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Neurology Alert

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  • Post-Traumatic Epilepsy and the Risk of Dementia

    A subset of people with head injury will develop post-traumatic epilepsy (PTE). This prospective cohort study demonstrated a 4.5-fold increased risk of dementia in those with PTE compared to people without head trauma or epilepsy, and that this risk exceeds that observed in people with head trauma or epilepsy alone.

  • Acute Small Fiber Neuropathy

    Acute-onset small fiber neuropathy most often is precipitated by infections, medication side effects, or vaccinations. Most cases recover spontaneously.

  • Cholinergic Basal Forebrain Involvement in Posture, Gait, and Cognitive Impairment in Parkinson’s Disease

    The features of gait difficulty, postural instability, and cognitive deficits in patients with Parkinson’s disease appear to be attributable to degeneration of cholinergic basal forebrain systems, including loss of fiber tract integrity and reduction of cortical projections.

  • Medications for Progressive Supranuclear Palsy: A Note of Caution

    In this post hoc secondary analysis of a Phase II/III randomized clinical trial of davunetide for progressive supranuclear palsy (PSP), investigators found that patients with PSP prescribed benzodiazepine derivatives experienced more rapid worsening of their PSP Rating Scale scores over time.

  • Neuropeptides in Patients with Restless Legs Syndrome

    The diurnal onset of restless legs syndrome (RLS) has been replicated in a mouse model using central instillation of the main melanocortin agonist, α-MSH, which stimulates excessive locomotion and grooming in rodents as well as a state of hyperalgesia. The actions of β-endorphin (β-EDP) oppose those of α-MSH, since β-EDP promotes passivity and analgesia. In this study, these prohormones were measured in plasma and cerebrospinal fluid in patients with RLS and compared to controls. Patients with RLS had elevated levels of α-MSH and lower levels of β-EDP compared to the control group.

  • Posterior Cortical Atrophy: An Important Variant of Alzheimer’s Disease

    This is the first comprehensive international study of patients with posterior cortical atrophy, including clinical, biomarker, and pathology data from 1,092 patients. These patients present at a younger age, have a very high prevalence of amyloid positivity on cerebrospinal fluid studies and positron emission tomography, and 94% had autopsy evidence of Alzheimer’s disease.

  • The Optic Nerve as Part of the Diagnostic Criteria for Multiple Sclerosis

    A recent prospective study showed that including the optic nerve as an additional topographic area in multiple sclerosis diagnostic decision-making improves sensitivity and diagnostic performance compared to the McDonald 2017 criteria: 92.5% sensitivity of the modified criteria vs. 88.2% of the current criteria.

  • Cerebral Amyloid Angiopathy Is a Risk Factor for Subdural Hemorrhage

    In this large, observational population study using databases from the UK Biobank and the All of Us research program, spontaneous subdural hemorrhage occurred more often in patients with cerebral amyloid angiopathy compared to a matched control group.

  • Myopathy with Elevated Aldolase and Normal CK: Differential Diagnosis

    Elevated serum creatine kinase (CK) is considered the hallmark of myopathy, yet some patients with biopsy-proven myopathy have normal CK with elevated aldolase, a less-specific marker of muscle disease. Most of those cases ultimately prove to be dermatomyositis.

  • A Comparison of Acute Migraine Therapies Using Big Data

    In a big data-driven observational study that compared 3 million treated migraine attacks captured from a migraine diary smartphone app, triptans were found to be the most efficacious treatment class. Among the triptans, eletriptan had the highest rate of success. Consistent with clinical practice and recent consensus statements, the success of triptans was followed by ergots and antiemetics.