Deep brain stimulation for childhood dystonia: current evidence and emerging practice.
Authors: Elkaim LM, De Vloo P, Kalia SK, Lozano AM, Ibrahim GM Abstract INTRODUCTION: Dystonia, one of the most common childhood movement disorders, is often medically refractory and can lead to profound impacts on the child and their caretakers' quality of life. Limited efficacy of pharmacological treatments has fueled enthusiasm for innovative neurosurgical approaches, notably deep brain stimulation (DBS) as a treatment for refractory dystonia. Areas covered: DBS is increasingly applied to successfully treat childhood dystonia. While generally safe and effective, results vary widely depending on underlying dystonia ...
Source: Expert Review of Neurotherapeutics - September 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Select hyperacute complications of ischemic stroke: cerebral edema, hemorrhagic transformation, and orolingual angioedema secondary to intravenous altepase.
Authors: Bar B, Biller J Abstract INTRODUCTION: Remarkable advances have occurred in the management of acute ischemic stroke especially in regards to reperfusion treatments. With advances in reperfusion treatments come the risk of complications associated with these treatments. Areas covered: The paper focuses on three acute complications that can occur in the setting of acute ischemic stroke: cerebral edema, hemorrhagic transformation, and orolingual angioedema following administration of alteplase, a recombinant tissue plasminogen activator. Predictors of the development of these complications are reviewed. The mana...
Source: Expert Review of Neurotherapeutics - September 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

New guidelines for the diagnosis and treatment of neurocysticercosis: a difficult proposal for patients in endemic countries.
Authors: Carpio A, Fleury A, Kelvin EA, Romo ML, Abraham R, Tellez-Zenteno J Abstract INTRODUCTION: Recent guidelines for the diagnosis and treatment for neurocysticercosis (NC) from the Infectious Disease Society of America/American Society of Tropical Medicine and Hygiene were developed to be used in the United States and Canada, where only a small fraction of NC cases occur. Areas covered: The paper discusses the strengths and weakness of the proposed guidelines. Expert commentary: Although these new guidelines bring much needed attention to a neglected parasitic disease, some of the recommendations made are based ...
Source: Expert Review of Neurotherapeutics - September 7, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Diagnostic challenges in rapidly progressive dementia.
Authors: Zerr I, Hermann P Abstract INTRODUCTION: Rapidly progressive dementia is a syndrome caused by numerous disease entities. Accurate diagnosis is crucial as substantial proportion of these diseases is highly treatable. Others might implicate specific hygienic problems. Still, differential diagnosis remains challenging because of a huge overlap of clinical presentations. Areas covered: The paper reviews PubMed-listed research articles with a focus on diagnosis and treatment of diseases showing rapid cognitive decline such as inflammatory diseases, rapid progressive neurodegenerative diseases, toxic-metabolic ence...
Source: Expert Review of Neurotherapeutics - September 4, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Interactions between tumor associated macrophages and tumor cells in glioblastoma: unraveling promising targeted therapies.
Authors: Morisse MC, Jouannet S, Dominguez-Villar M, Sanson M, Idbaih A Abstract INTRODUCTION: Glioblastoma (GBM) is the deadliest primary malignant central nervous system tumor with a median overall survival of 15 months despite a very intensive therapeutic regimen including maximal safe surgery, radiotherapy and chemotherapy. Therefore, GBM treatment still raises major biological and therapeutic challenges. Areas covered: One of the hallmarks of the GBM is its tumor microenvironment including tumor-associated macrophages (TAM). TAM, accounting for approximately 30% of the GBM bulk cell population, may explain, at le...
Source: Expert Review of Neurotherapeutics - August 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Reminiscence therapy for dementia: an abridged Cochrane systematic review of the evidence from randomized controlled trials.
