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Advances in the Treatment of Thyroid Eye Disease Associated Extraocular Muscle Myopathy and Optic Neuropathy
AbstractPurpose of ReviewTo review emerging treatments for thyroid eye disease (TED) associated extraocular muscle myopathy and dysthyroid optic neuropathy (DON).Recent FindingsEmerging targeted biologic therapies may alter the disease course in TED. Teprotumumab, a type I insulin-like growth factor receptor inhibitor, is the most recent addition to the treatments available for TED-associated extraocular muscle myopathy causing diplopia. Small studies also suggest a potential therapeutic benefit for DON. Various recent studies have also expanded our knowledge on conventional TED therapies.SummaryThe therapeutic landscape o...
Source: Current Neurology and Neuroscience Reports - May 26, 2022 Category: Neuroscience Source Type: research

Bilirubin Encephalopathy
AbstractPurpose of ReviewHyperbilirubinemia is commonly seen in neonates. Though hyperbilirubinemia is typically asymptomatic, severe elevation of bilirubin levels can lead to acute bilirubin encephalopathy and progress to kernicterus spectrum disorder, a chronic condition characterized by hearing loss, extrapyramidal dysfunction, ophthalmoplegia, and enamel hypoplasia. Epidemiological data show that the implementation of universal pre-discharge bilirubin screening programs has reduced the rates of hyperbilirubinemia-associated complications. However, acute bilirubin encephalopathy and kernicterus spectrum disorder are sti...
Source: Current Neurology and Neuroscience Reports - May 19, 2022 Category: Neuroscience Source Type: research

Neurological Manifestations of Myocarditis
AbstractPurpose of ReviewThe present review discusses the neurological complications associated with myocarditis of different etiologies.Recent FindingsMyocarditis can be idiopathic or caused by different conditions, including toxins, infections, or inflammatory diseases. Clinical findings are variable and range from mild self-limited shortness of breath or chest pain to hemodynamic instability which may result in cardiogenic shock and death. Several neurologic manifestations can be seen in association with myocarditis. Tissue remodeling, fibrosis, and myocyte dysfunction can result in heart failure and arrhythmias leading...
Source: Current Neurology and Neuroscience Reports - May 19, 2022 Category: Neuroscience Source Type: research

The Pathogenesis of Central and Complex Sleep Apnea
AbstractPurposeThe purpose of this article is to review the recent literature on central apnea. Sleep disordered breathing (SDB) is characterized by apneas (cessation in breathing), and hypopneas (reductions in breathing), that occur during sleep. Central sleep apnea (CSA) is sleep disordered breathing in which there is an absence or diminution of respiratory effort during breathing disturbances while asleep. In obstructive sleep apnea (OSA), on the other hand, there is an absence of flow despite ongoing ventilatory effort.Recent FindingsCentral sleep apnea is a heterogeneous disease with multiple clinical manifestations.S...
Source: Current Neurology and Neuroscience Reports - May 19, 2022 Category: Neuroscience Source Type: research

Advances in the Diagnosis and Treatment of Leptomeningeal Disease
AbstractPurpose of ReviewLeptomeningeal disease (LMD) is a rare, late complication of systemic cancer and is associated with significant neurological morbidity and high mortality. Here we provide an overview of this condition, summarizing key recent research findings and clinical practice trends in its diagnosis and treatment. We also review current clinical trials for LMD.Recent FindingsImproved molecular diagnostic tools are in development to enable more sensitive detection of LMD, including circulating tumor cells and circulating tumor DNA. The use of targeted and CNS-penetrant therapeutics has shown survival improvemen...
Source: Current Neurology and Neuroscience Reports - May 19, 2022 Category: Neuroscience Source Type: research

