NYUHSL Faculty Bibliography

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597

Neurology. 2019:92:249-249.DOI: 10.1212/WNL.0000000000006844

Editors' note: Opinion and Special Articles: Stress when performing the first lumbar puncture may compromise patient safety [Letter]

Lewis, Ariane; Galetta, Steven

I read with interest the Henriksen et al.(1) article on physician stress levels while performing lumbar puncture (LP). They concluded that stress levels of physicians who are LP procedure novices was high before and during procedure performance as compared to physicians who are experts in this procedure. The high stress levels in LP procedure novice physicians was directly related to patient confidence in the operator and risk of post LP headache. This study fails to take into consideration many physician extrinsic factors that determine the outcome of LP. LP procedure novice physicians are most likely to be physicians in training who, many times, are performing the procedure in less than optimal conditions, such as late at night under emergent situations when time is limited, operators are overworked and sleep-deprived, and the patient is frequently in an altered mental state lying on a gurney in the emergency department. Outcomes of LP procedure under these settings are more likely to be less than desired as compared to when the procedure is carried out electively, in the confines of the office setting, and with the physician well-rested and not rushed for time.

ISI:000462547500029

ISSN: 0028-3878

CID: 3803712

Neurology. 2019:92:248-248.DOI: 10.1212/WNL.0000000000006842

Editors' note: Clinical Reasoning: A 56-year-old woman with acute vertigo and diplopia [Letter]

Lewis, Ariane; Galetta, Steven

There are wider implications of the treatments described by Sharma et al.(1) Bortezomib works by promoting apoptosis in long-lived and short-lived plasma cells responsible for long-lived immunity. These cells produce background levels of vaccine-induced protective antibodies. Therefore, there may be reduced titers of immunoglobulins against measles, mumps, and tetanus after bortezomib treatment of systemic lupus erythematosus.(2) Bortezomib is now also considered treatment in many antibody-mediated chronic autoimmune diseases. It may provide a rapid reduction in antibody titers in treatment-refractory neurologic antibody-mediated diseases, such as NMDAR encephalitis, if standard immunotherapies are ineffective.(3) Standard immunotherapies, such as methylprednisolone, rituximab, and cyclophosphamide, do not target these long-lived and short-lived plasma cells(4); however, as some patients do not respond when these antibody-secreting cells are targeted, there is clearly more complexity to the immunopathogenesis than is currently understood.(5) Neurologists should be aware of the potential pan-immunodeficient risks, particularly when it comes to vaccination-induced immunity, and also the potential therapeutic options in antibody-mediated neurologic conditions.

ISI:000462547500026

ISSN: 0028-3878

CID: 3803722

Neurology. 2019:92(2).DOI: 10.1212/WNL.0000000000006723

Editors' note: Teaching NeuroImages: DWI and EEG findings in Creutzfeldt-Jakob disease

Lewis, Ariane; Galetta, Steven

ORIGINAL:0014569

ISSN: 1526-632x

CID: 4354572

Neurology neuroimmunology & neuroinflammation. 2019:6(1).DOI: 10.1212/NXI.0000000000000526

A young man in "double-trouble": Hallucinations and cranial nerve palsies: From the National Multiple Sclerosis Society Case Conference Proceedings

Bradshaw, Michael J; Lisak, Robert P; Meltzer, Ethan; Melamed, Esther; Lucas, Ashlea; Freeman, Leorah; Frohman, Teresa C; Costello, Kathleen; Balcer, Laura; Galetta, Steven; Chitnis, Tanuja; Zamvil, Scott S; Frohman, Elliot M

PMCID:6310360

PMID: 30637300

ISSN: 2332-7812

CID: 3594742

Neurology. 2019:92(8):396-396.DOI: