Journal of neurology, neurosurgery, and psychiatry
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J. Neurol. Neurosurg. Psychiatr. · Oct 2021
Observational StudyIntravenous immunoglobulin treatment for mild Guillain-Barré syndrome: an international observational study.
To compare the disease course in patients with mild Guillain-Barré syndrome (GBS) who were treated with intravenous immunoglobulin (IVIg) or supportive care only. ⋯ In patients with mild GBS, one course of IVIg did not improve the overall disease course. The certainty of this conclusion is limited by confounding factors, selection bias and wide confidence limits. Residual symptoms were often present after one year, indicating the need for better treatments in mild GBS.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2021
Factors affecting the risk of relapsing-onset and progressive-onset multiple sclerosis.
It has been debated whether the different clinical disease courses in multiple sclerosis (MS) are the consequence of different pathogenic mechanisms, with distinct risk factors, or if all MS clinical phenotypes are variations of similar underlying disease mechanisms. We aimed to study environmental risk factors and their interactions with human leucocyte antigen DRB1*15:01 with regards to relapsing-onset and progressive-onset MS. ⋯ Our finding that the same environmental and lifestyle factors affect both relapsing-onset and progressive-onset MS supports the notion that the different clinical phenotypes share common underlying disease mechanisms.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2021
IgG1 pan-neurofascin antibodies identify a severe yet treatable neuropathy with a high mortality.
We aimed to define the clinical and serological characteristics of pan-neurofascin antibody-positive patients. ⋯ IgG1 pan-neurofascin antibodies define a very severe autoimmune neuropathy. We urgently recommend trials of targeted immunotherapy for this serologically classified patient group.
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J. Neurol. Neurosurg. Psychiatr. · Oct 2021
Ischaemic stroke on anticoagulation therapy and early recurrence in acute cardioembolic stroke: the IAC study.
A subset of ischaemic stroke patients with atrial fibrillation (AF) have ischaemic stroke despite anticoagulation. We sought to determine the association between prestroke anticoagulant therapy and recurrent ischaemic events and symptomatic intracranial haemorrhage (sICH). ⋯ AF patients with ischaemic stroke despite anticoagulation may have higher recurrent ischaemic event risk compared with anticoagulation-naïve patients. This suggests differing underlying pathomechanisms requiring different stroke prevention measures and identifying these mechanisms may improve secondary prevention strategies.