Neurology Topics
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Diagnostic Criteria for Paraneoplastic Neurologic Syndromes
This study evaluates the effectiveness of the updated 2021 Paraneoplastic Neurologic Syndromes (PNS)-CARE score in diagnosing PNS, highlighting significant improvements in sensitivity and specificity compared to the 2004 criteria, while also addressing limitations related to study design, diagnostic criteria comparison, and the need for further research in diverse patient populations.
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Epilepsy and Cardiovascular Events
This large prospective cohort study found that older adults with a lifetime history of epilepsy were more likely to experience cardiovascular events (CVEs), and that enzyme-inducing antiseizure medications (EIASMs) may account for a significant portion of this risk. The findings suggest a potential causal link between epilepsy treated with EIASMs and CVE, highlighting the need for careful medication selection in epilepsy management.
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DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke
In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), there were no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.
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Neurologic Toxicity with Immune Checkpoint Inhibitors
In a nationwide, multicenter, retrospective study of patients with neurologic immune-related adverse events related to immune checkpoint inhibitors, more than half of patients developed a chronic condition associated with a higher rate of severe neurologic disability and mortality.
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Migraine Trigger or Prodromal Symptom: Which Came First — the Chocolate or the Craving?
Knowledge of the differentiation between the triggers for a potential migraine attack and the prodromal symptoms of an initiated migraine attack reveals strategies that decrease migraine disability. Recognition of migraine triggers allows for a modification of behavior to avoid precipitating an attack. Recognition of common migraine prodromal symptoms creates an early time window when rapid treatment enhances the therapeutic intervention’s efficacy.
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Eculizumab for Treating Aquaporin-4 Antibody-Positive NMOSD
In this retrospective study of a cohort of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) patients treated with eculizumab, the authors reported efficacy with decreasing relapse rate, magnetic resonance imaging changes, and disability outcomes, but cautioned about the risk of serious infections.
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A microRNA Diagnostic Biomarker for ALS
A specific pattern of eight micro ribonucleic acids (microRNAs) has been shown to differentiate patients with amyotrophic lateral sclerosis (ALS) from those with primary lateral sclerosis, Parkinson’s disease, and healthy controls. It remains to be determined if these differences will continue throughout the course of the disease.
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Repeated Head Trauma May Lead to Parkinsonism in Patients with CTE
Repeated head injury from years of contact sports play in men with confirmed chronic traumatic encephalopathy (CTE) may cause pathological changes in the substantia nigra that lead to parkinsonism in a subset of patients with CTE.
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Genetic Testing for Patients with Parkinson’s Disease
In this large scale, international study of Parkinson’s disease (PD) patients, approximately 15% of participants were found to have a positive PD-related genetic variant, most commonly in the GBA1 and LRRK2 genes.
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Thrombectomy for Basilar Artery Occlusion
This randomized trial from China demonstrates a dramatic benefit from endovascular thrombectomy in patients with acute basilar artery occlusion. This benefit was sustained and improved at one year compared to 90 days.