H. Royden Jones

Isolated radial nerve lesion in the newborn

Two newborn infants had isolated radial nerve lesion documented on electromyography. Fibrillation potentials present in one child at age 6 days suggest the possibility of an in utero onset. Skin necrosis present above the triceps muscle and radial nerve favors an entrapment mechanism, possibly from the umbilical cord. Because both patients had complete resolution in 4 months, it is important to differentiate this lesion from the more common but more serious medial brachial plexus lesion.

Ataxic Creutzfeldt-Jakob disease: diagnostic techniques and neuropathologic observations in early disease.

We studied two cases of ataxic Creutzfeldt-Jakob disease. EEG, CT, evoked responses, and CSF were normal in one purely ataxic patient. Diagnosis was established by cerebellar biopsy. Autopsy demonstrated devastating spongiform changes in the cerebellum, basal ganglia, and thalamus with rare focal changes in cerebral cortex. In the second patient, late generalized changes developed with dementia. Diagnostic studies included abnormal visual evoked responses, CSF with abnormal oligoclonal bands and IgG, and subacute spongiform encephalopathy in frontal lobe biopsy. Early diagnosis is best established by biopsy of brain areas most likely to be involved on the basis of clinical neurologic findings.

Clinical neurophysiology training and certification in the United States: 2000 American Board of Psychiatry and Neurology, Neurology Residency Review Committee

Accredited training programs in clinical neurophysiology (CNP) and individual certification in the subspecialty of Clinical Neurophysiology have been available for about 5 years. We review the current status of CNP training and certification to provide an overview of CNP certification. The accreditation of CNP training programs was established to monitor the quality of the training of neurologists who have a major commitment to the practice of CNP. The Accreditation Council for Graduate Medical Education (ACGME) approved the CNP training program requirements in 1993 on the recommendation of the Neurology Residency Review Committee (RRC). The CNP program requirements were updated recently by the RRC, to become effective January 2001, and are posted on the ACGME Web site (www.ACGME.org). CNP training programs have been accredited since 1995 with a total of 76 now accredited among the 117 accredited core neurology programs. A number of additional programs are being accredited each year.nnThe American Board of Medical Specialties (ABMS) approved Clinical Neurophysiology as an added qualification certification in 1990 under the aegis of the American Board of Psychiatry and Neurology (ABPN). The first CNP examination was given in 1992 with required recertification in 10 years. Since then, 1588 candidates have taken the CNP subspecialty certification examination and 1211 have been certified. As of the year 2000, 1 year of CNP training in an accredited program is required to take the certification examination. The next examination is being given on April 3, 2001. Applications had to be submitted by September 30, 2000. The examination is given biannually and the subsequent opportunity to take this examination will be in the spring of 2003. Applications need to be submitted by the early autumn of 2002.nnAccredited, core neurology training programs provide education and experience in each of the subspecialty areas in neurology, such as movement disorders, …