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Biomarker Defined Acute Optic Neuritis: A Review and Perspective
AbstractPurpose of reviewThis review provides a comprehensive summary of treatment options and management considerations for patients with acute inflammatory optic neuritis. A critical appraisal of the findings from landmark trials to the more recent studies is presented to provide a reference for diagnostic approaches, treatment options, and future research perspectives.Recent findingsThe Optic Neuritis Treatment Trial (ONTT) provides the best natural history study of optic neuritis and its relationship to remitting relapsing multiple sclerosis. In addition, the ONTT produced some unexpected and controversial results abou...
Source: Current Treatment Options in Neurology - August 15, 2023 Category: Neurology Source Type: research

Update on Therapy for Myotonic Dystrophy Type 1
AbstractPurpose of reviewThis review aimed to summarize the clinical characteristics of myotonic dystrophy type 1 and to provide a comprehensive review of the current management options for DM1 patients.Recent findingsTremendous advances in understanding the molecular pathophysiology of the disease have led to the first successful preclinical or even clinical studies of disease-modifying therapies. Repurposed small molecules, such are metformin and tideglusib, are probably closest to receiving market authorization, although they showed limited clinical efficiency in treated patients. In the last decade, different synthetic...
Source: Current Treatment Options in Neurology - July 14, 2023 Category: Neurology Source Type: research

Update on Transient Global Amnesia (TGA): Current Theories Underlying the Etiology, Diagnosis, Prognosis, and Management of TGA
AbstractPurpose of reviewThis review discusses a condition known as Transient Global Amnesia (TGA). We discuss the most up-to-date theories related to etiology and risk factors, as well as its correlations to other conditions such as Takotsubo cardiomyopathy and reversible cerebral vasoconstriction syndrome (RCVS).Recent findingsIn these other conditions,  there appears to be an involvement in a mind-brain-body connection, potentially through a sympathetic surge leading to cerebral vasoconstriction and hypoperfusion. Although TGA is thought to be a seemingly benign condition, it can mimic other neurological emergencies s...
Source: Current Treatment Options in Neurology - July 3, 2023 Category: Neurology Source Type: research

Update on Large-Vessel Revascularization in Acute Ischemic Stroke
AbstractPurpose of reviewThis review presents the critical appraisal of current therapeutic strategies for patients with large-vessel occlusion (LVO) acute ischemic stroke (AIS). We provide the reader with most recent evidence supporting endovascular thrombectomy (EVT), different techniques used for thrombectomy, and highlight knowledge gaps regarding therapeutic efficacy of this intervention in respective subgroup of these patients based on site of occlusion, size of ischemic core, time from symptom onset, utility of concurrent intravenous thrombolysis (IVT), mild strokes, or tandem occlusions.Recent findingsEVT is the es...
Source: Current Treatment Options in Neurology - July 1, 2023 Category: Neurology Source Type: research

Update on ALS Treatment
AbstractPurpose of ReviewWhile amyotrophic lateral sclerosis (ALS) remains a progressive fatal diagnosis, there have been numerous advances in the last several years, both in disease-modifying and symptomatic treatment. This review aims to provide a comprehensive and updated review of the literature of current treatment options for ALS.Recent FindingsWe will discuss the proposed mechanisms of action, evidence for efficacy, and safety profiles for the four current Food and Drug Administration (FDA) –approved disease-modifying treatments: riluzole, edaravone, AMX0035 (combination of sodium phenylbutyrate and taurursodiol) ...
Source: Current Treatment Options in Neurology - June 20, 2023 Category: Neurology Source Type: research

Article Topic: Neuropathies Due to Infections and Antimicrobial Treatments
AbstractPurpose of eviewThe aim of this review is to discuss the presentation, diagnosis, and management of polyneuropathy (PN) in selected infections. Overall, most infection related PNs are an indirect consequence of immune activation rather than a direct result of peripheral nerve infection,   Schwann cell infection, or toxin production, though note this review will describe infections that cause PN through all these mechanisms. Rather than dividing them by each infectious agent separately, we have grouped the infectious neuropathies according to their presenting phenotype, to serve a s a guide to clinicians. Finally,...
Source: Current Treatment Options in Neurology - June 10, 2023 Category: Neurology Source Type: research

Diagnosis and Treatment of Inflammatory Cerebral Amyloid Angiopathy
AbstractPurpose of reviewIn this article, we discuss the current consensus approach to the evaluation and treatment of inflammatory cerebral amyloid angiopathy (CAA). We also outline critical knowledge gaps and identify questions for future research.Recent findingsRecent cohort studies found that immunosuppressive treatment for inflammatory CAA was associated with higher probability of clinical and radiographic improvement and reduced risk of disease recurrence. A recent case series showed correlations between changes in cerebrospinal fluid levels of anti-A β autoantibodies, changes in microglial activation, and clinical ...
Source: Current Treatment Options in Neurology - May 18, 2023 Category: Neurology Source Type: research

