Neurology Alert
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The Optic Nerve as Part of the Diagnostic Criteria for Multiple Sclerosis
A recent prospective study showed that including the optic nerve as an additional topographic area in multiple sclerosis diagnostic decision-making improves sensitivity and diagnostic performance compared to the McDonald 2017 criteria: 92.5% sensitivity of the modified criteria vs. 88.2% of the current criteria.
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Cerebral Amyloid Angiopathy Is a Risk Factor for Subdural Hemorrhage
In this large, observational population study using databases from the UK Biobank and the All of Us research program, spontaneous subdural hemorrhage occurred more often in patients with cerebral amyloid angiopathy compared to a matched control group.
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Myopathy with Elevated Aldolase and Normal CK: Differential Diagnosis
Elevated serum creatine kinase (CK) is considered the hallmark of myopathy, yet some patients with biopsy-proven myopathy have normal CK with elevated aldolase, a less-specific marker of muscle disease. Most of those cases ultimately prove to be dermatomyositis.
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A Comparison of Acute Migraine Therapies Using Big Data
In a big data-driven observational study that compared 3 million treated migraine attacks captured from a migraine diary smartphone app, triptans were found to be the most efficacious treatment class. Among the triptans, eletriptan had the highest rate of success. Consistent with clinical practice and recent consensus statements, the success of triptans was followed by ergots and antiemetics.
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Can Young-Onset Dementia Be Prevented?
In this large, population-based prospective cohort study, the investigators identified 15 risk factors that have strong associations with young-onset dementia. Modifications of these risk factors might delay the onset of, or prevent the development of, young-onset dementia.
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Electrophysiology, Muscle Ultrasound, and MRI in the Diagnosis of Neuromuscular Disorders
To accomplish accurate diagnosis of nerve and muscle disorders, clinical collaboration with ultrasound and magnetic resonance imaging experts is invaluable and can provide critically important information beyond electrophysiology.
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Metformin Use Is Associated with Decreased Diabetes-Associated Dementia
In two recent cohort studies, metformin use was found to decrease the risk of developing dementia in older adults with type 2 diabetes mellitus.
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Adverse Neurological Events from Immune Checkpoint Inhibitors
Immune checkpoint inhibitors have transformed the natural history of many metastatic cancers and now are widely used. However, the activation of killer T-cells also has caused serious, often fatal complications from the treatment. The central nervous system is a common victim of these complications.
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What Is the Best First-Line Treatment for Young Women with Generalized Epilepsy?
Valproate is a highly efficacious drug for treating idiopathic generalized epilepsy (IGE) but is not an option for many young women because of known teratogenic risks. This retrospective, multicenter study examined women with IGE who were treated initially with either levetiracetam or lamotrigine monotherapy, demonstrating superior efficacy of levetiracetam, although exclusively in women with juvenile myoclonic epilepsy.
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What Are F-Waves and What Do They Tell Us?
The presence or absence of F-waves is an important observation during the electrophysiological investigation of a patient with acute, progressive weakness. But the underlying physiological basis of F-waves has been elusive. This ex vivo animal study showed that F-waves are solely generated by motor nerves arising from the ventral horn of the spinal cord and require intact synapses.