Current opinion in neurology
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Curr. Opin. Neurol. · Jun 2013
ReviewAdvances in the diagnosis and treatment of tuberculous meningitis.
Early diagnosis and treatment of tuberculous meningitis (TBM) saves lives, but current laboratory diagnostic tests lack sensitivity and the best treatment regimens are uncertain. This article reviews the advances towards better TBM diagnosis and treatments made over the last 2 years. ⋯ Much remains to be done to improve the outcome from TBM. There have been important advances in the treatment, which may influence treatment guidelines in the near future, but there remains an urgent need for better diagnostic tests.
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This review comments on the recent advances in the understanding of the controversial aspects of neurocysticercosis (NCC). ⋯ During the last few years, there has been an increased knowledge on the controversial aspects of NCC, including epidemiology, mechanisms of disease acquisition, the natural involution of lesions in the brain parenchyma, and the role of calcifications as responsible for symptom occurrence.
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Tremendous advances have occurred in recent years in elucidating basic mechanisms of epilepsy at the level of ion channels and neurotransmitters. Epilepsy, however, is ultimately a disease of functionally and/or structurally aberrant connections between neurons and groups of neurons at the systems level. Recent advances in neuroimaging and electrophysiology now make it possible to investigate structural and functional connectivity of the entire brain, and these techniques are currently being used to investigate diseases that manifest as global disturbances of brain function. Epilepsy is such a disease, and our understanding of the mechanisms underlying the development of epilepsy and the generation of epileptic seizures will undoubtedly benefit from research utilizing these connectomic approaches. ⋯ An understanding of the fundamental mechanisms underlying the development of epilepsy and the generation of epileptic seizures will require delineation of the aberrant functional and structural connections of the whole brain. The field of connectomics now provides approaches to accomplish this.
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Curr. Opin. Neurol. · Dec 2012
ReviewEndpoints for clinical trials and revised assessment in neuro-oncology.
Recent advances in survival for patients with newly diagnosed and recurrent brain tumors, combined with the development of an ever-increasing number of potential treatments, has led to significant growth in the number of clinical trials for patients with brain tumors. Suitable clinical trial design and endpoints are vital for successfully evaluating these new treatments that may continue to improve outcome. However, inadequacies of clinical trial endpoints have challenged how best to evaluate promising new therapeutics. ⋯ An awareness of the benefits and imperfections of clinical trial endpoints will lead to improved clinical trial design and results. Validated endpoints of patient function, QOL, and cognition are available and increasingly valued as secondary endpoints.