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Neurologic Clinics

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https://www.readbyqxmd.com/read/30072077/the-interface-between-neurology-and-oncology
#1
EDITORIAL
Eudocia Q Lee, Patrick Y Wen
No abstract text is available yet for this article.
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072076/paraneoplastic-neurologic-syndromes
#2
REVIEW
Myrna R Rosenfeld, Josep Dalmau
Paraneoplastic neurologic syndromes (PNS) are mostly immune-mediated disorders that occur in patients with cancer. Because the same neurologic syndromes may occur without a cancer association it is important to know the likelihood of PNS, which is based in part on the syndrome and the patient's demographics and risk factors for cancer. The presence of specific antineuronal antibodies can facilitate the diagnosis and suggest treatment strategies. Although some PNS are rarely responsive to therapies, other disorders are highly treatment responsive...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072075/neurocognitive-function-in-adult-cancer-patients
#3
REVIEW
Rebecca A Harrison, Jeffrey S Wefel
Impaired neurocognitive function is an increasingly recognized morbidity in patients who have cancer. Cancer treatments, psychosocial stressors, and the malignancy itself can alter brain function. The mechanisms by which this occurs are under active investigation. Although there is a growing appreciation of its prevalence and causes, there remain limited therapeutic options for the treatment of neurocognitive dysfunction in this population. A persistent scientific and clinical effort to understand its mechanisms and impact is critical to the care of oncology patients...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072074/neurologic-complications-of-systemic-anticancer-therapy
#4
REVIEW
Kien-Ninh Ina Ly, Isabel C Arrillaga-Romany
Neurologic complications of systemic cancer therapy encompass a range of symptoms that can affect the central nervous system (CNS), peripheral nervous system (PNS), or both. Their incidence will likely increase as novel agents, such as targeted therapy and immunotherapy, become incorporated into standard treatment regimens, and the number of long-term cancer survivors rises. Recognizing the common adverse effects of treatment is important to avoid misdiagnosis of cancer recurrence in the nervous system or paraneoplastic disease...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072073/neurologic-complications-of-radiation-therapy
#5
REVIEW
Shyam K Tanguturi, Brian M Alexander
Cranial radiation therapy (CRT) is used to treat a wide range of malignant and benign conditions and is associated with a unique set of risks and complications. Early complications from CRT include fatigue, skin reaction, alopecia, headaches, anorexia, nausea/vomiting, exacerbation of neurologic symptoms, serous otitis media, parotitis, and encephalopathy. Delayed complications include pseudoprogression, radiation necrosis, neurocognitive changes, cerebrovascular effects, migrainelike disorders, cataracts, xerophthalmia, optic neuropathy, hearing loss, tinnitus, chronic otitis, endocrinopathy, and secondary malignancy...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072072/metastatic-complications-of-cancer-involving-the-central-and-peripheral-nervous-systems
#6
REVIEW
Joe S Mendez, Lisa M DeAngelis
Neurologic complications of cancer may involve both the central nervous system and peripheral nervous system manifesting as brain, leptomeningeal, intramedullary, intradural, epidural, plexus, and skull base metastases. Excluding brain involvement, neurologic complications affecting these other sites are relatively infrequent, but collectively they affect more than 25% of patients with metastatic cancer causing significant morbidity and mortality. Early diagnosis and intervention optimize quality of life and improve survival...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072071/brain-metastases
#7
REVIEW
Ayal A Aizer, Eudocia Q Lee
Brain metastases from solid tumors are associated with increased morbidity and mortality. Standard treatment is local therapy with surgery and/or radiation therapy although there is increasing interest in systemic therapies that can control both intracranial and extracranial disease. We review the most recent data for local therapy and systemic therapy options. Active areas of research within radiation oncology include hippocampal sparing whole brain radiation therapy and stereotactic approaches for patients with more than 4 brain metastases...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072070/pediatric-brain-tumors
#8
REVIEW
Yoko T Udaka, Roger J Packer
Pediatric central nervous system (CNS) tumors are the most common solid tumors in children and comprise 15% to 20% of all malignancies in children. Presentation, symptoms, and signs depend on tumor location and age of the patient at the time of diagnosis. This article summarizes the common childhood CNS tumors, presentations, classification, and recent updates in treatment approaches due to the increased understanding of the molecular pathogenesis of pediatric brain tumors.
