the parasite Trypanosoma cruzi which is transmitted to animals and people by insect vectors and is found only in the Americas (mainly in rural areas of Latin America). Chagas disease can be life-threatening or the patients can be symptom free.
 
CHARCOT MARIE TOOTH DISEASE (CMT)
also known as hereditary motor and sensory neuropathy (HMSN) and peroneal muscular atrophy (PMA), is a genetically and clinically heterogeneous group of inherited disorders of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. Currently incurable, this disease is one of the most common inherited neurological disorders.
 
UNCINATE EPILEPSY

a form of psychomotor epilepsy or complex partial seizure initiated by a dreamy state and hallucinations of smell and taste, usually the result of a medial temporal lesion.

TARDIVE DYSKINESIA
a difficult-to-treat and often incurable form of dyskinesia, a disorder resulting in involuntary, repetitive body movements. In this form of dyskinesia, the involuntary movements are tardive, meaning they have a slow or belated onset. Most frequently occurs as the result of long-term or high-dose use of antipsychotic drugs, or in children and infants as a side effect from usage of drugs for gastrointestinal disorder.
 
NEUROMYELITIS OPTICA (NMO)

an uncommon disease syndrome of the CNS that affects the optic nerves and spinal cord, causes pain in the eye and vision loss, and transverse myelitis, which causes weakness, numbness, and sometimes paralysis of the arms and legs, along with sensory disturbances and loss of bladder and bowel control. NMO leads to loss of myelin when immune system cells and antibodies attack and destroy myelin cells in the optic nerves and the spinal cord.

PSEUDOMENINGOCELE
a collection of cerebrospinal fluid due to a dural leak after spine surgery; not a congenital disorder.
 
MICROPSIA

condition affecting visual perception in which objects are perceived to be smaller than they actually are. Factors known to cause micropsia include traumatic brain injury, swelling of the cornea, epilepsy, migraines, prescription and illicit drug use, retinal edema, macular degeneration, brain lesions, and psychological factors.

FOCAL SEIZURE WITHOUT DYSCOGNITIVE FEATURES
also known as simple partial seizure or simple focal seizure; characterized in no loss of consciousness or awareness; characterized by jerking of a body part or sensory symptoms such as tingling, dizziness, or flashing lights.
 
NEGLECT SYNDROME
a multifaceted neurological disorders in which patients act as if portions of their world do not exist. Patients may even deny ownership of a limb on the neglected side of their body.  Patients with neglect fail to report, respond, or orient to external stimulation contralateral to a brain lesion.
 
MENINGISMUS

the collection of symptoms in which the meninges are neither diseased nor inflamed. The symptoms include neck stiffness or difficulty moving the neck, photophobia or difficulty with bright lights, and headache.  Can be caused by a viral illness or by a brain hemorrhage.

NEUROPRAXIA

disorder of the peripheral nervous system in which there is temporary loss of motor and sensory function due to blockage of nerve conduction. Condition is typically cause by blunt neural injury due to external blows or shock-like injuries to muscle fibers which leads to repeated or prolonged pressure buildup on the nerve.

AICARDI’S SYNDROME

is a disorder that occurs almost exclusively in females, characterized by absent or underdeveloped tissue connecting the left and right halves of the brain (agenesis or dysgenesis of the corpus callosum); seizures beginning in infancy (infantile spasms), which tend to progress to recurrent seizures (epilepsy) that can be difficult to treat; and chorioretinal lacunae, which are defects in the light-sensitive tissue at the back of the eye (retina).

VARICELLA ZOSTER VIRUS (VZV)

causes chicken pox in childhood after which it establishes latency in the sensory ganglia and can re-emerge as shingles.

QUADRANTANOPIA
refers to an anopia affecting a quarter of the field of vision. It can be associated with a lesion of an optic radiation. Can be caused by lesions in the temporal and parietal lobes, but is most commonly associated with lesions in the occipital lobe. If Meyer's loop (temporal pathway) is lesioned, the vision loss is superior (colloquially referred to as "pie in the sky"); if Baum's loop (parietal pathway) is lesioned, the vision loss is inferior.
 
NYQUIST THEOREM
also known as the sampling theorem, is a principle that engineers follow in the digitization of analog signals. For analog-to-digital conversion (ADC) to result in a faithful reproduction of the signal slices, called samples, of the analog waveform must be taken frequently. The number of samples per second is called the sampling rate or sampling frequency.
 
Any analog signal consists of components at various frequencies. The simplest case is the sine wave, in which all the signal energy is concentrated at one frequency. In practice, analog signals usually have complex waveforms, with components at many frequencies. The highest frequency component in an analog signal determines the bandwidth of that signal. The higher the frequency, the greater the bandwidth, if all other factors are held constant.
 
Suppose the highest frequency component, in hertz, for a given analog signal is fmax. According to the Nyquist Theorem, the sampling rate must be at least 2fmax, or twice the highest analog frequency component. The sampling in an analog-to-digital converter is actuated by a pulse generator (clock). If the sampling rate is less than 2fmax, some of the highest frequency components in the analog input signal will not be correctly represented in the digitized output. When such a digital signal is converted back to analog form by a digital-to-analog converter, false frequency components appear that were not in the original analog signal. This undesirable condition is a form of distortion called aliasing.
 
