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Thalamic Stroke and Sleep Impairment: An Experiment of Nature

In a detailed clinical and electrophysiological study of sleep patterns in 12 patients with thalamic stroke, comparing them with 11 patients who had extrathalamic stroke, the investigators identified a marked decrease in slow wave sleep activity in the group with thalamic stroke. The clinical significance of this finding is uncertain but may have an effect on daytime cognitive performance.

Eculizumab for Refractory Myasthenia Gravis

Eculizumab, a monoclonal antibody that inhibits the C-5 complement terminal complex formation, is a safe and effective treatment for generalized myasthenia gravis with acetylcholine receptor auto-antibodies, even after failed treatment with other immunosuppressive regimens.

Infections Before Age 20 Years Increase the Risk of Multiple Sclerosis

The relationship between childhood infections and the risk of multiple sclerosis is supported by increasing evidence. Using the Swedish Total Population Register, researchers found that patients diagnosed with infection in adolescence showed an increased risk of multiple sclerosis, even after exclusion of infectious mononucleosis, pneumonia, and central nervous system infection.

Gene and Substrate Therapy for Neurogenetic Disease: A Combined Approach to Treat Mitochondrial Myopathy

A combined adenoviral-mediated gene therapy plus substrate therapy delivered to a mouse model of thymidine kinase 2 (TK2) deficiency, manifested most often as a fatal mitochondrial myopathy in infants and children, rescued TK2 activity and prolonged animal lifespan, thus indicating a promising therapeutic approach for affected patients.

TSPO PET Imaging for Monitoring Natalizumab-Associated Progressive Multifocal Leukoencephalopathy

Authors of a recent study evaluated inflammatory activity in multiple sclerosis patients who developed natalizumab-associated progressive multifocal leukoencephalopathy (PML) using translocator protein positron emission tomography (TSPO PET) for imaging of microglia. They demonstrated that TSPO PET can monitor PML longitudinally.

Incidence, Prevalence, and Long-Term Consequences of Small Fiber Neuropathy

Small fiber neuropathy (SFN), a subtype of peripheral neuropathy characterized by painful distal neuropathic pain and autonomic symptoms, is increasing in incidence. SFN associated with diabetes and other causes is more likely to progress to large-fiber polyneuropathy and have faster deterioration and higher disability compared to slow progression with idiopathic SFN. Glucose impairment, obesity, and elevated triglycerides are modifiable risk factors of idiopathic SFN. Although major disability and neurologic impairment are uncommon in this slowly progressive condition, higher mortality and cardiovascular events are noted in patients with SFN.

Electrodiagnostic Findings in Thoracic Outlet Syndrome

The diagnosis of thoracic outlet syndrome may be difficult and relies on specific clinical, imaging, vascular, and electrodiagnostic features. None of the currently recommended treatments have been shown to be effective, but there are few randomized clinical treatment trials.

Is Pimavanserin Safe to Use in Patients with Parkinson’s Disease?

This retrospective cohort study of patients with Parkinson’s disease ages 65 years or older residing in Medicare-certified long-term care facilities revealed pimavanserin use vs. nonuse is associated with an increased risk of 30-day hospitalization and higher 90-, 180-, and 365-day mortality.

Neurodegenerative Ataxia: Improvement in Motor and Cognitive Outcomes with Cerebello-Spinal Stimulation

Concurrent cerebellar and spinal stimulation with a transcranial direct current stimulation device resulted in improvement of both motor and cognitive functions in patients with several different forms of neurodegenerative ataxia.

Is the Suicidality Class Warning Warranted for Antiseizure Medications?

This study reports data that refutes the U.S. Food and Drug Administration’s class warning regarding suicidality risk in patients with epilepsy who are taking the newer antiepileptics, approved since 2008. The class warning should be reconsidered.