Authors: O' Philbin L, Woods B, Farrell EM, Spector AE, Orrell M Abstract INTRODUCTION: Reminiscence therapy (RT) is a popular psychosocial intervention widely used in dementia care. It involves discussion of past events and experiences, using tangible prompts to evoke memories or stimulate conversation. Areas covered: The aim of this review is to evaluate the effectiveness of RT for people with dementia. It includes studies from the specialized register of the Cochrane Dementia and Cognitive Improvement Group (ALOIS). Searches yielded 185 records of which 22 (n=1972) were eligible for inclusion. The meta-analysis com...
Source: Expert Review of Neurotherapeutics - August 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on the treatment of restless legs syndrome/Willis-Ekbom disease: prospects and challenges.
Authors: Zucconi M, Galbiati A, Rinaldi F, Casoni F, Ferini-Strambi L Abstract INTRODUCTION: Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is a sleep disorder characterized by an urge to move the legs, frequently associated or triggered by unpleasant sensations in the lower limbs that affects approximately 2.5% of adults. Therapy and management of RLS/WED require long term interventions, since the typical manifestation of this disorder is chronic. Areas covered: In this review, we provide an update regarding the treatment of RLS/WED with particular attention to future challenges for its management. We reviewed...
Source: Expert Review of Neurotherapeutics - August 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

How would we combat menopause as an Alzheimer's risk factor?
Authors: Mosconi L, Brinton RD PMID: 30091648 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - August 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Controlled-release pregabalin in the treatment of fibromyalgia.
Authors: Alciati A, Atzeni F, Masala IF, Cirillo M, Sciortino D, Perna G, Sarzi-Puttini P Abstract INTRODUCTION: Fibromyalgia (FM) is a chronic disorder whose symptoms of musculo-skeletal pain, fatigue, sleep disturbances and cognitive impairment pervade the personal, occupational and social aspects of a patient's life. Together with the antidepressants duloxetine and milnacipram, the anticonvulsant pregabalin (PGB) is one of the three drugs approved by the Food and Drug Administration (FDA) for the treatment of FM. The aim of this narrative review is to summarise the data relating to the efficacy and safety of the co...
Source: Expert Review of Neurotherapeutics - August 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on diagnostic options and considerations in limb girdle dystrophies.
Authors: Angelini C, Giaretta L, Marozzo R Abstract INTRODUCTION: Limb Girdle Muscular Dystrophies (LGMD) encompasses a clinically heterogeneous group of rare, genetic progressive muscle disorders presenting with weakness and atrophy of predominant pelvic and shoulder muscles. The spectrum of disease severity ranges from severe childhood-onset muscular dystrophy to adult-onset dystrophy. Areas covered: The review presents an update of the clinical phenotypes and diagnostic options for LGMD including both dominant and recessive LGMD and consider their differential clinical and histopathological features. An overview of...
Source: Expert Review of Neurotherapeutics - August 8, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

New discoveries in progressive myoclonus epilepsies: a clinical outlook.
Authors: Bhat S, Ganesh S Abstract INTRODUCTION: Progressive myoclonus epilepsies (PMEs) constitute a rare and heterogeneous group of genetic disorders with a distinctive triad of myoclonus, seizures and progressive neurological deterioration. PMEs, even though rare, are arguably the severest form of epilepsies accounting for
Source: Expert Review of Neurotherapeutics - July 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Clinical and pre-clinical utility of genomics in medulloblastoma.
Authors: Nör C, Ramaswamy V Abstract INTRODUCTION: Integrated genomics has significantly advanced our understanding of medulloblastoma heterogeneity. It is now clear that it is actually comprised of at least four distinct molecular subgroups termed WNT, SHH, Group 3 and Group 4 with stark clinical and biological differences. Areas Covered: This paper reviews advances in the classification and risk stratification of medulloblastoma, specifically integrating subgroup with clinical and cytogenetic risk factors, with a summary of the potential to lead to more precise therapies. Moreover, the current state of pre-clin...
Source: Expert Review of Neurotherapeutics - July 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Role of the Personal KinetiGraph in the routine clinical assessment of Parkinson's disease: Recommendations from an Expert Panel.
