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OBJECTIVE To determine the effect of subacute administration of methylphenidate on recovery from moderate to moderately severe closed head injury. DESIGN Double-blind placebo-controlled with random assignment. Patients were enrolled when their Galveston Orientation and Amnesia Test score was at least 65. Drug/placebo treatment began the day following(More)
BACKGROUND While spasticity is commonly treated with oral agents or botulinum neurotoxin (BoNT) injection, these treatments have not been systematically compared. METHODS This study performed a randomised, double-blind, placebo-controlled trial to compare injection of BoNT-Type A into spastic upper limb muscles versus oral tizanidine (TZD), or placebo, in(More)
OBJECTIVE To update the 2008 American Academy of Neurology (AAN) guidelines regarding botulinum neurotoxin for blepharospasm, cervical dystonia (CD), headache, and adult spasticity. METHODS We searched the literature for relevant articles and classified them using 2004 AAN criteria. RESULTS AND RECOMMENDATIONS Blepharospasm: OnabotulinumtoxinA(More)
BACKGROUND Intrathecal baclofen (ITB) effectively reduces muscle hypertonia; however, associated complications influence its utility and acceptance. OBJECTIVE To systematically review the literature on procedure- and device-related complications associated with ITB infusion therapy for adult muscle hypertonia of spinal or cerebral origin. METHODS The(More)
OBJECTIVE To assess the incidence of medical complications in patients with recent traumatic disorders of consciousness (DOCs). DESIGN Data on adverse events in a placebo controlled trial of amantadine hydrochloride revealed no group difference, which allowed these events to be reanalyzed descriptively as medical complications experienced by the 2 groups(More)
OBJECTIVE Investigate the impact of race on productivity outcome after traumatic brain injury (TBI) and evaluate the influence of confounding factors on this relationship. DESIGN Inception cohort of 1083 adults with TBI for whom 1-year productivity follow-up data were available. RESULTS Univariable logistic regression indicated that race was a(More)
OBJECTIVES To evaluate predictors of early impaired self-awareness after traumatic brain injury (TBI); to examine interrelationships of the perceptions of patient, clinician, family, and significant other of how patients are functioning after TBI; and to determine how early impaired self-awareness helps to predict employability at rehabilitation discharge.(More)
BACKGROUND Impaired self-awareness (ISA) is common among patients with severe traumatic brain injury (TBI) and contributes to poorer functional outcome. There is keen interest in improving the understanding of this disorder as the neuroanatomic substrate of posttraumatic ISA is poorly understood. OBJECTIVE Determine whether (1) greater number of brain(More)
BACKGROUND Classification of traumatic brain injury (TBI) severity guides management and contributes to determination of prognosis. Common indicators of TBI severity include Glasgow Coma Scale (GCS) scores, length of coma (LOC) and duration of post-traumatic amnesia (PTA). OBJECTIVE To compare GCS, LOC and PTA by examining distributions and(More)
OBJECTIVE To prospectively characterize the prevalence, course, and impact of acute sleep abnormality among traumatic brain injury (TBI) neurorehabilitation admissions. DESIGN Prospective observational study. SETTING Freestanding rehabilitation hospital. PARTICIPANTS Primarily severe TBI (median emergency department Glasgow Coma Scale [GCS] score=7;(More)