Fulminant Idiopathic Intracranial Hypertension
AbstractPurpose of ReviewThe goal of this review is to describe the presenting features of fulminant idiopathic intracranial hypertension (IIH) and outline the multimodal approach to its treatment.Recent FindingsVenous sinus stenting may be an appropriate alternative to optic nerve sheath fenestration or cerebrospinal fluid shunting in select patients with fulminant IIH. Prompt surgical intervention maximizes the chance of visual recovery in patients with fulminant IIH.Summary“Fulminant IIH” is defined as intracranial hypertension with no secondary cause, severe vision loss within 4 weeks of symptom onset,...
Source: Current Neurology and Neuroscience Reports - March 26, 2020 Category: Neuroscience Source Type: research

Emergency Department and Inpatient Management of Headache in Adults
This article reviews treatment options for patients presenting with headache in the emergency department (ED) and for inpatients, including red flags and status migrainosus (SM).Recent FindingsMost patients presenting with headache in the ED will have migraine, but red flags must be reviewed to rule out secondary headaches. SM refractory to home treatment is a common reason for ED presentation or inpatient admission, but high-quality treatment evidence is lacking. Common treatments include intravenous fluids, anti-dopaminergic agents with diphenhydramine, steroids, divalproex, nonsteroidal anti-inflammatory drugs, intraven...
Source: Current Neurology and Neuroscience Reports - March 18, 2020 Category: Neuroscience Source Type: research

In Vivo Imaging of Neuroinflammatory Targets in Treatment-Resistant Epilepsy
This article reviews recent research on in vivo imaging of neuroinflammatory targets in patients with treatment-resistant, non-lesional epilepsy.Recent FindingsA number of advanced approaches based on imaging neuroinflammation are being implemented in order to assist localization of epileptogenic onset zone. The most exciting tools are based on radioligand-based nuclear imaging or revisiting of existing technology in novel ways. The greatest limitations stem from gaps in knowledge about the exact function of neuroinflammatory targets (e.g., neurotoxic or neuroprotective). Further, lingering questions about each approach &r...
Source: Current Neurology and Neuroscience Reports - March 12, 2020 Category: Neuroscience Source Type: research

EEG Monitoring of the Epileptic Newborn
AbstractPurpose of ReviewAlthough differentiating neonatal-onset epilepsies from acute symptomatic neonatal seizures has been increasingly recognized as crucial, existing guidelines, and recommendations on EEG monitoring are mainly based on acute symptomatic seizures, especially secondary to hypoxic-ischemic encephalopathy. We aimed to narratively review current knowledge on neonatal-onset epilepsies of genetic, metabolic, and structural non-acquired origin, with special emphasis on EEG features and monitoring.Recent FindingsA wide range of rare conditions are increasingly described, reducing undiagnosed cases. Although di...
Source: Current Neurology and Neuroscience Reports - March 12, 2020 Category: Neuroscience Source Type: research

Update on Pediatric Optic Neuritis
AbstractPurpose of ReviewThe purpose of this review is to provide an update on advances in the understanding of pediatric demyelinating optic neuritis.Recent FindingsIn the past decade, the disease phenotypes for demyelinating syndromes in children have been more clearly defined. Pediatric optic neuritis may present as a clinically isolated syndrome or in the setting of underlying neurologic disease. In addition to optic neuritis associated with multiple sclerosis or neuromyelitis optica, recent work has identified antibodies to the myelin oligodendrocyte glycoprotein (MOG IgG) as a unique demyelinating cause with distinct...
Source: Current Neurology and Neuroscience Reports - March 3, 2020 Category: Neuroscience Source Type: research

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy
This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019.Recent FindingsEffective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pre...
Source: Current Neurology and Neuroscience Reports - February 21, 2020 Category: Neuroscience Source Type: research