Ocular Myasthenia Gravis
AbstractPurpose of reviewTo review the diagnosis and current treatments for ocular myasthenia gravis (OMG) with a focus on recent advances.Recent findingsNovel microRNA biomarkers show promise in predicting which patients with OMG will subsequently develop generalized disease. Newly developed clinical rating scales may enable more effective OMG-specific research. A recent meta-analysis suggested that treatment with prednisone may reduce the risk of developing generalized myasthenia gravis (GMG) in patients with OMG. Multiple new steroid-sparing immunotherapies, including complement inhibitors and neonatal Fc receptor antib...
Source: Current Treatment Options in Neurology - April 19, 2023 Category: Neurology Source Type: research

Cerebral Venous Thrombosis: Medical Management vs. Endovascular Therapy
We present a review of recent clinical evidence for treatment and propose areas of future study.Recent findings.Low molecular weight heparin (LMWH) may be beneficial over standard unfractionated heparin (UFH). While limited randomized trials assessed direct oral AC (DOAC) therapy in CVT, multiple studies, including the recent ACTION-CVT and RESPECT CVT trials, suggest the safety and efficacy of DOACs over warfarin. The role of endovascular therapy remains unclear; however, evidence demonstrates relative safety and potential clinical efficacy in improving recanalization rates. Advancements in endovascular therapy will be in...
Source: Current Treatment Options in Neurology - April 11, 2023 Category: Neurology Source Type: research

Treatment Updates for Neuropathy in Hereditary Transthyretin Amyloidosis
AbstractPurpose of reviewTo present an overview of current and upcoming therapies for hereditary transthyretin-mediated amyloidosis with peripheral neuropathy.Recent findings.Hereditary transthyretin-mediated amyloidosis (hATTR) also known as ATTRv (v for variant) is a rare, progressively debilitating disease associated with high morbidity. The past decades have seen the development of TTR stabilizers including diflunisal and tafamidis, as well as gene silencers including inotersen, patisiran, and vutrisiran, the lattermost gaining FDA approval most recently in 2022. There are also promising therapies under investigation i...
Source: Current Treatment Options in Neurology - April 10, 2023 Category: Neurology Source Type: research

Clinical Management in Alzheimer ’s Disease in the Era of Disease-Modifying Therapies
AbstractPurpose of reviewDiscuss emerging anti-amyloid disease-modifying therapies for Alzheimer ’s disease (AD) and outline how these therapies will change our clinical management of patients with AD.Recent findingsBuilding on decades of preclinical work supporting an initiating role of amyloid- β (Aβ) in driving downstream neurodegeneration in AD, monoclonal antibody therapies have been developed against pathologic forms of Aβ to treat AD. Recent phase III clinical trials have demonstrated clinical benefit for several of these anti-amyloid agents, with additional agents currently under investigation. However, these ...
Source: Current Treatment Options in Neurology - March 21, 2023 Category: Neurology Source Type: research

Correction to: Diagnosis and Management of Posterior Cortical Atrophy
(Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - March 21, 2023 Category: Neurology Source Type: research

Parkinson Disease Dementia Management: an Update of Current Evidence and Future Directions
We present the reader with a critical appraisal of evidence for approved and recently investigated therapies in the management of PDD, particularly highlighting recent findings in the management of cognitive impairment and psychotic symptoms.Recent Findings.Several disappointing trials for treatment of cognitive impairment in PDD leave rivastigmine as the only on-label treatment option; evidence supporting possible benefit of other therapies is reviewed. Several clinical trials are currently ongoing and studying novel treatment options for cognitive impairment in PDD. Pimavanserin has demonstrated efficacy for management o...
Source: Current Treatment Options in Neurology - March 13, 2023 Category: Neurology Source Type: research

Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review
AbstractPurpose of reviewThe risks of cerebrovascular manifestations due to SARS-CoV-2 infection are significantly increased within the first 6 months of the infection. Our work aims to give an update on current clinical aspects of diagnosis and treatment of cerebrovascular manifestations during acute and long-term SARS-CoV-2 infection.Recent findingsThe incidence of acute ischemic stroke and haemorrhagic stroke during acute SARS-CoV-2 patients is estimated at 0.9 to 4.6% and 0.5 –0.9%, respectively, and were associated with increased mortality. The majority presented with hemiparesis, dysarthria, sensory deficits, and a...
Source: Current Treatment Options in Neurology - March 4, 2023 Category: Neurology Source Type: research

Rescue Medications for Acute Repetitive Seizures
This article reviews the current evidence-based treatments for the management of acute repetitive seizures (ARS).Recent findingsHalf of patients with refractory epilepsy will experience ARS, but rescue medications are underutilized. Benzodiazepines remain first-line treatment for the management of acute seizures. There are multiple approved medications, and ongoing studies investigating new routes of administration.SummaryClinicians must recognize patients at risk of acute repetitive seizures and be aware of available options for their treatment in the outpatient setting. Additional research is needed to identify which spe...
Source: Current Treatment Options in Neurology - March 4, 2023 Category: Neurology Source Type: research