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Current treatment options for meningioma.
Authors: Apra C, Peyre M, Kalamarides M Abstract INTRODUCTION: With an annual incidence of 5/100,000, meningioma is the most frequent primary tumor of the central nervous system. Risk factors are radiotherapy and hormone intake. Most meningiomas are grade I benign tumors, but up to 15% are atypical and 2% anaplastic according to the WHO 2016 histological criteria. Areas covered: This review details the current standard therapy based on international guidelines and recent literature, and describes new approaches developed to treat refractory cases. First-line treatments are observation and surgery, but adjuvant radioth...
Source: Expert Review of Neurotherapeutics - January 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

mTOR dysregulation and tuberous sclerosis-related epilepsy.
Authors: Curatolo P, Moavero R, van Scheppingen J, Aronica E Abstract INTRODUCTION: The mammalian target of rapamycin (mTOR) pathway has emerged as a key player for proper neural network development, and it is involved in epileptogenesis triggered by both genetic or acquired factors. Areas covered. The robust mTOR signaling deregulation observed in a large spectrum of epileptogenic developmental pathologies, such as focal cortical dysplasias and tuberous sclerosis complex (TSC), has been linked to germline and somatic mutations in mTOR pathway regulatory genes, increasing the spectrum of "mTORopathies". The ...
Source: Expert Review of Neurotherapeutics - January 18, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Immunotherapy for brain tumors: understanding early successes and limitations.
Authors: Lieberman NAP, Vitanza NA, Crane CA Abstract INTRODUCTION: Adverse effects and toxicities related to standard treatments for brain tumors significantly reduce patients' quality of life. Although most immunotherapy approaches for solid tumors have not been successful, several early-phase clinical trials are beginning to reveal a potential role for immunotherapy in the treatment of brain tumors. In particular, methods that activate the innate immune system and induce a polyclonal anti-cancer response have demonstrated that brain tumors are susceptible to immune-mediated tumor destruction. Compared with conventi...
Source: Expert Review of Neurotherapeutics - January 13, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Do anti-epileptic drugs increase suicide in epilepsy? 10 years after the FDA alert.
Authors: Mula M PMID: 29319362 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - January 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The ILAE Classification of Seizures and Epilepsies: Implications for the Clinic.
Authors: Beghi E, Sander JW Abstract INTRODUCTION: The classification of epileptic seizures and the epilepsies has recently been revised by the International League Against Epilepsy (ILAE) and a new classification scheme issued. Areas covered: The new classification scheme has been critically appraised in the light of the previous classifications and subsequent revisions. The purposes of the classification and its potential use have been extensively discussed. Expert Commentary: This ILAE classification scheme, the latest of a series of proposals published in the last thirty years, has made progress as it has a multi-...
Source: Expert Review of Neurotherapeutics - January 11, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Clinical implications of myelin regeneration in the central nervous system.
Authors: McMurran CE, Kodali S, Young A, Franklin RJ Abstract INTRODUCTION: Amongst strategies to repair the brain, myelin repair offers genuine cause for optimism. Myelin, which sheaths most axons in the central nervous system (CNS), is vital for normal neurological function, as demonstrated by the functional deficits that accrue when it is absent in a range of debilitating myelin diseases. Following demyelination, post-mortem and imaging studies have shown that extensive regeneration of myelin is possible in the human brain. Over recent decades preclinical research has given us a strong understanding of the biology ...
Source: Expert Review of Neurotherapeutics - December 30, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Optimizing the long-term management of chronic migraine with onabotulinumtoxinA in real life.
Authors: Tassorelli C, Tedeschi G, Sarchielli P, Pini LA, Grazzi L, Geppetti P, De Tommaso M, Aguggia M, Cortelli P, Martelletti P Abstract INTRODUCTION: Management of chronic migraine is challenging. OnabotulinumtoxinA (OBT-A) is the only medication licensed for prevention of chronic migraine, and has been widely adopted in clinical practice. Limited data is available on its long-term use. Areas covered: Data from controlled trials are combined with available data on the long-term use of OBT-A in real-life studies, with information obtained in a recent survey among Italian headache centers, and the clinical experienc...