Neurological Complications of Measles (Rubeola)
AbstractPurpose of ReviewOwing to vaccine hesitancy, there has been a resurgence of measles infections in developed countries. Practitioners can expect to see an increase in patients with neurologic complications of measles. These devastating disorders include primary measles encephalitis, acute post measles encephalitis, subacute sclerosing panencephalitis (SSPE), and measles inclusion body encephalitis (MIBE).Recent FindingsAlthough there are many unanswered questions regarding the neurologic complications of measles, recent advances have led to better understanding of the mechanism of the spread of measles within the ne...
Source: Current Neurology and Neuroscience Reports - February 7, 2020 Category: Neuroscience Source Type: research

Transcranial Magnetic Stimulation as Treatment in Multiple Neurologic Conditions
AbstractPurpose of ReviewTranscranial magnetic stimulation (TMS) is a method of Non-Invasive Brain Stimulation that is based on electro-physical principles discovered by Michael Faraday. A TMS device is made of one or two copper coils, positioned superficially to a site of interest in the brain, to non-invasively produce a brief magnetic pulse to an estimated depth from the surface of the scalp with the following axonal depolarization. This axonal depolarization activates cortical and subcortical networks with multiple effects. There are different methods of TMS used, all with different mechanisms of action. TMS is well to...
Source: Current Neurology and Neuroscience Reports - February 4, 2020 Category: Neuroscience Source Type: research

Neurological Manifestations of Achondroplasia
AbstractPurpose of reviewThis review is to delineate the neurological complications seen in patients with achondroplasia.Recent findingsAs the understanding of the genetics of this disorder has advanced, the possibility of targets for intervention which might modify the development and management of the neurological complications of this disease may be identified.SummaryAchondroplasia is a hereditary short-limbed dwarfism which has been known for millennia. The genetic defect is a gain of function sequence variation in the fibroblast growth factor receptor 3 (FGFR3). This gene normally regulates (inhibits) bone growth thus...
Source: Current Neurology and Neuroscience Reports - November 28, 2019 Category: Neuroscience Source Type: research

Sherpas, Coca Leaves, and Planes: High Altitude and Airplane Headache Review with a Case of Post-LASIK Myopic Shift
AbstractPurpose of ReviewHigh altitude headache is a common neurological symptom that is associated with ascent to high altitude. It is classified by the International Classification of Headache Disorders, 3rd Edition (ICHD-3) as a disorder of homeostasis. In this article, we review recent clinical and insights into the pathophysiological mechanisms of high altitude and airplane headache. We also report a second case of post-LASIK myopic shift at high altitude exposure secondary hypoxia. Headache attributed to airplane travel is a severe typically unilateral orbital headache that usually improves after landing. This was a ...
Source: Current Neurology and Neuroscience Reports - November 28, 2019 Category: Neuroscience Source Type: research

