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Fungal Infections of the Central Nervous System
This article summarizes current knowledge on the epidemiology, clinical presentations, diagnosis, and management of selected fungal infections of the central nervous system (CNS). Key syndromes, differential diagnoses, and therapeutic interventions according to host immune status and exposure are reviewed. Recent Findings:: Advancements in imaging of the brain and spinal cord, and molecular DNA and antigen-based laboratory diagnostics afford improved sensitivity for CNS mycoses. Newer therapeutic strategies may improve outcomes if provided early and host immunosuppression is abrogated. Adjunctive corticosteroid use for dis...
Source: CONTINUUM - December 1, 2015 Category: Neurology Tags: Review Articles Source Type: research

Report of cold agglutinins in a patient with acute ischemic stroke
Conclusion: We report here the first case of cerebral infarction probably due to the cold agglutinin disease. The underlying mechanism of cold agglutinins in the pathogenesis of acute ischemic stroke needs to be investigated further.
Source: BMC Neurology - October 30, 2015 Category: Neurology Authors: Haiqiang JinWei SunYongan SunYining HuangYunchuang Sun Source Type: research

Rituximab in treatment-resistant CIDP with antibodies against paranodal proteins
Conclusions: Rituximab treatment is an option for patients with CIDP with IgG4 anti-CNTN1/NF155 antibodies who are resistant to conventional therapies. Classification of evidence: This study provides Class IV evidence that rituximab is effective for patients with treatment-resistant CIDP with IgG4 anti-CNTN1 or anti-NF155 antibodies.
Source: Neurology Neuroimmunology and Neuroinflammation - September 3, 2015 Category: Neurology Authors: Querol, L., Rojas-Garcia, R., Diaz-Manera, J., Barcena, J., Pardo, J., Ortega-Moreno, A., Sedano, M. J., Sero-Ballesteros, L., Carvajal, A., Ortiz, N., Gallardo, E., Illa, I. Tags: Class IV, Chronic inflammatory demyelinating polyneuropathy Article Source Type: research

Refractory status epilepticus due to SMART syndrome
Conclusions Taking into account clinical evolution and ictal neuroimaging studies, status epilepticus could explain the origin of these episodes in SMART syndrome. Although most patients have reversible symptoms, in some cases, aggressive treatment to avoid sequelae is needed. This article is part of a Special Issue entitled “Status Epilepticus”.
Source: Epilepsy and Behavior - June 12, 2015 Category: Neurology Source Type: research

Refractory status epilepticus due to SMART syndrome.
CONCLUSIONS: Taking into account clinical evolution and ictal neuroimaging studies, status epilepticus could explain the origin of these episodes in SMART syndrome. Although most patients have reversible symptoms, in some cases, aggressive treatment to avoid sequelae is needed. This article is part of a Special Issue entitled "Status Epilepticus". PMID: 26071996 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - June 11, 2015 Category: Neurology Authors: Jaraba S, Puig O, Miró J, Velasco R, Castañer S, Rodríguez L, Izquierdo C, Simó M, Veciana M, Falip M Tags: Epilepsy Behav Source Type: research

Widespread arterial infection by varicella-zoster virus explains refractory giant cell arteritis
Virologic analysis of tissues from a patient with giant cell arteritis (GCA) who was treated with corticosteroids and died of extensive necrotizing granulomatous arteritis revealed widespread varicella-zoster virus (VZV) antigen in multiple large arteries. Long-term treatment with corticosteroids likely potentiated VZV infection.
Source: Neurology Neuroimmunology and Neuroinflammation - June 4, 2015 Category: Neurology Authors: Gilden, D., White, T., Galetta, S. L., Fogt, F., Nagel, M. A. Tags: Stroke prevention, Vasculitis, Viral infections Clinical/Scientific Notes Source Type: research

Tocilizumab for Treating Takayasu's Arteritis and Associated Stroke: A Case Series and Updated Review of the Literature
Takayasu's arteritis (TA) is a rare inflammatory disease that can result in stroke. Treatment of patients with TA requires prolonged use of corticosteroids (CS). We assessed the effectiveness of tocilizumab (TCZ) in inducing disease remission and reducing CS doses in patients with TA.
Source: Journal of Stroke and Cerebrovascular Diseases - April 10, 2015 Category: Neurology Authors: Mohammed Osman, Derek Emery, Elaine Yacyshyn Source Type: research

Clinical Outcomes of Metastatic Intra-cerebral Hemorrhage and Role of Acute Radiotherapy (P3.077)
CONCLUSIONS: Early recognition of metastatic disease as the etiology of ICH is important, particularly when it is the presenting manifestation. Despite the overall poor prognosis of metastatic cancer, early radiotherapy may increase survival and offer quality of life in selected group of patients. A larger case series is needed.Disclosure: Dr. Afzal has nothing to disclose. Dr. Mendoza has nothing to disclose. Dr. Latorre has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Afzal, U., Mendoza, M., Latorre, J. Tags: Cerebrovascular Disease and Interventional Neurology: Hemorrhagic and Ischemic Stroke Source Type: research

