Guillain-Barre syndrome (GBS) is an autoimmune neuropathy with a heterogeneous etiology affecting both the myelin and the axon. GBS is probably the most frequent cause of a rapidly progressive neuropathy in the Western world. Although the demyelinating variant is more frequent in Western forms of GBS in Asia, the axonal form (termed AMAN) is more […]
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CIDP: Diversity in therapy?
CIDP is an autoimmune disorder of the peripheral nerves. As its name implies, the disorder is chronic and long-term treatment (therapeutic dependance) may be frequently observed. The factors predicting such treatment dependence need to be elucidated in order to achieve a more appropriate patient management. In this issue of the journal, Rabin and colleagues identify […]
Pregnancy and MS. The need to commence treatment post-partum?
While pregnancy is associated with a reduced risk of relapses, caution is required in the post-partum period. In this issue of JNNP, Portaccio and colleagues elegantly demonstrate an increased risk of relapse in the post-partum period. Greater disease activity before and during pregnancy were reported as predictors of an increased chance of a relapse […]
Multiple sclerosis and neuroprotection: is laquinimod the answer?
Multiple sclerosis (MS) for most people engenders troublesome images of young people with disability, in wheelchairs, unable to care for themselves. The mere mention of the term elicits these fears. Surprisingly, the potential MS-mimic conditions tend to get a less fearful response. In my own practice, I have noticed that telling patients that their symptoms […]
New criteria for FTD: They work!
Frontotemporal dementia (FTD) is a devastating neurodegenerative disorder predominantly affecting the frontal and temporal regions of the brain, although the pathology may be more general. In the absence of a diagnostic test, the diagnosis of FTD remains clinically and pathologically based. Recently, novel clinical and pathological criteria have been developed to encompass the heterogeneous nature […]
How do neurologists make decisions?
I have often wondered about the fate of those patients that I see once or twice and then who seem to vanish into the wilderness. I have occasionally seen some of these patients at a shopping centre or walking down the street, and I must admit to a sense of relief that they are ambulant, […]
Traumatic brain injury: a case of too much oxygen?
The term itself is scary enough-“traumatic brain injury” (TBI). What exactly does it mean? Well, it is possibly the commonest cause of death and disability worldwide. It refers to neurological symptoms that occur as a consequence of sudden trauma to the brain. It is most commonly due to a direct blow to the head, but […]
Seizures and malignant MCS strokes: A real problem!
The risk of seizures after structural brain lesions, such as strokes, would be expected to be high, although this has not been studied in detail. Clearly, such issues would have great bearing on patient management. In this issue of JNNP, the risk of seizures in patients post malignant MCA territory strokes that underwent decompressive hemicraniectomy […]
Surgery in Normal Pressure Hydrocephalus: Dont wait to shunt!
Normal pressure hydrocephalus (NPH), a misnomer as the intracranial pressure is increased, may be a debilitating disorder presenting with cognitive decline, gait abnormalities and urinary incontinence. Surgery may arrest and reverse the neurological deficits. The consequences of postponing shunting surgery remain unknown, although the eager neurologist may be reassured by the neurosurgeons that there may […]
Dystrophin levels in Beckers MD: A cliff effect?
Becker muscular dystrophy (BMD) is an inherited muscle disorder caused by deficiency of dystrophin. The relationship between disease severity and dystrophin levels needs further assessment. In this issue of JNNP, a Dutch group reported an association between dystrophin level s and disease severity in BD. Specifically, dystrophin levels were not a major determinant of disease […]