*Nyquist is also the name of the horse who just won the 2016 Kentucky Derby.
 
TENTORIUM
a fold of the dura mater (one of the meninges) that separates the cerebrum from the cerebellum. The tentorium runs horizontally under the back portion of the cerebrum separating it from the cerebellum below.
 
ANALGOSEDATION
strategy that manages patient pain and discomfort first instead of using standard sedative-hypnotic regimens. Evidence has shown that if ICU patients requiring mechanical ventilation have good analgesia (absence of pain), they can be conscious, aware, and cooperative.
 
NEUROSARCOIDOSIS
complication of sarcoidosis in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system. Sudden facial weakness is the most common symptom. Bodily functions such as temperature regulation and sleep can be affected. Muscle weakness or sensory losses can occur with peripheral nerve involvement.  
 
ACETYLCHOLINE

the first neurotransmitter discovered, produced by cholinergic neurons, is the neurotransmitter at neuromuscular junctions. Originally described as “vagus stuff” by Otto Loewi because of its ability to mimic the electrical stimulation of the vagus nerve.  

ACALCULIA

inability to calculate or difficulty with arithmetic which may be the result of damage to the angular gyrus in the hemisphere dominant for speech and language.

LILLIPUTIAN HALLUCINATIONS – (aka Alice in Wonderland or Todd’s syndrome)
a disorienting neurological condition that affects human perception. Sufferers experience dysmetropsia (micropsia, macropsia, pelopsia, teleopsia) or size distortion of other sensory modalities. A temporary condition often associated with migraines, brain tumors, and the use of psychoactive drugs, and can also present as the initial sign of the Epstein–Barr virus. AIWS is also a common experience at sleep onset, and has been known to commonly arise due to a lack of sleep.
 
ENCOCHES FRONTAL
This pattern is intimately related to anterior dysrhythmia and the two are often seen admixed over the frontal regions. Encoches frontales consist of 50-100 μV pp broad diphasic transients (0.5-0.75 sec) with a small initial negative deflection and a larger positive deflection. Overall, they are typically synchronous and symmetric, often present in transitional sleep and most abundant in the transition from active to quiet sleep.
 
WERNICKE'S AREA
one of the two parts of the cerebral cortex linked to speech (the other is Broca's area). Involved in the production of written and spoken language. Damage caused to Wernicke's area results in receptive, fluent aphasia, i.e., able to fluently connect words, but will lack meaning. This is unlike non-fluent aphasia, in which the person will use meaningful words, but in a non-fluent, telegraphic manner.
 
CRANIOSYNOSTOSIS
birth defect in which one or more of the joints between the bones of a newborn’s skull close prematurely, before the baby's brain is fully formed, results in increased intracranial pressure leading possibly to visual impairment, obstructive sleep apnea, eating difficulties, or an impairment of mental development combined with a significant reduction in IQ.
 
TARDIVE DYSKINESIA
a difficult-to-treat and often incurable form of dyskinesia, a disorder resulting in involuntary, repetitive body movements. In this form of dyskinesia, the involuntary movements are tardive, meaning they have a slow or belated onset. Most frequently occurs as the result of long-term or high-dose use of antipsychotic drugs, or in children and infants as a side effect from usage of drugs for gastrointestinal disorder
 
TRANSVERSE MYELITIS 
a neurological condition in which the spinal cord is inflamed. This inflammation damages nerve fibers, and causes them to lose their myelin coating, thereby leading to decreased electrical conductivity in the nervous system.
 
SNATIATION 
a medical disorder characterized by uncontrollable bursts of sneezing brought on by fullness of the stomach, and typically observed in sufferers immediately after a large meal. It is thought to be passed along genetically as an autosomal dominant trait. The term "SNATIATION" is a portmanteau of the words sneeze and satiation.
 
VILIUISK ENCEPHALOMYELITIS (VE)
a fatal progressive neurological disorder found only in the Sakha population of central Siberia. About 15 new cases are reported each year. Causative agents, origin of the disease, and involved candidate genes are currently unknown. Those inflicted with the disease survive for a period of only a few months to several years. Initially, the infected patients experience symptoms such as: severe headaches, delirium, lethargy, meningism, bradykinesia, and incoordination. A small percentage of patients die during the acute phase as result of a severe coma. All cases are fatal.
 
QUADRANTANOPIA
refers to an anopia affecting a quarter of the field of vision. It can be associated with a lesion of an optic radiation. Can be caused by lesions in the temporal and parietal lobes, but is most commonly associated with lesions in the occipital lobe. If Meyer's loop (temporal pathway) is lesioned, the vision loss is superior (colloquially referred to as "pie in the sky"); if Baum's loop (parietal pathway) is lesioned, the vision loss is inferior.
 
UNCINATE EPILEPSY 
a form of psychomotor epilepsy or complex partial seizure initiated by a dreamy state and hallucinations of smell and taste, usually the result of a medial temporal lesion.
 
