Neurological Scottish neologisms.
PMID: 31611419 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - October 14, 2019 Category: Neurology Authors: Leach JP, Dani K, MacDougall NJ, Gallagher P, Newman EJ Tags: Pract Neurol Source Type: research

Untangling a case of painfulneuropathy.
PMID: 31585979 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - October 4, 2019 Category: Neurology Authors: Keddie S, Fehmi J, Jaunmuktane Z, D'Sa S, Stevens JC, Lunn MP Tags: Pract Neurol Source Type: research

Finger paresis as isolated manifestation of acute ischaemic stroke.
;vez-Luévanos BE PMID: 31575679 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - October 1, 2019 Category: Neurology Authors: Castillo-Torres SA, Ramírez-Gutiérrez R, Chávez-Luévanos BE Tags: Pract Neurol Source Type: research

Assessing neurology training in the UK.
PMID: 31575754 [PubMed - in process] (Source: Practical Neurology)
Source: Practical Neurology - October 1, 2019 Category: Neurology Authors: Fuller GN, Butterworth R Tags: Pract Neurol Source Type: research

Clinic letters revisited.
PMID: 31575755 [PubMed - in process] (Source: Practical Neurology)
Source: Practical Neurology - October 1, 2019 Category: Neurology Authors: Turner MR, Smith PEM Tags: Pract Neurol Source Type: research

ABN news.
PMID: 31575756 [PubMed - in process] (Source: Practical Neurology)
Source: Practical Neurology - October 1, 2019 Category: Neurology Authors: Lawrence J, Nicholl DJ Tags: Pract Neurol Source Type: research

Blood pressure and the brain: the neurology of hypertension.
Abstract Hypertension affects more than one in four adults. The brain is an early target of hypertension-induced organ damage, and may manifest as stroke, subclinical cerebrovascular abnormalities and dementia. Hypertension-related small vessel disease can cause vascular dementia and can potentiate Alzheimer's pathology, lowering the threshold at which signs and symptoms manifest. Many hypertensive emergencies may also have a neurological presentation, such as hypertensive encephalopathy, haemorrhagic stroke or pre-eclampsia. Here we highlight the importance of blood pressure in maintaining brain health and the br...
Source: Practical Neurology - September 26, 2019 Category: Neurology Authors: Kelly DM, Rothwell PM Tags: Pract Neurol Source Type: research

Listening with intent.
Abstract Know how to listen and you will profit even from those who talk badly. PlutarchListening in medicine is only of value when it is combined with an ability to decipher the patient's utterances and gestures and act upon them. PMID: 31558585 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - September 26, 2019 Category: Neurology Authors: Lees AJ Tags: Pract Neurol Source Type: research

Predicting the outcome of a comatose patient at the bedside.
Abstract The call to the bedside and the prognostication of a comatose patient-telling family members what to expect-commonly falls to neurologists. The assessment is often confounded by the treatment paradigms of modern intensive care (ie, drugs, drug interactions and targeted temperature management). Patients may be too unstable to leave the intensive care unit for neuroimaging; thus, repeated clinical examinations are decisive. Despite diverse causes, certain principles do apply: (1) Many patients can improve, although with significant abnormalities; (2) Neuroimaging and electrodiagnostic tests can help but are...
Source: Practical Neurology - September 19, 2019 Category: Neurology Authors: Wijdicks EFM Tags: Pract Neurol Source Type: research

To scan or not to scan your Parkinson patient: that is the question!
oem B PMID: 31534023 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - September 18, 2019 Category: Neurology Authors: Araújo R, van Rumund A, Bloem B Tags: Pract Neurol Source Type: research

Unusual cause of treatable Parkinsonism.
Abstract A 78-year-old woman presented with features of bilateral, asymmetric Parkinsonism for 1 year, with prominent difficulties with continence, swallowing and apathy. Brain imaging showed evidence of chronic venous sinus thrombosis with dilated serpiginous vessels over the brain surface in keeping with a dural arteriovenous fistula, together with high T2 signal on MRI in the basal ganglia. Having responded only modestly to levodopa, she received 6 months of anticoagulation followed by embolisation of the dural arteriovenous fistula, with good response. Cerebral dural arteriovenous fistula is a rare, str...
Source: Practical Neurology - September 18, 2019 Category: Neurology Authors: Wiblin L, Mitra D, Warren N Tags: Pract Neurol Source Type: research

