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2016 has marked 100 years since the landmark description of what we now know as Guillain–Barré syndrome (GBS). Goodfellow and Willison chart the great progress we have made in understanding the pathogenesis of GBS, and developing established and emerging therapies.
Neuroinflammation is central in many neurological conditions, and 'big data' have the potential to elucidate the complexity of inflammatory processes. This Review considers how the drive to collect and analyse big data is increasing our understanding of neuroinflammation in disease, and how these data can be used to improve clinical management.
The recently revised 5th edition of the WHO classification of brain tumours 'blue book' will have a major impact in stratifying diagnosis and treatment. However, low-grade neuroepithelial tumours (LEATs), which present with early-onset focal epilepsy, lack integrated clinicopathological and molecular genetic diagnostic tools. The Neuropathology Task Force of the International League against Epilepsy will critically discuss this issue, as well as offer perspectives on how to decipher and validate clinically meaningful LEAT entities using the current WHO approach.
A randomized placebo-controlled phase III trial of adjuvanted herpes zoster subunit vaccine has shown a substantial improvement in vaccine efficacy in adults aged ≥70 years compared with the currently used, live attenuated vaccine. The finding has profound implications for reducing illness burden, although the duration of vaccine protection needs further evaluation.
The central vein sign (CVS) has been proposed as a novel MRI biomarker to improve the accuracy and speed of multiple sclerosis (MS) diagnosis. This Consensus Statement from the NAIMS Cooperative provides a roadmap to help radiologists and neurologists to better understand, refine, standardize and evaluate the CVS in the diagnosis of MS.
Unruptured intracranial aneurysms (UIAs) have a prevalence of 3% in the adult population. Currently, there is a large variability in how patients with UIAs are managed. Here, the authors review the latest human data on the formation, progression and rupture of intracranial aneurysms, as well the risks associated with preventive treatment.
In a randomized, sham-controlled trial, transcranial focused ultrasound thalamotomy was shown to benefit patients with medication-refractory essential tremor, although the technique has limitations and the long-term benefits are unclear. Nevertheless, the work suggests that focused ultrasound thalamotomy will become an alternative to other surgical procedures for refractory essential tremor.
Analysis of data from a large number of deep brain stimulation (DBS) recipients in North America has revealed a higher rate of revisions and removals of DBS leads than was previously reported. Hardware malfunction, lead infection and malpositioning were the most frequent reasons for revision or removal.
The primary headache disorders are among the most common diseases worldwide. Nathaniel Schuster and Alan Rapoport discuss new and emerging preventive and acute treatments that have the potential to address unmet needs of patients with headache disorders, and to help treat and reduce headache-associated disability.
Opportunistic infections of the CNS, such as cryptococcal meningitis, cerebral toxoplasmosis, and tuberculous meningitis, are a major cause of morbidity and mortality in HIV-positive individuals. This Review provides an update on diagnosis and treatment of opportunistic infections, as well as management of immune reconstitution inflammatory syndrome in the setting of HIV-associated CNS infections.
The earliest stages of Parkinson disease (PD) offer the best opportunity to intervene, but detecting early disease is difficult. In this Review, Postuma and Berg provide an overview of established and potential markers of prodromal PD, and consider how these markers can be combined to identify patients who have prodromal PD and could benefit from treatment.