Neurology Alert
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Are Epidural Steroid Injections Cost-Effective?
In a retrospective review of patients treated for low back pain and lumbar radiculopathy at the Cleveland Clinic, at three- and six-month follow-up, epidural steroid injections were no better than conservative therapies in quality of life measures or overall cost of medical care.
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Cavum Septum Pellucidum and Cavum Vergae: Markers of Chronic Brain Injury?
A cohort study assessing participants from the Professional Fighters Brain Health Study found that the presence of cavum septum pellucidum and cavum vergae is associated with lower regional brain volumes and lower cognitive performance.
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Intravenous Immunoglobulin for Treatment of Autoimmune Epilepsies
Patients with LGI1 and CASPR2 IgG-associated autoimmune epilepsy were identified and randomized to treatment with intravenous immunoglobulin (IVIG) vs. placebo. The authors hypothesized that IVIG would show superiority over placebo, with a primary endpoint of 50% or greater seizure reduction.
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Rituximab for the Treatment of MOG and AQP4 Antibody Diseases
Based on an observational prospective study of 16 patients with anti-myelin oligodendrocyte protein (MOG) disease and 29 anti-aquaporin-4 disease, the authors report lesser efficacy of rituximab in anti-MOG patients, characterized by higher occurrence of relapses in the anti-MOG group, even while the biological effect of rituximab on memory B-cell suppression was sustained.
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Neurofilament Light Correlates With Postoperative Delirium Severity
Measurement of postoperative plasma neurofilament light protein (NfL) in plasma appears to have a dose-dependent correlation with delirium severity, independent of inflammation. This observation provides evidence of neuronal injury from delirium.
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Therapeutic Hypothermia in Coma After Cardiac Arrest With Nonshockable Rhythm
Therapeutic hypothermia is beneficial and increases the probability of brain recovery in patients with coma due to cardiac arrest with a nonshockable heart rhythm.
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Immune Cell Infiltration Drives Cerebral Edema in Glioblastoma
Accumulating evidence suggests that immune dysregulation by glioblastoma cells induces tumor-associated edema and that disruption of this tumor-immune interaction may represent a novel strategy to reduce cerebral edema in glioblastoma.
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Lifetime Risk and Heritability of Amyotrophic Lateral Sclerosis
In this prospective, population-based study, mean lifetime heritability of amyotrophic lateral sclerosis was 52% in the entire cohort and 37% in patients devoid of any known pathogenic mutations. The highest heritability was seen in mother-daughter parings in both groups.
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Spontaneous Anterior Interosseous Nerve Syndrome
Anterior interosseous nerve syndrome is part of the median neuropathy spectrum and often has been attributed to compression near the elbow. Modern magnetic resonance neurography and ultrasound studies have ruled-out compression in most cases.
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Diagnostic Criteria for Small Fiber Neuropathy
Multiple clinical tools have emerged to assess small fiber nerve dysfunction, but validated diagnostic criteria are needed to optimize diagnostic sensitivity, support clinical management, and facilitate patient selection for clinical trials.