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072069/primary-central-nervous-system-lymphoma
#9
REVIEW
Kaylyn Sinicrope, Tracy Batchelor
Primary central nervous system lymphoma (PCNSL) is an aggressive form of non-Hodgkin lymphoma restricted to the central nervous system. Stereotactic biopsy is the gold-standard for diagnosis of PCNSL. Extent of disease evaluation for newly diagnosed PCNSL patients includes brain imaging, eye examination, cerebrospinal fluid assessment, body imaging, and bone marrow biopsy. Methotrexate-based chemotherapy is the standard induction for PCNSL patients. Optimal consolidation therapy for PCNSL has not been defined, with several options feasible, including chemotherapy, high-dose chemotherapy, and autologous stem cell transplantation or whole-brain radiation therapy...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072068/benign-intracranial-tumors
#10
REVIEW
Justin T Jordan, Scott R Plotkin
Meningiomas are the most common primary intracranial tumor in adults. With schwannomas, these tumors account for almost all intracranial benign tumors. Despite the benign histologic nature, patients suffer from neurologic symptoms and require treatment. Surgery remains the primary treatment for many such tumors, though radiation may be used either as a primary treatment or, commonly, for surgically inaccessible or recurrent lesions. The epidemiology, risk factors, and current data for local and systemic therapy options are reviewed...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072067/understanding-and-treating-glioblastoma
#11
REVIEW
Wolfgang Wick, Michael Platten
For newly diagnosed patients, the standard has remained largely unchanged for the past decade and concept-driven approaches like anti-angiogenic therapies or use of molecularly targeted drugs in all-comers populations have failed. Tumor-treating fields appear as a new option. Most current immunotherapy or molecularly targeted, precision medicine trials are also focusing on this newly diagnosed patient population. At progression, no standard exists and most treatments offer little beyond supportive care. Past trials lacked target precision and all-comers approaches have produced false negative results...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072066/grade-ii-and-iii-oligodendroglioma-and-astrocytoma
#12
REVIEW
Martin J van den Bent, Susan M Chang
In the 2016 WHO classification of diffuse glioma, the diagnosis of an (anaplastic) oligodendroglioma requires the presence of both an IDH mutation (mt) and 1p/19q codeletion, whereas (anaplastic) astrocytoma are divided in IDH wild-type and IDHmt tumors. Standard of care for grade II and III glioma consists of resection. For patients with tumors that require postoperative treatment, radiotherapy and chemotherapy are recommended. Trials in newly diagnosed grade II and III glioma have shown survival benefit of the addition of chemotherapy to radiotherapy compared with initial treatment with radiotherapy alone; both temozolomide and PCV have been shown to improve survival...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072065/neurologic-and-medical-management-of-brain-tumors
#13
REVIEW
Kester A Phillips, Camilo E Fadul, David Schiff
Patients with brain tumor encounter a wide spectrum of tumor and treatment-related complications during their disease course. Tumors may serve as seizure substrates, are associated with a hypercoagulable state that results in thromboembolic complications, and may influence mood and cognition. Antitumor and supportive therapies may also have deleterious effects. Herein, we discuss major aspects of supportive care for patients with brain tumors, with attention to benefit and complications derived from the management of seizures, brain edema, venous thromboembolism, fatigue, mood alterations, and cognitive dysfunction...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072064/world-health-organization-2016-classification-of-central-nervous-system-tumors
#14
REVIEW
Phedias Diamandis, Kenneth Aldape
The recent update of the World Health Organization (WHO) classification of tumors of the central nervous system represents a paradigm shift. Previous iterations of the classification relied on morphologic features for classification. In the 2016 update, the definitions of specific neoplastic entities tumors now include precise molecularly defined entities. This article discusses this paradigm shift, and focuses on the refinements in classification criteria, relations to previous editions, and their implication to neuropathology and neuro-oncology practice...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072063/evolving-insights-into-the-molecular-neuropathology-of-diffuse-gliomas-in-adults