Authors: Pahwa R, Isaacson SH, Torres-Russotto D, Nahab FB, Lynch PM, Kotschet KE Abstract INTRODUCTION: Evaluation of people with Parkinson's disease (PD) is often complex due to heterogeneity of symptoms and disease course, including the variability of motor fluctuations and dyskinesia. Routine clinical evaluations may be incomplete, may not accurately capture important symptoms, and may not reflect day-to-day variability. While significant advances have been made in wearable ambulatory continuous objective monitoring (COM) technologies, many clinicians remain uncertain of how to incorporate them in clinical practic...
Source: Expert Review of Neurotherapeutics - July 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cerebrolysin: a multi-target drug for recovery after stroke.
Authors: Brainin M Abstract INTRODUCTION: Cerebrolysin is a neuropeptide preparation with neurotrophic factor-like effects and promotes recovery after brain injury. Its preclinical profile promises wide applications due to multi-target effects. Currently, Cerebrolysin is used for treatment of cerebral ischemia and neurodegeneration. Areas covered: In stroke, early clinical trials with Cerebrolysin were performed mostly in mildly affected stroke populations, which usually have a favourable prognosis. Due to this selection, a likely floor or ceiling effect of recovery measures in the mild cases may have prevented to sho...
Source: Expert Review of Neurotherapeutics - July 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Deutetrabenazine for the treatment of Huntington's chorea.
Authors: Bashir H, Jankovic J Abstract INTRODUCTION: Huntington's disease (HD) is an inherited neurodegenerative disorder for which no disease-modifying treatment is currently available. Only symptomatic treatment can be offered. Chorea is the most common motor manifestation of HD and may interfere with daily activities, reduce quality of life and cause injury. Areas covered: Deutetrabenazine is the first deuterated drug and second drug after tetrabenazine, the classic vesicular monoamine transporter type 2 (VMAT2) inhibitor, to receive approval for the treatment of chorea associated with HD. This review, based largel...
Source: Expert Review of Neurotherapeutics - July 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on intracerebral stem cell grafts.
Authors: Neal EG, Liska MG, Lippert T, Lin R, Gonzalez M, Russo E, Xu K, Ji X, Vale F, van Loveren H, Borlongan CV Abstract INTRODUCTION: Primary neurological disorders are notoriously debilitating and deadly, and over the past four decades stem cell therapy has emerged as a promising treatment. Translation of stem cell therapies from the bench to the clinic requires a better understanding of delivery protocols, safety profile, and efficacy in each disease. Areas Covered: In this review, benefits and risks of intracerebral stem cell transplantation are presented for consideration. Milestone discoveries in stem cell ap...
Source: Expert Review of Neurotherapeutics - July 3, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Advances in autoimmune myasthenia gravis management.
Authors: Wang S, Breskovska I, Gandhy S, Punga AR, Guptill JT, Kaminski HJ Abstract INTRODUCTION: Myasthenia gravis (MG) is an autoimmune neuromuscular disorder with no cure and conventional treatments limited by significant adverse effects and variable benefit. In the last decade, therapeutic development has expanded based on improved understanding of autoimmunity and financial incentives for drug development in rare disease. Clinical subtypes exist based on age, gender, thymic pathology, autoantibody profile, and other poorly defined factors, such as genetics, complicate development of specific therapies. Areas cove...
Source: Expert Review of Neurotherapeutics - June 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Value of nerve biopsy in the management of peripheral neuropathies.
Authors: Mathis S, Magy L, Le Masson G, Richard L, Soulages A, Solé G, Duval F, Ghorab K, Vallat JM, Duchesne M Abstract INTRODUCTION: Peripheral neuropathy is a common symptom throughout the population, with numerous possible etiologies. The diagnosis of peripheral neuropathies (and their causes) is mainly based on clinical, electrophysiological, biological and imaging features. Areas covered: This paper reviews the main causes of neuropathy and discuss the usefulness of nerve biopsy (NB) in such cases. Expert Commentary: In most cases, NB is not mandatory in the diagnostic work-up of a peripheral neuropathy. ...