Source: Expert Review of Neurotherapeutics - December 28, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Normobaric hyperoxia after stroke: a word of caution.
Authors: Taccone FS, Crippa IA, Vincent JL PMID: 29233067 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - December 14, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Tourette syndrome and other chronic tic disorders: an update on clinical management.
Authors: Martino D, Pringsheim TM Abstract INTRODUCTION: The management of Tourette syndrome (TS) and other chronic tic disorders occurs in multiple stages and begins with comprehensive assessment and complex psychoeducation. Behavioral and pharmacological interventions (second stage) are needed when tics cause physical or psychosocial impairment. Deep brain stimulation surgery or experimental therapies represent the third stage. Areas covered: Discussed are recent advances in assessment and therapy of chronic tic disorders, encompassing the three stages of intervention, with the addition of experimental, non-invasive...
Source: Expert Review of Neurotherapeutics - December 9, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Dysautonomia in the pathogenesis of migraine.
Authors: Gazerani P, Cairns BE Abstract INTRODUCTION: Migraine is a common complex neurological disorder involving multiple brain areas that regulate autonomic, affective, cognitive, and sensory functions. This review explores autonomic nervous system (ANS) dysfunction in migraine headache sufferers. Areas covered: Reference material for this review was obtained through PubMed searches. Migraine attacks can present with up to 4 phases (premonitory, aura, headache, postdrome) each with distinguishable signs and symptoms. Altered ANS tone can be found from the premonitory through the postdrome phases. Features of the mi...
Source: Expert Review of Neurotherapeutics - December 8, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Brain Circuits and Neurochemical Systems in Essential Tremor:Insights into Current and Future Pharmacotherapeutic Approaches.
Authors: Schaefer SM, Vives Rodriguez A, Louis ED Abstract INTRODUCTION: There are few medications that are available for the treatment of essential tremor (ET) and they are only moderately effective. Areas covered: Data were obtained from a PubMed search. Original articles, review articles, and clinical guidelines were included. Two disease models for ET have been proposed: 1) the olivary model, which attributes ET to a pathological pacemaker in the inferior olivary nucleus, and 2) the cerebellar degeneration model, which postulates that ET originates in the cerebellum and could be related to deficient or abnormal Pu...
Source: Expert Review of Neurotherapeutics - December 6, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The role of electroencephalogram in neonatal seizure detection.
Authors: Pisani F, Pavlidis E Abstract INTRODUCTION: The role of EEG in neonatal seizure detection is well-established, being the multichannel video-EEG the gold standard. However, in the clinical practice often amplitude integrated EEG (aEEG) is used, in order to overcome the difficulties related to EEG use. Areas covered: An overview regarding neonatal seizures, current tools used to detect these (multichannel EEG versus aEEG) with respective strenghts and limitations, and some tools that can implement the use of multichannel EEG in the NICU. Expert commentary: Multichannel video-EEG is still a gold standard for sei...
Source: Expert Review of Neurotherapeutics - December 5, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Immune-based strategies for mood disorders: facts and challenges.
Authors: Colpo GD, Leboyer M, Dantzer R, Trivedi MH, Teixeira AL Abstract INTRODUCTION: Inflammation seems to play a role in the pathophysiology of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). In the last years several studies have shown increased levels of inflammatory and/or immune markers in patients with mood disorders. Accordingly, the immune system has become a target of interest for the development of biomarkers and therapeutics for mood disorders. Areas covered: Here, we review the evidence showing low-grade inflammation in mood disorders and the studies evaluating immun...
Source: Expert Review of Neurotherapeutics - November 29, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pharmacotherapy and motor recovery after stroke.
Authors: Viale L, Catoira NP, Di Girolamo G, González CD Abstract INTRODUCTION: Stroke is one of the most prevalent neurological diseases worldwide, especially among the elderly population. There are various mechanisms that enhance motor recovery after a stroke. In clinical practice, we have the opportunity to enhance plasticity by designing specific rehabilitation programs. Areas covered: There are a variety of drugs commonly administered to people after the acute phase of a stroke. These drugs may modify motor performance. Herein reviewed is the evidence concerning motor enhancement or decline in stroke patie...