NEURONAL CEROID LIPOFUSCINOSES (NCL)
the general name for a family of at least eight genetically separate neurodegenerative disorders that result from excessive accumulation of lipopigments (lipofuscin) in the body's tissues. Characterized by progressive, permanent loss of motor and psychological ability with a severe intracellular accumulation of lipofuscins. 
 
OPSOCLONUS MYOCLONUS (Dancing Eyes-Dancing Feet Syndrome) 
a rare neurological condition whose symptoms include sudden, brief muscle spasms and rapid, irregular eye movements called opsoclonus. It may occur in children who have tumors, or as a result of a viral infection. Patients may also have trouble speaking. Other symptoms include poor muscle tone, irritability, or lethargy (feeling tired).
 
ANOSMIA 
Inability to perceive odor, or a lack of functioning olfaction. Due to an inflammation of nasal mucosa, blockage of nasal passages, or a destruction of one temporal lobe.
 
DENTATE GYRUS
One of two interlocking parts of the hippocampus (Ammon’s horn is the other), and is thought to contribute to the formation of new episodic memories, the spontaneous exploration of novel environments, and other functions.
 
AMMON’S HORN SCLEROSIS (AHS) 
A maldevelopmental disorder associated with temporal lobe epilepsy. This type of neuron cell loss, primarily in the hippocampus, can be observed in approximately 65% of people suffering from this form of epilepsy. 
 
AICARDI’S SYNDROME
is a disorder that occurs almost exclusively in females, characterized by absent or underdeveloped tissue connecting the left and right halves of the brain (agenesis or dysgenesis of the corpus callosum); seizures beginning in infancy (infantile spasms), which tend to progress to recurrent seizures (epilepsy) that can be difficult to treat; and chorioretinal lacunae, which are defects in the light-sensitive tissue at the back of the eye (retina).
 
PROSOPAGNOSIA 
also called face blindness, is a cognitive disorder of face perception where the ability to recognize faces is impaired, while other aspects of visual processing (e.g., object discrimination) and intellectual functioning (e.g., decision making) remain intact. The term originally referred to a condition following acute brain damage (acquired prosopagnosia), but a congenital or developmental form of the disorder also exist.
 
ACTION MYOCLONUS 
type of myoclonus that can come on when the person moves or even tries to move. It is the most disabling type, because the muscle spasms can affect the arms, legs, face, and voice
 
ACETYLCHOLINE 
the first neurotransmitter discovered, produced by cholinergic neurons, is the neurotransmitter at neuromuscular junctions. Originally described as “vagus stuff” by Otto Loewi because of its ability to mimic the electrical stimulation of the vagus nerve.  
 
CATAPLEXY 
A sudden, temporary loss of muscle tone triggered by strong emotions
 
HYPNAGOGIC HALLUCINATIONS 
Vivid dream-like experiences that occur during the transitions between wake and sleep
 
DYSTROPHY 
degeneration of tissue due to disease or malnutrition
 
NEUROMYELITIS OPTICA (NMO) 
an uncommon disease syndrome of the CNS that affects the optic nerves and spinal cord, causes pain in the eye and vision loss, and transverse myelitis, which causes weakness, numbness, and sometimes paralysis of the arms and legs, along with sensory disturbances and loss of bladder and bowel control. NMO leads to loss of myelin when immune system cells and antibodies attack and destroy myelin cells in the optic nerves and the spinal cord.
 
PHARMACORESISTANT EPILEPSY (PRE)
failure to achieve seizure freedom following adequate trials of two tolerated and appropriately chosen antiepileptic drugs (AEDs). The complexity of PRE reflects the dynamic nature of the underlying disease biology and the multiplicity of mechanisms of drug resistance.
 
CHARCOT MARIE TOOTH DISEASE (CMT) 
also known as hereditary motor and sensory neuropathy (HMSN) and peroneal muscular atrophy (PMA), is a genetically and clinically heterogeneous group of inherited disorders of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body. Currently incurable, this disease is one of the most common inherited neurological disorders.
 
BILATERAL PERISYLVIAN POLYMICROGYRIA (BPP) 
a rare neurological characterized mainly by partial paralysis of muscles on both sides of the face, tongue, jaws, and throat; difficulties in speaking, chewing, and swallowing (dysphagia); and/or seizures (epilepsy). While the exact cause of BPP is not fully understood, this condition is thought to be due to improper development of the outer surface of the brain (cerebral cortex) during embryonic growth.
 
SERPIGINOUS 
slowly spreading; healing over in one portion while continuing to advance in another. In dermatology serpiginous describes the shape or arrangement of lesions that have a wavy or serpent-like pattern.
 
INTELLECTUAL DISABILITY
formerly called “mental retardation”; is characterized by significant limitations both in intelligence and in adaptive behavior affect many everyday social and practical skills.
 
CHAGAS DISEASE 
also known as American Trypanosomiasis is caused by the parasite Trypanosoma cruzi which is transmitted to animals and people by insect vectors and is found only in the Americas (mainly in rural areas of Latin America). Chagas disease can be life-threatening or the patients can be symptom free.
 
