Neurology
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What Is the Best First-Line Treatment for Young Women with Generalized Epilepsy?
Valproate is a highly efficacious drug for treating idiopathic generalized epilepsy (IGE) but is not an option for many young women because of known teratogenic risks. This retrospective, multicenter study examined women with IGE who were treated initially with either levetiracetam or lamotrigine monotherapy, demonstrated superior efficacy of levetiracetam, although exclusively in women with juvenile myoclonic epilepsy.
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Thrombectomy for Basilar Artery Occlusion
This randomized trial from China demonstrates a dramatic benefit from endovascular thrombectomy in patients with acute basilar artery occlusion. This benefit was sustained and improved at one year compared to 90 days.
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Clinicopathological Correlation in Motor Neuron Disease and Frontotemporal Degeneration
Frontotemporal lobar degeneration commonly occurs with motor neuron disease and has similar cytoplasmic neuronal aggregates of TAR deoxyribonucleic acid-binding protein 43 (TDP-43) in the brain as well as the spinal cord.
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The Clinical Spectrum of Anti-GQ1b Antibody Syndrome
Antibodies targeting gangliosides, glycosphingolipids that play a role in synaptic plasticity, neurotransmission derangements, and axonal growth all are implicated in many autoimmune peripheral neuropathies. Miller Fisher syndrome (MFS) is the clinical triad of external ophthalmoplegia, ataxia, and areflexia classically associated with anti-GQ1b. However, there are other subtypes that present with only one or two clinical features of the clinical triad.
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Stratifying Seizure Risk with a Rapid EEG
In a retrospective, large, multicenter trial, rapid response electroencephalogram (EEG) was found to be non-inferior to conventional EEG when incorporated into the 2HELPS2B score to guide how long patients should stay on EEG.
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Blood Biomarkers for the Diagnosis of Alzheimer’s Disease
In this population-based study of patients in Sweden with cognitive complaints, mild cognitive impairment, and dementia, the use of blood biomarkers, specifically, phosphorylated tau 217 and amyloid-beta 42/40 ratios, improved the diagnostic accuracy for pathological Alzheimer’s disease in primary care patients as well as patients seen by dementia specialists.
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Indications for Reduced-Dose Direct Oral Anticoagulants
A subgroup analysis of the ENGAGE-AF TIMI 48 study of edoxaban 60 mg/day vs. 30 mg/day compared to warfarin in patients with atrial fibrillation of the group 80 years of age or older has shown that 30 mg/day results in less major bleeding without a concomitant increase in stroke risk compared to 60 mg/day or warfarin.
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Anchoring Alzheimer’s Disease Along an Amyloid Timeline
In 601 individuals from Wisconsin-based cohorts with amyloid-beta and tau positron emission tomography scans, the magnitude and topographical spread of tau pathology increased with longer duration of amyloid-beta positivity, and the cognitive decline was steepest in those with the longest duration of amyloid-beta positivity and elevated entorhinal tau.
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CSF Analysis May Help in the Diagnosis of Dementia with Lewy Bodies
This paper demonstrated that cerebrospinal fluid (CSF) alpha-synuclein seeding assays can distinguish between clinically diagnosed dementia with Lewy bodies and controls, and that the presence of hyposmia with core clinical features had the highest predictive value of detecting CSF alpha-synuclein.
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Anchoring Alzheimer’s Disease Along an Amyloid Timeline
In 601 individuals from Wisconsin-based cohorts with amyloid-beta and tau positron emission tomography scans, the magnitude and topographical spread of tau pathology increased with longer duration of amyloid-beta positivity, and the cognitive decline was steepest in those with the longest duration of amyloid-beta positivity and elevated entorhinal tau.