Source: Expert Review of Neurotherapeutics - November 11, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Treatment options for chorea.
Authors: Bashir H, Jankovic J Abstract INTRODUCTION: Chorea is defined as jerk-like movements that move randomly from one body part to another. It is due to a variety of disorders and although current symptomatic therapy is quite effective there are few etiology- or pathogenesis-targeted therapies. The aim of this review is to summarize our own experience and published evidence in the treatment of chorea. Areas covered: After evaluating current guidelines and clinical practices for chorea of all etiologies, PubMed was searched for the most recent clinical trials and reviews using the term 'chorea' cross referenced wit...
Source: Expert Review of Neurotherapeutics - November 10, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Nummular headache: an update and future prospects.
This article reviews epidemiological and clinical features of NH, the most recently proposed pathophysiological mechanisms, and state-of-the-art management according to the literature. Expert commentary: Information regarding true incidence and prevalence is lacking, but NH is a fairly common disorder in patients attending a headache clinic. Diagnostic work-up requires the exclusion of systemic and structural disease by a thorough physical examination, blood tests including immunology screening, and neuroimaging. No clinical trials have been conducted for NH, so the level of evidence for any treatment is low. Gabapentin se...
Source: Expert Review of Neurotherapeutics - November 7, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Long-term effects of internet-supported cognitive behaviour therapy.
Authors: Andersson G, Rozental A, Shafran R, Carlbring P Abstract INTRODUCTION: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer. Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Swe...
Source: Expert Review of Neurotherapeutics - November 3, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Protective Roles of Intestinal Microbiota derived Short Chain Fatty Acids in Alzheimer's Disease-type Beta-Amyloid Neuropathological Mechanisms.
CONCLUSION: Our studies support the hypothesis that intestinal microbiota may help protect against AD, in part, by supporting the generation of select SCFAs, which interfere with the formation of toxic soluble Aß aggregates. PMID: 29095058 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - November 3, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Key findings from the Atahualpa Project: what should we learn?
Authors: Del Brutto OH, Mera RM, Castillo PR, Del Brutto VJ PMID: 29088979 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - November 2, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on the diagnosis and treatment of vestibular schwannoma.
Authors: Halliday J, Rutherford SA, McCabe M, Evans GD Abstract INTRODUCTION: Vestibular schwannomas (VS) account for approximately 85% of tumors in the cerebello-pontine angle, with a lifetime incidence of approximately 1 in 1000. Most are sporadic, with approximately 5% related to the tumor predisposition syndrome Neurofibromatosis Type 2 (NF2). The mainstays of management strategies are: observation, surgery, radiosurgery/radiotherapy and, for patients with NF2 and rapidly growing tumors or deteriorating neurologic function the targeted therapy bevacizumab. While morbidity and mortality rates related to treatment o...
Source: Expert Review of Neurotherapeutics - November 2, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Comprehensive grading of Parkinson's disease using motor and non-motor assessments: Addressing a key unmet need.
Authors: Martinez-Martin P, Ray Chaudhuri K Abstract INTRODUCTION: Parkinson's disease (PD) is expressed through motor and non-motor symptoms (NMS) that differ considerably in presence and severity among patients and over time. Furthermore, the progression pattern of the NMS does not necessarily parallel the course of the motor impairment. Gradation of PD according to the motor impairment and burden of NMS is an unmet need for an appropriate management of patients. Areas covered: A review of the studies on clinical gradation methods applied to PD is carried out in this article. Studies have provided cut-off values for...
Source: Expert Review of Neurotherapeutics - November 2, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Improving diagnosis of childhood stroke arterial ischemic stroke.
Authors: Mackay MT, Monagle P, Babl FE Abstract INTRODUCTION: At least half of childhood stroke survivors suffer long-term impairments. Rapid identification of stroke is essential to minimize the extent of injury by restoring perfusion to viable brain. Improving diagnosis of childhood stroke requires correct identification of stroke by prehospital and emergency physicians, rapid performance of appropriate neuroimaging to confirm infarction, and targeted investigations to determine underlying causes, which guide treatment decisions to reduce recurrence risk. Areas covered: This review will summarize the barriers to rap...
Source: Expert Review of Neurotherapeutics - October 24, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

ROCK as a therapeutic target for ischemic stroke.
