Schiff and colleagues Article describe their motivation for, ethical framing of, and results from a recent single-subject study of central thalamic deep brain stimulation in a patient remaining in the chronic minimally conscious state. The results demonstrate dramatically a causal relationship between brain stimulation and cognitive recovery.
Birnbaum and Hellmann Article review their experience with primary angiitis of the central nervous system (PACNS). The clinical features, complex and difficult differential diagnosis, and current therapies are reviewed. However, most patients thought to have PACNS have a different disorder. Most interpretations of angiograms as being highly suggestive of PACNS will be owing to vasospasm. This and other compelling issues of diagnosis are amplified and defined.
Vernooij et al Article report that the use of platelet aggregation–inhibiting drugs is related to the presence of cerebral microbleeds. Further, their data support the position that aspirin and carbasalate calcium may relate to the presence of strictly lobar microbleeds. Editorial perspective is provided by Philip B. Gorelick, MD, MPH.Article
Kilbride and colleagues Article find that continuous electroencephalographic (cEEG) monitoring results in a change in antiepileptic drug (AED) prescribing during or after cEEG in a significant percentage of cases. Most AED changes were made owing to the detection of electrographic seizures.
Sadleir et al Article indicate that automatisms are frequent during childhood absence seizures. The characteristic pattern of automatisms suggests a reactive phenomenon to internal and external stimuli.
Percentage of seizures with automatisms in each state.
McKeon et al Article describe the clinical utility of the nicotinic ganglionic acetylcholine receptor autoantibody as a marker of neurological autoimmunity and cancer.
Lipp and colleagues Article report in a comprehensive study that the severity, distribution, and pattern of autonomic deficits at entry will distinguish multiple system atrophy (MSA) from Parkinson disease (PD) and MSA from PD with autonomic failure.
Van den Berg-Vos and colleagues Article note that patients who have lower motor neuron syndromes with a disease duration of at least 4 years usually have a favorable prognosis if muscle involvement has a segmental distribution. A generalized phenotype progression is relentlessly progressive, with a rapid degree of impairment.
Gordon et al Article emphasize that tracheostomy and permanent assisted ventilation are not equivalent to death in amyotrophic lateral sclerosis. The use of respiratory interventions differs between centers, leading to variability in combined outcome assessments.
Andersen et al Article find that lipids are an important source of fuel for exercising muscle in McArdle disease but that maximal rates of fat oxidation are limited and cannot be increased above the physiological normal rates during exercise.
Wilson and colleagues Article report that the presence and severity of mild cognitive impairment and Alzheimer disease are associated with reduced survival in African American individuals, and these effects are comparable with those in white persons.
Williams and colleagues Article note that despite changes in participant characteristics, the Clinical Dementia Rating demonstrated general stability for assessment of dementia over almost 3 decades.
This Month in Archives of Neurology. Arch Neurol. 2009;66(6):689-690. doi:10.1001/archneurol.2009.111