Current Treatment Options in Neurology Current Treatment Options in Neurology RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Immune-Related Neuromuscular Complications of Checkpoint Inhibitors
AbstractPurpose of ReviewImmune checkpoint inhibition for treatment of metastatic cancers is recognized to cause diverse immune-mediated neurological syndromes. This review will discuss current knowledge about the frequency and varied presentation of these syndromes affecting the peripheral nervous system as well as detail important diagnostic and management considerations.Recent FindingsImmune-related adverse events affect the peripheral nervous system more often than the central nervous system, and rates are likely underestimated. Most data regarding neurological immune –related adverse events are retrospective, and pr...
Source: Current Treatment Options in Neurology - July 31, 2020 Category: Neurology Source Type: research

Inflammatory Manifestations of Systemic Diseases in the Central Nervous System
AbstractPurpose of ReviewThis review presents the current recommended therapeutic interventions for inflammatory disease in the central nervous system (CNS) secondary to systemic diseases of immune dysregulation. Treatment recommendations for CNS inflammation associated with rheumatologic conditions, immune-related adverse effects from immune checkpoint inhibitors (ICIs), and demyelinating disease from tumor necrosis factor- α (anti-TNFs) are explored. Additional therapeutic options for inflammation related to postviral syndromes and genetic immunodeficiencies are also discussed.Recent FindingsIn addition to treatment of ...
Source: Current Treatment Options in Neurology - July 28, 2020 Category: Neurology Source Type: research

Neurologic Manifestations of Systemic Disease: Peripheral Nervous System
AbstractPurpose of ReviewThe impact that systemic disease has on the peripheral nervous system is vast. Polyneuropathies due to these disorders fall into broad categories including metabolic diseases, nutritional deficiencies, rheumatological diseases, infectious diseases, and malignancy-associated disorders. This review focuses on the treatment of these systemic disease –associated polyneuropathies.Recent FindingsMany of the specific polyneuropathies covered in this review are relatively rare and understudied. As such treatment recommendations are based on expert opinion, small case series, and case reports. Even more p...
Source: Current Treatment Options in Neurology - July 27, 2020 Category: Neurology Source Type: research

Myasthenia Gravis Treatment Updates
AbstractPurpose of reviewThis review presents an update of current treatment strategies for patients with myasthenia gravis (MG) depending on their clinical and immunological characteristics.Recent findingsNowadays, the available treatment options for MG are: (1) inhibitors of the acetylcholinesterase, useful as symptomatic treatment; (2) immunosuppressive drugs, the main treatment, initiated and escalated following international guidelines; (3) immunomodulatory drugs (intravenous immunoglobulin and plasma exchange), predominantly used in acute worsening or MG crisis; and (4) thymectomy, performed in patients with thymoma,...
Source: Current Treatment Options in Neurology - July 14, 2020 Category: Neurology Source Type: research

Pseudoprogression in Gliomas: the Use of Advanced MRI for Treatment Decisions
AbstractPurpose of reviewThe definitions of pseudoprogression (PsP) have greatly varied with time, with a reported incidence ranging from 10 to 30%. PsP is mainly a radiological definition, as a new or enlarging area of contrast agent enhancement, without argument of true tumor progression (TP), which will resolve or stabilize without any change in treatment. Because anatomical magnetic resonance imaging (MRI) is unsatisfactory in differentiating PsP from TP, advanced MR techniques are needed, adding sensitivity and specificity to obtain a more solid diagnosis.Recent findingsBecause of its high reported diagnostic accuracy...
Source: Current Treatment Options in Neurology - July 6, 2020 Category: Neurology Source Type: research

Thrombolysis Before Thrombectomy in Acute Large Vessel Occlusion: a Risk/Benefit Assessment and Review of the Evidence
AbstractPurpose of ReviewRecent evidence has shown an overwhelming benefit of mechanical thrombectomy for acute anterior circulation large vessel occlusion (LVO). Whether there is any additional benefit of IV tPA treatment prior to thrombectomy over thrombectomy alone is unproven in randomized trials. In this review, we summarize the available evidence for and against pre-thrombectomy treatment with IV tPA.Recent FindingsIn clinical trials demonstrating efficacy of thrombectomy, the majority of included patients were eligible for (and treated with) IV tPA. Systemic thrombolysis prior to thrombectomy is fraught with potenti...
Source: Current Treatment Options in Neurology - June 28, 2020 Category: Neurology Source Type: research

Management of Symptomatic Intracranial Atherosclerotic Stenosis
AbstractPurpose of reviewThis review addresses the current evidence of epidemiologic and therapeutic strategies in patients with intracranial atherosclerotic stenosis (ICAS).Recent findingsThere is a considerable number of patients with ICAS worldwide, especially in Asia. Modern neuroimaging techniques have improved assessment lately and they are providing insight into ICAS-related mechanisms causing cerebrovascular ischaemic events. Several studies have investigated vascular risk factors for ICAS, primarily in Asians. Vascular risk factors not only facilitate the occurrence of ICAS, but their optimal management is linked ...
Source: Current Treatment Options in Neurology - June 26, 2020 Category: Neurology Source Type: research