Preserving fertility: using cyclophosphamide and other cytotoxics in young people.
This article summarises the data with regards the impact of cytotoxics on long-term fertility and describes the current options to preserve fertility in these patients. We hope this will provide neurologists with a useful aid for counselling patients for whom they are considering these treatments. PMID: 31519764 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - September 13, 2019 Category: Neurology Authors: Ledingham D, Plant M, Mustafa F, Patil B Tags: Pract Neurol Source Type: research

Personalising secondary prevention: different treatments for different strokes.
This article provides practical tips to diagnose the underlying subtype of stroke, and in particular discusses non-lacunar pathologies that can present with a clinical lacunar syndrome. It also reviews the recent advances in recurrent stroke prevention, including using more intensive antiplatelet regimens in the acute phase, and the concept that undetected cardiac arrhythmias may be important in apparently cryptogenic stroke. PMID: 31484793 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - September 4, 2019 Category: Neurology Authors: Markus H Tags: Pract Neurol Source Type: research

Epstein-Barr virus associated CNS lymphoproliferative disorder after long-term immunosuppression.
We present a woman who developed subacute cognitive decline and unilateral weakness while taking long-term mycophenolate mofetil for granulomatosis with polyangiitis; her postmortem brain histopathology confirmed an EBV-driven lymphoproliferative disorder. Clinicians must have a high index of suspicion for EBV-driven lymphoma in people taking long-term immunosuppression who develop new neurological problems. We review the role of mycophenolate mofetil in EBV-driven lymphoproliferative disorders, and discuss checking EBV status in all patients starting immunosuppression and in older people already taking immunosuppression. ...
Source: Practical Neurology - August 29, 2019 Category: Neurology Authors: Lee A, Bridges LR, Lloyd M, Barker R, Wren DR, Galtrey CM Tags: Pract Neurol Source Type: research

Very-late-onset Friedreich's ataxia: diagnosis in a kindred with late-onset cerebellar ataxia.
We present the clinical, imaging and genetic findings of a kindred with very-late-onset Friedreich's ataxia and discuss the pitfalls and risk of misdiagnosis. PMID: 31467149 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - August 29, 2019 Category: Neurology Authors: Fearon C, Lonergan R, Ferguson D, Byrne S, Bradley D, Langan Y, Redmond J Tags: Pract Neurol Source Type: research

Central pontine (and extrapontine) myelinolysis despite appropriate sodium correction.
PMID: 31467150 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - August 29, 2019 Category: Neurology Authors: Micieli A, Najeeb U, Kingston W Tags: Pract Neurol Source Type: research

Sudden deafness and tuning fork tests: towards optimal utilisation.
Abstract The tuning fork tests have been under attack since their first use in clinical examination. However, the tuning fork is small and fits into every white coat, and tuning fork tests for hearing are easy, accurate and inexpensive. They should be used in patients with an acute unilateral hearing loss if an electric audiometer is not available. After more than 100 years, the tuning fork is not obsolete; tuning fork tests are a very useful if used correctly and for the appropriate indication. PMID: 31444233 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - August 23, 2019 Category: Neurology Authors: Bayoumy AB, de Ru JA Tags: Pract Neurol Source Type: research

Azathioprine and the neurologist.
Abstract Neurologists are very familiar with using corticosteroids and are aware of their considerable risk of adverse effects with prolonged use. Thus, we frequently consider alternative immunosuppression or corticosteroid sparing agents. However, unlike other specialties, such as rheumatology, there are few indications for corticosteroid-sparing agents in neurology and so our experience is less extensive; even these indications may reduce further as more disease-modifying treatments become available for neurological conditions. Azathioprine is perhaps the most commonly used corticosteroid-sparing agent in neurol...
Source: Practical Neurology - August 23, 2019 Category: Neurology Authors: McWilliam M, Khan U Tags: Pract Neurol Source Type: research