Source: Expert Review of Neurotherapeutics - June 21, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The diagnosis of progressive supranuclear palsy: current opinions and challenges.
Authors: Ali F, Josephs K Abstract INTRODUCTION: Progressive supranuclear palsy (PSP) is associated with microtubule associated protein tau dysfunction. Originally thought to result in a syndrome of atypical parkinsonism, vertical supranuclear gaze palsy and cognitive impairment, several additional phenotypic manifestations of PSP pathology have been described over the last 20 years. Furthermore, prototypical PSP features may develop late, making early diagnosis challenging. Areas covered: An in-depth view of emerging knowledge in the field of PSP. Advances in clinicopathologic correlation, blood, cerebrospinal, and m...
Source: Expert Review of Neurotherapeutics - June 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Sleep disorders and the risk of stroke.
Authors: McDermott M, Brown DL, Chervin RD Abstract INTRODUCTION: Stroke is a major cause of disability and death in the United States and across the world, and the incidence and prevalence of stroke are expected to rise significantly due to an aging population. Obstructive sleep apnea, an established independent risk factor for stroke, is a highly prevalent disease that is estimated to double the risk of stroke. It remains uncertain whether non-apnea sleep disorders increase the risk of stroke. Areas covered: This paper reviews the literature describing the association between incident stroke and sleep apnea, REM sle...
Source: Expert Review of Neurotherapeutics - June 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Efficacy and mode of action of external trigeminal neurostimulation in migraine.
Authors: Schoenen J, Coppola G Abstract INTRODUCTION: Available preventive drug treatments for migraine lack complete efficacy and often have unpleasant adverse effects. Hence their clinical utility and therapeutic adherence are limited. Hence, non-invasive neurostimulation methods applied over various peripheral sites (forehead, mastoid, upper arm, cervical vagus nerve) have raised great interest because of their excellent efficacy/tolerance profile. Amongst them external trigeminal nerve stimulation (eTNS) was first to obtain FDA approval for migraine therapy. Areas covered: All clinical trials of eTNS as preventive...
Source: Expert Review of Neurotherapeutics - June 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Advances in migraine neuroimaging and clinical utility: from the MRI to the bedside.
This article aims to review the recent advances in functional neuroimaging, the consequent progress in the knowledge of migraine pathophysiology and their putative application and impact in the clinical setting. A comprehensive review was conducted of PubMed citations by entering the key word "MRI" combined with "migraine" AND/OR "headache." Other key words included "grey matter" OR "white matter", "structural" OR "functional". The only restriction was English-language publication. The abstracts of all articles meeting these criteria were reviewed, and f...
Source: Expert Review of Neurotherapeutics - June 9, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Testosterone and estrogen in multiple sclerosis: from pathophysiology to therapeutics.
Authors: Collongues N, Patte-Mensah C, de Seze J, Mensah-Nyagan AG, Derfuss T Abstract INTRODUCTION: Neuroprotection and remyelination are two unmet needs in the treatment of multiple sclerosis (MS). Therapeutic potential has been identified with sexual hormones, supported in women by a decrease in MS activity during the pregnancy, in men by a greater severity of symptoms and a faster progression than in women. Areas covered: The therapeutic effect of testosterone and estrogens is reviewed. Both hormones have demonstrated an anti-inflammatory effect. Testosterone has an effect in protecting neurons in culture against ...
Source: Expert Review of Neurotherapeutics - May 29, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Epigenetic regulatory modifications in genetic and sporadic frontotemporal dementia.