B(I)RDs 
brief, potentially ictal rhythmic discharges. Rhythmic bursts of waves that share many characteristics with seizures (sharp morphology and/or evolution in frequency or morphology) but last less than 10 seconds.
 
DESICCATION 
state of extreme dryness; disc desiccation is a common degenerative change of intervertebral discs.
 
TAU PROTEINS 
proteins that stabilize microtubules and are abundant in neurons of the central nervous system and less common elsewhere. Defective tau proteins are found in Alzheimer’s disease. High levels  of tau protein in fluid bathing the brain are linked to poor recovery after head trauma. 
 
INFUNDIBULUM
connection between the hypothalamus ad the pituitary gland; contains the hypophyseal portal veins and axons of hypothalamic neurons that project to the posterior pituitary.
 
COUGH HEADACHE
transient, severe, explosive head pain upon coughing, sneezing, weight lifting, bending, or stooping.
 
ACALCULIA
inability to calculate or difficulty with arithmetic which may be the result of damage to the angular gyrus in the hemisphere dominant for speech and language.
 
TENTORIUM
a fold of the dura mater (one of the meninges) that separates the cerebrum from the cerebellum. The tentorium runs horizontally under the back portion of the cerebrum separating it from the cerebellum below.
 
PSEUDOMENINGOCELE
a collection of cerebrospinal fluid due to a dural leak after spine surgery; not a congenital disorder.
 
FACET JOINT 
each of four joints formed above and below and on either side of a vertebra. The lower bony projection of one vertebra meets the upper projections of the vertebra below it, forming facet joints.
 
CHIARI MALFORMATION 
the downward (caudal) displacement of part of the cerebellum or brainstem below the foramen magnum. May cause hydrocephalus.
 
MINI MENTAL STATE EXAMINATION (MMSE)
most commonly used instrument for screening for cognitive function. It is a brief 30-point questionnaire. The MMSE can be used to help diagnose dementia and to help assess its progression and severity.
 
METAMORPHOPSIA
type of distorted vision in which a grid of straight lines appears wavy and parts of the grid may appear blank. It is mainly associated with macular degeneration.
 
MILD COGNITIVE IMPAIRMENT (MCI) 
a measurable cognitive problem that does not lead to problems with activities of daily living. MCI had been associated with a risk for developing Alzheimer’s disease.
 
SEMANTIC DEMENTIA
progressive loss of the ability to remember the meaning of words, faces, and objects which results from shrinkage of the temporal lobes of the brain. Patients often present with the complaint of word-finding difficulties. As the disease progresses, behavioral and personality changes are often seen.
 
FOCAL SEIZURE WITHOUT DYSCOGNITIVE FEATURES
also known as simple partial seizure or simple focal seizure; characterized in no loss of consciousness or awareness; characterized by jerking of a body part or sensory symptoms such as tingling, dizziness, or flashing lights. 
 
FOCAL SEIZURE WITH DYSCOGNITIVE FEATURES
also known as complex partial seizure or complex focal seizure; characterized by altered consciousness or awareness and often purposeless movements or automatisms.
 
PROGRESSIVE SUPRANUCLEAR PALSY (PSP)
rare brain disorder that causes serious and progressive problems with control of gait and balance along with complex eye movement and thinking problems. One of the classic signs is an inability to aim the eyes properly which occurs because of lesions in the area of the brain that coordinates eye movements.
 
DEMENTIA WITH LEWY BODIES (DLB)
presents with a combination of Parkinsonism and dementia. Symptoms include prominent visual hallucinations and a fluctuating course. The patient is extremely sensitive to antipsychotics and will worsen considerably if taking antipsychotics. This worsening may not be able to be reversed. Characteristic finding is the Lewy Body present in the nuclei of the neuron.
 
INTRACRANIAL THROMBECTOMY
mechanical thrombectomy using stent retrievers is an emerging treatment for acute ischemic stroke. Catheters and stents are used to remove the clot.
 
PRONATOR DRIFT
pathologic sign seen during a neurological exam. The patient is asked to hold both arms fully extended at the shoulder level with palms upward and hold the position. Closing the eyes accentuates the effect. If a forearm pronates (turns so the palm faces down), the patient is said to have pronator drift on that side indicating a contralateral pyramidal tract lesion.
 
NEGLECT SYNDROME
a multifaceted neurological disorders in which patients act as if portions of their world do not exist. Patients may even deny ownership of a limb on the neglected side of their body.  Patients with neglect fail to report, respond, or orient to external stimulation contralateral to a brain lesion.
 
NEUROPRAXIA
disorder of the peripheral nervous system in which there is temporary loss of motor and sensory function due to blockage of nerve conduction. Condition is typically cause by blunt neural injury due to external blows or shock-like injuries to muscle fibers which leads to repeated or prolonged pressure buildup on the nerve.
 
SYNAPTOGENESIS
formation of synapses between neurons that occurs throughout a person’s lifespan. Exuberant synaptogenesis is an explosion of synapse formation that occurs during early brain development.
 
