Neurology
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Delays in Acute Stroke Treatment Contribute to Malpractice Claims
Recent research findings underscore the importance of always considering stroke in the differential diagnosis of altered mental status, even when the patient does not arrive by EMS.
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Focused Ultrasound Ablation of the Subthalamic Nucleus for Parkinson’s Disease Tremor
Researchers demonstrated the long-term efficacy and safety of unilateral MRI-guided high-frequency ultrasound subthalamotomy for Parkinson’s disease patients with motor fluctuations and dyskinesia three years after the procedure.
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Healthy Lifestyles Can Help Reduce Cognitive Decline
In a population-based, prospective cohort study of 29,000 Chinese adults, researchers found healthy lifestyle was associated with slower memory decline, even in the presence of the apolipoprotein E4 allele.
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Involvement of the Peripheral Nervous System in Neurolymphomatosis
Lymphoma that presents with peripheral neuropathy is a challenging diagnosis. Diagnosis and treatment often are delayed, but they can be facilitated by early consideration and imaging with fluorodeoxyglucose-positron emission tomography. Early diagnosis and hematologic treatment may be effective.
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Somatic Variants in Ras/Raf/MAPK Pathway Play a Role in Mesial Temporal Lobe Epilepsy
Eleven somatic variants enriched in the hippocampus were detected in a group of patients with drug-resistant mesial temporal lobe epilepsy (MTLE). Most somatic variants are mutations in the Ras/Raf/mitogen-activated protein kinase (MAPK) pathway. Overactivation of the Ras/Raf/MAPK pathway was detected in MTLE with somatic variants.
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Trichloroethylene Exposure Has Been Linked to an Increased Risk of Parkinson’s Disease
Preliminary evidence suggests trichloroethylene is a potential environmental risk factor for Parkinson’s disease. Further research is needed to confirm this association.
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Lovastatin for Reducing Risk and Delaying Onset of ALS
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease without available treatments that significantly alter the disease course. Using Medicare databases and pharmacy records, with multiple logistic regression models, researchers studied three candidate drugs (lovastatin, sulfasalazine, and telmisartan) that were identified as possible therapies for ALS and their effects on SOD1G93A transgenic mice. Animal testing showed a delay in disease onset and prolonged survival in mice treated with a mouse-equivalent dose of lovastatin 40 mg, but showed no benefit from the other two candidate drugs.
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A Primer on Excessive Daytime Sleepiness and Narcolepsy
Many new drugs are coming on the market to treat daytime sleepiness, as well as insomnia, as the prevalence of sleep disorders continues to grow in modern society. Neurologists should familiarize themselves with these disorders and the various ways to treat them safely.
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Sleep Apnea Appears to Age Brain Faster
Researchers observed patients who spent less time in deep sleep showed biomarkers indicative of poor neurological health.
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The Effect of Peripheral Neuropathy in Parkinson’s Disease on Gait and Balance
In this cohort study of 99 patients with Parkinson’s disease (PD), 40% were found to have peripheral neuropathy, with most meeting criteria for small fiber neuropathy. Gait and balance were worse in PD patients with neuropathy compared to those without.