Authors: Fenoglio C, Scarpini E, Galimberti D Abstract INTRODUCTION: Epigenetic modifications have recently been linked to neurodegenerative diseases such as frontotemporal dementia (FTD), which represents the second most common form of dementia in adulthood after Alzheimer's disease (AD). Epigenetic regulation occurs at different cellular levels and serve as a way to alter genetic information not only in aging but also following environmental signals. Thus, epigenetics mechanisms could exert their function at early stage of the disease, especially in sporadic cases. Areas covered: Herein, the available evidence suppo...
Source: Expert Review of Neurotherapeutics - May 29, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Cerebral amyloid angiopathy: diagnosis and potential therapies.
Authors: Weber SA, Patel RK, Lutsep HL Abstract INTRODUCTION: Cerebral amyloid angiopathy (CAA) is characterized by the pathologic deposition of amyloid-beta within cortical and leptomeningeal arteries, arterioles, capillaries and, in rare cases, the venules of the brain. It is often associated with the development of lobar intracerebral hemorrhages but may cause other neurologic symptoms or be asymptomatic. Magnetic resonance imaging characteristics, such as lobar microbleeds, support a diagnosis of CAA and assist with hemorrhage risk assessments. Immunosuppressants are used to treat rarer inflammatory forms of CAA. ...
Source: Expert Review of Neurotherapeutics - May 25, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Surgical treatment of dystonia.
Authors: Cury RG, Kalia SK, Shah BB, Jimenez-Shahed J, Prashanth LK, Moro E Abstract INTRODUCTION: Treatment of dystonia should be individualized and tailored to the specific needs of patients. Surgical treatment is an important option in medically refractory cases. Several issues regarding type of the surgical intervention, targets, and predict factors of benefit are still under debate. Areas covered: To date, several clinical trials have proven the benefit and safety of deep brain stimulation (DBS) for inherited and idiopathic isolated dystonia, whereas there is still insufficient evidence in combined and acquired d...
Source: Expert Review of Neurotherapeutics - May 22, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Therapies for mobility disability in persons with multiple sclerosis.
Authors: Baird JF, Sandroff BM, Motl RW Abstract INTRODUCTION: Mobility disability is one of the most widespread and impactful consequences of multiple sclerosis (MS). Disease modifying drugs (DMDs) may delay the progression of disability over time; however, there is minimal evidence supporting the efficacy of DMDs for reversing mobility disability or restoring ambulatory function in persons with MS. Areas covered: This review outlines symptomatic pharmacologic and non-pharmacologic therapeutic approaches that target mobility disability with the goal of restoring and improving walking function. First, the efficacy of ...
Source: Expert Review of Neurotherapeutics - May 19, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The modern role of antipsychotics for the treatment of agitation and psychosis in Alzheimer's disease.
Authors: Creese B, Da Silva MV, Johar I, Ballard C Abstract INTRODUCTION: Antipsychotics have long been the mainstay of treatment for agitation and psychosis in Alzheimer's disease. Despite their current use successive studies have shown that they only confer a modest benefit which must be balanced against their well-established serious side effects (extrapyramidal symptoms, stroke, accelerated cognitive decline and mortality). Areas covered: This review outlines the current guidance on antipsychotic usage and the evidence of their continued usage against a backdrop of emerging pharmacological treatments and an increa...
Source: Expert Review of Neurotherapeutics - May 17, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The interactions between non-motor symptoms of Parkinson's disease.
Authors: Ehgoetz Martens KA, Shine JM PMID: 29722588 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - May 4, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Perispinal etanercept advances as a neurotherapeutic.
Authors: Tobinick E PMID: 29695205 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - April 27, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Deep brain stimulation for trigeminal autonomic cephalalgias.
Authors: Messina G, Broggi G, Levi V, Franzini A Abstract INTRODUCTION: Deep brain stimulation (DBS) of the posterior hypothalamic region (pHyr) has been shown to be efficacious for more than a half of patients suffering from trigeminal autonomic cephalalgias (TACs); nonetheless, controversies about the mechanisms of action and the actual site of stimulation have arisen in recent years. Areas covered: Firstly, a review of the most recent literature on the subject is presented, stressing the critical points that could, in the future, make a difference for optimal management of patients afflicted by these life-threating...
