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Correction to: Treatment of Excessive Daytime Sleepiness in Patients with Narcolepsy
The correct spelling of the author should be listed as Laura P érez-Carbonell, MD as shown above. (Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - November 27, 2019 Category: Neurology Source Type: research

Pain Management in Multiple Sclerosis: a Review of Available Treatment Options
AbstractPurpose of reviewMultiple Sclerosis (MS) is a chronic autoimmune disease with no curative treatment available. While recent years have ushered in many effective new disease-modifying therapies for MS, they have not obviated the need for symptomatic treatments for MS-related pain. In this review, we discuss available approaches to control pain, which is one of the most common complaints MS patients have.Recent findingsThe most recent research in this topic is directed towards non-pharmacologic interventions including water exercises, yoga and cannabis. More trials are being conducted on neuromodulation for MS-relate...
Source: Current Treatment Options in Neurology - November 26, 2019 Category: Neurology Source Type: research

The Influence of Therapeutics on Prognostication After Cardiac Arrest
AbstractPurpose of reviewThe goal of this review is to highlight the influence of therapeutic maneuvers on neuro-prognostication measures administered to comatose survivors of cardiac arrest. We focus on the effect of sedation regimens in the setting of targeted temperature management (TTM), one of the principle interventions known to improve neurological recovery after cardiac arrest. Further, we discuss the critical need for novel markers, as well as refinement of existing markers, among patients receiving extracorporeal membrane oxygenation (ECMO) in the setting of failed conventional resuscitation, known as extracorpor...
Source: Current Treatment Options in Neurology - November 24, 2019 Category: Neurology Source Type: research

The Landscape of Hematopoietic Stem Cell Transplant and Gene Therapy for X-Linked Adrenoleukodystrophy
AbstractPurpose of reviewTo present an updated appraisal of hematopoietic stem cell transplant (HSCT) and gene therapy for X-linked adrenoleukodystrophy (ALD) in the setting of a novel, presymptomatic approach to disease.Recent findingsOutcomes in HSCT for ALD have been optimized over time due to early patient detection, improved myeloablative conditioning regimens, and adjunctive treatment for patients with advanced cerebral disease. Gene therapy has arrested disease progression in a cohort of boys with childhood cerebral ALD. New therapeutic strategies have provided the clinical basis for the implementation of Newborn Sc...
Source: Current Treatment Options in Neurology - November 24, 2019 Category: Neurology Source Type: research

Delirium Management in the ICU
AbstractPurpose of reviewDelirium occurs frequently in critically ill patients and is associated with adverse outcomes in both the short and long term. In this review, we aim to highlight recent study findings on the prevention and treatment of delirium, provide additional recommendations based on expert guidelines, and indicate knowledge gaps deserving of future study.Recent findingsMulticomponent non-pharmacologic interventions have been shown to be efficacious in non-ICU populations, and multicomponent strategies such as the ABCDEF bundle have been adopted in the ICU with several studies showing a potential benefit in d...
Source: Current Treatment Options in Neurology - November 13, 2019 Category: Neurology Source Type: research

Transcranial Magnetic Stimulation for the Treatment of Pediatric Neurological Disorders
AbstractPurpose of reviewRepetitive transcranial magnetic stimulation (rTMS) is a form of noninvasive brain stimulation that is used for the treatment of migraine and major depression in adults and is now being evaluated for use in other disorders. The purpose of this review is to summarize the physiology underlying TMS, the safety and tolerability in pediatric patients, and the evidence for TMS efficacy in the treatment of pediatric neurologic disorders.Recent findingsStudies investigating rTMS for adolescent depression, hemiparesis due to pediatric stroke, autism, and tics/Tourette syndrome have demonstrated some therape...
Source: Current Treatment Options in Neurology - November 12, 2019 Category: Neurology Source Type: research

Treatment of Excessive Daytime Sleepiness in Patients with Narcolepsy
AbstractPurpose of reviewThe aim of this review is to discuss and summarize the main therapeutic strategies for the management of excessive daytime sleepiness (EDS) in patients with narcolepsy. An overview of novel therapies and potential future options are covered as well.Recent findingsFirst line treatments for EDS in narcolepsy patients include modafinil/armodafinil and sodium oxybate. Other options with a stimulant effect, such as methylphenidate and amphetamines are considered if the former do not control the symptoms. More recently, pitolisant (H3 receptor inverse agonist) was approved by the European Medicines Agenc...
Source: Current Treatment Options in Neurology - November 11, 2019 Category: Neurology Source Type: research

