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The decision whether to withdraw antiepileptic drugs in adults who have been seizure-free for 2 years is a difficult one, with relief from adverse events weighing against the possibility of seizure recurrence with all its consequences. In this Viewpoint, Alla Guekht calls on clinicians not to dismiss lightly the risk of relapse.
Mitochondrial dysfunction and oxidative stress have been strongly implicated in the pathogenesis of Parkinson disease (PD), and the products of several PD-associated genes become localized to the mitochondria under certain conditions. In this article, Henchcliffe and Beal review recent developments in mitochondrial biology that have contributed to our understanding of the disease process in PD, and they discuss how this knowledge might aid in the development of 'mitochondrial therapies' for PD.
Therapeutic approaches to febrile seizures have changed since the 1970s when the main reference studies on this topic were published. It is, therefore, timely to consider whether outcomes of febrile seizures have changed in the intervening years. Here, Chungath and Shorvon assess data published since 1993 with respect to three outcomes: mortality, later development of afebrile seizures or epilepsy, and hippocampal or mesial temporal sclerosis.
This article discusses the case of a 40-year-old man with basilar artery thrombosis, which, after numerous investigations, was found to be attributable to cocaine use. The authors highlight the importance of asking patients about cocaine exposure as part of a routine cardiovascular history, and they provide the first description of the use of thrombolysis to treat cocaine-induced stroke.
This Case Study describes an 18-year-old woman who presented to a stroke center with dysphasia and right hemiparesis. The patient was diagnosed with cocaine-induced cerebral vasculitis. BOLD MRI cerebrovascular reactivity findings were particularly useful in the diagnosis and follow-up of this case, and the authors point to the technique's potential for imaging cerebral vasculitis in general.
Pain is a leading reason for seeking medical care, but the management of pain is often felt to be inadequate. A good place to start tackling this problem is in the training of future doctors. This Training Matters article provides excellent advice for neurologists who are involved in the teaching of pain and its management.
