Expert review of neurotherapeutics
-
Expert Rev Neurother · Aug 2014
The efficacy and tolerability of frovatriptan and dexketoprofen for the treatment of acute migraine attacks.
Frovatriptan is a triptan characterized by a high affinity for 5-HT1B/1D receptors and a long half-life contributing to a more sustained and prolonged action than other triptans. Dexketoprofen is a nonsteroidal anti-inflammatory drug with a relatively short half-life and rapid onset of action, blocking the action of cyclo-oxygenase, which is involved in prostaglandins' production, thus reducing inflammation and pain. Both drugs have been successfully employed as monotherapies for the treatment of acute migraine attacks. The combination of these two drugs (frovatriptan 2.5 mg plus dexketoprofen 25 or 37.5 mg) has been tested in migraine sufferers, showing a rapid and good initial efficacy, with 2-h pain free rates of 51%, and a high persistence in the 48-h following the onset of pain: recurrence occurred in only 29% of attacks and sustained pain free rates were 43% at 24- and 33% at 48-h.
-
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.
-
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.
-
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.
-
Recently the question of whether or not bilingualism may protect against the development of Alzheimer's disease (AD) has become a topic of great interest. Previous studies suggest that being bilingual slows the decline in executive control associated with the aging process. ⋯ A number of studies collectively suggest that being bilingual may lead to a delay in the diagnosis of AD by as much as 5 years, even when taking into account confounders. Although a recent landmark study provides physical evidence confirming this advantage in AD patients, further work needs to be done to clarify its' neuroanatomical basis.