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Objective: Sports-related concussion has received increasing attention as a cause of short-and long-term neurologic symptoms among athletes. The King-Devick (K-D) test is based on measurement of the speed of rapid number naming (reading aloud single-digit numbers from 3 test cards), and captures impairment of eye movements, attention, language, and other correlates of suboptimal brain function. We investigated the K-D test as a potential rapid sideline screening for concussion in a cohort of boxers and mixed martial arts fighters. Methods:The K-D test was administered prefight and postfight. The Military Acute Concussion Evaluation (MACE) was administered as a more comprehensive but longer test for concussion. Differences in postfight K-D scores and changes in scores from prefight to postfight were compared for athletes with head trauma during the fight vs those without. Results: Conclusions:The K-D test is an accurate and reliable method for identifying athletes with head trauma, and is a strong candidate rapid sideline screening test for concussion. Neurology Sports-related concussion has received increasing attention in the lay press, but has been a topic of interest in the medical literature for nearly a decade. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The importance of mild closed head injury is underscored by the frequent occurrence of postconcussion syndrome and the potential for devastating long-term symptoms, disability, and pathologic changes resembling those of Alzheimer disease. [21][22][23] Repeated concussion is associated with neuropsychological deficits, electrophysiologic changes, and metabolic abnormalities by brain magnetic resonance spectroscopy (MRS). 8, Since detecting early signs of concussion can improve outcomes, [8][9][10][11][12][13][14][15][16][17][18][19][20] there is a need for a rapid screening test to assess athletes who may have had a concussion. The King-Devick (K-D) test is based on measurement of the speed of rapid number naming. 36 Requiring less than 2 minutes to administer, the K-D test is practical for sideline use and is quicker than the e-Pub ahead of print on February 2, 2011, at www.neurology.org.

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Although the funduscopic manifestations of excess serum immunoglobulins are typically the sequelae of circulatory stasis, the serum hyperviscosity induced in Waldenström's macroglobulinemia has been shown on rare occasions to induce serous macular detachments. Physical elimination of the excess macroglobulins through plasmapheresis is quite effective in resolving the neurosensory detachments induced by Waldenström's macroglobulinemia. Only a fraction of neurosensory detachments resulting from Waldenström's macroglobulinemia persist despite multiple plasmapheresis treatments. Novel angiographic evidence of retinal pigment epithelium atrophy beneath the area corresponding to the serous detachment provides a plausible explanation for unresponsive nature of this presentation. Identification of this rare variant of the classic angiographically silent macula known to occur with Waldenström's macroglobulinemia can aid the clinician in determining a patient's potential response to plasmapheresis and their final visual prognosis.

This study showed that retinal axonal and neuronal loss is present among collision sport athletes, with most notable differences seen in boxers. These findings are accompanied by reductions in visual function and QOL, similar to patterns observed in multiple sclerosis, Alzheimer and Parkinson diseases. Vision-based changes associated with head trauma exposure that have the potential to be detected in vivo represent a unique opportunity for further study to determine if these changes in collision sport athletes are predictive of future neurodegeneration.