#15
REVIEW
Floris P Barthel, Kevin C Johnson, Pieter Wesseling, Roel G W Verhaak
Recent advances in molecular analysis and genome sequencing have prompted a paradigm shift in neuropathology. This article discusses the discovery and clinical relevance of molecular biomarkers in diffuse gliomas in adults and how these biomarkers led to revision of the World Health Organization classification of these tumors. We relate progress in clinical classification to an overview of studies using molecular profiling to study gene expression and DNA methylation to categorize diffuse gliomas in adults and issues dealing with intratumoral heterogeneity...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/30072062/epidemiology-of-brain-tumors
#16
REVIEW
Jill S Barnholtz-Sloan, Quinn T Ostrom, David Cote
Incidence, prevalence, and survival for brain tumors varies by histologic type, age at diagnosis, sex, and race/ethnicity. Significant progress has been made in identifying potential risk factors for brain tumors, although more research is warranted. The strongest risk factors that have been identified thus far include allergies/atopic disease, ionizing radiation, and heritable genetic factors. Further analysis of large, multicenter, epidemiologic studies, as well as well annotated omic datasets (including genomic, epigenomic, transcriptomic, proteomic, or metabolomics data) can potentially lead to further understanding of the relationship between gene and environment in the process of brain tumor development...
August 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655457/fifty-key-publications-on-myasthenia-gravis-and-related-disorders
#17
EDITORIAL
Mazen M Dimachkie, Richard J Barohn
No abstract text is available yet for this article.
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655456/lambert-eaton-myasthenic-syndrome
#18
REVIEW
Vita G Kesner, Shin J Oh, Mazen M Dimachkie, Richard J Barohn
Lambert-Eaton myasthenic syndrome is a paraneoplastic or primary autoimmune neuromuscular junction disorder characterized by proximal weakness, autonomic dysfunction and ariflexia. The characteristic symptoms are thought to be caused by antibodies generated against the P/Q-type voltage-gated calcium channels present on presynaptic nerve terminals and by diminished release of acetylcholine. More than half of Lambert-Eaton myasthenic syndrome cases are associated with small cell lung carcinoma. Diagnosis is confirmed by serologic testing and electrophysiologic studies...
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655455/congenital-myasthenic-syndromes
#19
REVIEW
Perry B Shieh, Shin J Oh
The congenital myasthenic syndromes (CMS) are a group of rare genetic conditions characterized by abnormal neuromuscular transmission. Typically, these conditions have been the result of a dysfunctional protein that is present in the presynaptic terminal, the synaptic cleft, or the postsynaptic terminal. Many of these syndromes present within the first few years of life with fluctuating and fatiguable weakness in a distribution similar to myasthenia gravis, although a limb-girdle distribution and late onset are also seen in certain specific types of CMS...
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655454/an-update-myasthenia-gravis-and-pregnancy
#20
REVIEW
Johanna Hamel, Emma Ciafaloni
Myasthenia gravis presents a risk factor for pregnancy and delivery, and can affect the newborn. In return, pregnancy can affect the course of myasthenia and worsen the disease during pregnancy requiring treatment modifications. Treatment optimization and drug safety should be addressed before conception. Delivery is complicated by prolonged labor. Newborns can develop neonatal myasthenia gravis, a treatable and transient disease. Patients should not be discouraged to become pregnant, but provided with supportive counseling, planning, and monitoring in a multidisciplinary team involving obstetrician, anesthesiologist, pediatrician, and neurologist...
May 2018: Neurologic Clinics
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