Neurology Alert
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COVID-19 Infection in MS Patients
In a multicenter, retrospective analysis of patients in a multiple sclerosis (MS) registry, the authors described the clinical characteristics and risks associated with severity of complications from COVID-19 infection in patients with MS.
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Ketamine for Super-Refractory Status Epilepticus
In this retrospective paper, the authors review the efficacy and safety of ketamine infusion in patients with status epilepticus who have failed benzodiazepine, standard anticonvulsant, and at least one other anesthetic drip.
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Gut Microbiome in Patients at Risk for Parkinson’s Disease
Certain risk factors and prodromal markers of Parkinson’s disease (PD), such as constipation and rapid eye movement sleep behavior disorder, are associated with specific bacterial compositions of the gut. However, the value of gut microbiome data to predict the risk of PD development needs further investigation.
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Auditory Startle Response as a Predictor of Recovery from Coma
Preserved habituation of the auditory startle response, performed at the bedside, indicates intact cortical structures and cortico-cortical white matter tract connections. Preservation of this reaction in patients with unresponsive wakefulness can help distinguish the vegetative state from minimally conscious state and may even predict eventual awakening.
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Oral Calcitonin Gene-Related Peptide Antagonist for Prevention of Migraine
Atogepant, an oral calcitonin gene-related peptide (CGRP) antagonist, was shown to be effective and safe for migraine prevention. This adds an additional CGRP antagonist to the growing arsenal of such medications, both oral and parenteral, for both prevention and treatment of migraine.
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A Novel Therapy for Amyotrophic Lateral Sclerosis Shows Promise
A novel drug combination was taken from an animal model and tested in a Phase II trial of patients with amyotrophic lateral sclerosis. Although there was a trend toward benefit, there were no statistically significant endpoints at the end of the trial. Future trials need to enroll a larger number of patients.
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Transthyretin Amyloidosis and Neuropathy
Wild-type transthyretin amyloidosis, referred to as “senile” amyloidosis previously, usually occurs in the aging population and affects the peripheral nerves and the heart. Usually, neurological symptoms precede cardiac symptoms.
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Nerve Disorders from Mutations in the BSCL2 Gene
The neuromuscular syndromes caused by BSCL2 gene mutations may mimic several other disorders, including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis.
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Molecular and Cellular Correlates of Human Nerve Regeneration
Specific and objective measures of improvement after carpal tunnel decompression (i.e., electrodiagnostic testing, somatosensory function, and intraepidermal nerve fiber density) also correlated with upregulation of ADCYAP1/PACAP genes. These genes may be potential therapeutic targets in the future.
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Dermatomyositis Sine Dermatitis Is an Important Clinical Entity
Dermatomyositis is an autoimmune disorder of skeletal muscle associated with a variety of auto-antibodies and specific muscle pathology but it may not have a skin rash. Muscle pathology and antibody determinations are important for accurate diagnosis and treatment.