Neurology Alert
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Long-Term Outcome for Patients with CIDP
In a careful meta-analysis of published series of treated patients with chronic inflammatory demyelinating polyneuropathy (CIDP), about one-half of patients achieved a good long-term remission with independent function and only about 8% were unable to walk independently.
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Involvement of the Peripheral Nervous System in Neurolymphomatosis
Lymphoma that presents with peripheral neuropathy is a challenging diagnosis. Diagnosis and treatment often are delayed, but they can be facilitated by early consideration and imaging with fluorodeoxyglucose-positron emission tomography. Early diagnosis and hematologic treatment may be effective.
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Somatic Variants in Ras/Raf/MAPK Pathway Play a Role in Mesial Temporal Lobe Epilepsy
Eleven somatic variants enriched in the hippocampus were detected in a group of patients with drug-resistant mesial temporal lobe epilepsy (MTLE). Most somatic variants are mutations in the Ras/Raf/mitogen-activated protein kinase (MAPK) pathway. Overactivation of the Ras/Raf/MAPK pathway was detected in MTLE with somatic variants.
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Trichloroethylene Exposure Has Been Linked to an Increased Risk of Parkinson’s Disease
Preliminary evidence suggests trichloroethylene is a potential environmental risk factor for Parkinson’s disease. Further research is needed to confirm this association.
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Lovastatin for Reducing Risk and Delaying Onset of ALS
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease without available treatments that significantly alter the disease course. Using Medicare databases and pharmacy records, with multiple logistic regression models, researchers studied three candidate drugs (lovastatin, sulfasalazine, and telmisartan) that were identified as possible therapies for ALS and their effects on SOD1G93A transgenic mice. Animal testing showed a delay in disease onset and prolonged survival in mice treated with a mouse-equivalent dose of lovastatin 40 mg, but showed no benefit from the other two candidate drugs.
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A Primer on Excessive Daytime Sleepiness and Narcolepsy
Many new drugs are coming on the market to treat daytime sleepiness, as well as insomnia, as the prevalence of sleep disorders continues to grow in modern society. Neurologists should familiarize themselves with these disorders and the various ways to treat them safely.
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Sleep Apnea Appears to Age Brain Faster
Researchers observed patients who spent less time in deep sleep showed biomarkers indicative of poor neurological health.
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Neurologists Try to Predict Cognitive Impairment Earlier
Researchers used easy memory tests among healthy participants to determine who might be more likely to need closer monitoring.
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Subcutaneous IVIG for Treatment of Myasthenia Gravis
A Phase II trial comparing subcutaneous (SC) administration of pooled immunoglobulin to intravenous (IV) administration of immunoglobulin in 23 patients with seropositive myasthenia gravis demonstrated a stable course after transition from IV to SC.
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Inclusion Body Myositis: Variability and Clinical Subsets
Inclusion body myositis (IBM) is a progressive myopathy characterized by prominent finger flexor and quadriceps involvement. Black patients with IBM have more prominent proximal weakness, in addition to finger flexion and quadriceps weakness. Female patients have less prominent finger flexion and quadriceps weakness and slower progression, whereas younger patients had a greater delay in diagnosis. There are variability and distinct clinical subsets among IBM patients, which can have implications in terms of timely diagnosis and possibly response to treatments.