Neurology of Nutritional Deficiencies
AbstractPurpose of ReviewThe goal of this chapter is to educate clinicians on the neurologic manifestations of certain nutritional deficiencies in order to promptly identify and appropriately treat these patients.Recent FindingsMany vitamin and nutritional deficiencies have been described dating back to the early days of neurology and medicine. Some are very rare and thus, there are no randomized controlled studies to assess supplementation or dosage; however, there are reviews of case reports that can assist clinicians in choosing treatments.SummaryWhile endemic vitamin and nutritional deficiencies may be rarely encounter...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Current Diagnosis and Treatment of Painful Small Fiber Neuropathy
AbstractPurpose of ReviewSmall fiber neuropathy (SFN) could cause significant morbidity due to neuropathic pain and autonomic dysfunction. SFN is underdiagnosed and the knowledge on the condition is limited among general public and health care professionals. This review is intended to enhance the understanding of SFN symptoms, causes, diagnostic tools, and therapeutic options.Recent FindingsThere is evidence of SFN in up to 40% patients with fibromyalgia. The causes of SFN are glucose metabolism defect, dysimmune, gluten sensitivity and celiac disease, monoclonal gammopathy, vitamin deficiencies, toxic agents, cancer, and ...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Neuroimaging in Vascular Parkinsonism
AbstractPurpose of ReviewBeing a disease with heterogeneous presentations and unclear consensus on its diagnostic criteria, it is difficult to differentiate vascular parkinsonism (VaP) from other neurodegenerative parkinsonism variants. Ongoing research on structural and functional neuroimaging targeting dopaminergic pathway provides us more insight into the pathophysiology of VaP to improve diagnostic accuracy. The aim of this article is to review how the emerging imaging modalities help the diagnostic process and treatment decision in VaP.Recent FindingsDopamine transporter imaging is a promising tool in differentiating ...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Management of Elevated Intracranial Pressure: a Review
AbstractPurpose of ReviewPrinciples of intracranial pressure (ICP) management continue to be an essential part of the neurointensivist ’s skillset as appropriate treatment decisions can prevent secondary injury to the central nervous system. This review of the literature aims to: discuss commonly encountered pathologies associated with increased ICP, summarize diagnostic approaches used in evaluating ICP, and present evidence-bas ed treatment paradigms that drive clinical care in intensive care units.Recent FindingsRecent topics of discussion include invasive and non-invasive modalities of diagnosis and monitoring, r...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Evidence-Based Management of External Ventricular Drains
AbstractPurpose of ReviewThe optimal management of external ventricular drains (EVD) in the setting of acute brain injury remains controversial. Therefore, we sought to determine whether there are optimal management approaches based on the current evidence.Recent FindingsWe identified 2 recent retrospective studies on the management of EVDs after subarachnoid hemorrhage (SAH) which showed conflicting results. A multicenter survey revealed discordance between existing evidence from randomized trials and actual practice. A prospective study in a post-traumatic brain injury (TBI) population demonstrated the benefit of EVDs bu...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Can Salient Stimuli Enhance Responses in Disorders of Consciousness? A Systematic Review
AbstractPurpose of ReviewDiagnostic classification of patients with disorders of consciousness (DoC) is based on clinician ’s observation of volitional behaviours. However, patients’ caregivers often report higher levels of responsiveness with respect to those observed during the clinical assessment. Thus, increasing efforts have been aimed at comprehending the effects of self-referential and emotional stimuli on pa tients’ responsiveness. Here we systematically reviewed the original experimental studies that compared behavioural and electrophysiological responses with salient vs. neutral material in pati...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Neurological Complications in Patients with Systemic Lupus Erythematosus
AbstractPurpose of ReviewSystemic lupus erythematosus (SLE) is commonly associated with neurological manifestations. Rapid recognition and treatment of these complications may improve outcomes. In this article, we review the neurological conditions associated with SLE, their diagnosis and management strategies.Recent FindingsRecent meta-analysis showed that patients with neuropsychiatric manifestations of SLE were more likely to have positive antiphospholipid, antiribosomal P, and antineuronal antibodies. Another meta-analysis showed an association between SLE and antiphospholipid antibodies with cognitive impairment. Two ...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Inflammatory Disorders of the Skull Base: a Review
AbstractPurpose of ReviewIn recent years, literature on neuroinflammatory disorders has dramatically expanded, as have options for treatment. However, few reviews have focused on skull-based manifestations of inflammatory disorders.Recent FindingsHere, we review the clinical manifestations, etiologies, diagnostic workup, and treatment of both systemic and localized inflammatory diseases of the skull base with a focus on recent updates to the literature.SummaryThis review aims to guide the workup and management of this complex set of diseases. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Links Between the C9orf72 Repeat Expansion and Psychiatric Symptoms
AbstractPurpose of ReviewTo present recent findings on the links between theC9orf72 expansion and psychiatric impairment.Recent FindingsRepeat hexanucleotide expansions in theC9orf72 gene are a cause of familial frontotemporal dementia (FTD), amyotrophic lateral sclerosis (ALS), and the mixed phenotype, FTD-ALS. Symptomatic expansion carriers display higher rates of psychotic and other psychiatric symptoms than non-carriers. Neuroanatomical associations of these symptoms have been found in cortical and subcortical areas. Family members of symptomatic carriers have higher rates of primary neuropsychiatric disorders than con...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Atypical Pediatric Demyelinating Diseases of the Central Nervous System
AbstractPurpose of ReviewPediatric central nervous system demyelinating diseases include multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and acute disseminated encephalomyelitis (ADEM). As diagnostic criteria become more inclusive, the risk of misdiagnosis of atypical demyelinating diseases of rheumatologic, infectious, and autoimmune etiology increases.Recent FindingsWe review mimics of multiple sclerosis, neuromyelitis optica spectrum disorder, and acute disseminated encephalomyelitis, including rheumatologic diseases: systemic lupus erythematosus and neuro-Beh çet disease; infectious dise...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Clinical Characteristics and Treatment of MOG-IgG –Associated Optic Neuritis
AbstractPurpose of ReviewAntibodies against myelin oligodendrocyte glycoprotein (MOG) are associated with a unique acquired central nervous system demyelinating disease —termed MOG-IgG-associated disorder (MOGAD)—which has a variety of clinical manifestations, including optic neuritis, transverse myelitis, acute disseminating encephalomyelitis, and brainstem encephalitis. In this review, we summarize the current knowledge of the clinical characteristics, neuroi maging, treatments, and outcomes of MOGAD, with a focus on optic neuritis.Recent FindingsThe recent development of a reproducible, live cell –base...
Source: Current Neurology and Neuroscience Reports - November 26, 2019 Category: Neuroscience Source Type: research

