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Current Treatment Options in Neurology

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https://www.readbyqxmd.com/read/28484983/ischemic-preconditioning-in-the-intensive-care-unit
#1
REVIEW
Maranatha Ayodele, Sebastian Koch
Preconditioning is the premise that controlled preemptive exposure to sub-lethal doses of a stressor and can condition an organism or organ to later withstand a lethal dose. This process relies on marshaling endogenous survival resources that have evolved as part of an organism's evolutionary struggle to overcome at times harsh environmental conditions. This preconditioning response occurs through activation of myriad complex mechanisms that run the gamut from alterations in gene expression to the de novo synthesis and post-translational modification of proteins, and it may occur across exposure to a wide variety of stressors (i...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28478511/cataplexy-and-its-mimics-clinical-recognition-and-management
#2
REVIEW
Sigrid Pillen, Fabio Pizza, Karlien Dhondt, Thomas E Scammell, Sebastiaan Overeem
This review describes the diagnosis and management of cataplexy: attacks of bilateral loss of muscle tone, triggered by emotions and with preserved consciousness. Although cataplexy is rare, its recognition is important as in most cases, it leads to a diagnosis of narcolepsy, a disorder that still takes a median of 9 years to be diagnosed. The expression of cataplexy varies widely, from partial episodes affecting only the neck muscles to generalized attacks leading to falls. Moreover, childhood cataplexy differs from the presentation in adults, with a prominent facial involvement, already evident without clear emotional triggers ('cataplectic facies') and 'active' motor phenomena especially of the tongue and perioral muscles...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28466429/sleep-disturbances-in-the-prodromal-stage-of-parkinson-disease
#3
REVIEW
Ahmed Al-Qassabi, Seyed-Mohammad Fereshtehnejad, Ronald B Postuma
Decades of research on neurodegenerative diseases such as Parkinson's disease (PD) have shifted our focus from clinical symptomatic stages to one step earlier, the prodromal stage. There is convincing evidence showing that sleep disorders such as excessive daytime somnolence, insomnia, obstructive sleep apnea, and particularly REM sleep behavior disorder (RBD) are potential prodromal features starting years and decades before conversion to PD. This review aims to provide an overview on various sleep disorders as prodromal features of PD...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28456915/reversible-cerebral-vasoconstriction-syndrome-recognition-and-treatment
#4
REVIEW
Cecilia Cappelen-Smith, Zeljka Calic, Dennis Cordato
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare but increasingly recognized disorder with over 500 cases published in the literature. The condition is characterized by recurrent severe thunderclap headaches with or without other neurological symptoms and diffuse segmental narrowing of the cerebral arteries which is reversible within 3 months. RCVS may occur spontaneously but in over 50% of cases, it is associated with various other conditions, including vasoactive medications or illicit drugs and the post-partum state...
June 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28451934/defining-disease-activity-and-response-to-therapy-in-ms
#5
REVIEW
Ulrike W Kaunzner, Mais Al-Kawaz, Susan A Gauthier
Disease activity in multiple sclerosis (MS) has classically been defined by the occurrence of new neurological symptoms and the rate of relapses. Definition of disease activity has become more refined with the use of clinical markers, evaluating ambulation, dexterity, and cognition. Magnetic resonance imaging (MRI) has become an important tool in the investigation of disease activity. Number of lesions as well as brain atrophy have been used as surrogate outcome markers in several clinical trials, for which a reduction in these measures is appreciated in most treatment studies...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28417345/imaging-markers-for-monitoring-disease-activity-in-multiple-sclerosis
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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