Lipid-Modifying Therapies and Stroke Prevention
AbstractPurpose of ReviewWe reviewed lipid-modifying therapies and the risk of stroke and other cerebrovascular outcomes, with a focus on newer therapies.Recent FindingsStatins and ezetimibe reduce ischemic stroke risk without increasing hemorrhagic stroke risk. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors similarly reduce ischemic stroke risk in statin-treated patients with atherosclerosis without increasing hemorrhagic stroke, even with very low achieved low-density lipoprotein cholesterol levels. Icosapent ethyl reduces the risk of total and first ischemic stroke in patients with established cardiova...
Source: Current Neurology and Neuroscience Reports - May 13, 2022 Category: Neuroscience Source Type: research

Internal Carotid Artery Occlusion: Management
AbstractPurpose of ReviewAcute internal carotid artery occlusion (ICAO) is associated with high rates of morbidity and mortality, whereas chronic ICAO can present insidiously with recurrent strokes. In this review, we discuss the medical and surgical management approaches among patients with acute, subacute, and chronic ICAO.Recent FindingsWe reviewed the recent literature regarding clinical presentation of acute and chronic cases of ICAO, and discuss the current data, accepted guidelines, and prospects.SummarySurgical, endovascular, or a combination (hybrid) revascularization has been shown to be effective in recanalizati...
Source: Current Neurology and Neuroscience Reports - May 13, 2022 Category: Neuroscience Source Type: research

Management of Patients with Embolic Stroke of Unknown Source: Interpreting the Evidence in the Light of Clinical Judgement
AbstractPurpose of ReviewTo assess the validity of the belief that anticoagulation is not beneficial in patients with embolic stroke of unknown source (ESUS), and to asssess the benefits and safety of direct-acting oral anticoagulants (DOACs).Recent FindingsThe failure of randomized trials to show benefit of anticoagulation in ESUS is probably due to misclassification of large artery atherosclerosis (LAA) as ESUS, as defined by a stenosis ≥ 50%. There are important differences among DOACs. There are a number of problems with dabigatran, and rivaroxaban and edoxaban are not suitable for once-daily dosing. Recent evid...
Source: Current Neurology and Neuroscience Reports - May 7, 2022 Category: Neuroscience Source Type: research

Updates in Functional Movement Disorders: from Pathophysiology to Treatment Advances
AbstractPurpose of ReviewThis review discusses advances in functional movement disorders (FMD) over the past 3 years, with a focus on risk factors, diagnosis, pathophysiology, neuroimaging studies, and treatment.Recent FindingsThe past decade has brought a revived interest in functional movement disorders, with a growing number of studies exploring pathophysiological mechanisms. Here, we review recent studies demonstrating changes in attention, emotional and sensorimotor function in FMD. Through international collaborative efforts, progress has been made in defining biomarkers and outcome measures, an important prerequis...
Source: Current Neurology and Neuroscience Reports - May 1, 2022 Category: Neuroscience Source Type: research

Utilizing Implementation Science to Bridge Cerebrovascular Health Disparities: a Local to Global Perspective
AbstractPurpose of ReviewStroke is a prime example of a medical disorder whose incidence, prevalence, and outcomes are strongly characterized by health disparities across the globe. This scoping literature review seeks to depict how implementation science could be utilized to advance health equity in the prevention, acute treatment, and post-acute management of stroke in the underserved regions of high-income countries as well as in all low-income countries.Recent FindingsA major reason for the persisting and widening cerebrovascular disease disparities is that evidence-based stroke prevention and treatment interventions h...
Source: Current Neurology and Neuroscience Reports - May 1, 2022 Category: Neuroscience Source Type: research

Migraine and Diet: Updates in Understanding
AbstractPurpose of ReviewWe explore recent developments in the prevention and treatment of migraine through dietary interventions.Recent FindingsHealthier diets (defined in multiple ways), meal regularity, and weight loss are associated with decreased headache burden. Specific diets including the ketogenic diet, the low-glycemic index diet, and the DASH diet are supported by modest evidence for the prevention of migraine. Neither a gluten-free diet, in patients without celiac disease, nor elimination diets have sufficient evidence for their routine consideration.SummaryDiet remains a crucial, but underexplored, component o...
Source: Current Neurology and Neuroscience Reports - April 28, 2022 Category: Neuroscience Source Type: research