Emergencies and critical issues in Parkinson's disease.
Abstract Complications from Parkinson's disease may develop over the disease course, sometimes unexpectedly, and require prompt or even urgent medical intervention. The most common are associated with aggravation of motor symptoms; serious non-motor complications, such as psychosis, orthostatic hypotension or sleep attacks, also occur. Here we review such complications, their clinical presentation, precipitating factors and management, including those related to using device-aided therapies. Early recognition and prompt attention to these critical situations is challenging, even for the Parkinson's disease special...
Source: Practical Neurology - August 19, 2019 Category: Neurology Authors: Simonet C, Tolosa E, Camara A, Valldeoriola F Tags: Pract Neurol Source Type: research

The eye is the window to the diagnosis: tuberculous meningoencephalitis with choroidal tubercle.
PMID: 31427384 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - August 19, 2019 Category: Neurology Authors: Fernandes M, Meira B, Marto JP, Correia AS, Costa J, Viana-Baptista M Tags: Pract Neurol Source Type: research

Epilepsy surgery.
Abstract Epilepsy surgery offers the chance of seizure remission for the 30%-40% of patients with focal epilepsy whose seizures continue despite anti-epileptic medications. Epilepsy surgery encompasses curative resective procedures, palliative techniques such as corpus callosotomy and implantation of stimulation devices. Pre-surgical evaluation aims to identify the epileptogenic zone and to prevent post-operative neurological and cognitive deficits. This entails optimal imaging, prolonged video-electroencephalogram (EEG) recordings, and neuropsychological and psychiatric assessments; some patients may then require...
Source: Practical Neurology - August 16, 2019 Category: Neurology Authors: Rugg-Gunn F, Miserocchi A, McEvoy A Tags: Pract Neurol Source Type: research

Brain imaging in epilepsy.
Abstract Brain imaging with MRI identifies structural cerebral pathology that may give rise to seizures. The greatest yield is from MRI at 3T using epilepsy protocols, and reported by expert neuroradiologists who possess the full clinical data. X-ray CT scanning has a role in assessing patients with seizures in the context of an acute neurological illness. Identifying a relevant structural lesion with MRI is fundamental in the consideration of epilepsy surgery; it is crucial to establish if a lesion is relevant to the epilepsy or not. If no lesion is identified, developmental MRI and image processing may identify ...
Source: Practical Neurology - August 16, 2019 Category: Neurology Authors: Duncan JS Tags: Pract Neurol Source Type: research

Letter from aviation neurology.
PMID: 31420417 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - August 16, 2019 Category: Neurology Authors: Evans S Tags: Pract Neurol Source Type: research

ABN news for the August issue.
PMID: 31296667 [PubMed - in process] (Source: Practical Neurology)
Source: Practical Neurology - July 14, 2019 Category: Neurology Authors: Lawrence J, Nicholl DJ Tags: Pract Neurol Source Type: research

Plasma exchange in neurological disease.
Abstract Plasma exchange is a highly efficient technique to remove circulating autoantibodies and other humoral factors rapidly from the vascular compartment. It was the first effective acute treatment for peripheral disorders such as Guillain-Barré syndrome and myasthenia gravis before intravenous immunoglobulin became available. The recent recognition of rapidly progressive severe antibody-mediated central nervous system disorders, such as neuromyelitis optica spectrum disorders and anti-N-methyl-D-aspartate-receptor encephalitis, has renewed interest in using plasma exchange for their acute treatment als...
Source: Practical Neurology - July 12, 2019 Category: Neurology Authors: Osman C, Jennings R, El-Ghariani K, Pinto A Tags: Pract Neurol Source Type: research

Rapid alterations in MR imaging in MELAS syndrome.
PMID: 31292237 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 10, 2019 Category: Neurology Authors: Doppler CEJ, Kabbasch C, Fink GR, Lehmann HC, Wunderlich G Tags: Pract Neurol Source Type: research

