Gagandeep Singh, Alfred K Njamnshi, Ley Sander
PURPOSE OF THE REVIEW: Malaria, Chagas Disease and Human African Trypanosomiasis are vector-borne protozoan illnesses, frequently associated with neurological manifestations. Intriguing but ignored, limited mainly to resource-limited, tropical settings, these disorders are now coming to light because of globalisation and improved diagnosis and treatment. Enhanced understanding of these illnesses has prompted this review. RECENT FINDINGS: Methods of diagnosis have currently transitioned from blood smear examinations to immunological assays and molecular methods...
March 11, 2021: Current Opinion in Neurology
Robert Kaniecki
PURPOSE OF REVIEW: Clinicians frequently face questions from headache patients regarding the roles played by sinus issues, muscle tension, and temporomandibular joint (TMJ) problems. This review highlights new concepts regarding the diagnosis and management of these headache conditions and their differentiation from migraine. RECENT FINDINGS: Recent research has clarified the roles played by pathology in the paranasal sinuses and TMJ in patients reporting headache...
March 11, 2021: Current Opinion in Neurology
Sarah B Simmons, Sven Schippling, Gavin Giovannoni, Daniel Ontaneda
PURPOSE OF REVIEW: Multiple sclerosis (MS) is a clinically heterogeneous disease, which complicates expectant management as well as treatment decisions. This review provides an overview of both well established and emerging predictors of disability worsening, including clinical factors, imaging factors, biomarkers and treatment strategies. RECENT FINDINGS: In addition to well known clinical predictors (age, male sex, clinical presentation, relapse behaviour), smoking, obesity, vascular and psychiatric comorbidities are associated with subsequent disability worsening in persons with MS...
March 11, 2021: Current Opinion in Neurology
Finja Schweitzer, Nina N Kleineberg, Yasemin Göreci, Oezguer A Onur, Christiana Franke, Clemens Warnke
PURPOSE OF REVIEW: To provide an overview on current knowledge of neurological symptoms and complications of COVID-19, and to suggest management concepts. RECENT FINDINGS: Headache, dizziness, excessive tiredness, myalgia, anosmia/hyposmia, and ageusia/dysgeusia are common nonspecific neurological manifestations during early COVID-19 disease found in the majority of patients. Less frequent but more severe and specific neurological manifestations include Guillain--Barré syndrome, encephalopathy, encephalitis/meningitis, epileptic seizures, and cerebrovascular events...
March 11, 2021: Current Opinion in Neurology
Mark W Green
PURPOSE OF REVIEW: Medication overuse headache (MOH)is a disabling problem worldwide with areas of controversy regarding its cause. This article reviews the recent ideas regarding the development of this disorder and its effective management. RECENT FINDINGS: It has been proposed that all acute migraine medications can lead to MOH, with differences in the propensity of different agents to cause the problem. Early data suggests that gepants, which are small-molecule calcitonin gene-related peptide antagonists used for the acute treatment of migraine, may be an exception...
March 11, 2021: Current Opinion in Neurology
Arne May, Jan Hoffmann
PURPOSE OF REVIEW: Trigeminal neuralgia is a well-known facial pain syndrome with several treatment options. In contrast, non-neuralgiform idiopathic facial pain syndromes are relatively rare, reflected by the fact that, until 2020, no internationally accepted diagnostic classification existed. Like trigeminal neuralgia, these non-dental facial pain syndromes need to be managed by neurologists and pain specialists, but the lack of pathophysiological understanding has resulted in an underrepresented and undertreated patient group...
March 3, 2021: Current Opinion in Neurology
Sofiati Dian, Ahmad Rizal Ganiem, Arjan van Laarhoven
PURPOSE OF REVIEW: Central nervous system (CNS) tuberculosis is the most devastating form of tuberculosis (TB), with mortality and or neurological sequelae in over half of individuals. We reviewed original research and systematic reviews published since 1 January 2019 for new developments in CNS TB pathophysiology, diagnosis, management and prognosis. RECENT FINDINGS: Insight in the pathophysiology is increasing steadily since the landmark studies in 1933, focussing on granuloma type classification, the relevance of the M...
March 3, 2021: Current Opinion in Neurology
Nouchine Hadjikhani, Maurice Vincent
PURPOSE OF REVIEW: This review covers several aspects our understanding of episodic manifestations and unusual symptoms that may be associated with migraine aura. RECENT FINDINGS: The episodic manifestation of migraine aura is typically visual in nature, although five other types are currently recognized: sensory, speech and/or language, motor, brainstem, and retinal. Other transitory perceptions or experiences such as emotional, olfactory, or auditory have been reported as possible migraine auras...
March 1, 2021: Current Opinion in Neurology
Chun-Yu Chen, Jong-Ling Fuh
PURPOSE OF REVIEW: Thunderclap headache (TCH) is an abrupt-onset of severe headache that needs to be thoroughly investigated because the most common secondary cause is subarachnoid hemorrhage (SAH). There has been no consensus guideline regarding the diagnostic workup. This review aims to provide an update on the evaluation of TCH. RECENT FINDINGS: The most important update in the 2019 American College of Emergency Physicians guideline for evaluation of acute headache in the emergency department is that a negative noncontrast brain computed tomography (CT) findings within 6 h from ictus essentially excludes SAH...