Authors: Sladojevic N, Yu B, Liao JK Abstract INTRODUCTION: Stroke is a major cause of disability and the fifth leading cause of death. Currently, the only approved acute medical treatment of ischemic stroke is tissue plasminogen activator (tPA), but its effectiveness is greatly predicated upon early administration of the drug. There is, therefore, an urgent need to find new therapeutic options for acute stroke. Areas covered: In this review, we summarize the role of Rho-associated coiled-coil containing kinase (ROCK) and its potential as a therapeutic target in stroke pathophysiology. ROCK is a major regulator of cel...
Source: Expert Review of Neurotherapeutics - October 24, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Management of post-stroke mood and emotional disturbances.
Authors: Kim JS Abstract INTRODUCTION: Mood and emotional disturbances are common in stroke patients. Out of diverse post-stroke emotional disturbances, depression, anxiety, emotional incontinence, anger proneness, and fatigue are frequent and important symptoms. These symptoms are distressing for both the patients and their caregivers, and negatively influence the patient's quality of life. The emotional symptoms are not apparent and are therefore often neglected by neurologists. Their phenomenology, predicting factors, and pathophysiology have been under-studied, and are under-recognized. In addition, well-designed ...
Source: Expert Review of Neurotherapeutics - October 24, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

It is dopey to stop giving dopamine to hospitalized patients with Parkinson's disease.
Authors: Margolesky J, Singer C PMID: 29027821 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - October 15, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Potential clinical utility of multiple system atrophy biomarkers.
Authors: Jellinger KA Abstract INTRODUCTION: Multiple system atrophy (MSA), an adult-onset, fatal disorder of uncertain aetiology, characterized by parkinsonism, cerebellar, autonomic and motor dysfunctions, is an α-synucleinopathy with glioneuronal degeneration involving multiple parts of the nervous system. The clinical variants correlate with the morphological phenotypes of striatonigral degeneration (MSA-P), olivoponto-cerebellar atrophy (MSA-C), and mixed type MSA. Neuropathological hallmark is the deposition of aberrant α-synuclein in glia and neurons forming cytoplasmic inclusions that cause cell dy...
Source: Expert Review of Neurotherapeutics - October 13, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Valbenazine for the treatment of tardive dyskinesia.
Authors: Müller T Abstract Introduction Chronic intake of typical neuroleptics or centrally acting dopamine receptor blocking antiemetics may cause onset of tardive syndromes. Various types exist. One of them is tardive dyskinesia, characterised by often stigmatising, purposeless, rapid, repetitive, stereotypic, involuntary movements of face, limbs or trunk. Effective symptomatic drug treatment options beyond application of tetrabenazine are rare. Tetrabenazine is usually administered three times daily due to the short half life of this agent. Areas covered This narrative review discusses the value of valbenazine...
Source: Expert Review of Neurotherapeutics - October 4, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pharmacological Therapies for Pain in Parkinson's disease - a review paper.
Authors: Rana AQ, Qureshi D, Sabeh W, Mosabbir A, Rahman E, Sarfraz Z, Rana R PMID: 28949252 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - September 28, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Treatment options for severe traumatic brain injuries in children: current therapies, challenges, and future prospects.
Authors: DelSignore LA, Tasker RC Abstract INTRODUCTION: Severe traumatic brain injury (TBI) afflicts many children and adults worldwide, resulting in high rates of morbidity and mortality. Recent therapeutic advances have focused on both surgical and medical treatment options, but none have been proven to reduce overall morbidity and mortality in this population. Areas covered: Several emerging therapies are addressed that focus on treating related secondary injuries and other clinical sequelae post-TBI during the acute injury phase (defined by authors as up to four weeks post-injury). Information and data were obtai...
Source: Expert Review of Neurotherapeutics - September 19, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Nusinersen for the treatment of spinal muscular atrophy.
This article reviews the results of the published open label nusinersen studies in infants and children, and briefly covers the preliminary findings of the recently completed but as yet unpublished nusinersen-sham controlled trials, as well as the presymptomatic nusinersen trial known as Nurture. Clinical use of nusinersen is also reviewed. Expert commentary: Collectively, the studies show improvement in motor function across SMA of all types, including SMA type 3. Best motor response was observed with early treatment; presymptomatic treatment prevented disease manifestations. Nusinersen was found to be safe and well toler...