Source: Expert Review of Neurotherapeutics - April 20, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Transdermal buprenorphine for moderate chronic noncancer pain syndromes.
Authors: Pergolizzi JV, Coluzzi F, Taylor R Abstract INTRODUCTION: Chronic noncancer pain has remained a challenging clinical problem. Opioid analgesics are effective, but they are known to be associated with opioid use disorder and potentially treatment-limiting side effects. Buprenorphine is a Schedule III synthetic opioid in the USA with a chemical structure similar to that of morphine but with a longer duration of action, greater potency, and other unique pharmacological attributes. Its role in treatment of chronic noncancer pain may be broader than currently thought. Areas covered: The pharmacokinetics, pharmacod...
Source: Expert Review of Neurotherapeutics - April 19, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Implications of structural and functional brain changes in amyotrophic lateral sclerosis.
Authors: Dharmadasa T, Huynh W, Tsugawa J, Shimatani Y, Ma Y, Kiernan MC Abstract INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that causes progressive muscle weakness and disability, eventually leading to death. Heterogeneity of disease has become a major barrier to understanding key clinical questions such as prognosis and disease spread, and has disadvantaged clinical trials in search of therapeutic intervention. Patterns of disease have been explored through recent advances in neuroimaging, elucidating structural, molecular and functional changes. Unique brain signatures have eme...
Source: Expert Review of Neurotherapeutics - April 19, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Chronic subdural collection overlying an intra-axial hemorrhagic lesion in chronic myelomonocytic leukemia: special report and review of the literature.
Authors: Bernat AL, Priola SM, Elsawy A, Farrash F, Taslimi S, Gentili F Abstract INTRODUCTION: Chronic myelomonocytic leukaemia (CMML) is a clonal hematopoietic stem cell disorder characterized by the presence of an absolute monocytosis in the peripheral blood (>1 x 109/L) and the presence of myelodysplastic and myeloproliferative features in the bone marrow. Involvement of the central nervous system (CNS) is uncommon in CMML. Areas covered: Herein described is a case report of a CMML patient who presents with symptomatic chronic subdural collection overlying a haemorrhagic brain lesion, along with diffuse dural i...
Source: Expert Review of Neurotherapeutics - April 17, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Oxidative stress in epilepsy.
Authors: Geronzi U, Lotti F, Grosso S Abstract INTRODUCTION: The brain is particularly susceptible to oxidative stress being the most aerobically active organ in the body due to its high metabolic demands. There is evidence that neuronal hyperexcitability and oxidative injury produced by an excessive production of free radicals may play a role in the initiation and progression of epilepsy. Understanding the role of oxidative stress in epileptogenesis is essential to delineate appropriate therapeutic strategies. Neuroprotectant or antioxidant compounds may exert positive effects when associated with antiepileptic drugs...
Source: Expert Review of Neurotherapeutics - April 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

To diagnose or not to diagnose? Timing is the question: balancing early diagnosis of multiple sclerosis with misdiagnosis.
Authors: Dixon C, Robertson D PMID: 29641937 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - April 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Challenges and prospects in the diagnosis and treatment of primary central nervous system lymphoma.
Authors: Citterio G, Calimeri T, Ferreri AJM Abstract INTRODUCTION: Primary central nervous system lymphoma (PCNSL) retains peculiar biological and clinical characteristics and a worse prognosis with respect to other comparable lymphomas. The need for high doses of chemotherapy to achieve valid drug concentrations in cerebral tissues and/or radiotherapy results in severe treatment-related toxicities, mainly neurologic, which are frequently as disabling as the disease itself. Areas covered: Several emerging combined therapies are addressed that focus on treating PCNSL. The prognosis has improved in the last years but s...
Source: Expert Review of Neurotherapeutics - April 12, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Neuroimaging in amyotrophic lateral sclerosis: current and emerging uses.
