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Current Treatment Options in Neurology

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https://www.readbyqxmd.com/read/28417345/imaging-markers-for-monitoring-disease-activity-in-multiple-sclerosis
#1
REVIEW
Suradech Suthiphosuwan, David Kim, Aditya Bharatha, Jiwon Oh
Multiple sclerosis (MS) is an immune-mediated disease affecting the central nervous system (CNS). Magnetic resonance imaging (MRI) has long been recognized as an important tool in the diagnosis of MS. It is increasingly recognized that in addition to its role in diagnosis, MRI can play a key role as a noninvasive tool for prognostication, disease monitoring, assessment of treatment efficacy, and safety monitoring of disease-modifying therapies (DMTs). A confluence of factors, including increased availability of MRI, development of improved MRI techniques, and increased availability of DMTs have contributed to the expanding role of MRI in MS clinical care...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28417344/biotherapy-in-inflammatory-diseases-of-the-cns-current-knowledge-and-applications
#2
REVIEW
Nicolas Collongues, Laure Michel, Jérôme de Seze
Biotherapy represents an innovative therapeutic approach that includes immunotherapy (vaccines, apheresis, and antibodies); gene therapy; and stem cell transplants. Their development helps to cross the bridge from bench to bedside and brings new hope of a cure for severe diseases in different fields of medicine. In neurology, a growing range of applications is being developed for these medications. Valuable results are now available in the field of autoimmunity, neuro-oncology, paraneoplastic manifestations, and neurodegenerative disorders...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28386850/therapeutic-approaches-in-clippers
#3
REVIEW
Guillaume Taieb, Thibaut Allou, Pierre Labauge
CLIPPERS for chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids, is a steroid-sensitive and steroid-dependent brainstem inflammatory disease of unknown origin. Since its first description in 2010, about 60 cases have been reported throughout the world. The mean age at onset is 50 years and men seem to be more frequently affected. In patients without chronic corticosteroid therapy or immunosuppressive agents, the disease had a relapsing remitting course, and the mean annualized relapse rate was 0...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28374234/targeted-therapies-for-melanoma-brain-metastases
#4
REVIEW
Anna S Berghoff, Matthias Preusser
Brain metastases are a major clinical challenge occurring in up to 60% of patients suffering from metastatic melanoma. They cause significant clinical symptoms and impair the overall survival prognosis. The introduction of targeted therapies including BRAF and MEK inhibitors as well as CTLA-4 and PD-1 axis targeting immune checkpoint inhibitors have dramatically improved the treatment and prognosis of patients with extracranial metastatic melanoma. Although, similar response rates for extra- and intracranial metastases have been reported, only few data from brain metastasis specific trails are available so far...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28374233/neurological-deficits-in-obstructive-sleep-apnea
#5
REVIEW
Luigi Ferini-Strambi, Giulia Elisabetta Lombardi, Sara Marelli, Andrea Galbiati
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive episodes of complete or partial obstruction of the upper airway. The prevalence of this disorder is strictly dependent on its gravity. At ≥15 events/h apnea-hypopnea index (AHI), it ranges from 6 to 17% in the general population, with higher rates in men and increasing with age. The hypoxia induced by OSA severely affects the structure and function of blood vessels, culminating in mortality and morbidity...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28374232/monitoring-the-course-of-ms-with-optical-coherence-tomography
#6
REVIEW
Alexander U Brandt, Elena H Martinez-Lapiscina, Rachel Nolan, Shiv Saidha
Retinae of patients with multiple sclerosis (MS), as part of the central nervous system (CNS), display inflammatory and neurodegenerative changes. There is increasing evidence suggesting that retinal changes, and in particular neurodegeneration, mirror global CNS alterations in MS. Spectral domain optical coherence tomography (SD-OCT) is an inexpensive, rapid, non-invasive, and reproducible imaging technique that generates high-resolution images of tissues such as the retina. An advantage of SD-OCT over magnetic resonance imaging techniques in the assessment of neurodegeneration may be its sensitivity to capture changes at the individual patient level...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28374231/neurological-manifestations-of-igg4-related-disease
#7
REVIEW
Bernardo Baptista, Alina Casian, Harsha Gunawardena, David D'Cruz, Claire M Rice
IgG4-related disease (IgG4-RD) is a multisystem inflammatory disorder. Early recognition of IgG4-RD is important to avoid permanent organ dysfunction and disability. Neurological involvement by IgG4-RD is relatively uncommon, but well recognised-hypertrophic pachymeningitis and hypophysitis are the most frequent manifestations. Although the nervous system may be involved in isolation, this more frequently occurs in conjunction with involvement of other systems. Elevated circulating levels of IgG4 are suggestive of the condition, but these are not pathognomonic and exclusion of other inflammatory disorders including vasculitis is required...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28365895/does-proton-therapy-have-a-future-in-cns-tumors
#8
REVIEW
Stephanie E Combs
Proton therapy is characterized by certain physical properties leading to a reduction in integral dose. As proton therapy becomes more widely available, the ongoing discussion on the real indications for proton therapy becomes more important. In the present article, data on proton therapy for tumors of the central nervous system (CNS) is summarized and discussed in view of modern photon treatments. Still today, no randomized controlled trials are available confirming any clinical benefit of protons in CNS tumors...