TB or not TB?
PMID: 31292238 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 10, 2019 Category: Neurology Authors: Kobylecki C, Montague E, Blanchard T, Siripurapu R, McKee D Tags: Pract Neurol Source Type: research

Progressive myelopathy in an adult.
PMID: 31292239 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 10, 2019 Category: Neurology Authors: Tanveer R, Hamdalla H Tags: Pract Neurol Source Type: research

Clinically isolating syndrome: when neurology hits a neurologist.
PMID: 31292240 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 10, 2019 Category: Neurology Authors: Seachrist E Tags: Pract Neurol Source Type: research

Managing cluster headache.
This article aims to guide general neurologists to an accurate diagnosis and practical management options for cluster headache patients. PMID: 31278205 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 5, 2019 Category: Neurology Authors: Wei DY, Khalil M, Goadsby PJ Tags: Pract Neurol Source Type: research

Stroke after lung biopsy.
PMID: 31273076 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: De Oliveira DS, Pinto BD, Vale TC, Pires LA Tags: Pract Neurol Source Type: research

Multiple myeloma with multiple neurological presentations.
We describe a 40-year-old woman who presented with lower cranial neuropathies mimicking variant Guillain-Barré syndrome, with normal brain and spinal cord imaging and cerebrospinal fluid (CSF) albuminocytological dissociation, and subsequently diagnosed with IgD myeloma. She relapsed repeatedly with differing neurological presentations: numb chin syndrome and twice with impaired vision, first from cerebral venous sinus thrombosis and later from leptomeningeal infiltration of the optic chiasm. We discuss the neurological complications of myeloma, emphasising the need to consider it in a wide variety of neurological p...
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: Smith N, Kimberger K, Parrish C, Currie S, Butterworth S, Alty J Tags: Pract Neurol Source Type: research

Medication-overuse headache.
Abstract Medication-overuse headache is defined as headache occurring on more than 15 days in a month in people with pre-existing primary headache, and developing as a consequence of regular overuse of acute headache treatments. Medication-overuse headache is common in general neurology clinics and can be difficult to manage. Most patients have a background of migraine, which has slowly transformed over months and years from the episodic to chronic form; with this comes an increased use of acute migraine treatment. This paper identifies who is at risk of developing medication-overuse headache, and reviews preventi...
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: Wakerley BR Tags: Pract Neurol Source Type: research

Essential tremor: a nuanced approach to the clinical features.
Abstract Essential tremor is the most common form of tremor in humans. Given neurologists' high exposure to this condition, and its seemingly straightforward phenotype, it might seem easy to diagnose. However, 30%-50 % of patients labelled as having 'essential tremor' have other diagnoses, mostly Parkinson's disease and dystonia. The tremor of essential tremor is neither non-descript nor featureless but is multifaceted and highly patterned. This review focuses on its clinical features, beginning with a discussion of tremors and then briefly discussing its additional motor features, and presents several aids to hel...
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: Louis ED Tags: Pract Neurol Source Type: research

Tracheostomy in motor neurone disease.
This article considers the current prevalence of tracheostomy in MND, the evidence for its benefit both for survival and quality of life, and the practicalities of its implementation. The decision to request invasive ventilatory support is among the most challenging for those living with MND. Neurologists should be prepared to discuss this option openly and objectively: we suggest a framework for discussion, including withdrawal of therapy. PMID: 31273080 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: Turner MR, Faull C, McDermott CJ, Nickol AH, Palmer J, Talbot K Tags: Pract Neurol Source Type: research

I Am, I Am, I Am: Seventeen Brushes With Death, by Maggie O'Farrell.
PMID: 31273081 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: Moullaali TJ, Scott S Tags: Pract Neurol Source Type: research

Hypersensitivity reactions to recombinant tissue plasminogen activator.
Abstract Recombinant tissue plasminogen activator (rtPA) is currently the only approved thrombolytic agent for treating acute ischaemic stroke that is widely used in clinical practice. However, it may cause haemorrhage and hypersensitivity reactions. Orolingual angioedema is an infrequent, usually mild but potentially life threatening, hypersensitivity reaction to rtPA. Our understanding of the basic biology of angioedema has increased in recent years. There is growing evidence that rtPA-induced orolingual angioedema is driven mainly by bradykinin generation rather than it being an anaphylactic response. Monitorin...
Source: Practical Neurology - July 4, 2019 Category: Neurology Authors: Alakbarzade V, O'Kane D, Pereira AC Tags: Pract Neurol Source Type: research