Update on KMT2B -Related Dystonia
AbstractPurpose of ReviewTo summarize the molecular and clinical findings ofKMT2B-related dystonia (DYT-KMT2B), a newly identified genetic dystonia syndrome.Recent FindingsSince first described in 2016, 66 differentKMT2B-affecting variants, encompassing a set of frameshift, nonsense, splice-site, missense, and deletion mutations, have been reported in 76 patients. Most mutations are de novo and expected to mediate epigenetic dysregulation by inducingKMT2B haploinsufficiency. DYT-KMT2B is characterized phenotypically by limb-onset childhood dystonia that tends to spread progressively, resulting in generalized dystonia with ...
Source: Current Neurology and Neuroscience Reports - November 25, 2019 Category: Neuroscience Source Type: research

Stroke in the Young: a Global Update
AbstractPurpose of ReviewWe aim to evaluate the epidemiology, racial and gender disparity, etiology, and treatment of stroke in the younger population.Recent FindingsThe younger age group without vascular risk factors exhibits an increased prevalence of cardio-embolism in context of patent foramen ovale/atrial septal aneurysm strokes, from other determined etiology of non-atherosclerotic vasculopathy including dissection, inherited or acquired thrombophilia, and other unusual causes of stroke. Ethnic disparities also exist in certain populations.SummaryThe prevalence of stroke in the young is increasing due to several fact...
Source: Current Neurology and Neuroscience Reports - November 25, 2019 Category: Neuroscience Source Type: research

