Seizure Management in the Intensive Care Unit
AbstractPurpose of this reviewThis review presents current therapy for seizures in the intensive care unit. The reader is provided with recent evidence regarding the use of EEG in determining treatment for acute seizures. Proposed treatment approaches for seizures and status epilepticus are provided. Controversies and complexity of selecting treatments are discussed.Recent findingsCritical Care EEG Monitoring Research Consortium analyzed the association of periodic and rhythmic electroencephalographic patterns with seizures and found that lateralized and generalized periodic discharges and lateralized rhythmic delta were a...
Source: Current Treatment Options in Neurology - October 21, 2021 Category: Neurology Source Type: research

Treatment of Vascular Myelopathies
This article reviews the treatment of vascular myelopathies of various causes, with an emphasis on the treatment and prevention of the most common non-traumatic etiologies: ischemia secondary to open and endovascular interventions for treatment of thoracoabdominal aortic aneurysms and spontaneous (non-periprocedural) spinal cord ischemia and infarction.Recent findingsAcute vascular myelopathies can present as sudden or rapid onset of paraplegia or quadriplegia. In such cases, spine MRI allows rapid and reliable exclusion of compressive or hemorrhagic lesions and may identify acute spinal cord ischemia; thus, it should be t...
Source: Current Treatment Options in Neurology - October 14, 2021 Category: Neurology Source Type: research

Management/Treatment of Lambert-Eaton Myasthenic Syndrome
This article reviews the current treatment strategies for patients with Lambert-Eaton myasthenic syndrome (LEMS) including potassium channel blockers, immunosuppressant therapies, and management of dysautonomia.Recent findingsSince the first report in 1983, 3,4-diaminopyridine (amifampridine) has been used as a symptomatic treatment for LEMS. The biggest recent development in LEMS treatment is the approval of two amifampridine drugs in 2018 by the Food and Drug Administration (FDA). Amifampridine phosphate (Firdapse ®) is a salt form that was approved for adult patients with LEMS. Amifampridine (Ruzurgi®) was appro...
Source: Current Treatment Options in Neurology - September 30, 2021 Category: Neurology Source Type: research

Current Treatment Options for Patients with Myotonic Dystrophy Type 2
AbstractPurpose of the reviewMyotonic dystrophy types 1 and 2 are frequent forms of muscular dystrophies in adulthood. Their clinical differences need to be taken into account for the most appropriate treatment of patients. The aim of this article is to provide an overview on the current and upcoming therapeutic options for patients with myotonic dystrophy type 2 (DM2).Recent findingsAt the moment, no disease-modifying therapies are available for DM2; next-generation therapies may however be available in the near future. In the meanwhile, the symptomatic management of patients has greatly improved, thank to the production ...
Source: Current Treatment Options in Neurology - September 27, 2021 Category: Neurology Source Type: research

Race/Ethnicity Considerations in the Prevention and Treatment of Stroke
AbstractPurpose of reviewTo describe racial and ethnic considerations that exist for the prevention and treatment of ischemic and hemorrhagic stroke.Recent findingsMultiple studies have characterized stroke disparities. The Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) found that Black individuals have nearly twice the rates of stroke compared to White individuals. Differences in the incidence of stroke risk factors, both inherited and acquired, contribute to these disparities. Black individuals have an earlier age of onset, a longer duration, and greater severity of hypertension compared to White individuals....
Source: Current Treatment Options in Neurology - September 27, 2021 Category: Neurology Source Type: research

Advanced Imaging in the Era of Tissue-Based Treatment for Acute Ischemic Stroke —a Practical Review
AbstractPurpose of the reviewAdvanced imaging is now used to identify acute ischemic stroke (AIS) patients for treatment with tissue plasminogen activator or mechanical thrombectomy, who are either out of the traditional treatment window or have an unknown last known well time. Current guidelines recommend adapting the complex inclusion criteria used in the clinical trials to provide optimal individual patient decisions in clinical practice. This review aims to facilitate such integration by organizing the available data in a practical clinical context.Recent findingsWe review two clinical vignettes of advanced imaging for...
Source: Current Treatment Options in Neurology - September 20, 2021 Category: Neurology Source Type: research

Clinical Trial Outcome Measurements in Lennox-Gastaut Syndrome and Their Application to the Development of Targeted Treatments
AbstractPurpose of ReviewLennox-Gastaut syndrome (LGS) is an epileptic encephalopathy that is challenging to treat, with  >80% of patients remaining refractory to therapy. Patient-oriented clinical outcome measures are essential for  treatment guidance and the development of new therapies. Here, we provide a comprehensive review of outcome measures used in clinical trials targeting patients with LGS, in order to inform future studies, develop, and implement targeted patient and caregiver-relevant outcome measures.Recent FindingsPublished clinical trials that include, or specifically target, individua...
Source: Current Treatment Options in Neurology - September 9, 2021 Category: Neurology Source Type: research

Correction to: Ultrasound-Guided Therapies in the Neuro ICU
(Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - August 26, 2021 Category: Neurology Source Type: research

Surgical Management of Spontaneous Intracerebral Hemorrhage
AbstractPurpose of reviewThis review presents the current evidence and recommendations regarding surgical management of spontaneous intracerebral hemorrhage (ICH). In particular, we discuss the emerging minimally invasive surgical techniques and provide a surgical decision-making algorithm based on current evidence for the practicing clinician.Recent findingsHematoma evacuation is an attractive strategy to relieve mass effect, reduce intracranial pressure, and prevent secondary ongoing tissue injury and thereby reduce mortality and improve outcome. Enthusiasm for open surgical techniques such as craniotomy with clot evacua...
Source: Current Treatment Options in Neurology - August 2, 2021 Category: Neurology Source Type: research

Update on Nodopathies of the Peripheral Nerve
AbstractPurpose of reviewThe purpose of this paper is to provide an up-to-date review of the current knowledge on immune-mediated neuropathies secondary to antibodies against nodal and paranodal proteins.Recent findingsAntibodies against neurofascins and contactin have recently been linked to characteristic neuropathy presentations including a more acute/subacute presentation, involvement of cranial nerves, presence of tremor, and refractory to typical first-line treatments for immune-mediated neuropathies.SummaryNodopathies are a group of disorders associated with humoral autoimmunity to antigens of the node, paranode, an...
Source: Current Treatment Options in Neurology - June 24, 2021 Category: Neurology Source Type: research

The Importance and Opportunity for Healthy Aging Through Lifestyle, Behavior Medicine Among Older Adults With Multiple Sclerosis: the Case Based on Physical Activity
AbstractPurpose of reviewThere is a “graying” of the population of persons living with multiple sclerosis (MS), and the effects of normal aging occur on top of those associated with MS itself (i.e., aging with a long-term disabling disease). We develop the perspective that “Lifestyle Behavior Medicine for Healthy Aging with MS” may be an effective strategy for promoting healthy longevity in this immune-mediated, neurodegenerative disease of the central nervous system.Recent findingsThe perspective is based on recent evidence regarding (a) outcomes of aging with MS for declines in physical and cognit...
Source: Current Treatment Options in Neurology - June 24, 2021 Category: Neurology Source Type: research

Treatment and Prognosis After Hypoxic-Ischemic Injury
AbstractPurpose of reviewThis review summarizes current and emerging treatments for hypoxic-ischemic brain injury (HIBI). Guidance on neuroprognostication after HIBI is also presented.Recent findingsAfter two 2002 studies demonstrated cooling improved neurologic outcome after HIBI, a 2013 trial found targeting 36 °C was non-inferior to targeting 33 °C. Research is ongoing, but there is no other definitive human data on therapies to prevent secondary brain injury after HIBI.SummaryGuideline-recommended treatment of HIBI includes early, optimal cardiopulmonary resuscitation to prevent primary brain injury, and target...
Source: Current Treatment Options in Neurology - June 24, 2021 Category: Neurology Source Type: research

Update on the Diagnostic and Therapeutic Landscape of Sporadic Inclusion Body Myositis
AbstractPurpose of the reviewThe purpose of this paper is to review the recent findings that pertain to the diagnosis and treatment of sporadic inclusion body myositis.Recent findingsNew evidence highlighting lack of correlation between the presence of cytosolic 5 ′-nucleotidase 1A antibody with any of the clinical features, or laboratory findings in inclusion body myositis. New studies emphasizing heterogeneity and showing separation of inclusion body myositis patients into separate trajectories. The failure of bimagrumab and arimoclomol as potential treat ments of inclusion body myositis and the mixed results of th...
Source: Current Treatment Options in Neurology - June 24, 2021 Category: Neurology Source Type: research

Ultrasound-Guided Therapies in the Neuro ICU
AbstractPurpose of ReviewThe purpose of this paper is to provide an overview of the utility and indications of sonography in the Neuro ICU, with focus on recent studies and advances.Recent FindingsEmerging data continue to shed light on the benefit of critical care sonography with neurovascular ultrasound being of particular interest in the Neuro ICU. Recent development of safe and feasible robotic TCDs holds promise in allowing continuous bedside monitoring of cerebrovascular hemodynamics, especially in conjunction with the use of automated software such as ICM+. Although newer and feasible methods for non-invasive measur...
Source: Current Treatment Options in Neurology - June 24, 2021 Category: Neurology Source Type: research

Neurocritical Care of the Pregnant Patient
AbstractPurpose of reviewTo summarize recent changes in management and emerging therapies for pregnant neurocritical care patients.Recent findingsDiagnostic and treatment options for managing neurologic emergencies in pregnant patients have expanded with both greater understanding of the effects of imaging modalities and medications on pregnancy and application of standard treatments for non-pregnant patients to pregnant populations. Specifically, this includes cerebrovascular diseases (pregnancy-associated ischemic stroke, pregnancy-associated intracerebral hemorrhage, cerebral venous sinus thrombosis), post-maternal card...
Source: Current Treatment Options in Neurology - June 21, 2021 Category: Neurology Source Type: research

Current Management of Thyroid Eye Disease
We describe recent developments in treatment paradigms including recently approved agents, upcoming future therapies, and current technologies and strategies in approaching patients surgically.Recent findingsThe development of biologic agents, such as rituximab, tocilizumab, and most recently the human monoclonal antibody teprotumumab that binds to the IFG-1 receptor, has altered the management of patients in the active phase of thyroid eye disease. Randomized controlled trials have demonstrated teprotumumab infusion in the relatively early phase of orbital inflammation results in a durable reduction in proptosis and strab...
Source: Current Treatment Options in Neurology - June 11, 2021 Category: Neurology Source Type: research

A Review of Adult-Onset Hearing Loss: a Primer for Neurologists
AbstractPurpose of the ReviewThe goal of this review is to highlight current approaches to diagnosis and treatment for adult-onset hearing loss in patients likely to present to a neurologist ’s office. The review will discuss primary and secondary causes of acute and chronic hearing loss, and will discuss common situations that can be managed by a neurologist as well as situations that require immediate care and referral for further management by an otolaryngologist-head and neck surg eon.Recent FindingsHearing screening assessments using mobile applications and tablet devices are now available and can be integrated ...
Source: Current Treatment Options in Neurology - May 19, 2021 Category: Neurology Source Type: research

Early Aggressive Treatment Approaches for Multiple Sclerosis
AbstractPurpose of reviewThis review presents a comprehensive analysis of the current high-efficacy disease-modifying therapies (DMTs) available for treatment of multiple sclerosis (MS). We discuss the existing approved and emerging therapeutics in patients with relapsing and progressive forms of MS using data from clinical trials and observational studies. Treatment considerations in pediatric and pregnant populations are also reviewed. Finally, we discuss the treatment paradigms of the escalation and early aggressive approaches to treatment of MS, with review of ongoing clinical trials to compare these approaches.Recent ...
Source: Current Treatment Options in Neurology - May 15, 2021 Category: Neurology Source Type: research

Subependymal Giant Cell Astrocytomas (SEGAs): a Model of Targeting Tumor Growth and Epilepsy
AbstractPurpose of reviewSubependymal giant cell astrocytomas (SEGAs) are grade I astrocytic tumors according to WHO 2016, mainly associated to tuberous sclerosis complex. They are rare and achievements in their management are often the result of small series and case reports. The main purpose of this review was to summarize recent developments in diagnosis and treatment of SEGAs.Recent findingsThe role of treatment with mTOR inhibitors has been confirmed through many studies in the last decade. New treatment options for patients with contraindication to surgery have been proposed, like Gamma Knife and laser interstitial t...
Source: Current Treatment Options in Neurology - April 14, 2021 Category: Neurology Source Type: research

MOG-IgG Associated Disease (MOG-AD) in Adults
AbstractPurpose of reviewThis review offers a look into available treatment strategies for patients with MOG-IgG associated disease (MOG-AD). We will focus on evidence-based management options in the acute setting. We will also present recommendations for initiation of long-term immunotherapy for patients with a relapsing course and discuss our approach for monitoring disease progression and escalation of therapy.Recent findingsAs commercial testing for MOG-IgG did not become widely available until 2016, most of the evidence concerning management is from retrospective observational studies. Acutely, 1  g daily of intr...
Source: Current Treatment Options in Neurology - April 7, 2021 Category: Neurology Source Type: research

Evaluation, Treatment, and Impact of Neurologic Injury in Adult Patients on Extracorporeal Membrane Oxygenation: a Review
AbstractPurposeExtracorporeal membrane oxygen (ECMO) is increasingly used as an advanced form of life support for cardiac and respiratory failure. Unfortunately, in infrequent instances, circulatory and/or respiratory recovery is overshadowed by neurologic injury that can occur in patients who require ECMO. As such, knowledge of ECMO and its implications on diagnosis and treatment of neurologic injuries is indispensable for intensivists and neurospecialists.Recent findingsThe most common neurologic injuries include intracerebral hemorrhage, ischemic stroke, seizure, cerebral edema, intracranial hypertension, global cerebra...
Source: Current Treatment Options in Neurology - March 31, 2021 Category: Neurology Source Type: research

Severe Neurologic Complications of SARS-CoV-2
We present readers with a review of the literature of severe neurologic complications of SARS-CoV-2 and cases from our institution to illustrate these conditions.Recent FindingsNeurologic manifestations are being increasingly recognized in the literature. Some patients can have severe neurologic manifestations, though the true prevalence is unknown.SummarySevere neurologic complications of COVID-19 include large vessel occlusion ischemic stroke, intracranial hemorrhage, encephalitis, myelitis, Guillain-Barre syndrome, status epilepticus, posterior reversible encephalopathy syndrome, and hypoxic-ischemic encephalopathy. The...
Source: Current Treatment Options in Neurology - March 31, 2021 Category: Neurology Source Type: research

Nutrition in the Neurocritical Care Unit: a New Frontier
AbstractPurpose of ReviewThis review presents the most current recommendations for providing nutrition to the neurocritical care population. This includes updates on initiation of feeding, immunonutrition, and metabolic substrates including ketogenic diet, cerebral microdialysis (CMD) monitoring, and the microbiome.Recent FindingsLittle evidence exists to support differences in feeding practices among the neurocritical care population. New areas of interest with limited data include use of immunonutrition, pre/probiotics for microbiome manipulation, ketogenic diet, and use of CMD catheters for substrate utilization monitor...
Source: Current Treatment Options in Neurology - March 31, 2021 Category: Neurology Source Type: research

New Therapeutic Landscape in Neuromyelitis Optica
AbstractPurpose of reviewThis review discusses the current treatment trends and emerging therapeutic landscape for patients with neuromyelitis optica spectrum disorder (NMOSD).Recent findingsConventional immune suppressive therapies, such as B cell depletion, have been used for long-term treatment. However, the availability of recent FDA-approved and investigational drugs has made therapeutic choices for NMOSD more complex.SummaryRecent randomized clinical trials have shown that eculizumab, inebilizumab, and satralizumab are efficacious therapies for AQP4 seropositive NMOSD. These therapies may not have the same benefit in...
Source: Current Treatment Options in Neurology - March 30, 2021 Category: Neurology Source Type: research

Treatment of Women with Multiple Sclerosis Planning Pregnancy
We present recent data on disease-modifying therapies (DMT) before/during pregnancy and while breastfeeding, with treatment recommendations.Recent FindingsObservational data support the safety of injectable DMTs (glatiramer acetate, interferon-beta) for use in pregnancy, while some oral DMTs might be associated with fetal risk. Monoclonal antibodies (mAbs) before pregnancy such as rituximab or natalizumab likely do not pose significant fetal risks, but can cross the placenta with neonatal hematological abnormalities if given in the second trimester or later. Breastfeeding is associated with decreased risk of postpartum rel...
Source: Current Treatment Options in Neurology - March 30, 2021 Category: Neurology Source Type: research

Innovative Therapeutic Strategies for Primary CNS Lymphoma
AbstractSummaryPrimary central nervous system (CNS) lymphoma (PCNSL) represents 4% of all CNS malignancies and 4 –6% of all extranodal lymphomas. Its low incidence is the main reason why it has been difficult to develop guidelines on the treatment and management of PCNSL patients. The lack of consensus around standard therapy and best diagnostic approach, inevitably, affected the outcome of these patients fo r many years. Current efforts are focusing on: (1) defining the optimal induction and consolidation therapies in fit and frail patients, (2) establishing when and how to use the new non-cytotoxic agents, (3) inve...
Source: Current Treatment Options in Neurology - March 30, 2021 Category: Neurology Source Type: research

Diagnosis and Management of Cognitive Concerns in the Oldest-Old
AbstractPurpose of reviewThe fastest-growing group of elderly individuals is the “oldest-old,” usually defined as those age 85 years and above. These individuals account for much of the rapid increase in cases of dementing illness throughout the world but remain underrepresented in the body of literature on this topic. The aim of this review is first to outline the unique c ontributing factors and complications that must be considered by clinicians in evaluating an oldest-old individual with cognitive complaints. Secondly, the evidence for management of these cognitive concerns is reviewed.Recent findingsI...
Source: Current Treatment Options in Neurology - March 26, 2021 Category: Neurology Source Type: research

Neurological Complications of Targeted Therapies and Immunotherapies for Cancer
AbstractPurpose of ReviewTargeted therapies and immunotherapies for cancer are associated with a wide spectrum of neurological complications. This review summarizes the neurological toxicity associated with some of the most recently FDA-approved agents or indications.Recent FindingsNeurological complications of oral small molecule inhibitors are generally rare or mild, though some recently approved receptor tyrosine kinase inhibitors display significant central nervous system toxicities. Immune checkpoint inhibitors are associated with many neurological adverse events, some fatal, and consensus guidelines have been establi...
Source: Current Treatment Options in Neurology - February 15, 2021 Category: Neurology Source Type: research

Treating MS After 50: the Role of Age in Therapeutic Decision-Making
AbstractPurpose of ReviewThis review presents the latest evidence available regarding treating patients with MS over age 50. This includes what is known about disease-modifying therapies, symptomatic interventions, and comorbid conditions that influence disease management in older patients.Recent FindingsThere is limited clinical trial data for patients over age 50. Recent meta-analyses of clinical trials of immunomodulatory therapies indicate there is minimal efficacy after age 50 on disability progression. Additionally, immunosenescent changes increase risks of adverse effects in older adults. Advances in understanding d...
Source: Current Treatment Options in Neurology - February 3, 2021 Category: Neurology Source Type: research

Imaging of Response to Radiosurgery and Immunotherapy in Brain Metastases: Quo Vadis?
AbstractPurpose of ReviewThis review presents an overview of how advanced imaging techniques may help to overcome shortcomings of anatomical MRI for response assessment in patients with brain metastases who are undergoing stereotactic radiosurgery, immunotherapy, or combinations thereof.Recent FindingsStudy results suggest that parameters derived from amino acid PET, diffusion- and perfusion-weighted MRI, MR spectroscopy, and newer MRI methods are particularly helpful for the evaluation of the response to radiosurgery or checkpoint inhibitor immunotherapy and provide valuable information for the differentiation of radiothe...
Source: Current Treatment Options in Neurology - January 30, 2021 Category: Neurology Source Type: research

Renal Replacement Therapy and Dialysis-associated Neurovascular Injury (DANI) in the Neuro ICU: a Review of Pathophysiology and Preventative Options
AbstractPurpose of ReviewDialysis-associated neurovascular injury (DANI) is a significant contributor to secondary neurologic injury for patients with acute brain injury undergoing renal replacement therapy (RRT). This manuscript reviews the multi-faceted pathophysiologic aspects of DANI and focuses on options for neuro-monitoring and RRT prescription modification to prevent DANI.Recent FindingsWe consider DANI a clinical syndrome encompassing cerebral edema, impaired cerebral blood flow, and cerebrospinal fluid metabolic alterations during RRT, all of which may lead to secondary brain injury. Neurological monitoring in di...
Source: Current Treatment Options in Neurology - January 16, 2021 Category: Neurology Source Type: research

One Giant Step for Giant Cell Arteritis: Updates in Diagnosis and Treatment
AbstractPurpose of ReviewGiant cell arteritis (GCA), a medium and large vessel vasculitis occurring in the aged, remains a formidable disease, capable of taking both vision and life, through a multitude of vascular complications. Our understanding of the spectrum of its manifestations has grown over the years, to include limb claudication, aortitis, and cardiac disease, in addition to the more classic visual complications resulting from of ischemia to branches of the external and internal carotid arteries. While a clinical presentation of headache, jaw claudication, scalp tenderness, fever and other systemic symptoms and s...
Source: Current Treatment Options in Neurology - January 16, 2021 Category: Neurology Source Type: research

Neurologic Manifestations of Systemic Disease: Movement Disorders
AbstractPurpose of reviewTo summarize the state of the art of therapeutic approaches for movement disorders occurring in the context of systemic disorders. These secondary movement disorders, e.g., parkinsonism, tremor, chorea, dystonia, ballism, ataxia, and dyskinesia, among others, can be transitory manifestations of systemic diseases or part of syndromes that combine systemic and neurological symptoms (e.g., Wilson ’s disease). These conditions are frequently treatable and in certain cases also curable. Therefore, their recognition and treatment impact the outcomes of these patients.Recent findingsMost current kno...
Source: Current Treatment Options in Neurology - January 5, 2021 Category: Neurology Source Type: research

The Diagnosis and Management of Reversible Dementia Syndromes
This article discusses the diagnostic evaluation and management of reversible dementia syndromes. It highlights clinical syndromes and explores the recent literature implicating certain reversible factors in Alzheimer ’s disease pathogenesis.Recent FindingsThe prevalence of fully reversible dementia is low, but there is growing awareness for potentially reversible contributors to neurodegenerative disease. In particular, exposure to anticholinergic medications, obstructive sleep apnea, and depression have emerged as potentially modifiable targets in the pathogenesis of preclinical and early Alzheimer ’s disease...
Source: Current Treatment Options in Neurology - January 5, 2021 Category: Neurology Source Type: research

Correction to: Imaging Predictors of Vasospasm and Delayed Cerebral Ischaemia After Subarachnoid Haemorrhage
A correction to this paper has been published:https://doi.org/10.1007/s11940-020-00658-w (Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - January 5, 2021 Category: Neurology Source Type: research

Diagnosis and Management of Seizures in Neurodegenerative Diseases
AbstractPurpose of ReviewThis review presents a critical appraisal of epileptic seizures in common neurodegenerative diseases related to proteinopathy, including Alzheimer ’s disease (AD), dementia with Lewy bodies, frontotemporal dementias, and prion diseases. Studies on prevalence, seizure type, and treatment are reviewed, and tentative management recommendations made. Gaps in the evidence base are indicated.Recent FindingsEpidemiological studies show that patients with AD are at increased risk of epileptic seizures. Cumulative seizure frequency of>  10% is reported and may be higher if subtle seizure fea...
Source: Current Treatment Options in Neurology - January 2, 2021 Category: Neurology Source Type: research

Imaging Predictors of Vasospasm and Delayed Cerebral Ischaemia After Subarachnoid Haemorrhage
AbstractPurpose of ReviewAcute spontaneous subarachnoid haemorrhage (SAH) is a severe disease, frequently complicated by vasospasm and delayed cerebral ischaemia (DCI), which have a negative impact on prognosis. Imaging studies are essential in the diagnosis of SAH. In this article, we review the available imaging techniques for prediction, monitoring and diagnosis of these complications of SAH.Recent FindingsNon-contrast computed tomography (CT) and transcranial Doppler (TCD) have been so far the mainly used techniques to evaluate SAH patients during the acute stage of disease and to screen for vasospasm and DCI. However,...
Source: Current Treatment Options in Neurology - November 24, 2020 Category: Neurology Source Type: research

Recent Advances in the Management of Cluster Headache
AbstractPurpose of reviewAmong the spectrum of pain conditions, cluster headache represents one of the most severe. Targeted therapies for cluster headache are evolving thus improving the available therapeutic armamentarium. A better understanding of the currently available therapies, as well as new and emerging options, may aide physicians to manage affected sufferers better by evolving treatment guidance.Recent findingsWhile classic first-line medications are useful in some patients with cluster headache, they are often accompanied by significant side effects that limit their use. Recently, novel treatments with better t...
Source: Current Treatment Options in Neurology - November 23, 2020 Category: Neurology Source Type: research

New Avenues in Radiotherapy of Glioblastoma: from Bench to Bedside
AbstractPurpose of ReviewThis review presents the new updates in treatment by radiotherapy of patients with glioblastoma. Despite the standard treatment, patients with glioblastoma present a relapse quasi-systematic observed in radiation fields with recurrent tumors resistant to therapy. We will highlight new targets involved in radioresistance, discovered in vitro, and that could have an impact in new treatments for glioblastoma, which remains a lethal tumor.Recent FindingsSo far, clinical studies did not show any efficacy for patients except the one involving tumor-treating fields. For the last decade, it has been discov...
Source: Current Treatment Options in Neurology - November 20, 2020 Category: Neurology Source Type: research

Stroke Treatment in the Setting of Systemic Disease
AbstractWhile the possible stroke risks for more prevalent conditions, such as cardiac disease or cancer, are important to recognize, there are other equally devastating systemic diseases that can affect younger adults and, if not cautious, may be misdiagnosed if stroke is the initial presentation.Purpose of reviewWe aim to discuss treatments of three rarer, but important systemic diseases associated with an increased incidence of ischemic stroke, specifically sickle cell anemia, human immunodeficiency virus (HIV), and Takayasu ’s arteritis.Recent findingsGiven that individuals with these diseases are now living long...
Source: Current Treatment Options in Neurology - November 13, 2020 Category: Neurology Source Type: research

Advances in Targeted Therapies for Pediatric Brain Tumors
AbstractPurpose of ReviewOver the last years, our understanding of the molecular biology of pediatric brain tumors has vastly improved. This has led to more narrowly defined subgroups of these tumors and has created new potential targets for molecularly driven therapies. This review presents an overview of the latest advances and challenges of implementing targeted therapies into the clinical management of pediatric brain tumors, with a focus on gliomas, craniopharyngiomas, and medulloblastomas.Recent FindingsPediatric low-grade gliomas (pLGG) show generally a low mutational burden with the mitogen-activated protein kinase...
Source: Current Treatment Options in Neurology - November 12, 2020 Category: Neurology Source Type: research

Treatment of SUNCT/SUNA, Paroxysmal Hemicrania, and Hemicrania Continua: An Update Including Single-Arm Meta-analyses
AbstractPurpose of ReviewThis review presents a critical appraisal of the treatment strategies for short-lasting unilateral neuralgiform headache attacks (SUNHA), paroxysmal hemicrania (PH), and hemicrania continua (HC). We assess the available, though sparse, evidence on both medical and surgical treatments. In addition, we present estimated pooled analyses of the most common treatments and emphasize recent promising findings.Recent FindingsThe majority of literature available on the treatment of these rare trigeminal autonomic cephalalgias are small open-label observational studies and case reports. Pooled analyses revea...
Source: Current Treatment Options in Neurology - November 11, 2020 Category: Neurology Source Type: research

Pharmacotherapy for Small Fiber Neuropathy
AbstractPurpose of reviewSmall fiber neuropathy (SFN) is a condition that affects small nerve fibers leading to a variety of symptoms, including pain, discomfort, tingling, and sensory loss. The development of new drugs is commonly complicated by variable medication pharmacokinetics and patients ’ response to treatment due to comorbidities. In this review, we discuss currently used drugs, including the evidence about their efficacy. We also mention the medications with a questionable response in SFN treatment and those that are potential emerging therapies.Recent findingsSFN treatment is aimed towards addressing the ...
Source: Current Treatment Options in Neurology - November 9, 2020 Category: Neurology Source Type: research

Vascular Events, Vascular Disease and Vascular Risk Factors —Strongly Intertwined with COVID-19
AbstractPurpose of reviewTo elucidate the intertwining of vascular events, vascular disease and vascular risk factors and COVID-19.Recent findingsStrokes are a leading cause of disability and death worldwide. Vascular risk factors are important drivers of strokes. There are unmodifiable vascular risk factors such as age and ethnicity and modifiable vascular risk factors. According to the INTERSTROKE study, the 10 most frequent modifiable vascular risk factors are arterial hypertension, physical inactivity, overweight, dyslipidaemia, smoking, unhealthy diet, cardiac pathologies, diabetes mellitus, stress/depression and over...
Source: Current Treatment Options in Neurology - October 8, 2020 Category: Neurology Source Type: research

COVID-19 Era Stroke Service: Virtually Normal
ConclusionsZoom conferences are a promising technology for stroke services. Further studies are needed to further elucidate their benefits and drawbacks. (Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - October 8, 2020 Category: Neurology Source Type: research

Secondary Causes of Myositis
AbstractPurpose of reviewThe purpose of this paper is to comprehensively evaluate secondary causes of inflammatory myopathies (myositis) and to review treatment options.Recent findingsThis review highlights recent advancements in our understanding of known causes of myositis, including newer drugs that may cause myositis such as checkpoint inhibitors and viruses such as influenza, HIV, and SARS-CoV2. We also discuss treatment for malignancy-associated myositis and overlap myositis, thought to be a separate entity from other rheumatologic diseases.SummaryInfections, drugs, rheumatologic diseases, and malignancies are import...
Source: Current Treatment Options in Neurology - October 5, 2020 Category: Neurology Source Type: research

Unraveling the Possible Routes of SARS-COV-2 Invasion into the Central Nervous System
We present data regarding the family of Coronaviruses (CoVs) and the central nervous system (CNS), and describe parallels between SARS-CoV-2 and other members of the family, which have been investigated in more depth and combine these findings with the recent advancements regarding SARS-CoV-2.SummarySARS-CoV-2 like other CoVs is neuroinvasive, neurotropic and neurovirulent. Two main pathways of CNS penetration seem to be the strongest candidates, the hematogenous and the neuronal. Τhe olfactory route in particular appears to play a significant role in neuroinvasion of coronaviruses and SARS-CoV-2, as well. However, exi...
Source: Current Treatment Options in Neurology - September 24, 2020 Category: Neurology Source Type: research

A Literature Systematic Review with Meta-Analysis of Symptoms Prevalence in Covid-19: the Relevance of Olfactory Symptoms in Infection Not Requiring Hospitalization
AbstractPurpose of reviewTo investigate the association between the olfactory dysfunction and the more typical symptoms (fever, cough, dyspnoea) within the Sars-CoV-2 infection (COVID-19) in hospitalized and non-hospitalized patients.Recent findingsPubMed, Scopus and Web of Science databases were reviewed from May 5, 2020, to June 1, 2020. Inclusion criteria included English, French, German, Spanish or Italian language studies containing original data related to COVID19, anosmia, fever, cough, and dyspnoea, in both hospital and non-hospital settings. Two investigators independently reviewed all manuscripts and performed qu...
Source: Current Treatment Options in Neurology - August 27, 2020 Category: Neurology Source Type: research

Treatment Updates in Postural Tachycardia Syndrome
AbstractPurpose of reviewPostural tachycardia syndrome is a common condition characterized by the presence of orthostatic intolerance in conjunction with excessive postural tachycardia. This review will focus on treatment updates in postural tachycardia syndrome and will include a discussion of rehabilitative, vasopressor, heart rate modulation, volume expansion, and immunomodulatory treatment strategies.Recent findingsA recent study added to existing literature the benefits of exercise retraining in postural tachycardia syndrome (POTS) patients who were able to successfully complete a 3-month exercise regimen. Another rec...
Source: Current Treatment Options in Neurology - August 24, 2020 Category: Neurology Source Type: research

Treatment Updates for Neuromuscular Channelopathies
This article aims to review the current and upcoming treatment options of primary muscle channelopathies including the non-dystrophic myotonias and periodic paralyses.Recent findingsThe efficacy of mexiletine in the treatment of myotonia is now supported by two randomised placebo-controlled trials, one of which utilised a novel aggregated n-of-1 design. This has resulted in licencing of the drug via orphan drug status. There is also good evidence that mexiletine is well tolerated and safe in this patient group without the need for intensive monitoring. A range of alternative antimyotonic treatment options include lamotrigi...
Source: Current Treatment Options in Neurology - August 21, 2020 Category: Neurology Source Type: research