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Could saccadic function be a useful marker of stroke recovery?
There is no pharmacological therapy presently available to improve the long-term recovery from acute ischaemic stroke. Either there hasn't yet been a suitable treatment trialled, or the tools for measuring recovery have not been sensitive enough. It is critical therefore to continue to search for robust objective markers of stroke recovery in parallel with the push for drug discovery. Can saccade measures provide such a marker? Dong et al report that in a limited number of mild stroke patients, saccadic parameters that probe cognitive function, especially errors of inhibition during antisaccade and memory-guided paradigms,...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Anderson, T. Tags: Other rehabilitative therapies, Genetics, Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Movement disorders (other than Parkinsons), Multiple sclerosis, Parkinson's disease, Spinal cord, Stroke, Ophthalmology, Memor Source Type: research

Measuring arm function early after stroke: is the DASH good enough?
Conclusions RMT methods identified limitations missed by CTT and indicate areas for improvement of the DASH as an upper limb measure for acute stroke. Findings, similar to those identified in multiple sclerosis, highlight the need for scales to have strong conceptual underpinnings, with their development and modification guided by sophisticated psychometric methods.
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 12, 2016 Category: Neurosurgery Authors: Baker, K., Barrett, L., Playford, E. D., Aspden, T., Riazi, A., Hobart, J. Tags: Immunology (including allergy), Multiple sclerosis, Stroke Cerebrovascular disease Source Type: research

Risk of stroke in multiple sclerosis and neuromyelitis optic spectrum disorder: a Nationwide cohort study in South Korea
Conclusions The risk of stroke is increased in patients with MS and NMOSD and seemed comparable between the two conditions. This is the first study that estimates the risk of stroke in patients with MS and NMOSD within the same population.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2022 Category: Neurosurgery Authors: Cho, E. B., Yeo, Y., Jung, J. H., Jeong, S.-M., Han, K.-d., Shin, D. W., Min, J.-H. Tags: Multiple sclerosis Source Type: research

Idiopathic hypertrophic cranial pachymeningitis: a rare but treatable cause of headache and facial pain
Introduction Idiopathic Hypertrophic Cranial Pachymeningitis (IHCP) is a rare disease with pain and compression related cranial nerve dysfunction as main clinical features. The leading diagnostic finding of IHCP consists of diffuse or localised thickening of the dura, which demands appropriate imaging and image interpretation. This case description aims at increasing the awareness for the clinical symptoms and imaging findings of this rare disease to allow prompt diagnosis and treatment initiation. Case description An 82-year-old man presented with recurrent left sided headache and worsening facial pain, which had begun mo...
Source: Journal of Neurology, Neurosurgery and Psychiatry - February 15, 2013 Category: Neurosurgery Authors: Khalil, M., Ebner, F., Fazekas, F., Enzinger, C. Tags: Immunology (including allergy), Meningitis, Brain stem / cerebellum, Cranial nerves, Headache (including migraine), Infection (neurology), Multiple sclerosis, Pain (neurology), Stroke, Hypertension, Ophthalmology, Radiology, Surgical diagnostic tests, Ear Source Type: research

Trigeminal neuralgia after pontine infarction affecting the ipsilateral trigeminal nerve
A 57-year-old man presented with numbness, paraesthesia and lancinating pain on the left side of the face, which had developed suddenly 10 days previously. He had hypertension and no history of headache. His facial pain was characterised by a brief electric shock-like pain, which was evoked by light stimuli, and also occurred spontaneously. A neurological examination showed a mild decrease in sensation on the left side of the face, mainly with V2 and V3 distribution, and on the left oral cavity, including the tongue and buccal mucosa. Other neurological examinations were normal, including the corneal reflex and the mo...
Source: Journal of Neurology, Neurosurgery and Psychiatry - July 8, 2013 Category: Neurosurgery Authors: Kim, J. B., Yu, S. Tags: Immunology (including allergy), Brain stem / cerebellum, Cranial nerves, Headache (including migraine), Multiple sclerosis, Neuroimaging, Neuromuscular disease, Pain (neurology), Peripheral nerve disease, Stroke, Hypertension, Ophthalmology, Drugs: psychi Source Type: research