Neurogenic Stunned Myocardium in Severe Neurological Injury
AbstractPurpose of ReviewNeurogenic stunned myocardium (NSM) is a poorly recognized cardiac manifestation of neurological illness. This review addresses the contemporary understanding of NSM pathophysiology, epidemiology, diagnosis, and clinical management.Recent FindingsWhile the precise pathophysiology and diagnosis remain unclear, NSM is phenotypically atypical stress cardiomyopathy that can be partially attributed to excess catecholaminergic toxicity. NSM is a diagnosis of exclusion where electrocardiography, echocardiography, and cardiac biomarkers are frequently abnormal. Clinical expertise is crucial to evaluate and...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Gray Matter Changes in Parkinson ’s and Alzheimer’s Disease and Relation to Cognition
AbstractPurpose of ReviewWe summarize structural (s)MRI findings of gray matter (GM) atrophy related to cognitive impairment in Alzheimer ’s disease (AD) and Parkinson’s disease (PD) in light of new analytical approaches and recent longitudinal studies results.Recent FindingsThe hippocampus-to-cortex ratio seems to be the best sMRI biomarker to discriminate between various AD subtypes, following the spatial distribution of tau pathology, and predict rate of cognitive decline. PD is clinically far more variable than AD, with heterogeneous underlying brain pathology. Novel multivariate approaches have been used t...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Updates in the Treatment of Post-Stroke Pain
AbstractPurpose of ReviewTo provide an overview of the current treatment strategies for common subtypes of post-stroke pain.Recent FindingsThere is growing research interest in non-pharmacological treatment approaches for chronic pain, including neurostimulation as well as lifestyle and psychosocial interventions. Newer pharmacotherapy research includes cannabinoids and NMDA-receptor antagonists as well as bee venom. Persistent post-stroke headache is an increasingly appreciated entity, though the role of novel chronic migraine treatments for post-stroke headache is not known.SummaryOverall, most treatment approaches to po...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Music Therapy and Music-Based Interventions for Movement Disorders
AbstractPurpose of ReviewThere is emerging evidence that music therapy and other methods using music and rhythm may meaningfully improve a broad range of symptoms in neurological and non-neurological disorders. This review highlights the findings of recent studies utilizing music and rhythm-based interventions for gait impairment, other motor symptoms, and non-motor symptoms in Parkinson disease (PD) and other movement disorders. Limitations of current studies as well as future research directions are discussed.Recent FindingsMultiple studies have demonstrated short-term benefits of rhythmic auditory stimulation on gait pa...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Exercise as Medicine in Multiple Sclerosis —Time for a Paradigm Shift: Preventive, Symptomatic, and Disease-Modifying Aspects and Perspectives
AbstractPurpose of ReviewFor many years, exercise was controversial in multiple sclerosis (MS) and thought to exacerbate symptoms and fatigue. However, having been found to be safe and effective, exercise has become a cornerstone of MS rehabilitation and may have even more fundamental benefits in MS, with the potential to change clinical practice again. The aim of this review is to summarize the existing knowledge of the effects of exercise as primary, secondary, and tertiary prevention in MS.Recent FindingsInitial studies established exercise as an effective symptomatic treatment (i.e., tertiary prevention), but recent st...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Sleep Disorders in Wilson ’s Disease
AbstractPurpose of ReviewWe aimed to review the sleep disorders described in Wilson ’s disease (WD), focusing on their mechanisms and treatments.Recent FindingsREM sleep behavior disorder or sleepiness can be warning signs of future WD. These early symptoms may significantly reduce the time to WD diagnosis. Early anti-copper therapies (chelators or zinc salts), reducing copper accumulation in the brain and though saving brain tissue, can allow the complete disappearance of these sleep disorders and of course improve the other symptoms of WD.SummaryInsomnia, restless legs syndrome (RLS), daytime sleepiness, cataplexy,...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Machine Learning and Artificial Intelligence in Neurocritical Care: a Specialty-Wide Disruptive Transformation or a Strategy for Success
AbstractPurpose of ReviewNeurocritical care combines the complexity of both medical and surgical disease states with the inherent limitations of assessing patients with neurologic injury. Artificial intelligence (AI) has garnered interest in the basic management of these complicated patients as data collection becomes increasingly automated.Recent FindingsIn this opinion article, we highlight the potential AI has in aiding the clinician in several aspects of neurocritical care, particularly in monitoring and managing intracranial pressure, seizures, hemodynamics, and ventilation. The model-based method and data-driven meth...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Clinical Characteristics of Multiple Sclerosis in African-Americans
AbstractPurpose of ReviewMultiple sclerosis (MS) is an autoimmune disease of the central nervous system that affects nearly 1 million people in the USA and has the potential to profoundly affect physical ability and income potential at a young age. Since a landmark paper was published in 2014, few studies have looked at differences in MS disease characteristics between African-American and Caucasian patients.Recent FindingsAfrican-American patients often have a more severe MS disease course, as well as biomarker data which can portend a worse prognosis. While the sample sizes are usually quite small, subgroup analyses of A...
Source: Current Neurology and Neuroscience Reports - November 13, 2019 Category: Neuroscience Source Type: research

Limb Apraxia: a Disorder of Learned Skilled Movement
AbstractPurpose of ReviewThis chapter focuses on limb apraxia, a cognitive-motor disorder of learned skilled movement, and the nature of the spatiotemporal errors that disrupt movement sequences.Recent FindingsA cognitive model that attempts to reconcile conceptual and preparatory aspects of the motor program with perceptual and kinematic features will be discussed. An update on the localization of the praxis network will be provided. In addition, a long-held view that limb apraxia does not have ecological relevance will be disputed in the context of studies that have shown that limb apraxia (i) is one of the most importan...
Source: Current Neurology and Neuroscience Reports - November 12, 2019 Category: Neuroscience Source Type: research

