European journal of neurology : the official journal of the European Federation of Neurological Societies
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We have shown that brain disorders cost Europe almost 400 billion euros annually, whereas the funding for brain research is only 1% of that amount. There is a growing understanding of the ability of research to improve prevention, treatment and rehabilitation of brain disease and thereby reduce the burden on the affected individuals and on society. ⋯ We argue that increased public investment in brain research in Europe is critical and will most likely be highly cost-effective to European society. If Europe wants to remain competitive in the field of brain research, public investments must be increased several fold over today's investment.
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Randomized Controlled Trial Clinical Trial
Double-blind crossover trial of gabapentin in SPG4-linked hereditary spastic paraplegia.
Patients with hereditary spastic paraplegia (HSP) are often treated with antispastic drugs to relieve symptoms but documentation is lacking. In this study, gabapentin was tested in a double-blind crossover trial on a group of patients with HSP and linkage to the SPG4 locus. There was no difference between periods with gabapentin and placebo treatment in clinical assessment, self-reported parameters or paired transcranial magnetic stimulation evaluation of motor cortical excitability.
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The coexistence of progressive multifocal leukoencephalopathy (PML) and primary central nervous system lymphoma (PCNSL) is a rare event, usually associated with a fatal outcome. We report the case of a human immunodeficiency virus (HIV)-infected individual presenting with both PML and PCNSL who made a remarkable recovery after highly active anti retroviral therapy (HAART) and radiation therapy, and discuss diagnostic and therapeutic aspects of both conditions.
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Clinical Trial
The use of gabapentin in chronic cluster headache patients refractory to first-line therapy.
Chronic cluster headache (CCH) is a rare but challenging condition. About 20% of CCH patients get refractory to treatment. Gabapentin has recently been reported to be efficacious in the treatment of CCH. ⋯ In some individuals, increasing doses were needed with time. We conclude that gabapentin may be offered as treatment trial in patients refractory to first-line treatment. However, patients may fail to respond to treatment and drug tolerance may occur with time.
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The aim of this study was to evaluate the causes, prevalences, clinical manifestations of hospital-referred polyneuropathies, and evaluate neurophysiological findings in idiopathic polyneuropathy. From 2000 to 2005, 226 patients with polyneuropathy were examined. Polyneuropathy was diagnosed when symptoms, clinical- and neurophysiological findings were compatible with affection of at least two peripheral nerves. ⋯ Symptomatic polyneuropathy was common and diabetes mellitus, inflammation and hereditary were frequent causes. In IDPN, DPN, HPN and INPN different clinical patterns were found. Additionally, in IDPN axonal demyelinating affection was more frequent than previously reported.