Con Yiannikas - Academia.edu (original) (raw)

Papers by Con Yiannikas

Research paper thumbnail of Familial hyperlysinemia in a patient presenting with progressive spastic paraparesis

Research paper thumbnail of Significant dermatological side effects of intravenous immunoglobulin

Journal of Clinical Neuroscience, Aug 1, 2013

Research paper thumbnail of Expansion of chronic lesions is linked to disease progression in relapsing–remitting multiple sclerosis patients

Multiple Sclerosis Journal, Nov 20, 2020

Research paper thumbnail of Nitrofurantoin Neuropathy

Australian and New Zealand Journal of Medicine, Jun 1, 1981

Four cases of severe peripheral neuropathy directly attributable to nitrofurantoin are reported. ... more Four cases of severe peripheral neuropathy directly attributable to nitrofurantoin are reported. The neuropathy was not dose-related and not necessarily associated with abnormal renal function. Recovery was slow, and neither severity nor recovery was related to the total dose of the drug. The pathological changes seen on light microscopy and electron microscopy were those of acute, severe axonal degeneration. It is emphasised that nitrofurantoin is a neurotic drug and should not be prescribed to the elderly not to anyone with impairment of renal function.

Research paper thumbnail of Peripheral neuropathy associated with polycythemia Vera

Neurology, Feb 1, 1983

Nerve conduction studies were performed on 26 patients with polycythemia vera, 11 of whom had sen... more Nerve conduction studies were performed on 26 patients with polycythemia vera, 11 of whom had sensory symptoms in the extremities and 3 of whom had clinical signs of peripheral neuropathy. There was significant impairment of sensory conduction in the ulnar and sural nerves and mild slowing of motor conduction in the lateral popliteal nerve. Sural nerve biopsies were performed on three patients. The pathological findings, including teased fiber studies, were consistent with mild chronic axonal degeneration. There is an association between polycythemia vera and peripheral neuropathy.

Research paper thumbnail of Progressive Loss of Retinal Ganglion Cells and Axons in Nonoptic Neuritis Eyes in Multiple Sclerosis: A Longitudinal Optical Coherence Tomography Study

Investigative Ophthalmology & Visual Science, Apr 29, 2016

Research paper thumbnail of Theinvestigation oftraumatic lesions ofthebrachial plexus byelectromyography andshort latency somatosensory potentials evoked bystimulation of multiple peripheral nerves

Research paper thumbnail of A comparison of multifocal visual evoked potentials with conventional full-field pattern reversal stimulation

Clinical Neurophysiology, Mar 1, 2008

drome was considered and aspirin prescribed. At age 14, he developed paraesthesiae of the left ha... more drome was considered and aspirin prescribed. At age 14, he developed paraesthesiae of the left hand and then an acute right foot drop. Nerve conduction studies demonstrated an asymmetrical sensori-motor axonal neuropathy: right deep peroneal to EDB motor CV 46.6 m/s, CMAP 1.05 mV, no conduction block found, left deep peroneal to EDB motor CV 49.4 m/s, CMAP 4.2 mV, left sural SNAP not obtained, right sural SNAP 7.2 lV, CV 47.2 m/s, left median sensory CV 55.8 m/s, SNAP 15.6 lV. ESR was 25 mm/h. ANA, ANCA, ENA and antiphospholipid antibodies were negative. Right sural nerve biopsy confirmed a florid necrotizing vasculitis. Conclusion: The neurophysiological and pathological findings established the diagnosis of mononeuritis multiplex due to vasculitic neuropathy. Significance: The combination of cutaneous, central and peripheral nervous system vasculitis has not previously been reported in the paediatric population. This probably represents a rare genetic disorder.

Research paper thumbnail of A comparison of standard Madopar and controlled release Madopar in Parkinson's disease

Australian and New Zealand Journal of Medicine, Feb 1, 1991

In a randomised, double-blind cross-over study, objective measures were used to compare the effec... more In a randomised, double-blind cross-over study, objective measures were used to compare the effect of a single oral dose of a standard preparation of levodopa-benserazide (Madopar M) with a sustained-release preparation (Madopar HBS) in 9 Parkinsonian patients with 'end of dose deterioration'. The response of patients to an optimised regimen of each preparation was also assessed using a patient diary. In all patients the onset of effect of Madopar HBS following a single dose was delayed compared with Madopar M. The duration of effect of a single dose of Madopar HBS was substantially (38-120%) longer than Madopar M in five patients and the same or shorter in four patients. According to the patients' diaries, six patients noted an increase in 'on' hours while on Madopar HBS. The duration and severity of dyskinesia was similar for the two preparations. Madopar HBS is likely to be useful in some Parkinsonian patients with 'end of dose deterioration'. As the effect of each dose is delayed it is probably best given in combination with standard Madopar.