PATHOGNOMONIC
characteristic or diagnostic of a specific disease. For example,  Koplik’s spots inside the mouth in measles, Negri bodies within brain tissue infected with rabies.
 
EPILEPTIC NYSTAGMUS
rare, ictal phenomenon characterized by rapid, repetitive eye movement during seizure activity.
 
HEMIMEGALENCEPHALY
a rare neurological condition in which one half of the brain is abnormally larger than the other. It can cause partial epilepsy which may be treated with hemispherectomy. Hemimegalencephaly can also cause intellectual disability and impair normal movement on the side of the body opposite the malformation.
 
“STOP” EEG PATTERN
medium voltage, semi-rhythmic, sharply contoured theta range activity noted occipitally in prematures. This pattern is noted throughout the preterm period and may be unilateral or bilateral. Its persistence after term suggests a nonspecific abnormality.
 
PALINOPSIA
visual disturbance that causes images to persist to some extent even after their corresponding stimulus has left. These images are known as afterimages and occur in persons with normal vision.
 
POSTICAL PSYCHOSIS (PIP)
phenomenon of psychosis that occurs following a seizure or series of seizures. PIP most commonly occurs following an increase in seizure activity. Patients often appear well for a few hours or days and then express disordered thoughts, delusional ideas, and even aggressive behavior.
 
SACRAL ALA
the “wings” of the sacrum. The sacral ala are an important part of the connection between the sacrum and the pelvis. They are often used during spinal surgery as a point of attachment for instrumentation that helps to stabilize the lumbosacral junction.
 
BORBORYGMUS
rumbling or gurgling noise that occurs from the movements of fluid and gas in the intestines.
 
FOMITE
an object (such as a dish or an article of clothing) that may be contaminated with infectious organisms and serves in the transmission of the infectious organisms.
 
ION CHANNEL
a pore in the cell membrane that is composed of membrane proteins. The ion channel gates the flow of ions in and out of the cell thereby establishing a resting membrane potential and participating in the formation of action potentials.
 
ANARTHRIA
loss of the motor ability that enables speech; occurs during wakefulness in children with Benign Rolandic Epilepsy
 
ANALGOSEDATION
strategy that manages patient pain and discomfort first instead of using standard sedative-hypnotic regimens. Evidence has shown that if ICU patients requiring mechanical ventilation have good analgesia (absence of pain), they can be conscious, aware, and cooperative.
 
MACROPSIA
a defect in vision in which objects appear to be larger than their actual size. Macropsia has a wide range of causes from prescription and illicit drugs to migraines to rarely complex partial seizures.
 
TALL MAN LETTERING
FDA and Institute for Safe Medication Practices recommends TALL Man lettering which is the practice of writing part of a drug’s name in upper case letters to help distinguish sound-alike, look-alike drugs from one another to avoid medication errors. Example: DOBUTamine vs DOPamine.
 
CYTOMEGALOVIRUS (CMV)
common virus that affects people of all ages. CMV is spread by direct contact of body fluids such as saliva, blood, urine, semen, vaginal fluids, and breast milk. Most people infected with CMV do not have any symptoms. Acute CMV infection may cause symptoms such as fever, enlarged lymph nodes, sore throat, muscle aches, loss of appetite, and fatigue.
 
BEST PRACTICES
the use of care concepts, interventions, and techniques that are grounded in research and know to promote higher quality of care. Hospitals use best practices to support their clinical protocols and standards of care.
 
NERNST POTENTIAL EQUATION
calculates the equilibrium potential for an ion based on temperature, the ion’s valence (charge), and its concentration gradient across the membrane.
 
GESTE ANTAGONISTE
physical gesture or position (such as touching the chin) which may serve to temporarily interrupt dystonic symptoms.
 
NEUROSARCOIDOSIS
complication of sarcoidosis in which inflammation occurs in the brain, spinal cord, and other areas of the nervous system. Sudden facial weakness is the most common symptom. Bodily functions such as temperature regulation and sleep can be affected. Muscle weakness or sensory losses can occur with peripheral nerve involvement. 
 
MICROPSIA
condition affecting visual perception in which objects are perceived to be smaller than they actually are. Factors known to cause micropsia include traumatic brain injury, swelling of the cornea, epilepsy, migraines, prescription and illicit drug use, retinal edema, macular degeneration, brain lesions, and psychological factors.
 
MENINGISMUS
the collection of symptoms in which the meninges are neither diseased nor inflamed. The symptoms include neck stiffness or difficulty moving the neck, photophobia or difficulty with bright lights, and headache.  Can be caused by a viral illness or by a brain hemorrhage.
 
AEROPHOBIA
an abnormal fear or sensitivity to air or the movement of air. Aerophobia is a symptom of rabies.
 
PURPURA
the appearance of red or purple discolorations of the skin that do not blanch on applying pressure. Purpura spots less than 3 millimeters in diameter are petechiae. Purpura spots larger than 1 centimeter are ecchymoses.
 
VARICELLA ZOSTER VIRUS (VZV)
causes chicken pox in childhood after which it establishes latency in the sensory ganglia and can re-emerge as shingles.
 
ANHEDONIA
one of the main symptoms of major depressive disorder and is defined as the inability to experience pleasure from activities usually found enjoyable such as exercise, hobbies, music, friends…
 
AXONAL SHEAR INJURY
diffuse axonal injury caused by the differences in the densities of gray and white matter of the brain.
 
PARKINSONISM
neurological syndrome characterized by tremor, hypokinesia, rigidity, and postural instability that can be caused by multiple etiologies including: Parkinson’s disease, dementia with Lewy bodies, toxins, medications.
 
ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM)
brief but widespread attack of inflammation in the brain and spinal cord that damages myelin. ADEM often follows viral or bacterial infections, or less often, vaccination for measles, mumps, or rubella.
 
COPROLALIA
uttering obscene or inappropriate words aloud. Although coprolalia is what many people equate with Tourette’s syndrome (TS), as few as 15% of individuals diagnosed with TS actually experience this symptom.
 
HEMICRANIECTOMY
half of the skull is removed in order to save the brain from severe brain swelling. Skull bone can be replaced or titanium is used.
 
APOPTOSIS
programmed cell death. Proteins called caspases go into action and break down the cellular components needed for survival. They spur the production of enzymes known as DNases which destroy the DNA in the nucleus of the cell.
 
INTRANIDAL
being within the nidus or aggregate of nerve cells; intranidal aneurysms are found with the nucleus of an arteriovenous malformation (AVM).
 
MAGNETIC RESONANCE ANGIOGRAM (MRA)
scan that uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels. MRA is used to generate images of the arteries in order to evaluate them for stenosis (abnormal narrowing), occlusion or aneurysms (vessel wall dilatations at risk of rupture).
 
NEUROPSYCHOMETRIC
pertaining to the quantitative testing of neurological processes underlying cognitive processes and behaviors.
 
SPASMUS NUTANS
triad of clinical symptoms: monocular nystagmus, head nodding, and head tilt. Symptoms are recurrent throughout the day and may be mistaken for seizures.
 
STEPPAGE GAIT
the gait in footdrop in which the advancing leg is lifted high in order that the toes may clear the ground. It is due to paralysis of the anterior tibial and peroneal muscles and is seen in lesions of lower motor neurons, of the anterior motor horn cells, and of the cauda equina.
 
CAPNOGRAPHY
monitoring of the concentration of exhaled carbon dioxide in order to assess the physiological status of patients with acute respiratory problems or who are receiving mechanical ventilation and to determine the adequacy of ventilation in anesthetized patients.
 
STIFF BABY SYNDROME
hyperexplexia is an autosomal dominant disorder characterized by excessive startle or stiffness of the baby in response to sudden, unexpected auditory or tactile stimuli.
 
HYPNIC JERKS
quick, brief, sudden movements occurring at sleep onset. These movements may involve any part or all of the body.
 
ALPHA SQUEAK
a speeding up of the background alpha activity immediately upon eye closure; a normal finding.
 
PROPRIOSPINAL MYOCLONUS
a rare movement disorder characterized by involuntary axial jerks originating from muscles innervated by multiple spinal segments. Propriospinal myoclonus can occur at any time.
 
OPERCULAR REGION
the part of the cerebral cortex that covers the insula.
 
FRONTAL BOSSING
an unusually prominent forehead, sometimes associated with a heavier than normal brow ridge. Frontal bossing is seen only in a few rare syndromes, including acromegaly.
 
DE NOVO GENE MUTATION
a genetic mutation that neither parent possessed nor transmitted.
 
SCOLIOSOMETER
an apparatus for measuring curves, especially those of the vertebral column.
 
LEWY BODY DEMENTIA
the second most common type of progressive dementia after Alzheimer’s disease, causes a progressive decline in mental abilities. It may also cause visual hallucinations, which may take the form of seeing shapes, colors, people or animals that aren't there or, more complexly, having conversations with deceased loved ones. It is characterized anatomically by the presence of Lewy bodies, clumps of alpha-synuclein and ubiquitin protein in neurons, detectable in post mortem brain histology.
 
“ALICE IN WONDERLAND” SYNDROME
disturbances of visual perception, such as micropsia, macropsia, and metamorphopsia, described by patients during a migraine.
 
GIGANTISM
abnormally large growth due to an excess of growth hormone during childhood, before the bone growth plates have closed. The child will grow in height, as well as in the muscles and organs. This excessive growth makes the child extremely large for his or her age.
 
DYSEMBRYOPLASTIC NEUROEPITHELIAL (DNET) TUMORS
benign, slow growing tumors arising from either cortical or deep grey matter. The vast majority are centered in cortical grey matter, arise from secondary germinal layers and are frequently associated with cortical dysplasia (up to 80% of cases). They characteristically cause intractable partial seizures.
 
INTERBURST INTERVAL (IBI)
a simple time domain measure that identifies the period of time between each burst of EEG activity. It is not a ratio, but is absolute measure of time. IBIs can be used to grade hypoxic encephalopathy and assist with prognosis in neonates with perinatal asphyxia.
 