New Insights Into Cryptococcus Spp. Biology and Cryptococcal Meningitis
AbstractPurpose of ReviewDefective cell –mediated immunity is a major risk factor for cryptococcosis, a fatal disease if untreated. Cryptococcal meningitis (CM), the main presentation of disseminated disease, occurs through hematogenous spread to the brain from primary pulmonary foci, facilitated by yeast virulence factors. We revisit r emarkable recent improvements in the prevention, diagnosis and management of CM.Recent FindingsCryptococcal antigen (CrAg), main capsular polysaccharide ofCryptococcus spp. is detectable in blood and cerebrospinal fluid of infected patients with point of care lateral flow assays. Rece...
Source: Current Neurology and Neuroscience Reports - October 31, 2019 Category: Neuroscience Source Type: research

Next Steps in Wearable Technology and Community Ambulation in Multiple Sclerosis
AbstractPurpose of ReviewWalking impairments are highly prevalent in persons with multiple sclerosis (PwMS) and are associated with reduced quality of life. Walking is traditionally quantified with various measures, including patient self-reports, clinical rating scales, performance measures, and advanced lab-based movement analysis techniques. Yet, the majority of these measures do not fully characterize walking (i.e., gait quality) nor adequately reflect walking in the real world (i.e., community ambulation) and have limited timescale (only measure walking at a single point in time). We discuss the potential of wearable ...
Source: Current Neurology and Neuroscience Reports - September 4, 2019 Category: Neuroscience Source Type: research

Assessment and Measurement of Spasticity in MS: State of the Evidence
AbstractPurpose of ReviewThe purpose of this review is to familiarize the reader with assessments and measurement of spasticity in people with multiple sclerosis (MS). Spasticity affects 60 –84% of people with MS, worsening as disability worsens and impacting activity, participation, and quality of life. Spasticity manifests in many ways, including spasms, resistance to passive stretch, pain, and perception of tightness, and can affect muscles throughout the body, making assessment a nd quantification of spasticity challenging but important. Assessment tools include those quantified by clinicians, instrumentation, an...
Source: Current Neurology and Neuroscience Reports - August 30, 2019 Category: Neuroscience Source Type: research

Early Brain Injury After Poor-Grade Subarachnoid Hemorrhage
AbstractPurpose of ReviewOver the last years, the focus of clinical and animal research in subarachnoid hemorrhage (SAH) shifted towards the early phase after the bleeding based on the association of the early injury pattern (first 72  h) with secondary complications and poor outcome. This phase is commonly referenced as early brain injury (EBI). In this clinical review, we intended to overview commonly used definitions of EBI, underlying mechanisms, and potential treatment implications.Recent FindingsWe found a large heterogeneity in the definition used for EBI comprising clinical symptoms, neuroimaging parameters, a...
Source: Current Neurology and Neuroscience Reports - August 29, 2019 Category: Neuroscience Source Type: research

Depression and Suicidality in Multiple Sclerosis: Red Flags, Management Strategies, and Ethical Considerations
AbstractMultiple sclerosis (MS) causes physical, emotional, and cognitive changes that impact function and quality of life (QoL). Risk factors for suicidality in MS patients include a high incidence of depression, increased isolation, and reduced function/independence.Purpose of ReviewTo describe the epidemiology of depression and suicidality in this population, highlight warning signs for suicidal behavior, provide recommendations and resources for clinicians, and discuss ethical decisions related to patient safety vs. right to privacy.Recent FindingsFifty percent of MS patients will experience a major depression related ...
Source: Current Neurology and Neuroscience Reports - August 28, 2019 Category: Neuroscience Source Type: research

Healthcare-Associated Infections in the Neurocritical Care Unit
This article summarizes updated data and knowledge on healthcare-associated infections in the neurocritical care unit, with a focus on central nervous system infections and systemic infectious complications in patients with acute brain disease. It also reviews the concept of brain injury-induced immune modulation, an underlying mechanism to explain why the neuro-ICU population is particularly susceptible to infections.Recent FindingsHealthcare-associated infections in the neuro-ICU are common: up to 40  % of meningitides in the developed world are now healthcare-associated. The number of gram-negative infections is ri...
Source: Current Neurology and Neuroscience Reports - August 27, 2019 Category: Neuroscience Source Type: research

Technological Advancements in Magnetic Resonance Neurography
AbstractPurpose of ReviewMagnetic resonance neurography (MRN) is being increasingly used as a problem-solving tool for diagnosis and management of peripheral neuropathies. This review is aimed at summarizing important technological advances, including MR pulse sequence and surface coil developments, which have facilitated MRN ’s use in clinical practice.Recent FindingsThe most recent research in MRN focuses on its clinical applications, with concomitant development of three-dimensional, parallel imaging and vascular suppression techniques that facilitate higher spatial resolution and depiction of small nerve branches...
Source: Current Neurology and Neuroscience Reports - August 24, 2019 Category: Neuroscience Source Type: research

Epigenetics of the Synapse in Neurodegeneration
AbstractPurpose of ReviewIn the quest for understanding the pathophysiological processes underlying degeneration of nervous systems, synapses are emerging as sites of great interest as synaptic dysfunction is thought to play a role in the initiation and progression of neuronal loss. In particular, the synapse is an interesting target for the effects of epigenetic mechanisms in neurodegeneration. Here, we review the recent advances on epigenetic mechanisms driving synaptic compromise in major neurodegenerative disorders.Recent FindingsMajor developments in sequencing technologies enabled the mapping of transcriptomic patter...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Cerebral Venous Thrombosis: an Update
AbstractPurpose of ReviewThe purpose of this update is to summarize the recent advances on the management of cerebral venous thrombosis (CVT).Recent FindingsThere is a trend in declining frequency of CVT patients presenting with focal deficits or coma and a decrease in mortality over time. Anemia and obesity were identified as risk factors for CVT. During pregnancy and puerperium, the higher risk of CVT occurs in the first months post-delivery. With appropriate management, 1/3 of comatose CVT patients can have a full recovery.SummaryThe management of CVT patients includes treatment of associated conditions, anticoagulation...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Cancer and Cerebrovascular Disease
AbstractPurpose of ReviewTo review the latest information about the interactions between cancer and cerebrovascular disease.Recent FindingsAdditional data support the finding that both ischemic and hemorrhagic stroke are important complications of cancer or its treatment. Reperfusion therapy is being given successfully to patients with stroke complicating cancer.SummaryHemorrhagic stroke may occur with metastatic disease to the brain, coagulopathies from cancer, in particular leukemia, or as complications of chemotherapy. Ischemic stroke also may be a complication of metastatic disease with local invasion of vessels, a pro...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Automated Pupillometry in Neurocritical Care: Research and Practice
AbstractPurpose of ReviewThe purpose of this review is to examine the impact of pupillometer assessment on care and research of patients with neurological injury.Recent FindingsRecent studies demonstrate that automated pupillometry outperforms manual penlight pupil examination in neurocritical care populations. Further research has identified specific changes in the pupillary light reflex associated with pathologic conditions, and pupillometry has been used to successfully identify early changes in neurologic function, intracranial pressure, treatment response to osmotherapy, and prognosis after cardiac arrest.SummaryAutom...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

MYORG Mutations: a Major Cause of Recessive Primary Familial Brain Calcification
AbstractPurpose of ReviewUntil recently, the gene associated with the recessive form of familial brain calcification (PFBC, Fahr disease) was unknown.MYORG, a gene that causes recessive PFBC was only recently discovered and is currently the only gene associated with a recessive form of this disease. Here, we review the radiological and clinical findings in adultMYORG mutation homozygous and heterozygous individuals.Recent FindingsMYORG was shown to be the cause of a large fraction of recessive cases of PFBC in patients of different ethnic populations. Pathogenic mutations include inframe insertions and deletions in additio...
Source: Current Neurology and Neuroscience Reports - August 23, 2019 Category: Neuroscience Source Type: research

