Letters to the Editor

Letter to the Editor: Elevated Level of CXCL13 in Nonenhancing Diffuse Primary Lymphoma of the Brainstem
Innov Clin Neurosci. 2021;18(10–12):8. Dear Editor: Primary central nervous system (CNS) lymphoma (pCNL) is a rare neoplasia predominantly of the brain. Histologically, most of these neoplasias are diffuse large B-cell lymphomas.1 Although the exact diagnosis requires pathological confirmation, magnetic resonance imaging (MRI) often shows characteristic results, such as enhancement.2 However, nonenhancing pCNL have been described […]

Letter to the Editor: Beyond Robotics and Virtual Reality: It’s Time to go Back to the Patient!
Dear Editor: There is great scientific activity regarding robotics, virtual reality (VR), telehealth, and digital medicine.1–2 A “mischievous” point of view could tell that they are running after the real life, like the poor boy’s finger in the Harlem Dam hole. Evidence-based medicine, cost/efficacy ratio, and consensus papers are trying to put the hat over […]

Letter to the Editor: Beware of Neuroleptic Malignant Syndrome in COVID-19 Pandemic
Dear Editor: I read with great interest the recent article by Buttar et al1 detailing fatal consequences of the chronic neuroleptic malignant syndrome (NMS) from the United States. The authors prescribed the challenges of treating psychiatric patients with the possibility of NMS. They also indicated that ethnic groups concerning metabolic enzyme polymorphisms for antipsychotics, such […]

Letter to the Editor: Adjunct Ketamine in Electroconvulsive Therapy
Dear Editor: Electroconvulsive therapy (ECT) is a medical treatment that involves the electrical stimulation of the brain under general anesthesia. This treatment modality has been utilized worldwide for over 80 years.1 According to the American Psychiatric Association, ECT is indicated for major depression, mania, and schizophrenia.2 Unfortunately, there are occasions in which a psychiatrist is […]

Letters to the Editor: Sexual Behavior During the COVID-19 Pandemic: It’s Telecounseling Time!
Dear Editor: COVID-19 is having a tremendous impact on the healthcare and economic systems worldwide, as well as on human behavior, negatively affecting both personal and social relationships. COVID-19 is an acute respiratory illness caused by the SARS-COV2, with transmission that occurs via droplets or direct contact with contaminated objects (i.e., fomites).1 As such, first-line […]

Letters to the Editor: What About Biomarkers for Parkinson’s Disease?
Dear Editor: Parkinson’s disease (PD) affects over 600,000 patients in the United States; these numbers might double by 2040, as the population of older people increases.1 Diagnostic clues include the signs of resting tremor, bradykinesia, muscle rigidity, and postural imbalance. However, these clinical indicators might be inaccurate much of the time. A low rate of […]

Letters to the Editor: Nonresponsive myasthenia is suspicious for congenital myasthenic syndrome or myopathy
Dear Editor: We read the excellent article by Diaz-Abad et al1 about a 54-year-old male patient with double seronegative myasthenia gravis. In the article, Diaz et al1 explained the patient did not tolerate pyridostigmine or steroids and did not respond sufficiently to immunoglobulins or plasmapheresis. However, respiratory failure (due to involvement of the respiratory muscles), […]

Frontiers in Detecting Consciousness: The Growing Use of EEG Analysis
Dear Editors: There is growing scientific interest regarding the use of electroencephalogram (EEG) and multivariate analysis as a means to classify states of consciousness. A recent work assessed the validity of 28 potential EEG markers of consciousness, using the Disorders of Consciousness (DoC)-Forest (the name of the algorithm) tool, to establish states of awareness in […]

Role of Norepinephrine in Schizophrenia: An Old-fashioned but New Story from Emergency Medicine
Dear Editor: A number of hypotheses have been put forth regarding the etiology of schizophrenia, including dopamine hypothesis and glutamate hypothesis.1 However, a lesser known theory is that elevated norepinephrinergic signaling plays a causative role in schizophrenia.2 We treated a patient with septic shock schizophrenia who developed delusions and hallucinations following continuous norepinephrine infusion. This […]

Letter to the Editor: Is Dropped Head Syndrome in Sporadic Late-onset Nemaline Myopathy Always Untreatable?
Dear Editor: Dropped head syndrome (DHS) is a rare condition characterized by cervical paraspinal muscles weakness that causes a recognizable deformity with various degrees of “chin on chest” posture.1–3 Though the etiology of DHS is still unclear, some authors have suggested aging-related postural changes to be a mechanical cause of the disease.2,3 Moreover, DHS might […]