ACTIVITÉ MOYENNE
low voltage and discontinuous 4 to 7 Hz theta activity interspersed with low voltage delta rhythms in the full-term infant during wakefulness.
 
TARDIVE DYSKINESIA
complex, involuntary movements especially of the lower jaw in patients exposed to antipsychotic drugs
 
PHOBIA
obsessive, persistent, unrealistic, intense fear of an object or situation
 
RADICULOPATHY
a condition due to a compressed nerve in the spine that can cause pain, numbness, tingling, or weakness along the course of the nerve. Radiculopathy can occur in any part of the spine, but it is most common in the lower back (lumbar radiculopathy) and in the neck (cervical radiculopathy)
 
HERPES ZOSTER
usually referred to as shingles which is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox.
 
CONFABULATION
the spontaneous production of false memories: either memories for events which never occurred, or memories of actual events which are displaced in space or time. These memories may be elaborate and detailed. Some may be obviously bizarre, as a memory of a ride in an alien spaceship; others are quite mundane, as a memory of having eggs for breakfast.
 
RETROGRADE AMNESIA
amnesia caused by a trauma such as concussion, in which the memory loss relates to material learnt before the trauma
 
ACROMEGALY
a long-term condition in which there is too much growth hormone and the body tissues get larger over time. It is caused by abnormal production of growth hormone after the skeleton and other organs finish growing. The cause of the increased growth hormone release is usually a noncancerous (benign) tumor of the pituitary gland.
 
FEBRILE INFECTION-RELATED EPILEPSY SYNDROME (FIRES)
explosive-onset, potentially fatal acute epileptic encephalopathy that develops in previously healthy children and adolescents following the onset of a non-specific febrile illness. Characterized by convulsive and recurrent focal seizures followed by refractory focal epilepsy along with a decline in memory, cognition, and behavior.
 
DUROTOMY
incursion of the dura, especially in spinal surgery
 
PRAXIS
the ability to plan and then execute movement
 
ASTROGLIOSIS – (also known as astrocytosis) is an abnormal increase in the number of astrocytes due to the destruction of nearby neurons from CNS trauma, infection, ischemia, stroke, autoimmune responses, and neurodegenerative disease.
 
HYPOXIC ISCHEMIC ENCEPHALOPATHY (HIE)
a condition in which the brain does not receive enough oxygen. This particular condition refers to an oxygen deficiency to the brain as a whole, rather than a part of the brain. Although the term most often refers to injury sustained by newborns, HIE can be used to describe any injury from low oxygen.
 
DECLARATIVE MEMORY
explicit memory for facts, sometimes referred to as explicit memory. Declarative memory can be divided into two categories: episodic memory which stores specific personal experiences and semantic memory which stores factual information.
 
ICTOGENESIS
the initiation and propagation of a seizure in time and space
 
SUPPLEMENTARY SENSORIMOTOR AREA (SSMA)
defined in a functional rather than in a strict anatomical manner; this area is in the mesial aspect of the superior frontal lobe. Typical SSMA seizures are characterized by abrupt tonic posturing of extremities.
 
CATATHRENIA
described as sleep related groaning, moaning or just “making funny noises.” It is characterized by repeated episodes of monotonous moaning or groaning sounds in prolonged expiration, preceded by deep inspiration. These episodes last between 2 to 50 seconds and end with a sigh or arousal.
 
KIPPEL - TREANAUNAY SYNDROME
a rare condition that is present at birth. The syndrome usually involves port wine stains, excess growth of bones and soft tissue, and varicose veins. Patients with this syndrome may have excessive growth of bones and soft tissue. This occurs most commonly in the legs, but it also may affect the arms, face, head, or internal organs.
 
INVASIVE EEG (iEEG)
sometimes called intracranial EEG, is the recording of electrical activity directly from the brain by using grid, strip, or depth electrodes.
 
PALILALIA
an abnormal condition characterized by the increasingly rapid repetition of the same word or phrase, usually at the end of a sentence.
 
TRANSIENT EPILEPTIC AMNESIA
rare seizure which manifests as an episode of amnesia for recent events and sometimes events from years ago caused by hippocampal dysfunction. There is no loss of personal identity. Episodes often occur upon awakening and can last for a prolonged period of time.
 
CAVERNOUS ANGIOMA
A cavernous angioma is a blood vessel abnormality characterized by large, adjacent capillaries with little or no intervening brain. The blood flow through these vessels is slow. Cavernous angiomas can occur anywhere in the central nervous system.
 
SOMNAMBULISM
sleep walking; a sleep disorder belonging to the parasomnia family
 
PSEUDARTHROSIS
a pathologic entity characterized by deossification of a weight-bearing long bone, followed by bending and pathologic fracture, with inability to form normal callus; this leads to existence of the “false joint” that gives the condition its name.
 