Management of Cognitive Impairment After Stroke
AbstractPurpose of ReviewIn this review, we present the reader with the latest diagnostic and therapeutic approaches in the management of patients with post-stroke cognitive impairment (PSCI). We discuss the most commonly utilized and validated neuropsychological assessments and neuroimaging diagnostic assessment tools. We also provide a critical appraisal of the pharmacological treatment approaches of  PSCI, in addition to highlighting the latest emerging non-pharmacological and technological advances in cognitive rehabilitation techniques.Recent FindingsAdvanced MRI techniques and newer PET tracers are being utilized h...
Source: Current Treatment Options in Neurology - June 15, 2020 Category: Neurology Source Type: research

Is there Still a Time Window in the Treatment of Acute Stroke?
AbstractPurpose of reviewIt has become evident that strict time-based criteria are not optimal in selecting patients for acute stroke intervention, leaving the majority of patients untreated due to missing universal time-based criteria. We discuss the pathophysiologic basis for a shift of focus from time to the imaging evidence of salvageable tissue, as well as clinical and imaging tools.Recent findingsThere is strong evidence for the benefit of thrombectomy in patients with a sustained salvageable tissue presenting within 24  h. Although evidence of benefit is limited in patients presenting longer than 24 h, those patie...
Source: Current Treatment Options in Neurology - June 2, 2020 Category: Neurology Source Type: research

Infectious Encephalitis in the Neurocritical Care Unit
AbstractPurpose of reviewInfectious encephalitis is a rapidly progressive encephalopathy caused by a variety of pathogens, most commonly viruses. It is associated with significant mortality and morbidity, often requiring evaluation and treatment in the intensive care unit. This review article discusses the diagnosis of the infectious etiologies, the assessment for differential diagnoses, and the initiation of therapies, and most importantly, it entails the rapid and efficient management of the associated complications.Recent findingsNovel emerging technologies (e.g., metagenomic next-generation sequencing) have the potenti...
Source: Current Treatment Options in Neurology - May 27, 2020 Category: Neurology Source Type: research

Telemedicine for the Care of Neuromuscular Disorders
AbstractPurpose of reviewPatients with neuromuscular disorders have complex, multimodal needs. Weakness, fatigue, distance, and resources often limit access to health care. This review aims to summarize the progress to date on synchronous (real-time) telemedicine visits and asynchronous (store-and-forward) telehealth data collection in order to identify ways in which these can fill gaps in health care for these patients.Recent findingsMost of the research on telemedicine for neuromuscular disorders has been done with amyotrophic lateral sclerosis (ALS). Synchronous videoconferencing has been shown to be feasible and accept...
Source: Current Treatment Options in Neurology - May 10, 2020 Category: Neurology Source Type: research

Advancements in the Treatment of Cerebrovascular Complications of Cancer
AbstractPurpose of reviewTo present the new guidelines and therapeutic options regarding cerebrovascular complications of cancer, mainly ischemic stroke, cerebral venous thrombosis (CVT), and leptomeningeal carcinomatosis (LMC).Recent findingsA temporal trend study (2019) revealed that clinicians are still reluctant to apply thrombolysis to cancer patients, although two new studies (2018) reported no increased mortality. Several clinical trials on direct oral anticoagulants (DOACs) showed their superiority or, at least, non-inferiority compared with low molecular weight heparins in the treatment of venous thromboembolism (...
Source: Current Treatment Options in Neurology - April 29, 2020 Category: Neurology Source Type: research

Harnessing Big Data in Neurocritical Care in the Era of Precision Medicine
AbstractPurpose of reviewTo survey the literature around “big data” and “artificial intelligence” use, its challenges, and examples in clinical and research domains within neurocritical care.Recent findingsInnovations in digital data storage and integration technology have motivated the active development of data-driven tools for neurocritical care practice. There has been progress towards harmonization of data dictionaries within the field to boost generalizability of studies. Numerous collaborative groups have cultivated datasets that will enable further study of disease detection, prediction, and management of c...
Source: Current Treatment Options in Neurology - April 17, 2020 Category: Neurology Source Type: research

Cannabinoids for the Treatment of Epilepsy: a Review
AbstractPurpose of reviewTreatment-resistant epilepsy (TRE) is associated with severe morbidity and mortality and affects over 30% of epilepsy patients. Despite advances in epilepsy management over the last 30  years, this rate has largely remained unchanged. Through a largely patient driven movement and despite federal regulations, cannabidiol (CBD) emerged as a candidate drug for improving the management of treatment-resistant epilepsies. This review highlights the available research on CBD and its the rapeutic role in the treatment of TREs.Recent findingsRandomized controlled trials have established CBD as an add-on tr...
Source: Current Treatment Options in Neurology - April 1, 2020 Category: Neurology Source Type: research

Controversies in Brain Death Declaration: Legal and Ethical Implications in the ICU
This article provides a brief overview of the history and complexities of brain death determination. We examine a few legal cases that highlight some of the controversies surrounding the validity of brain death tests in light of varying state laws and institutional policy, the appropriateness of making religious accommodations, the dilemma of continuing organ-sustaining support in a pregnant brain-dead patient, and the issue of whether to obtain informed consent from surrogate decision makers before proceeding to testing.Recent findingsIn response to physician concerns about navigating these complex cases, especially with ...
Source: Current Treatment Options in Neurology - March 17, 2020 Category: Neurology Source Type: research