Authors: Agosta F, Spinelli EG, Filippi M Abstract INTRODUCTION: Several neuroimaging techniques have been used to define in vivo markers of pathological alterations underlying amyotrophic lateral sclerosis (ALS). Growing evidence supports the use of magnetic resonance imaging (MRI) and positron emission tomography (PET) for the non-invasive detection of central nervous system involvement in patients with ALS. Areas covered: A comprehensive overview of structural and functional neuroimaging applications in ALS is provided, focusing on motor and extra-motor involvement in the brain and the spinal cord. Implications for...
Source: Expert Review of Neurotherapeutics - April 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Astroglial 5-HT2B receptor in mood disorders.
Authors: Peng L, Song D, Li B, Verkhratsky A Abstract INTRODUCTION: Astroglia represent the main cellular homeostatic system of the central nervous system (CNS). Astrocytes are intimately involved in regulation and maintenance of neurotransmission by regulating neurotransmitters removal and turnover and by supplying neurons with neurotransmitters precursors. Astroglial cells are fundamental elements of monoaminergic transmission in the brain and in the spinal cord. Astrocytes receive monoaminergic inputs and control catabolism of monoamines through dedicated transporters and intracellular enzymatic pathways. Areas cov...
Source: Expert Review of Neurotherapeutics - March 31, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Do pre-clinical multiple sclerosis models allow us to measure neurodegeneration and clinical progression?
Authors: Hochstrasser T, Jiangshan Z, Rühling S, Schmitz C, Kipp M PMID: 29589965 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - March 29, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pediatric epilepsy surgery: the earlier the better.
Authors: Braun KPJ, Cross JH PMID: 29560752 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - March 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Precipitation and inhibition of seizures in focal epilepsies.
Authors: MameniškienÄ— R, Wolf P Abstract INTRODUCTION: There is growing awareness that reflex epileptic seizures offer unique insight into natural seizure generation in humans. In the last years, focus has mostly been on reflex seizures in generalized epilepsies whereas a comprehensive review of their role in focal epilepsies has been missing. Areas covered: This paper reviews reflex seizures strictly in focal epilepsies, not including focal reflex seizures in system epilepsies that also exist. They were categorized according to their triggers which can be sensory or cognitive, simple or complex. Numerous dive...
Source: Expert Review of Neurotherapeutics - March 24, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Tardive dyskinesia: placing vesicular monoamine transporter Type 2 (VMAT2) Inhibitors into Clinical Perspective.
Authors: Citrome L Abstract INTRODUCTION: Tardive dyskinesia (TD) is an iatrogenic movement disorder caused by exposure to dopamine receptor blocking agents. Two vesicular monoamine transporter type 2 (VMAT2) inhibitors for the treatment of TD were approved by the US Food and Drug Administration in 2017: valbenazine and deutetrabenazine. Areas covered: A brief review of TD and its identification, as well as a review of older treatment interventions is provided, followed by a detailed synthesis regarding the clinical utility of valbenazine and deutetrabenazine. Expert Commentary: As evidenced from well-designed clinica...
Source: Expert Review of Neurotherapeutics - March 21, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Low TT4 as a predictor of poor outcomes in severe encephalitis: a multivariate analysis of 94 patients.
Authors: Feng G, Tian X, Wang L, Zhao L, Wang X Abstract BACKGROUND: To investigate the prognostic value of acute thyroid function in patients with severe encephalitis. METHODS: We retrospectively analyzed information from patients with severe encephalitis from June 2012 to June 2017. Using multivariate logistic regression analysis, we examined predictors of poor outcomes in these patients after 6 months. RESULTS: A total of 94 patients with severe encephalitis were included in the study. Univariate analysis showed that patients with good or poor outcomes had significantly different total thyroxine (TT4) (P = 0....
Source: Expert Review of Neurotherapeutics - March 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Neurocysticercosis: the good, the bad, and the missing.
