Current opinion in neurology
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With the aging of the population, treatment of painful neuropathies is becoming more and more important for neurological practice. This short review highlights recent findings and current problems. ⋯ A large variety of drugs are being tried in the treatment of painful neuropathy. Neurologists now have a wide choice. Recent publications can help in choosing the best treatment course.
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Developments in imaging following traumatic brain injury are outlined. Numerous techniques have evolved over the past several years giving us more information about the injury and prognosis for recovery. Some of these techniques are in clinical use while others are used primarily in research but have the potential to become clinically useful. ⋯ CT and MRI are now the imaging techniques for acute and subacute brain injury, respectively. Diffusion tensor imaging is being developed to provide more information on structural damage in brain injury. There are several research techniques available for brain injury, particularly relating to cerebral blood flow and metabolism.
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Here we discuss recent advances regarding the molecular genetic basis of dominantly inherited ataxias. ⋯ The dominant ataxias, also known as spinocerebellar ataxias, continue to grow in number. Here we review the major categories of spinocerebellar ataxias: expanded polyglutamine ataxias; noncoding repeat ataxias; and ataxias caused by conventional mutations. After discussing features shared by these disorders, we present recent evidence supporting a toxic protein mechanism for the polyglutamine spinocerebellar ataxias and the recognition that both protein misfolding and perturbations in nuclear events represent key events in pathogenesis. Less is known about pathogenic mechanisms in spinocerebellar ataxias due to noncoding repeats, though a toxic RNA effect remains possible. Newly discovered, conventional mutations in spinocerebellar ataxias suggest a wide range of biological pathways can be disrupted to cause progressive ataxia. Finally, we discuss how new mechanistic insights can drive the push toward preventive treatment.
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Curr. Opin. Neurol. · Jun 2007
Review Comparative StudyComparative immunopathogenesis of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis.
Advanced immunopathological techniques hold promise for more precise diagnosis of idiopathic demyelinating diseases of the central nervous system. We review recent progress in differentiating and understanding the disease mechanisms of acute disseminated encephalomyelitis, neuromyelitis optica, and classical multiple sclerosis. ⋯ The clinically heterogeneous group of idiopathic inflammatory demyelinating diseases of the central nervous system is characterized by several immunopathological patterns that suggest the involvement of diverse pathogenic effector mechanisms. Future advances in experimental pathology, immunology, molecular genetics, and neuroimaging, as well as the discovery of specific biomarkers, will more precisely define these disorders and lead to better targeted therapies.
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Curr. Opin. Neurol. · Jun 2007
ReviewPatent foramen ovale, stroke, and cardiovascular disease in migraine.
We will review the literature on the association between migraine with patent foramen ovale, stroke, and coronary heart disease. ⋯ Migraine with aura and patent foramen ovale have higher coincidences than expected by chance only. It is possible that both conditions are inherited together. Until now there has been no evidence from placebo-controlled randomized trials that closure of patent foramen ovale improves migraine with aura. There is increasing evidence that migraine with aura is not only a risk factor for ischemic stroke but also for myocardial infarction and other ischemic vascular events.