March 1, 2021: Current Opinion in Neurology
Verena Rass, Mario Kofler, Ronny Beer, Raimund Helbok
PURPOSE OF REVIEW: Patients with infectious diseases of the central nervous system (CNS) commonly require treatment in the intensive care unit (ICU). In a subset of patients with a life-threatening course, a more aggressive and invasive management is required. Treatment relies on the expertise of the intensivists as most recommendations are currently not based on a high level of evidence. RECENT FINDINGS: Published data suggest that an invasive brain-focused management should be considered in life-threatening CNS infections...
June 1, 2021: Current Opinion in Neurology
Per S Sørensen
No abstract text is available yet for this article.
June 1, 2021: Current Opinion in Neurology
Massimiliano Calabrese, Damiano Marastoni, Francesco Crescenzo, Antonio Scalfari
PURPOSE OF REVIEW: With the introduction of new diagnostic criteria, the sensibility for multiple sclerosis (MS) diagnosis increased and the number of cases with the clinically isolated syndrome (CIS) decreased. Nevertheless, a misdiagnosis might always be around the corner, and the exclusion of a 'better explanation' is mandatory.There is a pressing need to provide an update on the main prognostic factors that increase the risk of conversion from CIS or from radiologically isolated syndrome (RIS) to MS, and on the potential 'red flags' to consider during the diagnostic workup...
June 1, 2021: Current Opinion in Neurology
Frank G Gilliam, Hrvoje Hecimovic, Matthew S Gentry
PURPOSE OF REVIEW: The serotonergic system is implicated in multiple aspects of epilepsy, including seizure susceptibility, sudden unexpected death in epilepsy (SUDEP), and comorbid depression. Despite the complexity of serotonin's effects on various neuronal networks, ongoing research provides considerable insight into the role of serotonin in human epilepsy. This review explores the potential roles of serotonergic therapies to improve clinical outcomes in epilepsy. RECENT FINDINGS: In recent decades, research has markedly increased our knowledge of the diverse effects of serotonin on brain function...
April 1, 2021: Current Opinion in Neurology
Shobi Sivathamboo, Piero Perucca
PURPOSE OF REVIEW: Epilepsy is associated with autonomic dysfunction. Here, we provide an up-to-date review on measures of interictal autonomic function, focusing on heart rate variability (HRV), baroreflex sensitivity (BRS) and electrodermal activity (EDA). RECENT FINDINGS: Resting HRV, BRS and EDA are altered in patients with epilepsy compared with healthy controls. A larger body of work is available for HRV compared with BRS and EDA, and points to interictal HRV derangements across a wide range of epilepsies, including focal, generalized, and combined generalized and focal epilepsies...
April 1, 2021: Current Opinion in Neurology
Vejay N Vakharia, Beate Diehl, Martin Tisdall
PURPOSE OF REVIEW: Surgery can provide a robust long-standing seizure remission in drug-refractory mesial temporal lobe epilepsy (MTLE). Despite this, a significant proportion of postoperative patients are ineligible to gain a driving licence due to the size of the subsequent visual field defect (VFD). The amygdala and hippocampus are intimately related to several important white fibre association tracts and damage to the optic radiation results in a contralateral superior quadrantanopia...
April 1, 2021: Current Opinion in Neurology
Andrea O Rossetti, Vincent Alvarez
PURPOSE OF REVIEW: Randomized controlled trials investigating the initial pharmacological treatment of status epilepticus have been recently published. Furthermore, status epilepticus arising in comatose survivors after cardiac arrest has received increasing attention in the last years. This review offers an updated assessment of status epilepticus treatment in these different scenarios. RECENT FINDINGS: Initial benzodiazepines underdosing is common and correlates with development of status epilepticus refractoriness...
April 1, 2021: Current Opinion in Neurology
Philippe Ryvlin, Dang Khoa Nguyen
PURPOSE OF REVIEW: The increased identification of seizures with insular ictal onset, promoted by the international development of stereo-electroencephalography (SEEG), has led to the recent description of larger cohorts of patients with insular or insulo-opercular epilepsies than those previously available. These new series have consolidated and extended our knowledge of the rich ictal semiology and diverse anatomo-clinical correlations that characterized insular seizures. In parallel, some experiences have been gained in the surgical treatment of insular epilepsies using minimal invasive procedures...
April 1, 2021: Current Opinion in Neurology
Philippe Ryvlin
No abstract text is available yet for this article.
April 1, 2021: Current Opinion in Neurology
Maria Clara Zanon Zotin, Lukas Sveikata, Anand Viswanathan, Pinar Yilmaz
PURPOSE OF REVIEW: We present recent developments in the field of small vessel disease (SVD)-related vascular cognitive impairment, including pathological mechanisms, updated diagnostic criteria, cognitive profile, neuroimaging markers and risk factors. We further address available management and therapeutic strategies. RECENT FINDINGS: Vascular and neurodegenerative pathologies often co-occur and share similar risk factors. The updated consensus criteria aim to standardize vascular cognitive impairment (VCI) diagnosis, relying strongly on cognitive profile and MRI findings...
April 1, 2021: Current Opinion in Neurology
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