March 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28349352/the-clinical-importance-of-periodic-leg-movements-in-sleep
#9
REVIEW
Michela Figorilli, Monica Puligheddu, Patrizia Congiu, Raffaele Ferri
Periodic leg movements during sleep (PLMS) are commonly found in patients with restless leg syndrome (RLS), but they may occur in other sleep disorders and several medical conditions. Their prevalence increases with age, but they can also be observed in children. During the last decades, very active research has been devoted to determine and understand the pathophysiology, associated events, and clinical significance of PLMS. This chapter tries to sum up the most relevant PLMS-related findings, focusing on the relationship between PLMS and the cardiovascular system, in order to understand the clinical implication of this complex motor phenomenon...
March 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28349351/advanced-mri-techniques-in-the-monitoring-of-treatment-of-gliomas
#10
REVIEW
Harpreet Hyare, Steffi Thust, Jeremy Rees
With advances in treatments and survival of patients with glioblastoma (GBM), it has become apparent that conventional imaging sequences have significant limitations both in terms of assessing response to treatment and monitoring disease progression. Both 'pseudoprogression' after chemoradiation for newly diagnosed GBM and 'pseudoresponse' after anti-angiogenesis treatment for relapsed GBM are well-recognised radiological entities. This in turn has led to revision of response criteria away from the standard MacDonald criteria, which depend on the two-dimensional measurement of contrast-enhancing tumour, and which have been the primary measure of radiological response for over three decades...
March 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28349350/visual-snow-a-potential-cortical-hyperexcitability-syndrome
#11
REVIEW
Alaa Bou Ghannam, Victoria S Pelak
The purpose of this review is to provide an overview of visual snow (VS) and provide information regarding current treatment options for VS. Visual snow (VS) is a rare disorder manifesting with a persistent visual phenomenon of seeing numerous tiny snow-like dots throughout the visual field, and it can cause debilitating visual and psychological consequences. It is emerging as a disorder separate from, but associated with, migraine visual aura, and neuronal cortical hyperexcitability is being considered as a theoretical mechanism for the persistent-positive visual symptoms...
March 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28337648/diagnosis-and-treatment-of-alternating-hemiplegia-of-childhood
#12
REVIEW
Melanie Masoud, Lyndsey Prange, Jeffrey Wuchich, Arsen Hunanyan, Mohamad A Mikati
The diagnosis and treatment of patients with Alternating Hemiplegia of Childhood (AHC) and related disorders should be provided by a multidisciplinary team experienced with the spectrum of presentations of this disease, with its related disorders, with its complex and fluctuating manifestations, and with cutting edge advances occurring in the field. Involvement in research to advance the understanding of this disease and partnership with international collaborators and family organizations are also important...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28251589/neurostimulation-devices-used-in-treatment-of-epilepsy
#13
REVIEW
Evren Burakgazi Dalkilic
Epilepsy is a chronic neurological disorder frequently requiring lifelong treatment. In 70% of epilepsy patients, seizures are well controlled by antiepileptic medications. About 30% of epilepsy patients remain refractory to medical treatments and may need surgical interventions for better seizure control. Unfortunately and not infrequently, surgical intervention is not feasible due to various reasons such as multiple seizure foci, not resectable focus because of eloquent cortex location, or inability to tolerate surgery due to ongoing concomitant medical conditions...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28251588/new-assessments-and-treatments-in-asd
#14
REVIEW
Roula N Choueiri, Andrew W Zimmerman
The assessment of autism spectrum disorder (ASD) is complex and remains clinical, despite advances in basic research. In this chapter, we review new and updated clinical tools, such as screening and diagnostic tests, and discuss the DSM-5 criteria introduced in 2013. We provide an algorithm to guide clinical evaluation and referrals. We also review non-behavioral treatments and summarize recent research. Current conventional treatment of ASD in children includes intensive behavioral interventions (known as applied behavioral analysis or ABA), rehabilitative services such as speech therapy, occupational therapy, physical therapy, social skills training, and counseling...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28251587/clinical-features-of-thalamic-stroke
