Animal therapy and ownership have been studied as a nonpharmacologic treatment option for cardiovascular and psychological disorders. Animal companionship is less studied in neurological disorders such as stroke, dementia, Parkinson's disease, multiple sclerosis, Huntington's disease, epilepsy, and acute brain injury. This review examines the effects that emotional support dogs, dog therapy, or dog ownership has on these specific neurological disorders. It may serve as a nonpharmaceutical option to improve patient symptoms, quality of life, or the disease course itself. Articles were gathered which studied the effect of animal-assisted therapy, pet therapy, dog ownership, and physical activity on neurological disorders. Studies relating to the topic were then assessed for the impact on neurological disorders which ranged from cognition, mobility, quality of life, mood, and improvement of disease course. Dog therapy and ownership were found to improve mood, quality of life, and disease symptoms across multiple neurological disorders. It also encouraged physical activity which was shown to help many diseases studied, even ones associated with skeletal muscle apoptosis, such as Huntington's disease. Dog therapy and ownership are a safe and effective nonpharmaceutical approach to treating chronic and progressive neurological disorders.
Headaches are one of the most frequent and nonspecific complaints of patients. A proper history and physical exam are crucial in properly diagnosing and treating a patient's headache. One rare cause of headaches is a cerebrospinal fluid (CSF) leak which is a phenomenon in which the cerebrospinal fluid surrounding the brain and spinal cord leaks out of the protective dural sac. This can be caused in response to trauma, but often occurs in the absence of any identifiable explanation. This is known as a spontaneous CSF leak and has an incidence of 5 per 100,000 per year making it easy to overlook in a patient presenting with headache. However, it is imperative to properly diagnose and treat patients with spontaneous CSF leak to ensure the best prognosis making it an important cause of headaches for medical providers to be aware of. Here we present a novel case of a 68-year-old African American female who was seen for a headache and was subsequently found to have a spontaneous CSF leak and was treated with an epidural blood patch. We also review the neuroimaging modalities used to localize and treat CSF leaks.
Sudden-onset anomic aphasia is a unique symptom that is suggestive of an acute etiology. This case presents a sudden-onset focal neurological deficit with an underlying brain tumor. A 68-year-old female awoke with sudden-onset anomic aphasia, with mild hypertension as her only medical history. After an initial stroke workup was unremarkable, magnetic resonance imaging found a focal lesion on the left temporal lobe. An electroencephalogram showed lateralized periodic discharge and a focal area of increased epileptic potential in the left temporal lobe. Brain biopsy revealed World Health Organization grade IV glioblastoma, followed by resection. This case is an important reminder that chronic etiologies may present with acute symptoms.
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