Neurology Alert
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Safety and Efficacy of Mogalizumab in HTLV-1-Associated Myelopathy
Human T-cell leukemia virus type 1-associated myelopathy/tropical spastic paraparesis develops in a small number of carriers of this retrovirus as the result of infection and suppression of CD4+ T-cells. Therapy with steroids has been the mainstay but is not safe or effective for the long term. Mogalizumab shows promise as long-term therapy of this debilitating disease.
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Gut Microbiome Metabolites and Progression of Parkinson’s Disease
A Mendelian randomization study shows that trimethylamine N-oxide and its precursor metabolites are not associated with risk of Parkinson’s disease (PD) but have both positive and negative causal effects on some indicators of PD severity and progression.
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Slow-Wave Sleep and Risk of Dementia
In this long-term observational study of sleep efficiency in the Framingham Heart Study population, researchers found a strong correlation between a decline in duration of slow-wave sleep during aging and the risk of incident dementia from all causes. However, a direct cause-and-effect relationship cannot be determined from this observational study.
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Repetitive Head Impacts and Chronic Traumatic Encephalopathy in Young Contact Sport Athletes
In a first of its kind study, researchers found neuropathological markers suggestive of chronic traumatic encephalopathy (CTE) pathology in 41% (n = 152) of young contact sport athletes (< 30 years of age) at autopsy. Clinical measures (obtained retrospectively via informant report) assessing for cognitive and psychiatric/behavioral dysfunction, while elevated across most measures for the entire group, did not significantly differ between brain donors with and without a CTE diagnosis. Functional impairments also were not commonly found.
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Acute Vertigo Caused by Herpes Zoster Oticus
Herpes zoster oticus (HZO) and vestibular neuritis (VN) can be difficult to distinguish, but treatments may be different. Magnetic resonance imaging may help by showing inflammatory lesions in the vestibular nuclei or the proximal portions of the eighth nerves in HZO, but not VN.
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Autoimmune Encephalitis After Herpes Simplex Virus Encephalitis
A recent study showed that about 25% of patients with herpes simplex encephalitis develop neurological symptoms three to six weeks after the infection, pointing toward an autoimmune process with different neurological and psychiatric symptoms. Anti-neuronal antibodies, such as anti-N-methyl-D-aspartate receptor antibodies, have been found in this post-viral autoimmune encephalitis presentation.
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Treatable Causes of Rapidly Progressive Dementias
Many cases of rapidly progressive dementia are caused by prion diseases and have no effective treatments. But, with the greater awareness of the presentation for autoimmune encephalitis, these disorders make up an increasing percentage of presenting cases and can be aggressively and successfully treated. The STAM3P score helps to identify potentially treatable cases of this disorder.
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Early Onset Post-Radiation Neuropathy
Biopsy studies of early onset neuropathies seen after radiation therapy consistently show evidence of microvasculitis and other signs of inflammation. Early and rapid treatment with anti-inflammatory medications may be effective in stopping the progression and speeding up recovery.
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Hepatitis E and Neuropathy
In this prospective case-control study of patents with neuralgic amyotrophy, Guillain-Barré syndrome, and Bell’s palsy, an association with acute hepatitis E infection was demonstrated only with neuralgic amyotrophy.
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Integrating Reproductive History Could Help Postmenopausal Women’s Long-Term Brain Health
Researchers observed patients with higher cumulative estrogen exposure throughout their life may be at lower risk of developing cerebral small vessel disease.