Cryptococcal Meningitis in a Fingolimod-Treated Patient: Positive Antigen Test a Year Before Onset
Repeated cryptococcal antigen testing in patients with multiple sclerosis who have been treated with fingolimod may facilitate early detection of cryptococcal meningitis. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Aoki, R., Mori, M., Suzuki, Y.-i., Uzawa, A., Masuda, H., Uchida, T., Ohtani, R., Kuwabara, S. Tags: Autoimmune diseases, Fungal infections, Multiple sclerosis Case Source Type: research
Upper Gastrointestinal Tract Lymphoma With Natalizumab: Evidence of Impaired Immune Surveillance?
In patients with multiple sclerosis who are treated with natalizumab, new, persistent, and/or upper gastrointestinal symptoms should prompt assessment for DLBCL (Tysabri, Biogen, RTP, NC). (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Gomes, L., Watson, E., Smith, M. R., Morris, E., Boggild, M. Tags: All Oncology, Multiple sclerosis Case Source Type: research
Dancing Larynx Syndrome Associated With Trigeminal Neuralgia Secondary to Multiple Sclerosis
Multiple sclerosis can be complicated by a variety of movement disorders, including focal myoclonus. Symptoms may respond well to botulinum toxin injections. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Shpiner, D. S., Ortega, M. R., Moore, H. Tags: MRI, Botulinum toxin, Myoclonus, Trigeminal neuralgia, Multiple sclerosis Case Source Type: research
Wearables for Neurologic Conditions: Considerations for Our Patients and Research Limitations
We present a narrative review to raise awareness of wearable technologies that may be relevant to the field of neurology. We also discuss the implications of these wearables for our patients and briefly discuss issues related to researching new wearable technologies.
Recent Findings
There are a variety of wearables for neurologic conditions, e.g., stroke (for potential arrhythmia capture), epilepsy, Parkinson disease, and sleep. Research is being performed to capture the risk of neuropsychiatric relapse. However, data are limited and adherence to these wearables is often poorly studied.
Summary
The care of neurology pati...
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Minen, M. T., Stieglitz, E. J. Tags: Parkinson's disease/Parkinsonism, All Cerebrovascular disease/Stroke, All Sleep Disorders, All Epilepsy/Seizures Review Source Type: research
Molecular Biomarkers for Spinal Muscular Atrophy: A Systematic Review
Conclusion
There is no sufficient evidence to support the clinical utility of SMN-related biomarkers to predict disease severity in SMA. pNF-H appears to be a promising biomarker of disease activity and treatment effect in SMA. Further studies should include longitudinal assessments of patients with SMA across functional groups and comparisons with age-matched healthy controls to evaluate the stability of putative biomarkers over time and in response to SMA therapeutics. PROSPERO registration: CRD42019139050. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Navarrete-Opazo, A., Garrison, S., Waite, M. Tags: All Clinical Neurology, Prognosis Review Source Type: research
Role of Optical Coherence Tomography in Identifying Retinal Biomarkers in Frontotemporal Dementia: A Review
We present a narrative review of the current literature focused on optical coherence tomography (OCT) to identify retinal biomarkers of dementia, discuss OCT findings in FTD, and explore the implications of an FTD-specific ocular biomarker for research and patient care.
Recent Findings
Recent studies suggest that outer retinal thinning detected via OCT may function as a novel ocular biomarker of FTD. The degree and rate of inner retinal thinning may correlate with disease severity and progression. In Alzheimer disease (AD), OCT demonstrates thinning of the inner retina, which may differentiate this condition from FTD. We ...
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Moinuddin, O., Khandwala, N. S., Young, K. Z., Sathrasala, S. K., Barmada, S. J., Albin, R. L., Besirli, C. G. Tags: Alzheimer's disease, Frontotemporal dementia, Assessment of cognitive disorders/dementia Review Source Type: research
Diskogenic Dural Defect Is the Reason for the Ventral Location of the Epidural Spinal Fluid Collection Seen in Superficial Siderosis
Purpose of Review
Superficial siderosis (SS) of the nervous system is often due to a dural pathology. This review focuses on recent developments related to the management of this subgroup of patients with SS.
Recent Findings
The presence of an epidural ventral spinal fluid collection in patients with SS is a clue to the presence of a diskogenic dural defect. The location of the defect is ascertained by a dynamic CT myelogram, which involves placing the patient in a prone position with hips elevated. This permits gravity-assisted preferential ventral localization of the contrast and active scanning during contrast injectio...
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Kumar, N. Tags: All Imaging, All Clinical Neurology, All Spinal Cord, Spinal cord trauma, Subarachnoid hemorrhage Review Source Type: research
The Potentially Modifiable Risk Factor in Idiopathic Intracranial Hypertension: Body Weight
Purpose of Review
Idiopathic intracranial hypertension (IIH) prevalence increased in conjunction with rising obesity rates. Here, we highlight the importance of weight management in IIH and introduce glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) as potential treatment strategy for IIH.