Source: Expert Review of Neurotherapeutics - September 9, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Recovery and Serious Mental Illness: A review of current clinical and research paradigms and future directions.
Authors: Leonhardt BL, Huling K, Hamm JA, Roe D, Hasson-Ohayon I, McLeod HJ, Lysaker PH Abstract INTRODUCTION: Recovery from serious mental illness has historically not been considered a likely or even possible outcome. However, a range of evidence suggests the courses of SMI are heterogeneous with recovery being the most likely outcome. One barrier to studying recovery in SMI is that recovery has been operationalized in divergent and seemingly incompatible ways, as an objective outcome, versus a subjective process. Areas Covered: This paper offers a review of recovery as a subjective process and recovery as an object...
Source: Expert Review of Neurotherapeutics - September 9, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Anti lingo 1 (opicinumab) a new monoclonal antibody tested in Relapsing Remitting Multiple Sclerosis.
Authors: Ruggieri S, Tortorella C, Gasperini C Abstract INTRODUCTION: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). The modern treatment era for MS witnessed a growing pool of drugs now available for use in clinical practice. These therapies work at different levels, however there is a lack of treatments acting on the neurodegenerative component or improving mechanism of repair. Areas covered: The latest knowledge about the pathophysiological changes occurring in MS have translated into novel treatments at different stages of development. Drugs for MS work mainly throu...
Source: Expert Review of Neurotherapeutics - September 9, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on behavioral treatments in migraine - current knowledge and future options.
Authors: Kropp P, Meyer B, Meyer W, Dresler T Abstract INTRODUCTION: Besides pharmacological and interventional treatments a variety of non-medical therapeutic options exist for migraine, which has largely been derived from behavioral therapy. Areas covered: For our update we collected available studies via PubMed searches. This review highlights that already consulting of the patient is able to reduce the frequency of migraine attacks. Relaxation techniques, especially progressive muscle relaxation, and various types of biofeedback are effective, as is the implementation of cognitive behavioral therapy. However, rece...
Source: Expert Review of Neurotherapeutics - September 8, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Normobaric hyperoxygenation: a potential neuroprotective therapy for acute ischemic stroke?
Authors: Poli S, Baron JC, Singhal AB, Härtig F PMID: 28872934 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - September 6, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pseudoprogression after glioma therapy: an update.
Authors: Galldiks N, Kocher M, Langen KJ Abstract INTRODUCTION: Initial diagnostics and follow-up of gliomas is usually based on contrast-enhanced MRI. However, the capacity of standard MRI to differentiate neoplastic tissue from posttherapeutic effects such as pseudoprogression is limited. Advanced neuroimaging methods may provide relevant additional information, which allow for a more accurate diagnosis especially in clinically equivocal situations. This review article focuses predominantly on PET using radiolabeled amino acids and advanced MRI techniques such as perfusion-weighted imaging (PWI) and summarizes the e...
Source: Expert Review of Neurotherapeutics - September 2, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Medication-Overuse Headache. Despite the advances in understanding it, treatment evidence still lacks.
Authors: Krymchantowski AV, Jevoux CDC PMID: 28854836 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - September 1, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Efficacy of antipsychotics for irritability and aggression in children: a meta-analysis.
Authors: van Schalkwyk GI, Beyer C, Johnson J, van Rensburg S, Bloch MH Abstract BACKGROUND: Aggression and irritability in children occur across a range of diagnoses, and are associated with both economic cost and negative psychosocial outcomes. Antipsychotics are frequently prescribed in these cases. RESEARCH DESIGN AND METHODS: A random effects meta-analysis of 14 random controlled trials was conducted. Overall effect sizes for antipsychotics for irritability and aggression were extracted. Subgroup analyses were conducted according to diagnostic indication, specific medication and degree of sedation. Meta-regres...
Source: Expert Review of Neurotherapeutics - August 30, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An Update on Medications and Noninvasive Brain Stimulation to Augment Language Rehabilitation in Post-Stroke Aphasia.
