Multifocal motor neuropathy: A blood-nerve barrier disease?

Multifocal motor neuropathy (MMN) is a rare autoimmune disorder of the peripheral motor nerves leading to muscle weakness, secondary to conduction block, and ultimately axonal degeneration. Debate emerged over the past decade as to whether MMN is a demyelinating or axonal neuropathy, although the debate seem rather academic as both processes may and do co-exist […]

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Amyotrophic lateral sclerosis/Lou Gehrigs’ disease: Is it all in the genes?

Amyotrophic lateral sclerosis/Lou Gehrigs’ disease is a devastating neuromuscular disorder of the motor neurons with a median survival of 3-5 years.   While the pathophysiological mechanisms underlying ALS development remain uncertain, the possibility of being with a predisposition to develop ALS is a popular theory.  Clearly, additional events are needed  to develop ALS, although these […]

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The complexities of ALS management: A genetic twist

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive and devastating neurodegenerative disorder of the human motor neurons and the systems that supply it.  Advances in the genetics of ALS have been staggering over the last two decades, although are we much the wiser?  The presence of a specific ALS genetic mutation may predispose a family […]

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CNS antibodies: How useful are they?

The detection of autoantibodies in autoimmune CNS disorders has been if immense interest, with implications for undelrying pathophysiology.  A variety of autoantibodies have been detected and associated with various CNS syndromes, although the question remians whether these antibodies are pathogenic, an epiphenomenon, or both.   In this issue of JNNP, Hacohen and colleagues report on […]

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Factors governing progression in MS: Something old, something frequent!

The holy grail of MS therpay is to prevent the onset of the debilitating MS phase.  All of the current therpaies are aimed at preventing such developments, and more importantly early treatment with immunomodulatory therapies was shown to be more efficacious at preventing disability development.   The issue of whether multiple relapses or “attacks” govern diability […]

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Relapses in multiple sclerosis. It’s all in the brain!

Acute neurological deficits, otherwise known as relapses, characterise relapsing-remitting forms of MS.  A high annualised relapse rate is associated with disability development in the future, and current therapeutic endeavours are aimed at reducing such relapses.  Clinically, relapses are typically represented by sensorimotor deficits, gait unsteadiness, optic neuritis etc.  While cognitive decline and worsening fatigue may […]

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Psychogenic disorders and persistent disability?

Psychogenic motor disorders may be frequently encountered in “organic” neurology, especially in the world of movement disorders.  This group of disorders needs to be distinguished from malingering as the patients really feel that they have a functional deficits even though neurology can not explain the site and origins of deficits.  Indeed, transcranial magnetic stimulation studies […]

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