Tardive Dyskinesia: Treatment Update
AbstractPurpose of ReviewTardive dyskinesia (TD) is caused by exposure to medications with dopamine antagonism, mainly antipsychotics. It often distresses individuals, physically and emotionally and affects their quality of life. We evaluated peer-reviewed recently published articles with a goal of providing a critically appraised update on the latest advancements in this field.Recent FindingsIn 2017, FDA approved VMAT2 inhibitors, deutetrabenazine and valbenazine. They have demonstrated efficacy in several class 1 studies. Also there have been update in the evidence-based guidelines for treatment for tardive dyskinesia.Su...
Source: Current Neurology and Neuroscience Reports - August 16, 2019 Category: Neuroscience Source Type: research

Updates in the Diagnosis and Management of Giant Cell Arteritis
AbstractPurpose of ReviewGiant cell arteritis is a systemic large vessel vasculitis that affects the older population and can cause progressive and at times, devastating complications including vision loss. While this has been commonly diagnosed and treated among vasculitides, the treatment options are limited and can have long-term adverse effects. The purpose of our review on GCA is to identify and discuss the pathophysiology and clinical aspects of GCA as they relate to the most recent data. The review will describe any new data on the diagnosis and treatment of this systemic large vessel vasculitis.Recent FindingsThe l...
Source: Current Neurology and Neuroscience Reports - August 8, 2019 Category: Neuroscience Source Type: research

Brain Imaging and Impulse Control Disorders in Parkinson ’s Disease
This article presents an update of recent findings from key neuroimaging studies in PD-related ICD, discusses results from controversial studies, and identifies areas for future research in the field. (Source: Current Neurology and Neuroscience Reports)
Source: Current Neurology and Neuroscience Reports - August 8, 2019 Category: Neuroscience Source Type: research

Focused Ultrasound and Other Lesioning Therapies in Movement Disorders
AbstractPurpose of ReviewLesioning therapies have been some of the earliest, most effective surgical treatments in movement disorders. This review summarizes recent studies, emerging modalities, and trends in lesioning procedures for movement disorders.Recent FindingsMagnetic resonance –guided high-intensity focused ultrasound (MRgFUS) is the newest incisionless technology for lesioning procedures in movement disorders. It has recent FDA approval for thalamotomy in essential tremor and tremor-dominant Parkinson disease. There are current studies exploring subthalamotomy and pall idotomy in PD. Gamma knife is another ...
Source: Current Neurology and Neuroscience Reports - August 3, 2019 Category: Neuroscience Source Type: research

Modern Medical Management of Spinal Cord Injury
AbstractPurpose of ReviewSpinal cord injury (SCI) shows an incidence of 10.4 –83 cases/million/year globally and remains a significant source of morbidity and cost to society. Despite greater understanding of the pathophysiology of SCI, neuroprotective and regenerative approaches to treatment have had limited clinical utility to date. Here, we review the key components of supportive care that are thus the mainstay of therapy and that have improved outcomes for victims of acute SCI in recent decades.Recent StudiesCurrent management strategies for acute SCI involve early surgical decompression and fixation, the use of ...
Source: Current Neurology and Neuroscience Reports - July 30, 2019 Category: Neuroscience Source Type: research

Antiplatelet Therapy in Cerebral Small Vessel Disease
AbstractPurpose of ReviewWe critically evaluate the evidence for the use of antiplatelet therapy for stroke prevention following lacunar stroke and in patients with hemorrhage-prone cerebral small vessel disease.Recent FindingsPooled lacunar stroke subgroup analyses of all relevant randomized controlled trials to date suggest a 22% relative risk reduction in recurrent stroke by single antiplatelet therapy (RR 0.77, 95% CI 0.62 –0.97) compared with placebo, no consistent suggestion of variable efficacy amongst specific antiplatelet agents, and the absence of clear benefit with dual over single antiplatelet therapy. Cu...
Source: Current Neurology and Neuroscience Reports - July 27, 2019 Category: Neuroscience Source Type: research