Neurology
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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.
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Controlling Blood Pressure During Pregnancy Could Lower Dementia Risk
Investigators found an association between high blood pressure during pregnancy and a higher likelihood of developing dementia later in life.
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Multivitamin-Mineral Supplementation vs. Cocoa Extract for Cognition
This large, randomized trial followed participants for three years and determined that daily use of a cocoa supplement was not associated with cognitive enhancement in older adults, whereas a multivitamin supplement was associated with significant cognitive benefits.
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How Vitamin Intake Affects Migraine Prevalence
In a large population-based survey, 21.6% of participants reported having severe headaches or migraine. Those reporting severe headaches also reported a lower intake of thiamine and riboflavin, based on 24-hour recall of food intake. There also was an inverse relationship between thiamine intake and reports of severe headaches.
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Can a Blood-Based Test Serve as a Biomarker for Parkinson’s Disease?
The authors of this proof-of-concept study proposed that a noninvasive assay detecting pathology-associated α-synuclein extracted from blood may reveal a reliable biomarker for Parkinson’s disease.
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Electrodiagnostic Features of Vasculitic Neuropathy
Electrophysiological studies of vasculitic neuropathy indicate that the best discriminators of vasculitis vs. other axonal neuropathies are the side-to-side differences between the same bilateral nerves. When the diagnosis is uncertain, nerve biopsy may be definitive.