Recent Findings
Weight gain is a risk factor for IIH, and weight loss (via any treatment strategy) plays a key role in IIH management. GLP-1 is an incretin secreted by the distal small intestine in response to a meal. GLP-1 RAs have been shown to improve glycaemic control (no hypoglycaemia) and lower body weight in patients with a...
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Mollan, S. P., Tahrani, A. A., Sinclair, A. J. Tags: Idiopathic intracranial hypertension, All Neuro-ophthalmology Review Source Type: research
Focused Ultrasound Thalamotomy Sensory Side Effects Follow the Thalamic Structural Homunculus
Conclusions
Distinct regions in the sensory thalamus and its afferent connections rise to specific sensory disturbances. These findings demonstrate the relationship between the sensory thalamus, ML, and bilateral sensory cortical areas. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Paff, M., Boutet, A., Germann, J., Elias, G. J. B., Chow, C. T., Loh, A., Kucharczyk, W., Fasano, A., Schwartz, M. L., Lozano, A. M. Tags: MRI, Tremor Research Source Type: research
Neuroinflammation Associated With Tumor Necrosis Factor-{alpha} Inhibitor Exposure
Conclusions
Neuroinflammatory phenomena following TNFi are a common concern for those treating patients with autoimmune disease. This is a large-scale study identifying the epidemiology surrounding this phenomenon. TNFi-associated inflammation was a rare outcome in our cohort. Most treated patients had either normal or nonspecific MRI findings. Further risk stratification parameters need to be identified. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Yu, A. W., Pecsok, M., Longbrake, E. E., Wesley, S. F. Tags: All Immunology, All Clinical Neurology, All Demyelinating disease (CNS), All epidemiology Research Source Type: research
High-Dose Diazepam Controls Severe Dyskinesia in Anti-NMDA Receptor Encephalitis
Conclusions
Dyskinesia in NMDAR encephalitis improved after treatment with enteral diazepam without significant side effects. This study suggests that enteral diazepam could be a treatment option for control dyskinesia in NMDAR encephalitis.
Classification of Evidence
This study provides Class IV evidence that for patients with dyskinesias associated with NMDAR encephalitis, enteral diazepam is effective and safe in dyskinesia control. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Shin, H.-R., Jang, Y., Shin, Y.-W., Chu, K., Lee, S. K., Lee, S.-T. Tags: Autoimmune diseases, Encephalitis, All Clinical Neurology, Class IV Research Source Type: research
Radicava/Edaravone Findings in Biomarkers From Amyotrophic Lateral Sclerosis (REFINE-ALS): Protocol and Study Design
Conclusions
Findings may help to further the understanding of the pharmacodynamic effect of edaravone, including changes in biomarkers, in response to treatment. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Berry, J., Brooks, B., Genge, A., Heiman-Patterson, T., Appel, S., Benatar, M., Bowser, R., Cudkowicz, M., Gooch, C., Shefner, J., Westra, J., Agnese, W., Merrill, C., Nelson, S., Apple, S. Tags: All Clinical Neurology, Amyotrophic lateral sclerosis, All Clinical trials, Clinical trials Methodology/study design Research Source Type: research
Use of Figurative Language by People With Parkinson Disease to Describe "Off" Periods: Clear as Mud
Conclusions
To describe off periods, individuals with PD use various forms of figurative language, but this language is not uniformly interpreted and understood by specialists. Given the subjective interpretation of figurative language, exploring what patients are trying to convey when they use such language is important and could improve patient-physician communication. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Chahine, L. M., Edison, B., Daeschler, M., Siddiqi, B., Kopil, C., Marras, C., Mantri, S. Tags: All Clinical Neurology, Parkinson's disease/Parkinsonism Research Source Type: research
Depressive Symptoms and Risk of Stroke in a National Cohort of Black and White Participants From REGARDS
Conclusions
The association of depressive symptoms with increased stroke risk was similar among a national sample of Black and White participants. These findings suggest that assessment of depressive symptoms should be considered in primary stroke prevention for both Black and White participants. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Ford, C. D., Gray, M. S., Crowther, M. R., Wadley, V. G., Austin, A. L., Crowe, M. G., Pulley, L., Unverzagt, F., Kleindorfer, D. O., Kissela, B. M., Howard, V. J. Tags: All Cerebrovascular disease/Stroke, Depression, Inclusion, Diversity, Equity, Anti-racism, and Social Justice (IDEAS), All epidemiology Research Source Type: research
Protocolizing the Workup for Idiopathic Normal Pressure Hydrocephalus Improves Outcomes
Conclusions
Implementing an INPH Protocol leads to standardized and more extensive assessment and better patient selection for and subsequent outcomes from shunting, specifically regarding gait. (Source: Neurology Clinical Practice)
Source: Neurology Clinical Practice - August 9, 2021 Category: Neurology Authors: Acosta, L. M. Y., Stubblefield, K., Conwell, T., Espaillat, K., Koons, H., Konrad, P., Fang, J., Kirshner, H., Davis, T. Tags: Hydrocephalus, Diagnostic test assessment, All Clinical Neurology, Gait disorders/ataxia, Assessment of cognitive disorders/dementia Research Source Type: research
