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Current Opinion in Neurology

Thomas G Liman, Eberhard Siebert, Matthias Endres
PURPOSE OF REVIEW: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by acute cerebral endotheliopathy with consecutive disruption of the blood-brain barrier and vasogenic edema. Since its first description in 1996, PRES is increasingly recognized. However, many aspects of this syndrome with its wide spectrum of clinical and radiological features are still incompletely understood. In this review, possible pathophysiological mechanisms, approaches to diagnosis, recent study results on outcome, and future directions of research are described...
December 10, 2018: Current Opinion in Neurology
Thomas Brandt, Marianne Dieterich
PURPOSE OF REVIEW: To apply the concept of nonreflexive sensorimotor and cognitive vestibular functions and disturbances to the current view of separate right and left thalamocortical systems. RECENT FINDINGS: The neuronal modules for sensorimotor and cognitive functions are organized in so-called provincial hubs with intracommunity connections that interact task-dependently via connector hubs. Thalamic subnuclei may serve not only as provincial hubs but also in higher order nuclei as connector hubs...
November 16, 2018: Current Opinion in Neurology
Adolfo M Bronstein, Marianne Dieterich
PURPOSE OF REVIEW: To review recent work on clinical and imaging aspects of vestibular neuritis (or acute vestibular syndrome), in particular with a view to identifying factors predicting long-term clinical outcome. RECENT FINDINGS: Evidence for a role of inflammation in the vestibular nerve, and the presence of Gadolinium enhancement acutely in vestibular neuritis, is accruing. Visual dependence, anxiety and somatization traits predict the development of chronic dizziness after acute vestibular neuritis...
February 2019: Current Opinion in Neurology
Jean-Philippe Guyot, Angelica Perez Fornos
PURPOSE OF REVIEW: Bilateral vestibular deficits exist and their prevalence is more important than believed by the medical community. Their severe impact has inspired several teams to develop technical solutions in an attempt to rehabilitate patients. A particularly promising pathway is the vestibular implant. This article describes the main milestones in this field, mainly focusing on work conducted in human patients. RECENT FINDINGS: There have been substantial research efforts, first in animals and more recently in humans, toward the development of vestibular implants...
February 2019: Current Opinion in Neurology
Carol Y Cheung, Victor T T Chan, Vincent C Mok, Christopher Chen, Tien Y Wong
PURPOSE OF REVIEW: To summarize the current findings on clinical retinal diseases and retinal imaging changes with dementia, focusing on Alzheimer's disease. RECENT FINDINGS: Studies observed that clinical retinal diseases such as age-related macular degeneration, open-angle glaucoma and diabetic retinopathy are related to dementia, but the associations are not entirely consistent. In terms of the retinal neuronal structure, multiple retinal neuronal layers are significantly thinner in Alzheimer's disease dementia, such as the parapapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC-IPL)...
February 2019: Current Opinion in Neurology
Julia Ferrari, Stefan Krebs, Marek Sykora
PURPOSE OF REVIEW: A substantial proportion of patients with ischemic stroke present with mild neurological deficits ('Stroke with mild symptoms,' SMS). Treating these patients with thrombolysis or with thrombectomy is controversial and clinical practice is different. We will highlight the importance of these treatment decisions by reviewing the recent advances in this area. RECENT FINDINGS: Intravenous thrombolysis with recombinant tissue plasminogen activator in patients with SMS showed a significant reduction in functional disability after 3 months...
February 2019: Current Opinion in Neurology
Michael Strupp, Marco Mandalà, Jose A López-Escámez
PURPOSE OF REVIEW: To provide an update on the most frequent peripheral vestibular disorders. RECENT FINDINGS: The on-going classification of vestibular disorders by the Bárány Society represents major progress. The diagnosis of bilateral vestibulopathy (BVP) requires quantitative testing of vestibular function. 'Acute unilateral peripheral vestibulopathy' (AUPVP) is now preferred over 'vestibular neuritis.' Menière's disease is a set of disorders with a significant genetic contribution...
February 2019: Current Opinion in Neurology
Jerome de Seze
PURPOSE OF REVIEW: Neuromyelitis optica spectrum disorder (NMOSD) is a severe inflammatory disease of the central nervous system, particularly characterized by disabling episodes of optic neuritis and longitudinally extensive transverse myelitis. The pathogenic characteristic is the presence of antiaquaporin 4 antibodies (AQP4-Abs) in the cerebrospinal fluid and serum of most of the affected patients. However, a proportion of the patients (around 20-30%) that have a typical phenotype of NMO are seronegative for AQP4-Abs...
February 2019: Current Opinion in Neurology
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No abstract text is available yet for this article.
February 2019: Current Opinion in Neurology
Susan P Mollan, Jan Hoffmann, Alexandra J Sinclair
PURPOSE OF REVIEW: To review the most relevant developments in the understanding of headache in idiopathic intracranial hypertension (IIH). RECENT FINDINGS: The phenotype of the typical IIH headache is diverging from the historical thinking of a raised intracranial pressure headache, with the majority being classified as having migraine. A larger proportion of those with IIH have a past medical history of migraine, compared with the general population, highlighting the importance of re-examining those who have a change or escalation in their headache...