Authors: Saxena S, Hillis AE Abstract INTRODUCTION: Aphasia is among the most debilitating outcomes of stroke. Aphasia is a language disorder occurring in 10-30% of stroke survivors. Speech and Language Therapy (SLT) is the gold standard, mainstay treatment for aphasia, but gains from SLT may be incomplete. Pharmaceutical and noninvasive brain stimulation (NIBS) techniques may augment the effectiveness of SLT. Areas covered: Herein reviewed are studies of the safety and efficacy of these adjunctive interventions for aphasia, including randomized placebo-controlled and open-label trials, as well as case series from Pub...
Source: Expert Review of Neurotherapeutics - August 30, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

The potential role of cannabinoids in epilepsy treatment.
Authors: De Caro C, Leo A, Citraro R, De Sarro C, Russo R, Calignano A, Russo E Abstract INTRODUCTION: Epilepsy is one of the world's oldest recognized and prevalent neurological diseases. It has a great negative impact on patients' quality of life (QOL) as a consequence of treatment resistant seizures in about 30% of patients together with drugs' side effects and comorbidities. Therefore, new drugs are needed and cannabinoids, above all cannabidiol, have recently gathered attention. Areas Covered: This review summarizes the scientific data from human and animal studies on the major cannabinoids which have been of int...
Source: Expert Review of Neurotherapeutics - August 29, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Unruptured intracranial aneurysms: Management strategy and current endovascular treatment options.
Authors: Pierot L, Gawlitza M, Soize S Abstract INTRODUCTION: Unruptured intracranial aneurysms (UIA) have a high prevalence (3.2%) and are increasingly diagnosed with modern imaging tools. The main risk of UIA is their rupture associated with intracranial bleeding with often severe clinical consequences. Areas Covered: This review discusses the management strategy of UIAs, based on the large series of the literature (ISUIA, ATENA, UCAS, …), knowing that no randomized controlled trial is available to compare different strategies. The different endovascular treatments are described. Expert Commentary: Due to the...
Source: Expert Review of Neurotherapeutics - August 24, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Long-acting injectable antipsychotics update: lengthening the dosing interval and expanding the diagnostic indications.
Authors: Citrome L Abstract INTRODUCTION: Long-acting injectable (LAI) antipsychotics are a useful but underutilized option in the management of schizophrenia. Areas covered: This is a narrative review of newer LAI antipsychotics approved by the US Food and Drug Administration and is an update to a previously published review from 2013. Emphasized are new indications and new dosing intervals. Expert commentary: Ensuring that persons receiving oral antipsychotics are aware that LAI antipsychotics are available is important. The use of LAI antipsychotics can decrease the risk of relapse in both first-episode and chronic...
Source: Expert Review of Neurotherapeutics - August 24, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Pharmacological treatment of trigeminal neuralgia.
This article, based on a systematic literature review, describes the pharmacological options, and indicates the future perspectives for treating trigeminal neuralgia. The article therefore provides current, evidence-based knowledge about the pharmacological treatment of trigeminal neuralgia, and suggests a practical approach to the various drugs, including starting dose, titration and side effects. Expert Commentary: Carbamazepine and oxcarbazepine are the reference standard drugs for treating patients with trigeminal neuralgia. They are effective in most patients. The undesired effects however cause withdrawal from treatm...
Source: Expert Review of Neurotherapeutics - August 23, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

An update on the Recognition and Treatment of Non-Convulsive Status Epilepticus in the Intensive Care Unit.
Authors: Kinney MO, Kaplan PW Abstract INTRODUCTION: Non-convulsive status epilepticus (NCSE) is a complex and diverse condition which is often an under-recognised entity in the intensive care unit. When NCSE is identified the optimal treatment strategy is not always clear. Areas covered: This review is based on a literature review of the key literature in the field over the last 5-10 years. The articles were selected based on their importance to the field by the authors. Expert commentary: This review discusses the complex situations when a neurological consultation may occur in a critical care setting and provides a...
Source: Expert Review of Neurotherapeutics - August 23, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Leukoaraiosis as an outcome predictor in the acute and subacute phases of stroke.
