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Neurology Alert – November 1, 2002
November 1, 2002
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Mesial Temporal Sclerosis: Chickens and Eggs
Mesial temporal sclerosis is the most common pathology found in surgical series of patients undergoing temporal lobectomy for pharmacologically intractable focal epilepsy. A better understanding of the mechanisms leading to this neuropathological substrate for temporal lobe epilepsy should provide fundamental insights into the pathophysiology of epileptogenesis. -
Syncope and the Thread of Consciousness
Although syncope is common, its epidemiology and prognosis have not been well described. Soteriades and colleagues, therefore, evaluated the incidence, causes, and prognosis of syncope among men and women taking part in the Framingham Heart Study. -
Coffee Drinking May be Associated with SAH
While hypertension and smoking have been previously associated with aneurysmal subarachnoid hemorrhage, this is the first report of a role for coffee consumption. The methodology of the study, however, begs several further questions. -
Treatment of Acute Stroke with Mechanical Clot Extraction
In an extremely preliminary report, Mayer and associates present data on 5 patients with basilar artery thromboses treated with a device called Neuronet. -
Depression and Multiple Sclerosis: No Negative Effects of Beta-interferon
The high lifetime prevalence of depression in MS, along with other variants of mood disorder including anxiety and bipolar-affective illness, should make the psychiatric complications of MS a central component of disease management. These studies provide an additional understanding of depression and suicidal behavior in patients with MS. -
Impaired Chemosensitivity to Hypoxia a Marker of Multiple System Atrophy
Multiple system atrophy (MSA) is a neurodegerative disorder that can take protean forms. In this elegant paper, Tsuda and colleagues show that patients with the cerebellar form of MSA can be distinguished from idiopathic cerebellar degeneration before other signs of autonomic or parkinsonian disability develop. -
Chemokines and CIDP
No single antigen has yet been identified as the target in all patients with chronic inflammatory demyelinating polyneuropathy, a presumed autoimmune disorder similar to chronic experimental allergic neuritis, where both humoral and cell-mediated immune responses have been documented. Evidence suggests that specific chemokines play a role in pathogenesis. -
New Treatments for Chorea in Huntington’s Disease
Metman and associates carried out a controlled trial using amantadine to determine whether they could ameliorate chorea. This was based on prior studies showing that N-methyl-D-aspartate antagonists such as dextrophan, dextromethorphan, and amantadine can alleviate levodopa-induced chorea inpatients with parkinsonism. -
Regional Atrophy Mapping: A Useful Window on Alzheimer’s Disease
Serial MRI measurements can be used to map the pattern of regional brain atrophy in a variety of neurologic disease states. Using robust techniques that minimize the subjectivity of morphometric analysis, Scahill and colleagues compared rates and regional distribution of brain atrophy in 4 presymptomatic patients, 10 with mild Alzheimers Disease (AD), 12 with moderate AD, and age-matched controls. -
Pharmacology Watch: High-Dose Rofecoxib Confirmed Prothrombotic, Study Shows
Debate over the cardiovascular effects of COX-2 inhibitors has raged for more than a year since a special communication was published in JAMA last August suggesting an increase in cardiovascular events with rofecoxib (Vioxx). Now a large retrospect, the cohort study from the Tennessee Medicaid program seems to confirm the prothrombotic effects of rofecoxib, at least in high dose. -
Clinical Briefs in Primary Care Supplement
MRC/BHF Heart Protection Study of Antioxidant Vitamin Supplementation in 20,536 High-Risk Individuals; Prolonged Erections Produced by Dihydrocodeine & Sildenafil; Effect of Magnesium Supplementation of Blood Pressure; Homocysteine-Lowering Therapy with Folic Acid, Vitamins, and Clinical Outcome after Percutaneous Coronary Intervention; Effect of Cataract Surgery on Motor Vehicle Accidents in Older Adults; Inflammatory Biomarkers, Hormone Replacement Therapy, and Incident Coronary Heart Disease