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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An education
Over the last few decades, there have been unprecedented advances in our capacity to treat medical disorders. Neurological disease in particular has made significant strides. While a cure may still be beyond our reach in many conditions, we are able to reduce suffering and improve quality of life in a way that would have been […]
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 […]
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 […]
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 […]
Neurophobia: not fatal, possibly even treatable.
There are social perks to being a neurologist. Once you drop this little fact into a conversation, it is possible/probable that you will engender a feeling of intellectual inferiority amongst your companions. Mind you, there is nothing that says that because you are adept at diagnosing illnesses of the brain that you necessarily have a […]
Variants of Guillain–Barré syndrome.
Guillain-Barre syndrome (GBS) is a rare, but much taught, autoimmune disorder of the peripheral nerves. Importantly, the variant of GBS are poorly recognized in the Western world, thereby leading to diagnostic and therapeutic delay. In the superb review by Wakerley and Yuki, pharyngeal-cervical-brachial (PCB) variant of GBS is expertly discussed. This must read review will […]
Vitamin D and multiple sclerosis: what’s going on?
Most neurologists know very little general medicine. OK, minor correction- I no longer know very much general medicine and it is arrogant for me to assume that all my colleagues are the same (although I am pretty sure that they are…). Anyway, the one minor detail regarding endocrinology that I had managed to tuck away […]
Are the sphingosine wars beginning?: Ponesimod-Promising new oral agent for RRMS
Another oral agent has shown promise in a phase IIb trial for relapsing-remitting MS. Ponesimod, a selective sphingosine 1-Phosphate Receptor 1 Agonist, reduced disease burden and activity as assessed by MRI and clinical measures (annualized relapse rates). Safety and tolerability were also assessed and proven to be good. Larger trials are required to confirm […]
Is one born to develop motor neuron disease?
Motor neuron disease is fatal and rapidly progressive neurodegenerative disorder of the human motor system. The disorder peaks in the late 50’s early 60’s and then declines after ager 80, an unusual statistic for a degenerative disease. In addition, familial forms of MND are increasing recognised, although the penetrance of the genotype is at best […]