#15
REVIEW
Xiang Yan Chen, Qiaoshu Wang, Xin Wang, Ka Sing Wong
The thalamus plays an important role in different brain functions including memory, emotions, sleep-wake cycle, executive functions, mediating general cortical alerting responses, processing of sensory (including taste, somatosensory, visual, and auditory) information and relaying it to the cortex, and sensorimotor control. Thalamic stroke, both in isolation and in combination with infarcts involving other structures, are not rare. The functional complexity of the thalami nuclei and the not uncommon normal variations of arteries supply the thalamus induce wide variations in presentation of thalami infarcts...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28243991/normothermia-and-stroke
#16
REVIEW
Jonathan Marehbian, David M Greer
In the past two decades, there has been much focus on the adverse effect of fever on neurologic outcome, the benefits of hypothermia on functional outcomes, and the interplay of associated complications. Despite decades of experience regarding randomized, safety and feasibility, case-controlled, retrospective studies, there has yet to be a large, randomized, multicenter, clinical trial with the appropriate power to address the potential benefits of targeted temperature modulation compared to hypothermia alone...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28155064/how-to-treat-involvement-of-the-central-nervous-system-in-hemophagocytic-lymphohistiocytosis
#17
REVIEW
AnnaCarin Horne, Ronny Wickström, Michael B Jordan, E Ann Yeh, Ahmed Naqvi, Jan-Inge Henter, Gritta Janka
Central nervous system (CNS)-hemophagocytic lymphohistiocytosis (HLH) is not a disease in itself, but it is part of a systemic immune response. The vast majority of patients with CNS-HLH also have systemic HLH and a large number of patients with primary and secondary HLH have CNS involvement. Reactivations within the CNS are frequent during the course of HLH treatment and may occur concomitant with or independent of systemic relapses. It is also important to consider primary HLH as an underlying cause of "unknown CNS inflammation" as these patients may present with only CNS disease...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28138903/the-treatment-of-giant-cell-arteritis
#18
REVIEW
Imran Jivraj, Madhura Tamhankar
Giant cell arteritis (GCA) is a systemic inflammatory vasculitis affecting medium and large vessels with potentially sight and life-threatening complications. Early diagnosis and prompt treatment are imperative in order to prevent vision loss and progression of the disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are elevated in the majority of patients and support the diagnosis of GCA among patients who present with typical symptoms. GCA is confirmed with superficial temporal artery biopsy which demonstrates characteristic pathological findings...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28130682/therapies-for-hemorrhagic-transformation-in-acute-ischemic-stroke
#19
REVIEW
Joshua A Stone, Joshua Z Willey, Salah Keyrouz, James Butera, Ryan A McTaggart, Shawna Cutting, Brian Silver, Bradford Thompson, Karen L Furie, Shadi Yaghi
Hemorrhagic transformation occurs in about 10-15% of patients with acute ischemic stroke. The treatment of hemorrhagic conversion is complex and includes blood pressure management, reversing coagulopathy, and managing its complications including increased intracranial pressure. Future research should be directed on identifying indications to treat and use of appropriate homeostatic regimens to effectively reverse the different anticoagulants and thrombolytic agents in an attempt to improve outcomes of patients with hemorrhagic transformation...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/27873215/current-and-future-treatment-approaches-in-transthyretin-familial-amyloid-polyneuropathy
#20
REVIEW
Philippe Kerschen, Violaine Planté-Bordeneuve
Treatment of transthyretin familial amyloid polyneuropathy (TTR FAP) must be tailored to disease stage. Patients with early stage disease (i.e., without major impairment in walking ability), especially younger patients, should be referred as soon as possible for liver transplantation (LT) in the absence of major comorbid conditions. LT remains the most effective treatment option to date and should be offered to these patients as early as possible. Bridging therapy with an oral TTR stabilizer (tafamidis or diflunisal, according to local access to these treatments) should be started as soon as the diagnosis of TTR FAP is established...
December 2016: Current Treatment Options in Neurology
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