Neurology
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Being Mindful of COVID’s Effects on Cognitive Decline
A large observational study finds objective evidence of lingering cognitive deficits associated with past COVID-19 infection, particularly in patients infected early in the pandemic, those hospitalized, or those with prolonged illness duration.
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Disorders of Immunity Are a Risk Factor for Herpes Simplex Virus Encephalitis
The current study of herpes simplex virus (HSV) encephalitis demonstrated an association of encephalitis with preexisting autoimmune disease and/or exposure to immunosuppressive and immunomodulatory medications. The findings underscore the potential underestimation of antecedent immune-related dysregulation in HSV encephalitis cases to date.
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Efgartigimod for Seronegative Myasthenia Gravis
In an uncontrolled, open-label series of patients with myasthenia gravis, double antibody-negative patients responded to immunosuppressive therapies in a similar manner as do those with antibodies to acetylcholine receptors (AChR) or muscle-specific tyrosine kinase. However, when treating myasthenia patients with a specific agent (efgartigimod) that blocks AChR antibodies at the level of endothelial cells, double antibody-negative patients do not respond as well.
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Usefulness of the Physical Examination in the Concussed Patient
This article suggests that certain specific physical examination findings may be helpful in evaluating and monitoring patients with sports-related concussion using oculovestibular responses and balance tests.
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Intensive Lifestyle Interventions May Prevent and Ameliorate the Symptoms of Alzheimer’s Disease
Recent clinical studies support the benefit of intensive lifestyle interventions, which should include a plant-based diet, exercise, stress management, and avoidance of smoking and alcohol, for the prevention of Alzheimer’s disease.
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Results from GLP-1 Receptor Agonists in Early Parkinson’s Disease
This paper demonstrated that after one year of treatment, lixisenatide resulted in less progression of motor disability. Longer studies are needed to determine if this represents true disease modification.
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Brentuximab Neuropathy
Brentuximab, an antibody-drug conjugate for the treatment of lymphomas, carries a high risk of inflammatory sensory and motor neuropathies.
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Risk of Autism After Prenatal Topiramate, Valproate, or Lamotrigine Exposure
The incidence of autism spectrum disorder was higher among children with prenatal exposure to the topiramate, valproate, and lamotrigine than the risk in the general population. However, after adjustment for indication of the medication (epilepsy) and other confounders, an increased risk was only observed in children with prenatal exposure to valproate.
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Seizures in Adolescents: Motor or Nonmotor?
The rate at which motor vs. nonmotor seizures are recognized in adolescents is unknown. This retrospective analysis demonstrates a high rate of misrecognition of nonmotor seizures among adolescents presenting to an emergency department and frequent misrecognition of any nonmotor seizures in those presenting with a first-time motor seizure.
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Novel Gene Therapy for Giant Axonal Neuropathy
The authors conducted a Phase I trial of a gene editing approach delivered by adeno-associated virus vector carrying a codon-optimized human giant axonal neuropathy transgene. The transgene targets anterior horn motor neuron bodies and sensory neurons in the dorsal root ganglia with the goal of repairing peripheral nerves and their axons. Each patient received a single intrathecal injection of the investigational agent. At one year, patients had less progression of disease compared to pretreatment intervals.