Research paper thumbnail of Conduction block in immune‐mediated neuropathy: paranodopathy versus axonopathy

European Journal of Neurology, Apr 26, 2019

Research paper thumbnail of Apomorphine can increase cutaneous inhibition of motor activity in Parkinson's disease

Electroencephalography and clinical neurophysiology, Feb 1, 1996

Research paper thumbnail of Parallel Changes in Structural and Functional Measures of Optic Nerve Myelination after Optic Neuritis

Research paper thumbnail of Brainstem myoclonus in a patient with non-dopa-responsive parkinsonism

Movement Disorders, Jul 1, 1996

Research paper thumbnail of Utility of magnetic resonance imaging in diagnosing ulnarneuropathy at the elbow

Clinical Neurophysiology, Mar 1, 2006

Research paper thumbnail of 026 Posturography as a biomarker of IVIG efficacy in CIDP patients

Research paper thumbnail of 114 Man-in-the-barrel syndrome as a complication of cervical decompressive surgery

Research paper thumbnail of Proximal Median Neuropathy Following Anterior Shoulder Dislocation: The Use of Magnetic Resonance Neurography

The Neurohospitalist, Aug 6, 2020

Research paper thumbnail of 12. EMG bursting characteristics of upper limb muscles in patients with CIDP and tremor

Clinical Neurophysiology, Mar 1, 2020

Research paper thumbnail of Comparison of mfVEP findings in neuromyelitis optica and multiple sclerosis patients with previous optic neuritis attacks

Clinical and Experimental Ophthalmology, Nov 1, 2016

Research paper thumbnail of 042 Chronic inflammatory demyelinating polyneuropathy presenting as focal amyotrophy

Journal of Neurology, Neurosurgery, and Psychiatry, May 24, 2018

IntroductionWe aimed to report a rare case of chronic inflammatory demyelinating polyneuropathy (... more IntroductionWe aimed to report a rare case of chronic inflammatory demyelinating polyneuropathy (CIDP) presenting as focal lower limb amyotrophy.CaseA 65 year old man presented with a 12 month history of painless, left anterior thigh wasting. Examination revealed marked left quadriceps and mild left hamstring and tibial wasting (Image 1). He had MRC grade 4/5 left hip flexion and 3/5 knee extension weakness, with normal power elsewhere. His left knee jerk was absent. Remaining reflexes were retained. There was reduced left L5 pinprick and light touch sensation. His neurological exam was otherwise normal. Blood tests, including creatine kinase, blood glucose, and autoimmune panel, were normal. Anti-neuronal, anti-ganglioside and anti-MAG antibodies were negative. Trace IgM lambda para-proteinaemia was detected. Cerebrospinal fluid was unremarkable [protein 0.37 g/L (n<0.45), glucose 4.1 mmol/L (2.5–4.5), leukocytes 0×106/L]. Nerve conduction studies showed normal lower limb motor velocities with reduced left peroneal motor amplitudes and mildly prolonged sural sensory latencies bilaterally. Electromyography showed chronic denervation of bilateral L3-S1 innervated muscles without fibrillation potentials. Posterior tibial somatosensory evoked potential studies demonstrated absent lumbar responses and prolonged cortical latencies. Muscle biopsy confirmed chronic denervation without evidence of myopathy or vasculitis. The patient declined sural nerve biopsy. MRI revealed bilateral multifocal lumbosacral plexopathy with increased T2 signal and thickening of multiple nerves, including femoral, lateral femoral cutaneous and L5 nerve roots (Image 2). CT chest, abdomen and pelvis, and whole body PET scan were normal. High-dose oral prednisone and induction intravenous immunoglobulin (IVIG) therapy followed by 4-weekly maintenance IVIG and low-dose prednisolone were commenced for a presumed diagnosis of CIDP.ConclusionIn this patient, the presence of multifocal nerve thickening on MRI was consistent with an inflammatory neuropathy. The normal PET scan and CSF studies made other diagnoses, such as neuro-lymphoma, less likely. CIDP should be considered in atypical presentations such as focal amyotrophy.