Changing course of Multiple Sclerosis (MS) after stroke: Excessive disease activity in a MS patient after cerebral infarction (P1.122)
CONCLUSIONS: This is a rare case of MS exacerbation after stroke in a patient with long-standing MS. The clear temporal relation with an increase of MS disease activity after stroke suggests possible interactions. One explanation could be an opening of the blood brain barrier after stroke with influx of activated immune cells into the central nervous system and consecutive MS exacerbation.Disclosure: Dr. Poellmann has received personal compensation for activities with Pfizer Inc., Novartis, Biogen Idec, and Merck Serono. Dr. Starck has nothing to disclose. Dr. Kümpfel has received personal compensation for activities ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Poellmann, W., Starck, M., Kuempfel, T., Koehler, J. Tags: MS and CNS Inflammatory Diseases: Symptoms, Specific Symptomatic Treatment, Co-morbidities, and Costs Source Type: research

Carotid plaque thickness is positively associated with decreased bone mineral density (P2.264)
CONCLUSIONS: This study showed that increased maximum carotid IMT/plaque value is significantly associated with decreased BMD after controlling for the effects of age, gender, and BMI in acute stroke patients. Study Supported by: NoneDisclosure: Dr. Han has nothing to disclose. Dr. Park has nothing to disclose. Dr. Park has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Lee has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Han, S. W., Park, J. H., Park, J. H., Lee, J. Y., Lee, K.-Y. Tags: Cerebrovascular Disease and Interventional Neurology: Carotid Disease and IMT Source Type: research

Homonymous hemianopsia in multiple sclerosis (MS) - a rare symptom with need for etiological clarification (P1.131)
Conclusions: Homonymous hemianopsy may be a symptom of multiple sclerosis. Often the patient may primarily describe uncharacteristic symptoms of ab ,,blurred vision". So perimetry can reveal especially incomplete homonymous deficits which should thoroughly investigated regarding also other causes than MS.Disclosure: Dr. Poellmann has received personal compensation for activities with Pfizer Inc., Novartis, Biogen Idec, and Merck Serono. Dr. Feneberg has received personal compensation for activities with Almirall, Biogen Idec, Genzyme, and Medtronic. Dr. Busch has nothing to disclose. Dr. Hofreiter has nothing to disclose. ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Poellmann, W., Feneberg, W. W., Busch, C., Hofreiter, R., Koehler, J. Tags: MS and CNS Inflammatory Diseases: Symptoms, Specific Symptomatic Treatments, Co-morbidities, and Costs Source Type: research

Spinal Cord Infarction as the Initial Presentation of Systemic Lupus Erythematosus (P2.077)
CONCLUSIONS:Aggressive therapy with high dose corticosteroids and intravenous cyclophosphamide followed by oral therapy may be a successful therapeutic approach to spinal cord infarcts secondary to systemic lupus erythematosus. Study Supported by: N/ADisclosure: Dr. Michael has nothing to disclose. Dr. Hayat has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Michael, A., Hayat, G. Tags: Neurological Consequences of Autoimmune Disease Source Type: research

Urticarial allergic reaction to alteplase: A case report (P6.243)
CONCLUSIONS: Physicians treating acute ischemic stroke with alteplase should be aware of this uncommon but potentially dangerous complication in the spectrum of anaphylactic reactions.Disclosure: Dr. Papolin has nothing to disclose. Dr. Mendes has nothing to disclose. Dr. Lange has nothing to disclose. Dr. Germiniani has nothing to disclose. Dr. Harger has nothing to disclose. Dr. Zetola has nothing to disclose. Dr. Chamma has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Papolin, L., Mendes, D., Lange, M., Germiniani, F., Harger, R., Zetola, V., Chamma, J. Tags: Cerebrovascular Disease and Interventional Neurology: Thrombolysis Complications Source Type: research

Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) with stroke like symptoms. A case report. (P5.104)
Conclusion: Clinicians should consider SREAT in the differential diagnosis of patients presenting with stroke like symptoms/vasculitis especially if investigations fail to establish a diagnosis.Disclosure: Dr. Javalkar has nothing to disclose. Dr. Abbas has nothing to disclose. Dr. Harris has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Javalkar, V., Abbas, S., Harris, M. Tags: Edema, Encephalopathy, and Encephalitis Source Type: research

Eosinophilic CNS vasculitis can mimic demyelinating disease of the brain and spinal cord
A 61-year-old man developed progressive ascending sensory loss to T8 and paraparesis over 4 weeks. MRI revealed ovoid T2-hyperintense lesions in juxtacortical and periventricular areas, and in the T7-T10 spinal segment, with varying degrees of peripheral gadolinium enhancement (figure 1). He received 5 days of high-dose corticosteroids and plasmapheresis for presumed demyelination, without clinical response. Brain biopsy showed vasculitis involving small arteries with transmural inflammatory cell infiltrates including numerous eosinophils (figure 2). Eosinophilic vasculitis can cause ischemic strokes1; it rarely involves t...
Source: Neurology - February 2, 2015 Category: Neurology Authors: Schneider, R., Tsai, J. P., Munoz, D. G., Selchen, D. H. Tags: Vasculitis, All Cerebrovascular disease/Stroke NEUROIMAGES Source Type: research

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