ALS: A long pre-clinical period. Does it start at conception?

ALS is a rapidly progressive neurodegenerative disorder of the motor neurons with median survival of 3-5 years.  The site of disease onset, and the timing of disease onset remain controversial, although a sudden and catastrophic degeneration of the motor neurons does occur.  In this issue of JNNP a though provoking review by Eisen and colleagues […]

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Genetic testing for peripheral neuropathy: we are entering a new era.

There are literally hundreds of different causes for peripheral neuropathy. While in most cases a decent history and a few blood tests can provide a potential cause, which often turns out be metabolic in nature (e.g diabetes, impaired glucose tolerance), in some patients a diagnosis proves elusive despite extensive investigations. This is a major problem […]

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Expanding the antibody spectrum of limbic encephalitis!

Limbic encephalitis (LE) mat have an underlying autoimmune etiologiy.  over the last decade numerous antibodies have emerged as potenital causative agents, and the antibodies have been directed against external epitopes of specific receptors.  In an upcoming issue of JNNP, Onugoren and colleagues reaffirm the association between GABAB and AMPR receptor antibodies and LE.  Importantly neoplastic […]

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Cholinesterase inhibitors in Parkinsons disease?

Cholinesterase inhibitors (ChIs) improve cholinergic transmission and thereby may lead to improved cognitive function in PD, although the risk of side-effects such as falls may be potentially increased.  In an upcoming issue of JNNP (On line first)  Pagano and colleagues conducted a meta-analysis to further assess these issues.  The results show a clear improvement of […]

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IVIg versus methylprednisone in CIDP: The treatment dilemmas!

The long-term treatment of CIDP is a vexing one often mired in lack of data from randomized controlled trials.  The ICE study suggested that a maintenance IVIg dose of 1g/kg every 3 weeks is associated with good therapeutic outcome.  Subsequent studies have suggested that steroids may lead to remission in a greater proportion of patients, […]

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