Therapies for Restless Legs in Parkinson ’s Disease
AbstractPurpose of reviewThe aim of this article was to review the options and particularities of the treatment of restless legs syndrome (RLS) in Parkinson ’s disease (PD).Recent findingsRLS is more frequent in PD than in the general population. Even if these two disorders share some specificity (dopa-sensitivity), they also differ in many features (iron load, genetic profile, dopaminergic cell count), resulting in different adaptations of the treatment. Only one study has specifically explored and demonstrated the efficacy of a treatment (rotigotine) in RLS with PD, constraining us to treat RLS with PD by analogy as id...
Source: Current Treatment Options in Neurology - November 8, 2019 Category: Neurology Source Type: research

Brain Metastases as a First Site of Recurrence in Patients Receiving Chemotherapy with Controlled Systemic Cancer: a Critical but Under-Recognized Clinical Scenario
AbstractPurpose of reviewAs the treatment of many malignancies has improved, brain metastases (BM) have been observed as a site of the first recurrence in patients with controlled systemic cancers. This suggests that while the administered chemotherapy is effective against systemic cancer, drug concentrations in the central nervous system (CNS) are likely too low to be effective. These findings are in accord with data suggesting that more than 98% of FDA-approved drugs on the market today are unable to cross the blood-brain barrier (BBB).Recent findingsThis retrospective literature review was conducted to estimate the prop...
Source: Current Treatment Options in Neurology - November 8, 2019 Category: Neurology Source Type: research

Functional Electrical Stimulation Cycling Exercise for People with Multiple Sclerosis
AbstractPurpose of reviewThere has been substantial interest in the role of exercise for managing impairments, limitations, and disability progression among persons with multiple sclerosis (MS). Despite established benefits of exercise training for persons who have mild-to-moderate MS, the ability to deliver exercise to persons who experience higher disability remains challenging. One promising approach for exercise in this population is functional electrical stimulation (FES) cycling. This review provides a summary of the current evidence for FES cycling as an exercise training modality in persons with MS with respect to ...
Source: Current Treatment Options in Neurology - November 7, 2019 Category: Neurology Source Type: research

Outcomes and Cost-Effectiveness of Autologous Hematopoietic Cell Transplant for Multiple Sclerosis
We present the reader with a brief review on the AHCT procedure, its immunomodulatory mechanism of action in MS, the most recent evidence in support of its use in patients with relapsing-remitting multiple sclerosis (RRMS), as well as its cost considerations.Recent findingsThe first meta-analysis of clinical trials of AHCT for patients with MS demonstrated durable 5-year progression-free survival rates and low treatment-related mortality. Recently, the first randomized controlled phase III clinical trial demonstrated AHCT to be superior to best available therapy for a subset of patients with RRMS. This led to the American ...
Source: Current Treatment Options in Neurology - October 16, 2019 Category: Neurology Source Type: research

Correction to: The Charles Bonnet Syndrome: a Systematic Review of Diagnostic Criteria
Shortly after publication, the authors became aware of several typographical errors in Table 1 which were introduced during the copy-editing process. (Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - October 3, 2019 Category: Neurology Source Type: research

Newer Treatment Approaches in Pediatric-Onset Multiple Sclerosis
AbstractPurpose of reviewWith the recognition that pediatric-onset multiple sclerosis (POMS) is characterized by more prominent disease activity, earlier age at onset of disability milestones, and more prominent cognitive impairment compared with physical disability earlier in the disease course compared with adult-onset multiple sclerosis (AOMS), there has been increasing interest in identifying optimal and safe treatment approaches to achieve better disease control in this group. Injectable therapies have been traditionally used as first line in this population, although not formally approved. This review focuses on curr...
Source: Current Treatment Options in Neurology - September 26, 2019 Category: Neurology Source Type: research

Postintensive Care Syndrome in Pediatric Critical Care Survivors: Therapeutic Options to Improve Outcomes After Acquired Brain Injury
AbstractPurpose of reviewChildren surviving the pediatric intensive care unit (PICU) with neurologic illness or injury have long-term morbidities in physical, cognitive, emotional, and social functioning termed postintensive care syndrome (PICS). In this article, we review acute and longitudinal management strategies available to combat PICS in children with acquired brain injury.Recent findingsFew intervention studies in this vulnerable population target PICS morbidities. Small studies show promise for both inpatient- and outpatient-initiated therapies, mainly focusing on a single domain of PICS and evaluating heterogeneo...
Source: Current Treatment Options in Neurology - September 26, 2019 Category: Neurology Source Type: research

The Role of Surgery in Meningiomas
AbstractPurpose of reviewThis review presents the most recent evidences and recommendations in the pre-, intra-, and post-surgical management of patients harboring meningiomas. Due to the increasing relevance of multimodal approaches, in order to preserve patients ’ neurological function and quality of life (QoL), the role of observation and radiation treatments (as either primary or adjuvant therapy) has also been discussed.Recent findingsMultiple advances in neurosurgery, including the use of the microscope and endoscope, improved preoperative neuroimaging, intraoperative image-guided approaches, and intraoperative neu...
Source: Current Treatment Options in Neurology - September 26, 2019 Category: Neurology Source Type: research