Research paper thumbnail of Familial hyperlysinemia in a patient presenting with progressive spastic paraparesis

Research paper thumbnail of Significant dermatological side effects of intravenous immunoglobulin

Journal of Clinical Neuroscience, Aug 1, 2013

Research paper thumbnail of Expansion of chronic lesions is linked to disease progression in relapsing–remitting multiple sclerosis patients

Multiple Sclerosis Journal, Nov 20, 2020

Research paper thumbnail of Nitrofurantoin Neuropathy

Australian and New Zealand Journal of Medicine, Jun 1, 1981

Four cases of severe peripheral neuropathy directly attributable to nitrofurantoin are reported. ... more Four cases of severe peripheral neuropathy directly attributable to nitrofurantoin are reported. The neuropathy was not dose-related and not necessarily associated with abnormal renal function. Recovery was slow, and neither severity nor recovery was related to the total dose of the drug. The pathological changes seen on light microscopy and electron microscopy were those of acute, severe axonal degeneration. It is emphasised that nitrofurantoin is a neurotic drug and should not be prescribed to the elderly not to anyone with impairment of renal function.

Research paper thumbnail of Peripheral neuropathy associated with polycythemia Vera

Neurology, Feb 1, 1983

Nerve conduction studies were performed on 26 patients with polycythemia vera, 11 of whom had sen... more Nerve conduction studies were performed on 26 patients with polycythemia vera, 11 of whom had sensory symptoms in the extremities and 3 of whom had clinical signs of peripheral neuropathy. There was significant impairment of sensory conduction in the ulnar and sural nerves and mild slowing of motor conduction in the lateral popliteal nerve. Sural nerve biopsies were performed on three patients. The pathological findings, including teased fiber studies, were consistent with mild chronic axonal degeneration. There is an association between polycythemia vera and peripheral neuropathy.

Research paper thumbnail of Progressive Loss of Retinal Ganglion Cells and Axons in Nonoptic Neuritis Eyes in Multiple Sclerosis: A Longitudinal Optical Coherence Tomography Study

Investigative Ophthalmology & Visual Science, Apr 29, 2016

Research paper thumbnail of Theinvestigation oftraumatic lesions ofthebrachial plexus byelectromyography andshort latency somatosensory potentials evoked bystimulation of multiple peripheral nerves

Research paper thumbnail of A comparison of multifocal visual evoked potentials with conventional full-field pattern reversal stimulation

Clinical Neurophysiology, Mar 1, 2008

drome was considered and aspirin prescribed. At age 14, he developed paraesthesiae of the left ha... more drome was considered and aspirin prescribed. At age 14, he developed paraesthesiae of the left hand and then an acute right foot drop. Nerve conduction studies demonstrated an asymmetrical sensori-motor axonal neuropathy: right deep peroneal to EDB motor CV 46.6 m/s, CMAP 1.05 mV, no conduction block found, left deep peroneal to EDB motor CV 49.4 m/s, CMAP 4.2 mV, left sural SNAP not obtained, right sural SNAP 7.2 lV, CV 47.2 m/s, left median sensory CV 55.8 m/s, SNAP 15.6 lV. ESR was 25 mm/h. ANA, ANCA, ENA and antiphospholipid antibodies were negative. Right sural nerve biopsy confirmed a florid necrotizing vasculitis. Conclusion: The neurophysiological and pathological findings established the diagnosis of mononeuritis multiplex due to vasculitic neuropathy. Significance: The combination of cutaneous, central and peripheral nervous system vasculitis has not previously been reported in the paediatric population. This probably represents a rare genetic disorder.

Research paper thumbnail of A comparison of standard Madopar and controlled release Madopar in Parkinson's disease

Australian and New Zealand Journal of Medicine, Feb 1, 1991

In a randomised, double-blind cross-over study, objective measures were used to compare the effec... more In a randomised, double-blind cross-over study, objective measures were used to compare the effect of a single oral dose of a standard preparation of levodopa-benserazide (Madopar M) with a sustained-release preparation (Madopar HBS) in 9 Parkinsonian patients with 'end of dose deterioration'. The response of patients to an optimised regimen of each preparation was also assessed using a patient diary. In all patients the onset of effect of Madopar HBS following a single dose was delayed compared with Madopar M. The duration of effect of a single dose of Madopar HBS was substantially (38-120%) longer than Madopar M in five patients and the same or shorter in four patients. According to the patients' diaries, six patients noted an increase in 'on' hours while on Madopar HBS. The duration and severity of dyskinesia was similar for the two preparations. Madopar HBS is likely to be useful in some Parkinsonian patients with 'end of dose deterioration'. As the effect of each dose is delayed it is probably best given in combination with standard Madopar.

