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This Month in Archives of Neurology
February 2008

This Month in Archives of Neurology

Author Affiliations

Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Neurol. 2008;65(2):172-173. doi:10.1001/archneurol.2007.32
Stereotactic Radiosurgery for Treatment of Epilepsy

Quigg and BarbaroArticle review recent studies using Gamma Knife radiosurgery in the treatment of hypothalamic hamartoma or mesialtemporal lobe epilepsy that suggest that seizures in these medically intractable syndromes remit in clinically significant rates.

Protein Misfolding and Neurodegeneration

Soto and EstradaArticle point out that a key molecular pathway implicated in neurodegenerative diseases is the misfolding, aggregation, and accumulation of proteins. They emphasize that protein aggregates in neurodegeneration and the potential for the misfolding process lead to a transmissible form of the disease by a prion-based model of propagation.

Apomorphine and Parkinsonism

Gunzler and colleaguesArticle report that subthreshold concentrations of apomorphine do not worsen parkinsonism, suggesting that presynaptic dopamine autoreceptors are not important to the motor response in moderate to advanced Parkinson disease.

Interferon Beta-1a and Doxycycline in Multiple Sclerosis: An Open-Label Trial

The combination of intramuscular interferon beta-1a and oral doxycycline is reported by Minagar et alArticle as being effective, safe, and well tolerated. This combination of drug therapy resulted in reductions in contrast-enhancing lesion numbers (Figure) and posttreatment Expanded Disability Status Scale values.

Image not available

Median number of gadolinium-enhancing (Gd+) lesions before and during treatment.

Clinical Spectrum of Reversible Posterior Leukoencephalopathy Syndrome

The largest clinical series to date of reversible posterior leukoencephalopathy syndrome with confirmed neuroimaging improvement is reported by Lee and colleaguesArticle. Clinical recovery occurs in most patients within days. The condition is rarely isolated to the parieto-occipital white matter, and atypical neuroimaging features are frequent.Article

Immunomodulatory Therapy in Autoimmune Autonomic Ganglionopathy

Combining immunosuppressive therapy using prednisone and mycophenolate mofetil followed by plasmapheresis is reported by Gibbons and colleaguesArticle to provide substantial and sustained clinical improvement in patients with autoimmune autonomic ganglionopathy that was not seen using either treatment alone. Multiagent immunomodulatory therapies may be necessary to satisfactorily treat this immune-mediated disorder.

Focal Neurologic Symptoms in Pregnancy

Liberman et alArticlefound that the occurrence of focal neurological symptoms in healthy pregnant women is frequently preceded by aural-visual phenomena and can then usually be attributed to a first-ever migraine attack.

Status Epilepticus Without an Underlying Cause

Logroscino and colleaguesArticle report that idiopathic/cryptogenic status epilepticus is associated with an increased risk of death among the elderly and in subjects who later developed epilepsy.

Impact of Neurologic Complications on Outcome After Heart Transplantation

From a retrospective cohort study of patients who underwent heart transplantation, van de Beek et alArticle show that perioperative neurologic complications are frequent in heart transplant recipients, but most are transient and minor. However, perioperative stroke is the most important neurologic complication impacting survival in the first year after heart transplantation. Importantly, infectious diseases of the central nervous system are associated with a fatal outcome.

Osteopontin and Multiple Sclerosis

Chowdhury and colleaguesArticle found that cerebrospinal fluid levels of osteopontin, a proinflammatory cytokine, do not correlate with disability in multiple sclerosis (MS) but tend to be higher in patients with active disease. Cerebrospinal fluid osteopontin is not a specific marker for MS because it is found in patients with other neurological diseases and nonneurological illnesses.

Voxel-Based Assessments of White Matter Lesions Between Patients With Primary Progressive and Relapsing-Remitting Multiple Sclerosis

In a comprehensive study using conventional and magnetization transfer magnetic resonance imaging in patients with primary progressive (PP) and relapsing-remitting (RR) multiple sclerosis (MS), Di Perri et alArticle found significant differences between RRMS and PPMS in cerebral pathological involvement that contribute to differences in clinical disability.

Increased Frequency of Learning Disability in Patients With Primary Progressive Aphasia and Their First-Degree Relatives

Both patients with primary progressive aphasia (PPA) and their first-degree family members have a significantly higher frequency of learning disabilities compared with other dementia and control groups as reported by Rogalski and colleaguesArticle. Some of the PPA families displayed unusual concentrations of learning disabilities, especially dyslexia.

Very Mild Behavioral Variant Frontotemporal Dementia

Seeley and colleaguesArticle report that very mild behavioral variant frontotemporal dementia targets a specific subset of frontal and insular regions. Of note, they indicate that more advanced disease affects white matter and posterior gray matter structures densely interconnected with the sites of earliest injury.

Plasma β Amyloid and the Risk of Alzheimer Disease and Dementia

Sundelöf et alArticle found that low plasma β amyloid 40 levels predicted incident Alzheimer disease (AD) in elderly men independently of potential confounders. Plasma β amyloid 42 levels were not significantly associated with AD incidence.