Neurology Alert – January 1, 2021
January 1, 2021
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Neurotropism of COVID-19: What Is New?
SARS-CoV-2 may gain access to the brain via the olfactory epithelium. The olfactory epithelium and bulbs may serve as an entry point for SARS-CoV-2 infection into the central nervous system.
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Cranial Neuropathy in CIDP
Cranial nerves are infrequently involved in typical chronic inflammatory demyelinating polyneuropathy, but involvement is more common in multifocal acquired demyelinating sensory and motor neuropathy (about 50%). The facial nerve is the most commonly affected cranial nerve, often bilateral.
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Rapid Eye Movement Sleep Duration Is Predictive of Life Expectancy
Total sleep duration declines with increasing age, as does the fraction of sleep spent in rapid eye movement (REM) sleep. The decline in REM is associated with increasing mortality, but it is not clear if this is a cause or a marker of declining health and declining brain function.
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Rhabdomyolysis Etiology
Rhabdomyolysis can be a life-threatening condition that often triggers a neurology consultation during an investigation for cause. However, in this recent study, the majority of cases (79%) were triggered by external, non-neuromuscular causes, and the others, although suspicious for an intrinsic muscular or genetic cause, rarely had a specific diagnosis confirmed.
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Medical Therapy vs. Carotid Endarterectomy in Patients with Asymptomatic Carotid Stenosis
Since the pivotal trials demonstrating the benefit of endarterectomy vs. medical therapy many years ago, there has been significant improvement in the risk factors for atherosclerosis, including better treatment of blood pressure and diabetes, as well as improved antiplatelet medication regimens and high-potency statins.
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Ticagrelor, a New Antiplatelet Agent, Shows Promise in Secondary Prevention of Ischemic Stroke
Ticagrelor is an antiplatelet agent that works by reversibly binding to P2Y12 adenosine diphosphate receptors on platelets, similar to the mechanism of action of clopidogrel. However, it is a direct-acting drug, and not a pro-drug, and does not need to be enzymatically converted to be active, like clopidogrel.
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A Mobile Interventional Stroke Team (MIST) Shows Promise in Performing Rapid Thrombectomy
Since 2015, when multiple international trials were reported showing clear benefit for mechanical thrombectomy in patients with large vessel occlusions, this treatment has been the standard of care. However, the speed of treatment remains paramount for good outcomes, and different models have been developed around the world in different geographic settings.