February 2019: Current Opinion in Neurology
Omar Akhand, Laura J Balcer, Steven L Galetta
PURPOSE OF REVIEW: To review emerging vision-based assessments in the evaluation of concussion. RECENT FINDINGS: Involvement of the visual pathways is common following concussion, the mildest form of traumatic brain injury. The visual system contains widely distributed networks that are prone to neurophysiologic changes after a concussion, resulting in visual symptoms and ocular motor dysfunction. Vision-based testing is increasingly used to improve detection and assess head injury...
February 2019: Current Opinion in Neurology
Neringa Jurkute, Joshua Harvey, Patrick Yu-Wai-Man
PURPOSE OF REVIEW: Leber hereditary optic neuropathy (LHON) is the most common primary mitochondrial DNA (mtDNA) disorder in the population and it carries a poor visual prognosis. In this article, we review the development of treatment strategies for LHON, the evidence base and the areas of unmet clinical need. RECENT FINDINGS: There is accumulating evidence that increasing mitochondrial biogenesis could be an effective strategy for protecting retinal ganglion cells in LHON...
February 2019: Current Opinion in Neurology
Monica Acciarresi, Riccardo Altavilla, Maria G Mosconi, Valeria Caso
PURPOSE OF REVIEW: The absolute risk of pregnancy-associated intracranial haemorrhage (ICH) has been reported to be relatively low and often associated with high risks of life-long disabilities and mortality. The aim of this narrative review was obtaining a better understanding of the current management practices for ICH, unruptured aneurysms and/or arteriovenous malformations during pregnancy, as well as the effects of future pregnancies, and the uses of oral contraceptive or HRT. RECENT FINDING: General guidelines for the management of ICH are used for pregnant women but additional expedient and thorough evaluation of foetal viability and its gestational age are requested...
February 2019: Current Opinion in Neurology
Valérie Biousse
No abstract text is available yet for this article.
February 2019: Current Opinion in Neurology
Didier Leys
No abstract text is available yet for this article.
February 2019: Current Opinion in Neurology
Breno Franco Silveira Fernandes, Paulo Caramelli
PURPOSE OF REVIEW: To address the important relationships between stroke and infection, focusing on the most frequent infections found in low-income and middle-income countries. RECENT FINDINGS: Stroke is one of the leading causes of mortality and disability worldwide, with a great proportion of the stroke burden occurring in low-income and middle-income countries. Infectious diseases are still a great health problem in developing countries and it is possible that the proportion of infection-related strokes is greater in these nations...
February 2019: Current Opinion in Neurology
Jason H Peragallo
PURPOSE OF REVIEW: To review the recent advances in understanding how primary brain tumors affect vision in children. RECENT FINDINGS: Children with primary brain tumors may have vision loss due to involvement of their afferent visual pathways or from papilledema. These vision deficits may go unrecognized until later in life, years after treatment of the primary lesion. Strabismus and cranial nerve palsies may occur as a result of brain tumors. Ophthalmologists can monitor and treat young children at risk for vision loss from amblyopia as a result of effects from their underlying lesion...
February 2019: Current Opinion in Neurology
Leanne Stunkel, Nancy J Newman, Valérie Biousse
PURPOSE OF REVIEW: This review summarizes the recent literature on diagnostic error relevant to the practice of neuro-ophthalmology, and evaluates the potential for increased access to neuro-ophthalmology to decrease rates of diagnostic error, thereby reducing medical harm and spending on unnecessary tests and treatments. RECENT FINDINGS: Despite medical advances, current research continues to show alarmingly high rates of diagnostic error. Research into diagnostic error shows that many of these errors can be traced to cognitive errors...
February 2019: Current Opinion in Neurology
Stefanie J Rodenbeck, Devin D Mackay
PURPOSE OF REVIEW: The funduscopic examination can be a technically difficult, and often omitted, portion of the neurologic examination, despite its great potential to influence patient care. RECENT FINDINGS: Medical practitioners are often first taught to examine the ocular fundus using a direct ophthalmoscope, however, this skill requires frequent practice. Nonmydriatic tabletop and portable fundus photography and even smartphone-based photography offer alternative and practical means for approaching examination of the ocular fundus...
February 2019: Current Opinion in Neurology
Gabriel J E Rinkel
PURPOSE OF REVIEW: Intracranial aneurysms are frequent incidental findings on cranial imaging. The decision for preventive treatment depends on the presumed risk of rupture, the efficacy and risk of complications of preventive treatment, and the quality of life having to live with an unruptured aneurysms. Data on all these factors are still incomplete, and additional data are needed. RECENT FINDINGS: The current review describes advances of the last 2 years in assessment of risk of rupture, on risks of preventive aneurysms occlusion, on follow-up imaging and on medical management of patients with unruptured intracranial aneurysms...
February 2019: Current Opinion in Neurology
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