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Shahim and colleagues determine whether sports-related concussion is associated with elevated levels of blood biochemical markers of injury to the central nervous system and assess whether plasma levels of these biomarkers predict return to play in professional ice hockey players with sports-related concussion. Total tau, S-100 calcium-binding protein B, and neuron-specific enolase concentrations in plasma and serum were measured. Sports-related concussion in professional ice hockey players is associated with acute axonal and astroglial injury. This can be monitored using blood biomarkers, which may be developed into clinical tools to guide sport physicians in the medical counseling of athletes in return-to-play decisions. Gatson and Diaz-Arrastia provide commentary in an accompanying editorial.
Continuing Medical Education
Wall and coauthors report the baseline clinical and laboratory features of patients enrolled in the Idiopathic Intracranial Hypertension Treatment Trial. Their data show that IIH is almost exclusively a disease of obese young women. Patients with IIH with mild visual loss have typical symptoms, may have mild acuity loss, and have visual field defects, with predominantly arcuate loss and enlarged blind spots that require formal perimetry for detection. Volpe presents important issues in an accompanying editorial.
Burkholder et al determine whether the following are associated with surgical outcomes in patients with magnetic resonance imaging–negative temporal lobe epilepsy (TLE) who underwent standard anterior temporal lobectomy with amygdalohippocampectomy (ATL): (1) unilateral-only interictal epileptiform discharges (IEDs) on preoperative scalp electroencephalography (EEG); (2) complete resection of tissue generating IEDs on intraoperative electrocorticography (ECoG); (3) complete resection of opioid-induced IEDs recorded on ECoG; and (4) location of IEDs recorded on ECoG. Unilateral-only IEDs on preoperative scalp EEG and complete resection of IEDs on baseline ECoG are associated with better outcomes following standard ATL in magnetic resonance imaging–negative TLE. Quigg provides perspective on the clinical importance of those findings.
Day et al characterize the unique organization of neuroglial elements within ovarian teratomas resected from patients with N-methyl-d-aspartate receptor (NMDAR) encephalitis. Atypical neurons were seen within teratomas resected from 4 of 5 cases but not in 39 controls, reliably distinguishing teratomas associated with NMDAR encephalitis (P < .001). Abnormal neurons within teratomas distinguish cases with NMDAR encephalitis from controls and may promote the development of autoimmunity.
Highlights. JAMA Neurol. 2014;71(6):665. doi:10.1001/jamaneurol.2013.4151