Neurology Alert
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The Neural Pathways of Pain Treatment Response in Small-Fiber Neuropathy
Pain in peripheral neuropathy, referred to as neuropathic pain, is thought to result from overexpression of pain receptors, regeneration of hypersensitive nerve sprouts, and denervation hypersensitivity of neurons in the sensory ganglia. Additionally, activation of the pain pathways appears to induce secondary structural and functional changes in the brain that contribute to pain perception, persistence, and response.
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Focused Ultrasound Ablation of the Subthalamic Nucleus for Parkinson’s Disease Tremor
This paper demonstrated the long-term efficacy and safety of unilateral magnetic resonance imaging-guided high-frequency ultrasound subthalamotomy for Parkinson’s disease patients with motor fluctuations and dyskinesia three years after the procedure.
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Role of the Hypothalamus in Migraine and Cluster Headaches
The hypothalamus plays a regulatory role in both migraine and cluster headaches. However, the two headache types have distinctive clinical features, characteristic areas of resting state functional connectivity on magnetic resonance imaging, and different genetic chronobiological associations.
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Poor Sleep Patterns Could Raise Stroke Risk
Researchers provide another reason why patients should be resting well every night.
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Bone Density as a Dementia Risk Indicator
Researchers found some associations between bone density loss and a higher risk of developing dementia.
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Diagnosis of Myasthenia Gravis May Be Challenging
Mimics of myasthenia gravis, including functional neurologic disorder, progressive external ophthalmoplegia, chronic ptosis, oculopharyngeal muscular dystrophy, mitochondrial cytopathy, or low-grade myositis, can make the diagnosis of myasthenia gravis difficult.
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Is the Long-Term Use of Low-Dose Opioids for the Treatment of Refractory RLS Safe and Effective?
A review of two-year longitudinal data regarding efficacy and dose stability in refractory restless legs syndrome (RLS) patients treated with low-dose opioids shows that patients do not escalate their opiate dosage and that there is clinical and therapeutic stability in the treatment of RLS with this therapeutic regimen. Methadone is the preferred opiate for the treatment of RLS because of its single-dose, long-acting profile and lack of euphoric effects.
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Viral Exposure and Risk of Neurodegenerative Disease
Twenty-two pairs of viral exposures associated with an increased risk of neurodegenerative diseases were identified and replicated across two national European biobanks.
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Can EEG and fMRI Help Predict Who Will Recover Consciousness After Brain Injury?
In conjunction with serial clinical examinations, electroencephalogram and functional magnetic resonance imaging may be helpful in predicting who will recover consciousness after an acute brain injury. However, in this study, early withdrawal of care leaves much uncertainty regarding the probability of eventual recovery.
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The Effect of Peripheral Neuropathy in Parkinson’s Disease on Gait and Balance
In this cohort study of 99 patients with Parkinson’s disease (PD), 40% were found to have peripheral neuropathy, with the majority meeting criteria for small fiber neuropathy. Gait and balance were worse in PD patients with neuropathy compared to those without.