Current opinion in neurology
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Curr. Opin. Neurol. · Aug 2010
ReviewDeep brain stimulation for hyperkinetics disorders: dystonia, tardive dyskinesia, and tics.
This review focuses on new insights in deep brain stimulation (DBS) for patients with hyperkinetic movement disorders: dystonia, tardive dyskinesia and Gille de la Tourette's syndrome, during the last 18 months. ⋯ The few controlled studies showed that bilateral GPi stimulation is a well tolerated and a long-term effective treatment for hyperkinetic disorders. However, recent published data of DBS applied in different targets or patients (especially secondary dystonia) are mainly uncontrolled case reports, precluding the clear determination of the efficacy of this procedure and the choice of the 'good' target for the 'good' patient.
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Chronic migraine is a common cause of chronic daily headache, which is often refractory to standard treatment. New research has increased our understanding of this disorder and its treatment. This review focuses on recent clinical trials and advances in our understanding of migraine pathophysiology. ⋯ This review explains advances in the treatment of chronic migraine, a common disorder seen in neurological practice. These new advances in preventive treatment and a better understanding of its risk factors will allow clinicians to better identify individuals at greatest risk and prevent the development of chronic migraine.
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Curr. Opin. Neurol. · Jun 2010
ReviewMechanisms of cerebral edema in traumatic brain injury: therapeutic developments.
Although a number of factors contribute to the high mortality and morbidity associated with traumatic brain injury (TBI), the development of cerebral edema with brain swelling remains the most significant predictor of outcome. The present review summarizes the most recent advances in the understanding of mechanisms associated with development of posttraumatic cerebral edema, and highlights areas of therapeutic promise. ⋯ Attenuating blood-brain barrier permeability has become a promising approach to managing brain edema and associated swelling given that increases in cranial water content can only be derived from the vasculature. Inflammation, both classical and neurogenic, offers a number of attractive targets.
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Experimental and clinical studies have suggested that epileptic seizures can be modulated or interrupted by electrical stimulations of subcortical structures that may exert a remote control on seizure generators. The aim of this review is to present these recent reports and to address the perspectives of this approach. ⋯ New directions for studies are proposed for a better understanding of the mechanisms of action of this treatment.
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The purpose of this study is to focus on recent advances in understanding of the genetic and epidemiologic risk factors, development, modeling, and prevention of epilepsy after traumatic brain injury (TBI). ⋯ These observations provide small but encouraging steps towards a better understanding of the mechanisms of posttraumatic epileptogenesis, which is a key to developing a cure for this condition.