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This Month in Archives of Neurology
September 2009

This Month in Archives of Neurology

Arch Neurol. 2009;66(9):1056-1057. doi:10.1001/archneurol.2009.193
Emerging Viral Infections of the Central Nervous System, Part 2

TylerArticle continues his 2-part comprehensive review describing the association of JC virus–associated progressive multifocal leukoencephalopathy with novel immunoregulatory agents. He discusses the emerging viral infections associated with importing infected animals (monkeypox virus), the spread of vectors and enhanced vector competence (chikungunya virus), and novel viruses causing central nervous system infections including Nipah/Hendra and bat lyssaviruses.

Preventive Antibiotics for Infections in Acute Stroke

The evidence is discussed by van de Beek and colleaguesArticle that in adults with acute stroke, preventive antibiotics reduced the risk of development of infection but did not reduce mortality. The observed effect warrants evaluation of preventive antibiotics in large stroke trials.

Robotic Devices as Therapeutic and Diagnostic Tools for Stroke Recovery

Volpe et alArticle focus their review on upper limb impairment reduction after robotic training. They propose that robotic devices be considered as novel tools that might be used alone or in combination with novel pharmacology and other bioengineered devices.

Strokes Following Open Heart Surgery

Li and colleaguesArticle show that there is no direct causal relationship between significant carotid stenosis and postoperative stroke in patients who have cardiac surgery. Further, they find that combining carotid and cardiac surgeries is neither necessary nor effective in reducing postoperative stroke in patients requiring cardiac surgery with asymptomatic carotid stenosis. Editorial perspective is provided by Louis R. Caplan, MD.Article

Timing of Symptomatic Treatment in Early Parkinson Disease

Parashos et alArticle report that in early Parkinson disease, greater impairment and disability and higher level of education are independently associated with earlier need of symptomatic treatment.

Occupation and Risk of Parkinsonism

Tanner and colleaguesArticle show that parkinsonism risk associated with pesticides may support a toxicant-induced etiology of parkinsonism.

Is Incidental Lewy Body Disease Related to Parkinson Disease?

Frigerio and colleaguesArticle indicate that incidental Lewy body disease and Parkinson disease (PD) appear to have similar risk factor profiles. Thus, at least some cases of incidental Lewy body disease might represent preclinical PD, arrested PD, or a partial syndrome owing to less burden of causative factors.

Extrapyramidal Signs Before and After the Diagnosis of Incident Alzheimer Disease

Portet et alArticle state that extrapyramidal signs (EPS) occur frequently and progress significantly in Alzheimer disease (AD). Subjects with incident AD and concomitant EPS have a faster rate of cognitive decline than subjects with incident AD without EPS.

Treatment of Neuromyelitis Optica With Mycophenolate Mofetil

Jacob and colleaguesArticle find that mycophenolate mofetil is associated with reduction of relapse frequency and stable or reduced disability in patients with neuromyelitis optica spectrum disorders.

Neuromyelitis optica relapses before and after treatment with mycophenolate mofetil (0 on the x-axis indicates the start date of treatment). Each interrupted line on the y-axis represents a patient. The relapses of patient 21 are distributed evenly over his mycophenolate mofetil treatment duration owing to incomplete data.

Neuromyelitis optica relapses before and after treatment with mycophenolate mofetil (0 on the x-axis indicates the start date of treatment). Each interrupted line on the y-axis represents a patient. The relapses of patient 21 are distributed evenly over his mycophenolate mofetil treatment duration owing to incomplete data.

Diagnosis of Neuromyelitis Spectrum Disorders

McKeon et alArticle report in this large, clinical, practice-based study, that neuromyelitis optica–IgG detected by immunofluorescence or immunoprecipitation assays was highly specific for neuromyelitis optica spectrum disorders. Immunoprecipitation was significantly less sensitive than immunofluorescence but combined testing improves sensitivity by 5%.

Multiple Sclerosis With Predominant, Severe Cognitive Impairment

Staff and colleaguesArticle describe patients with multiple sclerosis whose clinical phenotype is characterized by severe cognitive dysfunction and prominent cortical and psychiatric signs presenting as a subacute fulminant or chronic progressive clinical course.

Cortical Lesions and Atrophy Associated With Cognitive Impairment in Relapsing-Remitting Multiple Sclerosis

Calabrese et alArticle describe how the burden of cortical lesions and tissue loss are among the major structural changes associated with cognitive impairment in relapsing-remitting multiple sclerosis.

Progression of Mild Cognitive Impairment to Dementia in Clinic vs Community-Based Cohorts

Tomaszewski Farias et alArticle report that the degree of functional impairment at baseline is an important predictor of conversion to dementia and may help explain differences in findings between epidemiological and clinic-based studies.

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