Expert review of neurotherapeutics
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Expert Rev Neurother · Jun 2014
EditorialNewly identified precipitating factors in mechanical ventilation-induced brain damage: implications for treating ICU delirium.
Delirium is 1.5 to 4.1 times as likely in intensive care unit patients when they are mechanically ventilated. While progress in treatment has occurred, delirium is still a major problem in mechanically ventilated patients. ⋯ This argues for minimizing the duration and tidal volumes of mechanical ventilation and for more effectively reducing sustained D2R signaling than achieved with haloperidol alone. The latter might be accomplished by reducing D2R cell surface expression and D2R-mediated Akt inhibition by elevating protein expression of dysbindin-1C.
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Expert Rev Neurother · Jun 2014
ReviewAdvances in understanding spontaneous intracerebral hemorrhage: insights from neuroimaging.
Spontaneous (non-traumatic) symptomatic intracerebral hemorrhage is a devastating form of stroke, with very high overall mortality and morbidity. Even with the best current medical or surgical treatment, outcomes still remain poor. By contrast with ischemic stroke, the incidence of intracerebral hemorrhage is not decreasing. ⋯ New advances, especially related to neuroimaging biomarkers, are rapidly increasing our understanding of the spectrum of mechanisms of brain injury in intracerebral hemorrhage. The aim of this article is to review recent insights from neuroimaging studies into the pathophysiology and causes of intracerebral hemorrhage, focusing on MRI. We also discuss some of the current and future challenges facing clinicians in understanding and treating intracerebral hemorrhage.
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Expert Rev Neurother · Jun 2014
ReviewClinical management of epileptic encephalopathies of childhood and infancy.
Epileptic encephalopathies represent a group of devastating epileptic disorders that appear early in life and are characterized by pharmacoresistant generalized or focal seizures, persistent severe EEG abnormalities, and cognitive dysfunction or decline. The ictal and interictal epileptic discharges are age-specific and are either the main cause or contribute to cognitive deterioration in the idiopathic or symptomatic group respectively. ⋯ In those cases, consideration should be given to the quality of life of the child and carers. In this review we will discuss the clinical and EEG characteristics, evolution and management of age-related epileptic encephalopathies, recognized by the International League Against Epilepsy.