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This Month in Archives of Neurology
July 2003

This Month in Archives of Neurology

Arch Neurol. 2003;60(7):922. doi:10.1001/archneur.60.7.922
Postvaccinal Encephalitis

Miravalle and Roos describe the risks and complications of postvaccinal encephalitis. The use of antivaccinia gamma globulin and intravenous methylprednisolone are discussed as preventive therapies. The discussion is pertinent with reference to contemporary issues of smallpox bioterrorism.

Progress in Treating Epilepsy

Pharmacoresponsive and pharmacoresistant epilepsies, surgical options, and deep brain stimulation are reviewed by Nguyen and Spencer. Great progress has been made in the treatment of epilepsy during the past decade, with the marketing of 8 new anticonvulsants and an innovative neurostimulation device.

Fish and Alzheimer Disease

Dietary intake of n-3-fatty acids and weekly consumption of fish may reduce the risk of incident Alzheimer disease (AD). This important environmental variable and preventive therapy for AD is reported by Morris and colleagues. Editorial perspective is provided by Robert P. Friedland, MD.

Emergency Intubation in Guillain-Barré Syndrome

Emergency intubation in Guillain-Barré syndrome (GBS) is uncommon, but when associated with respiratory arrest it can lead to anoxic encephalopathy. Duration of ventilator use and pulmonary morbidity are not increased in these patients. In recent years, recognition of worsening neuromuscular respiratory failure has improved, and there has been less hesitation to intubate when confronted with a GBS patient who is rapidly worsening, as reported by Wijdicks and colleagues.

Distinguishing Alzheimer Disease from Semantic Dementia

As described by Boxer and colleagues in a careful neuroanatomical comparative study, progressive brain atrophy can be distinguished between Alzheimer disease and other dementias, including semantic dementia.

Plasma Amyloid β-Protein Levels: Age vs Alzheimer Disease

Plasma Aβ40 and Aβ42 levels in sporadic Alzheimer disease (AD) were measured with reference to clinical, demographic, and genetic variables. Fukumoto and colleagues studied plasma samples from patients with sporadic AD, mild cognitive impairment, nondemented Parkinson disease, and nondemented controls. They found that the mean Aβ40 and Aβ42 levels in plasma significantly increased with age in each diagnostic group. These findings put into perspective the use of Aβ as a plasma marker for mild cognitive impairment or AD.

Amyloid β-proteins Aβ40 (A) and Aβ42 (B) levels in relation to age and sex in the nondemented control group. Age had a significant positive relation to Aβ40 (P<.001) and Aβ42 (P = .005). Sex had a significant relation to Aβ40 (P = .02) and a marginal relation to Aβ42 (P = .07), in both cases women having a higher mean than men. Age had similar positive relations to Aβ measures in all diagnostic groups. Best-fit lines are indicated for men (solid lines) and women (dashed lines).

Amyloid β-proteins Aβ40 (A) and Aβ42 (B) levels in relation to age and sex in the nondemented control group. Age had a significant positive relation to Aβ40 (P<.001) and Aβ42 (P = .005). Sex had a significant relation to Aβ40 (P = .02) and a marginal relation to Aβ42 (P = .07), in both cases women having a higher mean than men. Age had similar positive relations to Aβ measures in all diagnostic groups. Best-fit lines are indicated for men (solid lines) and women (dashed lines).

Cerebellar Speech

This study correlates speech functions, including articulatory movements of the tongue and oral facial muscles, in the activation of the rostral paravermal area of the anterior lobe of the cerebellum. Cerebellar ischemia in this area results in clinical dysarthria, as reported by Urban and colleagues.

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