Volume 7 Issue 10, October 2011

Bacterial meningitis, one of the infections most feared by parents, and on the mind of every pediatrician who evaluates a febrile child, is an important cause of morbidity and mortality in childhood. New vaccines have the potential to prevent the majority of these cases and could transform child health.

Treatment of Parkinson disease (PD) with dopaminergic medication is associated with the development of impulse control disorders (ICDs). A new study suggests that, irrespective of medication, patients with PD are more likely to make impulsive decisions. How and why might the risk of ICDs be increased in patients with this disease?

For patients with transient cerebral ischemia, prompt diagnostic evaluation and rapid initiation of treatments markedly reduces the incidence of subsequent acute stroke. However, controversy exists about which patients to evaluate, and where and how quickly to perform the testing. Do current guidelines provide the best answers?

Perinatal brain injury is associated with a substantial risk of long-term disability. A recent study has shown that the severity of injury to the deep nuclear gray matter and brainstem, determined by early MRI, correlates with the risk of death and/or cerebral palsy at 2 years.

Intracranial arterial aneurysms can pose life-threatening risks to patients, so understanding the cause and the progression of these lesions is important for choosing the right treatment. This Review argues that aneurysms are a symptom of an underlying vascular disease rather than constituting a disease on their own. The authors classify intracranial aneurysms by vessel wall pathology and demonstrate that knowledge of the morphology and pathology of this structure is important in determining the therapeutic approach.

Research has shown that Huntington disease, a progressive and fatal neurodegenerative disorder resulting from polyglutamine expansion in the huntingtin protein, is associated with changes in cellular cholesterol metabolism. Drawing on data from clinical and animal studies, Karasinska and Hayden discuss the roles of cholesterol in the CNS and describe the current state of knowledge of cholesterol dysregulation in Huntington disease.

Neuropathy is the most common complication of diabetes and considerably reduces patient quality of life, yet no disease-modifying therapies are currently available and symptomatic treatments generally provide only partial relief. Vincent and colleagues provide an update on the cellular mechanisms that lead to diabetic neuropathy, which involves a complex interplay between oxidative and inflammatory pathways in neurons, Schwann cells and the microvascular endothelium. The authors highlight potential new therapeutic targets and discuss drug candidates that are in development for this debilitating diabetic complication.

Neurocysticercosis (caused by infection with the tapewormTaenia solium) is a major cause of acquired seizures and epilepsy worldwide. Nash and Garcia describe the different types of neurocysticercosis infection and discuss the role of the host inflammatory response in disease pathology. They also highlight recent advances in the diagnosis and treatment of the disease, including the limitations of current therapies.