Sunshine and multiple sclerosis
In 1960, Donald Acheson1 made the seminal observation that the global distribution of multiple sclerosis (MS) may be related to available hours of sunshine; this observation was met with disbelief at the time. However, over the subsequent more than 50 years, it has become clear that he may well be right. The effect of sunlight exposure and subsequent vitamin D production (generated by photolysis of 7-dehydrocholesterol in the skin by ultraviolet radiation (UVR)) on the onset and progression of MS has become a significant research focus particularly over the last 10 years, with large-scale clinical trials of vitam...
Source: Journal of Neurology, Neurosurgery and Psychiatry - September 2, 2013 Category: Neurosurgery Authors: Taylor, B. V. Tags: Immunology (including allergy), Multiple sclerosis, Stroke Editorial commentaries Source Type: research

Think outside the box, collapse the box, and take a sharp knife to it!
A 74 year–old woman presented in December 2011 with left sided cerebellar symptoms. She was initially diagnosed as having a posterior circulation infarction and discharged from hospital on appropriate medication. However, over the following month she continued to deteriorate, developing increasing unsteadiness, falls, nausea and vomiting. Following a second admission in January 2012 she had a single seizure and developed focal left sided myoclonus affecting mainly the upper limb. Over the following month the myoclonus spread to affect all four limbs, although it remained more prominent on the left side. There was evi...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Dobson, R., McMillan, A., Kung, K., Thom, M., Davis, A., Simister, R., Giovannoni, G., Gnanapavan, S. Tags: Immunology (including allergy), HIV/AIDS, Tropical medicine (infectious diseases), Brain stem / cerebellum, Epilepsy and seizures, Infection (neurology), Multiple sclerosis, Stroke, Ophthalmology, Radiology, Surgical diagnostic tests Association of Brit Source Type: research

Cannabinoid use in progressive inflammatory brain disease (cupid) mri sub-study
Conclusion 9–THC was not better than placebo at reducing the rates of new T1 or T2 lesions or brain atrophy in patients with progressive MS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Mallik, S., Ball, S., Dalton, C., MacManus, D., Tozer, D., Miller, D., Zajicek, J. Tags: Immunology (including allergy), Drugs: CNS (not psychiatric), Multiple sclerosis, Stroke, Radiology, Drugs: musculoskeletal and joint diseases, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Phy Source Type: research

Electrolyte imbalance triggering relapse of inflammatory neuropathy
We describe a case of a 71 year old female with a fourteen year history of chronic inflammatory demyelinating polyneuropathy (CIDP) and stable monoclonal gammopathy, normally maintained on three–weekly intravenous immunoglobulin (IVIG) therapy. At her best baseline, she has a normal motor examination and reduced vibration sense only to the ankles. She presented with a four week history of progressive numbness and paresthesiae in all four limbs, reduced balance, a decline in mobility with frequent falls and reduced hand function. The deterioration developed after a week of non–bloody diarrhoea with night sweats ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Keshavan, A., Gandhi, S., Lunn, M., Reilly, M. Tags: Neurogastroenterology, Immunology (including allergy), Drugs: CNS (not psychiatric), Multiple sclerosis, Neuromuscular disease, Peripheral nerve disease, Stroke, Hypertension Association of British Neurologists (ABN) joint meeting with the Royal College Source Type: research

Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: an open-label phase 2a proof-of-concept study
Conclusions Autologous MSCs can be safely administered in secondary progressive MS with evidence to suggest structural, functional and physiological improvement following treatment consistent with neuroprotection. The transient treatment response seen implied a likely requirement for repeat infusions to sustain benefit in the long–term.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Connick, P., Chandran, S. Tags: Immunology (including allergy), Multiple sclerosis, Stroke, Ophthalmology Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Sodium accumulation is associated with disability and progression in multiple sclerosis: a 23na mri study
Conclusions Significant increases in sodium were seen in lesions and normal appearing brain tissues in MS. Increased concentration of sodium in lesions, cortical grey matter, NAWM and basal ganglia in SPMS versus RRMS indicates greater neuroaxonal metabolic dysfunction and/or loss in the former group. MRI measurement of sodium concentration in vivo is likely to reflect clinically relevant neuroaxonal pathophysiology and may be a useful outcome measure in trials of putative neuroprotective treatments.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Paling, D., Solanky, B., Riemer, F., Tozer, D., Wheeler-Kingshott, C., Kapoor, R., Golay, X., Miller, D. Tags: Immunology (including allergy), Multiple sclerosis, Stroke, Radiology, Radiology (diagnostics) Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Libera nos a malo
Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency in patients with MS: a solution or a harmful illusion? Percutaneous transluminal angioplasty (PTA) of stenosed jugular and/or azygos veins,1 also known as the ‘liberation treatment’,2 has been proposed as a solution to improve the clinical outcome of MS patients with chronic cerebrospinal venous insufficiency (CCSVI).3 In their paper van Zuuren and colleagues present the summary of a Cochrane systematic review outlining the randomised controlled trials (RCTs) on this topic and conclude that there is currently no ev...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 5, 2014 Category: Neurosurgery Authors: Baracchini, C. Tags: Immunology (including allergy), Multiple sclerosis, Stroke, Radiology, Radiology (diagnostics) Editorial commentaries Source Type: research

Is the 'liberation procedure' for multiple sclerosis really liberating?
Multiple sclerosis (MS) is an inflammatory disease, which is immune-mediated, and responds to immune-modulating therapies. However, it is uncertain what antigen, or antigens, trigger the immune system to attack the central nervous system's (CNS's) myelin. Could it be iron? The predominantly venotopic location of MS lesions in the CNS has recently been postulated to be a consequence of congenital stenosis of the internal jugular or azygous veins, causing venous congestion and hypertension, and local transmural extravasation of erythrocytes into the white matter. The erythrocytes subsequently degrade, but the residual iron r...
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 5, 2014 Category: Neurosurgery Authors: Hankey, G. J., Sandercock, P., Cantisani, T. A., Celani, M. G. Tags: Immunology (including allergy), Multiple sclerosis, Stroke, Hypertension Editorial commentaries Source Type: research

Percutaneous transluminal angioplasty for treatment of chronic cerebrospinal venous insufficiency in people with multiple sclerosis: a summary of a Cochrane systematic review
Conclusions There is currently no high level evidence to support or refute the efficacy or safety of percutaneous transluminal angioplasty for treatment of CCSVI in people with MS. Clinical practice should be guided by evidence supported by well-designed randomised controlled trials: closure of some of the gaps in the evidence may be feasible at completion of the six ongoing clinical trials.
Source: Journal of Neurology, Neurosurgery and Psychiatry - March 5, 2014 Category: Neurosurgery Authors: van Zuuren, E. J., Fedorowicz, Z., Pucci, E., Jagannath, V., Robak, E. W. Tags: Immunology (including allergy), Multiple sclerosis, Stroke Source Type: research

Potential disease-modifying effects of selective serotonin reuptake inhibitors in multiple sclerosis: systematic review and meta-analysis
Introduction Development of further effective and well-tolerated disease-modifying therapies (DMTs) for multiple sclerosis (MS) is a major research priority. Strategies include ‘repurposing’ drugs, which are already approved for other indications, as DMTs. While selective serotonin reuptake inhibitors (SSRIs) are widely used as antidepressants, preclinical and clinical studies suggest that disease-modifying effects in relapsing and progressive MS are plausible1 (see online additional material). Furthermore, a recent Cochrane systematic review demonstrated that, in adults with stroke, SSRIs improved measures of ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 6, 2014 Category: Neurosurgery Authors: Foley, P., Lawler, A., Chandran, S., Mead, G. Tags: PostScript Source Type: research

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