Research paper thumbnail of Conduction block in immune‐mediated neuropathy: paranodopathy versus axonopathy

European Journal of Neurology, Apr 26, 2019

Research paper thumbnail of Apomorphine can increase cutaneous inhibition of motor activity in Parkinson's disease

Electroencephalography and clinical neurophysiology, Feb 1, 1996

Research paper thumbnail of Parallel Changes in Structural and Functional Measures of Optic Nerve Myelination after Optic Neuritis

Research paper thumbnail of Brainstem myoclonus in a patient with non-dopa-responsive parkinsonism

Movement Disorders, Jul 1, 1996

Research paper thumbnail of Utility of magnetic resonance imaging in diagnosing ulnarneuropathy at the elbow

Clinical Neurophysiology, Mar 1, 2006

Research paper thumbnail of 026 Posturography as a biomarker of IVIG efficacy in CIDP patients

Research paper thumbnail of 114 Man-in-the-barrel syndrome as a complication of cervical decompressive surgery

Research paper thumbnail of Proximal Median Neuropathy Following Anterior Shoulder Dislocation: The Use of Magnetic Resonance Neurography

The Neurohospitalist, Aug 6, 2020

Research paper thumbnail of 12. EMG bursting characteristics of upper limb muscles in patients with CIDP and tremor

Clinical Neurophysiology, Mar 1, 2020

Research paper thumbnail of Comparison of mfVEP findings in neuromyelitis optica and multiple sclerosis patients with previous optic neuritis attacks

Clinical and Experimental Ophthalmology, Nov 1, 2016

Research paper thumbnail of 042 Chronic inflammatory demyelinating polyneuropathy presenting as focal amyotrophy

Journal of Neurology, Neurosurgery, and Psychiatry, May 24, 2018

IntroductionWe aimed to report a rare case of chronic inflammatory demyelinating polyneuropathy (... more IntroductionWe aimed to report a rare case of chronic inflammatory demyelinating polyneuropathy (CIDP) presenting as focal lower limb amyotrophy.CaseA 65 year old man presented with a 12 month history of painless, left anterior thigh wasting. Examination revealed marked left quadriceps and mild left hamstring and tibial wasting (Image 1). He had MRC grade 4/5 left hip flexion and 3/5 knee extension weakness, with normal power elsewhere. His left knee jerk was absent. Remaining reflexes were retained. There was reduced left L5 pinprick and light touch sensation. His neurological exam was otherwise normal. Blood tests, including creatine kinase, blood glucose, and autoimmune panel, were normal. Anti-neuronal, anti-ganglioside and anti-MAG antibodies were negative. Trace IgM lambda para-proteinaemia was detected. Cerebrospinal fluid was unremarkable [protein 0.37 g/L (n<0.45), glucose 4.1 mmol/L (2.5–4.5), leukocytes 0×106/L]. Nerve conduction studies showed normal lower limb motor velocities with reduced left peroneal motor amplitudes and mildly prolonged sural sensory latencies bilaterally. Electromyography showed chronic denervation of bilateral L3-S1 innervated muscles without fibrillation potentials. Posterior tibial somatosensory evoked potential studies demonstrated absent lumbar responses and prolonged cortical latencies. Muscle biopsy confirmed chronic denervation without evidence of myopathy or vasculitis. The patient declined sural nerve biopsy. MRI revealed bilateral multifocal lumbosacral plexopathy with increased T2 signal and thickening of multiple nerves, including femoral, lateral femoral cutaneous and L5 nerve roots (Image 2). CT chest, abdomen and pelvis, and whole body PET scan were normal. High-dose oral prednisone and induction intravenous immunoglobulin (IVIG) therapy followed by 4-weekly maintenance IVIG and low-dose prednisolone were commenced for a presumed diagnosis of CIDP.ConclusionIn this patient, the presence of multifocal nerve thickening on MRI was consistent with an inflammatory neuropathy. The normal PET scan and CSF studies made other diagnoses, such as neuro-lymphoma, less likely. CIDP should be considered in atypical presentations such as focal amyotrophy.