Neurofibromatosis

Neurofibromatosis

NF1

NF2/ NF2-related schwannomatosis
AKA: MISME (multiple inherited schwannomas, meningiomas, and ependymomas)

Definition
AD characterized by multiple CNS tumors

History
1992 Manchester criteria
2017 Revised Manchester
2022 NF2-related schwannomatosis

Pathophys
-22q12.2→ Merlin (tumor supressor gene)
>cytoskeletal and contact-dependent
-Schawannomas→ Antoni A & B
A→ dense (Verocay bodies)
B→ loose

Incidence
1 in 40,000 births

Dx
-NF2-SWN 2022
-Manchester
DDx
-Schwannomatosis→ only peripheral, no central

Management
-If found NF2:
>Annually eval→ bMRI, ophthal, audiologic
>Every 2y→ spine-MRI 
-If tumor present, more freq
-Therapies
>Bevacizumab→ good VS, poor meningioma; SAEs in 10% (HTN, thromboembolic)
>Brigatinib→ good VS and meningioma

Neuronland History

Neuronland Blogspot History

Purpose

- Self‑repository of articles
- Concepts and lessons learned throughout my life

Authors

Jamir Pitton Rissardo
Ana Leticia Fornari Caprara

Remarkable milestones

🏅Jan 3, 2020
>1st post

https://neuronland.blogspot.com/2020/01/number-1-article-type-case-report.html

🏅Jan 30, 2026
> 1,000,000 views

🏅Apr 12, 2026 → free Google indexation 



233. Accepted

232. Accepted

231. Accepted


230. Accepted


Rowan Research Day - 2026

Rowan Research Day - 2026

Reference list

Irritability and Related Behavioral Adverse Events Associated With Levetiracetam: A Meta‑Analysis and Meta‑Regression of Randomized Trials
Wearable and Technology‑Assisted Gait and Balance Interventions in Parkinson’s Disease: A Systematic Review and Meta‑Analysis
Trends and Disparities in Mortality Involving Epilepsy and Aspiration Pneumonia Among Older Adults in the United States, 1999–2020
Cerebrospinal Fluid and Serum Manganese Levels in Parkinson’s Disease: A Method‑Stratified Meta‑analysis
Efficacy and Safety of Levetiracetam for Essential Tremor: A Systematic Review and Meta‑Analysis
Prevalence and Clinical Correlates of Restless Legs Syndrome in Neuromyelitis Optica Spectrum Disorder: A Systematic Review and Meta‑analysis
Effects of Subthalamic Nucleus Deep Brain Stimulation on Depressive Symptoms in Patients with Parkinson’s Disease: A Meta‑Analysis
Efficacy and Safety of Droxidopa for Neurogenic Orthostatic Hypotension: A Systematic Review and Meta‑analysis
Focal Status Epilepticus in a Patient with Responsive Neurostimulation: A Rare Complication and Management Insights

Post-concussion syndrome

Post-concussion syndrome

Definition
mTBI ✚ persistent sx ✚ fx impact ✚ exclusion

mTBI
•Head trauma with ± brief loss of consciousness (<30 min)
•± post‑traumatic amnesia (<24 h)
•± confusion/disorientation
•GCS 13–15
•No structural brain injury explaining symptoms

Persistent sx
•One or more post‑concussive sx
•Persisting beyond expected recovery
>4 weeks (children/adolescents)
>3 months (adults)

Sx domains
-Somatic: headache, dizziness, fatigue, photophobia/phonophobia
-Cognitive: attention deficit, memory impairment, slowed processing, executive dysfunction
-Emotional/Behavioral: irritability, anxiety, depression, emotional lability
-Sleep: insomnia, hypersomnia, fragmented sleep

Cannabis use disorder

Cannabis use disorder (CUD)

Note
-DSM-V criteria for CUD
-RCVS

Cannabis withdrawal syndrome
>not life-threatening, but can last 2 wks

Treatment
-Psychosocial tx (CBT) 

-OFF-label
>Acetylcysteine (NAC 1200 mg BID)
>Gabapentin
>Mirtazapine
>Dronabinol/nabiximols

Increase Alertness

Increase Alertness
Situations
-Stroke (mainly thalamic)
-PD/ MS
-Consciousness disorder (TBI)
-Narcolepsy/ OSA residual sleepiness

Medications
Base on safety

In-hospital
1st: caffeine, amantadine
2nd: methylphenidate
3rd: levodopa

Outpatient: 
-modafinil/ armodafinil, bupropion, atomoxetine
-dextroamphetamine, lisdexamfetamine

Unclear:
-solriamfetol, pitolisant
Safety pearls
-Avoid late‑day dosing → insomnia, agitation
-Monitor BP/HR with methylphenidate, amphetamines, solriamfetol
-Renal adjust amantadine
-Modafinil induces CYP3A4 → ↓ OCP effectiveness
-Start low and titrate weekly

Subscribe to: Comments (Atom)