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Treatment of Progressive Multifocal Leukoencephalopathy

Progressive multifocal leukoencephalopathy, a rare opportunistic viral infection that occurs in patients who have chronic immunosuppression, has defied all attempts at treatment. This observational study, which pooled patient data from multiple centers around the world, showed that there is some benefit using checkpoint inhibitors to help reconstitute the immune system of these patients. However, survival, at best, is 50% of those treated.

Intravenous Immunoglobulin in Dermatomyositis

Treatment of dermatomyositis with intravenous immunoglobulin (IVIG) resulted in overall better clinical improvement after 16 weeks compared to patients treated with placebo. However, there was a significant number of thromboembolic adverse events in the treatment group. The group of patients treated was a heterogeneous group. However, IVIG now is U.S. Food and Drug Administration-approved for the treatment of dermatomyositis.

Is IVIG Treatment Really Better than Natural Recovery in Patients with Guillain-Barré Syndrome?

In this controversial report comparing patients with Guillain-Barré syndrome treated with intravenous immunoglobulin vs. no treatment, the group that appears to have fared the best were patients who had an acute demyelinating syndrome, and not an axonal variant. This was an observational study and not a randomized treatment trial.

Epilepsy: The Hidden Side Effect of Bariatric Surgery

The benefits of weight loss procedures are numerous, but a recently published paper reveals a long-term side effect clinicians and patients should heed.

Preventing Strokes After Transcatheter Aortic Valve Replacement

Researchers continue testing cerebral embolic protection devices as a solution — but are they effective?

Keep on the Sunny Side: Timing Meals for Better Mental Health

Feelings of anxiety and depression can fluctuate depending on when one eats throughout the day.

Expert Panel Debunks Common Sleep-Related Myths

Authors identified and deconstructed 10 misconceptions parents hold about teenage nocturnal patterns.

Should Endovascular Thrombectomy Be Performed With or Without Intravenous Alteplase?

With the widespread adoption of endovascular thrombectomy for the treatment of acute ischemic stroke caused by large vessel occlusion, a debate has raged about the role of intravenous thrombolysis. None of the clinical trials published to date have given us a clear evidence-based answer regarding the relative risks and benefits of this approach.

Long-Term Outcome in Patients with Intracerebral and Intraventricular Hemorrhage

Intracerebral hemorrhage continues to be a major cause of mortality and long-term disability. Early in the course of this severe disease prognosis is based on early characteristics, and care may be withdrawn at an early stage. The natural history and long-term recovery of survivors is uncertain because of withdrawal of care at an early time, resulting in a “self-fulfilling prophecy.”

Benefits and Risks of Dual Antiplatelet Therapy After Acute Ischemic Stroke or TIA

Secondary prevention of acute ischemic stroke is continuing to evolve with great interest in the use of dual antiplatelet treatment early in the course. A complicating factor has been the role of the CYP2C19 loss-of-function gene that interferes with the conversion of clopidogrel to its active antiplatelet metabolite.