HINTS works only in the right patient: continuous dizziness with nystagmus at rest

The edition in brief

A JAMA Neurology review argues that the HINTS examination is highly sensitive for stroke only in acute vestibular syndrome with spontaneous nystagmus at rest, after screening for central features; applied to patients without nystagmus it loses accuracy and can falsely reassure. In 89,414 Korean patients after ischaemic stroke, failing to achieve a 50% or greater LDL-cholesterol reduction was associated with more recurrent stroke, myocardial infarction and death even when LDL was below 70 mg/dL (aHR 1.12), and only about 30% reached the relative target. A post hoc analysis of 100 patients with carotid tandem lesions in MR CLEAN-MED found periprocedural aspirin or heparin during thrombectomy was associated with worse functional outcome (aOR 0.79) and numerically more symptomatic haemorrhage. Across 27,000 patients in two cohorts, levodopa use was not associated with freezing of gait once disease duration and severity were accounted for. The FDA recorded a supplement to a generic ethosuximide application, an administrative action.