Borderline personality disorder: an update for neurologists.
We present an overview of this common and important condition, its epidemiology, cause, common comorbidities and neurological associations. We then propose a practical, psychologically informed framework for enhancing the therapeutic alliance for the jobbing neurologist in managing these patients. PMID: 31249066 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - June 27, 2019 Category: Neurology Authors: Hall K, Moran P Tags: Pract Neurol Source Type: research

Using biomarkers to predict clinical outcomes in multiple sclerosis.
Abstract Long-term outcomes in multiple sclerosis (MS) are highly varied and treatment with disease-modifying therapies carries significant risks. Finding tissue biomarkers that can predict clinical outcomes would be valuable in individualising treatment decisions for people with MS. Several candidate biomarkers-reflecting inflammation, neurodegeneration and glial pathophysiology-show promise for predicting outcomes. However, many candidates still require validation in cohorts with long-term follow-up and evaluation for their independent contribution in predicting outcome when models are adjusted for known demogra...
Source: Practical Neurology - June 26, 2019 Category: Neurology Authors: Castle D, Wynford-Thomas R, Loveless S, Bentley E, Howell OW, Tallantyre EC Tags: Pract Neurol Source Type: research

Learning from history: Lord Brain and Hashimoto's encephalopathy.
We present two historic cases of severe encephalopathy associated with antithyroid antibodies. The first was published by Lord Brain of Eynsham, and the second was from our department's archives. Although both cases are from archival sources, they continue to inform current clinical care. We briefly review the poorly defined entity, Hashimoto's encephalopathy, and discuss diagnostic advances for autoimmune encephalopathy and for Creutzfeldt-Jakob disease. We advocate for giving a trial of corticosteroids to patients with 'encephalopathy, not otherwise specified' while awaiting antibody results or more definitive testing. O...
Source: Practical Neurology - June 26, 2019 Category: Neurology Authors: Crotty GF, Doherty C, Solomon IH, Berry JD, Samuels MA Tags: Pract Neurol Source Type: research

Niemann-Pick type C: contemporary diagnosis and treatment of a classical disorder.
We describe a patient, aged 22 years, with juvenile-onset Niemann-Pick type C who presented with seizures and a label of 'cerebral palsy'. We describe the approach to this syndrome in general, and highlight the classical features and red flags that should alert a neurologist to this treatable condition. PMID: 31243140 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - June 26, 2019 Category: Neurology Authors: Lad M, Thomas RH, Anderson K, Griffiths TD Tags: Pract Neurol Source Type: research

Hyperperfusion can identify epileptic stroke mimics.
t W PMID: 31227576 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - June 21, 2019 Category: Neurology Authors: Popkirov S, Grönheit W Tags: Pract Neurol Source Type: research

Cannabis and multiple sclerosis.
Abstract Patients with multiple sclerosis have long turned to complementary therapies to manage symptoms that licensed products can only partially control. Around half of patients with multiple sclerosis admit to previous or current cannabis use for medicinal purposes and would endorse legalisation. Despite many governments worldwide relaxing regulations around medicinal cannabis, there remain many unanswered questions as to how clinicians should prescribe or recommend products, and access to pharmaceutical-grade products remains highly restricted. Here we address what adult neurologists need to know about cannabi...
Source: Practical Neurology - June 14, 2019 Category: Neurology Authors: Ingram G, Pearson OR Tags: Pract Neurol Source Type: research

Neuropsychological outcomes following traumatic brain injury.
Abstract This review examines the clinical and neuroradiological features of traumatic brain injury that are most frequently associated with persistent cognitive complaints. Neuropsychological outcomes do not depend solely on brain injury severity but result from a complex interplay between premorbid factors, the extent and nature of the underlying structural damage, the person's neuropsychological reserve and the impact of non-neurological factors in the recovery process. Brain injury severity is only one of these factors and has limited prognostic significance with respect to neuropsychological outcome. We exami...
Source: Practical Neurology - June 13, 2019 Category: Neurology Authors: Baxendale S, Heaney D, Rugg-Gunn F, Friedland D Tags: Pract Neurol Source Type: research