Authors: Fierini F, Poggesi A, Pantoni L Abstract INTRODUCTION: Leukoaraiosis (LA) is one of the neuroimaging features of cerebral small vessel disease and is associated with poor long-term prognosis. Areas covered: This narrative review focuses on the predictive role of LA on the evolution of the ischemic brain damage and on the clinical outcome in the subacute phase of stroke and in the short-term period afterwards. Expert commentary: In acute stroke, LA is associated with a less favorable fate of brain infarct and is a marker of increased risk of thrombolysis-related hemorrhagic transformation. The impaired cerebra...
Source: Expert Review of Neurotherapeutics - August 23, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Transcutaneous Electrical Nerve Stimulation (TENS) as an Adjunct for Pain Management in Perioperative Settings: A Critical Review.
Authors: Johnson MI Abstract INTRODUCTION: Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settin...
Source: Expert Review of Neurotherapeutics - August 19, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Monitoring disease progression in spinocerebellar ataxias: implications for treatment and clinical research.
Authors: Sarro L, Nanetti L, Castaldo A, Mariotti C Abstract INTRODUCTION: Spinocerebellar ataxias (SCAs) are autosomal dominant diseases characterized by progressive gait and limb incoordination, disequilibrium, dysarthria, and eye movement disturbances. Approximately 40 genetic subtypes of SCAs are known and classified according to the causative disease gene/locus. With the possibility of the specific genetic diagnosis in patients and at-risk family members, several clinical scales and functional tests have been validated and used in ataxic patients with the purposes of measuring the entity of disease progression in...
Source: Expert Review of Neurotherapeutics - August 15, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Intravenous Carbamazepine: A New Formulation of a Familiar Drug.
Authors: Klein P, Tolbert D Abstract INTRODUCTION: Oral carbamazepine (CBZ), a broad-spectrum antiseizure drug (ASD) widely used for over 50 years, remains an important treatment choice for focal (partial) epilepsy. Although CBZ is a known inducer of cytochrome P450 (CYP) isoenzymes, many prescribers fail to recognize the potential issues with CBZ induction and are therefore unaware of the risk of drug toxicity upon CBZ withdrawal. Areas covered: Managing concomitant medications in CBZ-treated patients can be difficult. Abruptly stopping CBZ treatment, as may occur when patients are unable to take oral medication, can...
Source: Expert Review of Neurotherapeutics - August 9, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Antipsychotic-Induced Tardive Dyskinesia: From biological basis to clinical management.
Authors: Salem H, Pigott T, Zhang XY, Zeni C, Teixeira AL Abstract INTRODUCTION: Tardive dyskinesia (TD) is a chronic and disabling movement disorder with a complex pathophysiological basis. A significant percentage of patients does not receive correct diagnosis, resulting in delayed or inaccurate treatment and poor outcome. Therefore, there is a critical need for prompt recognition, implementation of efficacious treatment regimens and long-term follow up of patients with TD. Areas covered: The current paper provides an overview of emerging data concerning proposed pathophysiology theories, epidemiology, risk factors,...
Source: Expert Review of Neurotherapeutics - July 29, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Considerations for ADHD in the Child with Epilepsy and the Child with Migraine.
Authors: Dunn DW, Downs J, Giust J Abstract INTRODUCTION: Attention Deficit Hyperactivity Disorder (ADHD) is a common comorbid condition in children with epilepsy and migraine. Treatment of ADHD in children with epilepsy or migraine is essential but clinicians may overlook symptoms of ADHD and avoid appropriate use of medications that may reduce symptoms of ADHD without compromising treatment of epilepsy or migraine. Areas covered: PubMed was searched for articles on ADHD and epilepsy or migraine. Key papers were reviewed for additional articles. Areas of interest were: epidemiology, etiological factors, and treatment...
Source: Expert Review of Neurotherapeutics - July 28, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Is polysomnography screening effective for stroke prevention?
Authors: Proserpio P, Ciccone A, Nobili L PMID: 28743193 [PubMed - as supplied by publisher] (Source: Expert Review of Neurotherapeutics)
Source: Expert Review of Neurotherapeutics - July 27, 2017 Category: Neurology Tags: Expert Rev Neurother Source Type: research