Authors: Carpio A, Fleury A, Romo ML, Abraham R Abstract INTRODUCTION: Neurocysticercosis (NC) is a neglected disease that contributes substantially to neurological morbidity/mortality in lower-income countries and increasingly among high-income countries due to migration. Many advances have been made in understanding NC, but unanswered questions remain Areas covered: This review discusses the epidemiology, pathophysiology, immunology, diagnosis, treatment, and eradication of NC. Expert commentary: The global NC prevalence remains unknown and needs proper ascertainment. Further understanding of the pathophysiology of ...
Source: Expert Review of Neurotherapeutics - March 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Improving surgical outcome for gliomas with intraoperative mapping.
Authors: Ferracci FX, Duffau H Abstract INTRODUCTION: Radical glioma resection improves overall survival, both in low-grade and high-grade glial tumors. However, preservation of the quality of life is also crucial. Areas covered: Due to the diffuse feature of gliomas, which invade the central nervous system, and due to considerable variations of brain organization among patients, an individual cerebral mapping is mandatory to solve the classical dilemma between the oncological and functional issues. Because functional neuroimaging is not reliable enough, intraoperative electrical stimulation, especially in awake patie...
Source: Expert Review of Neurotherapeutics - March 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

A novel scoring system to predict the outcomes of adult patients with hypoxic-ischemic encephalopathy.
Authors: Li F, Liu G, Tian X, Quan F, Li B, Feng G, Wang X, Hu Y Abstract OBJECTIVES: Adult patients with hypoxic-ischemic encephalopathy (HIE) often incur large costs, but their outcomes are poor. Currently, there is lack of a comprehensive quantitative approach to predict patient prognoses. METHODS: A total of 73 adult patients with HIE participated in this prospective, observational study. Clinical assessments, laboratory tests, and electrophysiological examinations were conducted within 3 days after HIE occurred. Logistic regression model was used to identify independent factors associated with patient outcomes...
Source: Expert Review of Neurotherapeutics - March 3, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Surgical treatments for essential tremor.
Authors: Elble RJ, Shih L, Cozzens JW Abstract INTRODUCTION: Essential tremor is the most common form of pathologic tremor. Surgical therapies disrupt tremorogenic oscillation in the cerebellothalamocortical pathway and are capable of abolishing severe tremor that is refractory to available pharmacotherapies. Surgical methods are rapidly improving and are the subject of this review. Areas covered: A PubMed search on January 18, 2018 using the query essential tremor AND surgery produced 839 abstracts. 379 papers were selected for review of the methods, efficacy, safety and expense of stereotactic deep brain stimulation...
Source: Expert Review of Neurotherapeutics - February 25, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Recent advances in the management of chronic migraine in children.
Authors: Arruda MA, Chevis CF, Bigal ME Abstract INTRODUCTION: Migraine is a chronic-recurrent disorder that progresses in some adults and also in many children. Chronic migraine (CM) is the clinical result of this process. Since migraine does not progress in most children, identifying the risk factors for progression is an important public health priority that should be matched by evidence-based treatment. Areas covered: Herein we conduct a systematic review on the comorbidities and treatment of CM in children and adolescents in the last ten years, summarizing evidence-based recommendations for disease management. Ex...
Source: Expert Review of Neurotherapeutics - February 14, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Identifying and mitigating Sudden Unexpected Death in Epilepsy (SUDEP) risk factors.
Authors: Watkins L, Shankar R, Sander JW Abstract INTRODUCTION: Sudden Unexpected Death in Epilepsy (SUDEP) is a significant cause of death for people with chronic epilepsy. Good practice guidance in the UK and the USA expect SUDEP to be discussed with the individual. The event rarity, methodological variance and lack of robust research into the pathological mechanisms, associated risk factors, and management strategies have created a challenge on how and what to discuss. There are some significant associations which allows for risk assessment and mitigation. Areas covered: The current understanding of static and modi...
Source: Expert Review of Neurotherapeutics - February 10, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research