Drugs-without the hot air: minimising the harms of legal and illegal drugs.
PMID: 31196884 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - June 13, 2019 Category: Neurology Authors: Wong C Tags: Pract Neurol Source Type: research

Swollen optic nerve: an approach to diagnosis and management.
Abstract The differential diagnosis of swollen optic nerves differs according to whether the swelling is unilateral or bilateral, or whether visual function is normal or affected. Patients with a unilaterally swollen optic nerve and normal visual function most likely have optic nerve head drusen. Patients with abnormal visual function most likely have demyelinating optic neuritis or non-arteritic anterior ischaemic optic neuropathy. Patients with bilaterally swollen optic nerve heads and normal visual function most likely have papilloedema, and require neuroimaging followed by lumbar puncture. However, if their vi...
Source: Practical Neurology - June 13, 2019 Category: Neurology Authors: Margolin E Tags: Pract Neurol Source Type: research

Implementing clinical guidelines.
This article brings together evidence from the study of behaviour, education and clinical practice and offers practical tips on how practising neurologists might bring about change in the healthcare environment. Common themes include the importance of team working, multidisciplinary engagement, taking time to identify who and what needs changing, and selecting the most appropriate tool(s) for the job. Engaging with the challenge is generally more rewarding than resisting and is important for the effective provision of care. PMID: 31189692 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - June 12, 2019 Category: Neurology Authors: Mayer J, Kipps C, Cock HR Tags: Pract Neurol Source Type: research

Mountain neurology.
This article focuses on neurological-related high-altitude illnesses: acute mountain sickness and high-altitude cerebral oedema, as well as high-altitude retinopathy and other neurological disorders. This overview combines current understood pathogenesis with the experience of managing altitude-related illness at the foot of Mount Kilimanjaro in northern Tanzania, the tallest free-standing mountain in the world. PMID: 31177100 [PubMed - as supplied by publisher] (Source: Practical Neurology)
Source: Practical Neurology - June 8, 2019 Category: Neurology Authors: Dekker MCJ, Wilson MH, Howlett WP Tags: Pract Neurol Source Type: research

Clinical importance of molecular markers of adult diffuse glioma.
Abstract In 2016, the WHO incorporated molecular markers, in addition to histology, into the diagnostic classification of central nervous system (CNS) tumours. This improves diagnostic accuracy and prognostication: oligo-astrocytoma no longer exists as a clinical entity; isocitrate dehydrogenase (IDH) mutant and 1p/19q co-deleted oligodendroglioma is a smaller category with better prognosis; IDH wild-type 'low-grade' glioma has a much poorer prognosis; and glioblastoma is divided into IDH mutant (with an better prognosis than pre-2016 glioblastoma) and IDH wild type (with a poorer prognosis). Previous advice based...
Source: Practical Neurology - June 6, 2019 Category: Neurology Authors: Molinari E, Curran OE, Grant R Tags: Pract Neurol Source Type: research

Balancing immunosuppression and infection: recurrent enterovirus encephalitis in SLE.
Abstract A young woman with systemic lupus erythematosus (SLE) developed recurrent enterovirus meningoencephalitis while taking prednisolone, azathioprine and rituximab. After reducing the immunosuppression, she developed a central nervous system (CNS) flare of SLE, with enterovirus still present in the cerebrospinal fluid (CSF). There are no evidence-based specific treatments for enterovirus encephalitis, but she responded well to intravenous immunoglobulin alongside pulsed methylprednisolone and rituximab. This case highlights the difficulties in managing people with co-existing infective and autoimmune conditio...
Source: Practical Neurology - June 6, 2019 Category: Neurology Authors: Cheema S, Bunting E, Good C, Hajela V, Ridha BH, Saha RA Tags: Pract Neurol Source Type: research