SEIZURE SEMIOLOGY
the observable manifestations of a seizure used to localize the onset of a seizure based on its appearance; semiology is the science of interpreting signs and symptoms
 
JACTITATION
excessive restlessness seen in severe infections with high fevers and some psychiatric disorders
 
STEADY STATE VISUAL EVOKED POTENTIALS (SSVEPs)
signals evoked by visual stimulation at various frequencies. SSVEP-based brain computer interface (BCI) enables the user to select among several commands that depend on the application, for example, moving a cursor on a computer screen. Multiple stimuli are presented to the user who selects the command by focusing on a particular stimulus.
 
EMERGENCY NEUROLOGICAL LIFE SUPPORT (ENLS)
series of protocols, generated by experienced neurocritical care and emergency physicians that describe key steps when managing a patient within the first hours of a neurological emergency. The goals of ENLS include:   
  • Improving the care of patients with neurological emergencies
  • Providing protocols that list important steps in managing a patient with a potential neurological emergency
  • Attempting to standardize emergency neurological care by consensus of healthcare providers
  • Providing education to anyone dealing with neurological emergencies
  • Identifying areas where research is needed to improve the care of our patients.
 
HYPERMNESIA
abnormally vivid or complete memory or recall of the past
 
TELEMEDICINE
use of medical information exchanged from one site to another via electronic communications to improve patient’s health status. Telemedicine can be used as a teaching tool, by which experienced medical staff can observe, show and instruct medical staff in another location, more effective or faster examination techniques.
 
PERCENT ALPHA VARIABILITY (PAV)
Quantitative EEG parameter of alpha activity; decreased PAV indicates a poorer prognosis; PAV can help monitor cerebral blood flow and to predict blood flow abnormalities
 
NONEPILEPTIC PHYSIOLOGIC SEIZURES
sudden alterations in movement, sensations, or consciousness without any neurophysiological features of epileptic seizures. Examples of nonepileptic physiologic seizures include syncope, parasomnias, paroxysmal movement disorders, migraine, and drug and alcohol withdrawal states.
 
PRIVADEMIC
The “privademic” model is the safe and effective practice of academic medicine within a private practice setting. This is an increasingly popular form of medical practice that involves a physician’s participation in cutting edge research outside the spectrum of a university.
 
DECOMPRESSIVE HEMICRANIECTOMY
surgical technique used to relieve the increased intracranial pressure and brain tissue shifts that occur in the setting of large cerebral hemisphere mass, or space-occupying, lesions. In general, the technique involves removal of bone tissue (skull) and incision of the restrictive dura mater covering the brain, allowing swollen brain tissue to herniate upwards through the surgical defect rather than downwards to compress the brainstem. Hemicraniectomy has been used to treat brain swelling and mass effect secondary to a middle cerebral artery (MCA) territory infarction, hemispheric encephalitis, and large parenchymal intracerebral hemorrhage in subarachnoid hemorrhage.
 
PANDEMIC
An epidemic (a sudden outbreak) that becomes very widespread and affects a whole region, a continent, or the world.
 
SENSITIVITY AND SPECIFICITY
Sensitivity is how often a test will be positive in patients who have the disease; the proportion of actual positives which are correctly identified. Specificity is the number of normal or negative results obtained from a population of patients without the disease; the proportion of negatives which are correctly identified.
 
JACTITATION
extreme restlessness or tossing in bed, seen with acute infections and some psychiatric disorders.
 
ELECTROCLINICAL UNCOUPLING
after treatment with antiepileptic medications, the clinical signs of seizures vanish despite persistence of electrographic seizures.
 
POSTMENSTRUAL AGE
the time elapsed between the first day of the last menstrual period and birth (gestational age) plus the time elapsed after birth (chronological age). The American Academy of Pediatrics recommends using postmenstrual age in place of conceptional age. http://pediatrics.aappublications.org/content/114/5/1362.full.pdf+html
 
HYPNOPOMPIC HYPERSYNCHRONY
generalized, paroxysmal, synchronous, rhythmic, high voltage, 3 to 4.5 Hz activity that appears during arousal. Most prominent in ages 1 to 5 years and tends to disappear after adolescence.
 
DOOR-TO-NEEDLE-TIME
when treating a patient with acute ischemic stroke, the time from the patient’s arrival in the Emergency Department to the initiation of intravenous (IV) recombinant tissue plasminogen activator/alteplase (tPA) therapy.
 
FEVER INDUCED REFRACTORY EPILEPTIC ENCEPHALOPATHY (FIRES)
a devastating condition initiated by prolonged perisylvian refractory status epilepticus (SE) triggered by fever of unknown cause. SE may last more than 1 month, and this condition may evolve into pharmacoresistant epilepsy associated with severe cognitive impairment.
 
PRURITUS
the unpleasant sensation that elicits the desire to itch. Pruritus is a distressing symptom that can cause discomfort and threaten the effectiveness of the skin as a major protective barrier.
 
RENAL OSTEODYSTROPHY
bone disease due to kidney failure that occurs in both children and adults. The bones become thin, weak, brittle, and break easily.
 
SOMNILOQUY
also known as “sleep-talking” it is a parasomnia that refers to talking aloud while asleep. It can be quite loud, ranging from simple sounds to l