This Month in Archives of Neurology

Emilien et alArticle from France review our current knowledge of the pharmacologic therapies for Alzheimer disease, including cholinesterase inhibitors, estrogens, antioxidants, neurotrophins, and the use of transgenic animal models. The exciting observations by Schenk and colleagues concerning immunization with amyloid β to prevent and reverse Alzheimer-disease–like pathologic conditions in the PDAPP mouse are put into clinical perspective. New concepts and innovations are now part of our therapeutic approach to Alzheimer disease, and this review captures the state and spirit of our present knowledge.

Kim and colleaguesArticle from Korea precisely define the location of medullary infarctions and the occurrence of aspiration. Clinical outcomes correlated in general with the location of medullary infarctions, and their findings offer predictive clinical correlations.

Mori and colleaguesArticle from Japan describe the interesting finding of alterations in visual perception in patients with dementia associated with probable Lewy body disease. These findings are relatively unique compared with those for patients with Alzheimer disease, and they provide a structural basis for the occurrence of visual hallucinations and visual agnosias in patients with dementia of Lewy body type.

Chan and colleaguesArticle from China and Australia studied families with Parkinson disease for possible mutations in the α-synuclein gene. Mutations previously described in families in southern Europe were not found in any of the Chinese patients and controls. Thus, the α-synuclein mutations recorded in the literature continue to involve a restricted number of families in a precise focal geographic region.

Morgante et alArticle from Italy describe the natural history and survival of patients with Parkinson disease compared with those of a controlled sample. The causes of death in the 2 groups were compared. They found that patients with Parkinson disease had a shorter survival period compared with matched control subjects and that a higher frequency of deaths was caused by pneumonia among patients with Parkinson disease.

De Freitas et alArticle from Switzerland compared patients with strokes sparing the leg and those having leg involvement. They found that patients without leg involvement had different stroke lesions, had different causes of stroke, and were characterized by more superficial infarcts mainly as a result of emboli from large artery disease and atherosclerosis without stenosis. These findings are interesting and offer practical correlations between the neurological examination and precise cerebral vessel involvement.

Verrips and colleaguesArticle from the Netherlands describe their experience with patients with cerebrotendinous xanthomatosis (CTX) with the presence of diarrhea and absence of tendon xanthomas. Patients should be evaluated for CTX if they show premature cataracts, intractable diarrhea, and progressive neurological signs with or without tendon xanthomas, especially since CTX is a treatable neurogenetic disorder.

Mygland et alArticle from Norway and Italy describe and distinguish groups of patients with myasthenia gravis with thymoma based on specific autoantibodies. They provide an elegant and important extension of subsets of patients with myasthenia gravis and raise important therapeutic implications.

Tang et alArticle describe their extensive experience with dominantly inherited ataxia in China. Machado-Joseph disease was present in almost 50% of the families they studied. Spinocerebellar ataxia types 1 and 2 were also found, but at much lower prevalences. Their detailed findings extend those of previous epidemiological studies of the inherited ataxias in China.

Elovaara and colleaguesArticle from Finland present their findings of adhesion molecules in blood and cerebrospinal fluid found in patients with multiple sclerosis and offer specific therapeutic implications based on these unique findings.

Cohen and colleaguesArticle from Israel describe the presence of oligoclonal IgG in patients with a variety of non–multiple sclerosis lesions, including meningioma, trauma, and spinal arteriovenous malformation. Elevated IgG levels in the cerebrospinal fluid require a broader differential diagnosis than acute demyelinating disorders.