Volume 7 Issue 3, March 2011

Focal cortical dysplasia (FCD) is a commonly encountered neuropathology in drug-resistant focal epilepsy; the bizarre pathological appearance of FCD reflects molecular disorder bridging neurodevelopment and neurodegeneration. A new classification stands to resolve discrepancies in FCD categorization and accelerate advances in fundamental understanding and clinical management of drug-resistant epilepsy.

Decisions regarding resumption of anticoagulation are difficult in patients who present with a warfarin-associated intracranial hemorrhage and also have atrial fibrillation or a prosthetic heart valve. Current guidelines suggest waiting 1–2 weeks on average, but new research suggests that the optimal time to restart anticoagulation could be much later.

Acute exacerbations of myasthenia gravis (MG) need effective and urgent treatment because of life-threatening hypoventilation. Plasma exchange and intravenous immunoglobulin (IVIg) are both effective for acute MG. A new study suggests that these treatments produce similar patient outcomes and complications, with IVIg perhaps being superior from an economic perspective.

The occurrence of subarachnoid hemorrhage (SAH) in patients with acute headache is strongly associated with the presence of several clinical variables. Nevertheless, the absence of such variables should not discourage physicians from investigating for SAH in individuals with headache peaking in intensity within a few minutes of onset.

Alzheimer disease (AD) is the leading cause of dementia, and is set to rise in prevalence with the growth in the global elderly population. Here, Reitz and colleagues provide a comprehensive overview of our current understanding of AD epidemiology. The authors also examine the diagnostic criteria for this disease, and discuss the use of various biomarkers to improve the accuracy of AD detection and risk prediction.

Memory impairment is a major complicating feature of temporal lobe epilepsy (TLE), and our understanding of such cognitive disorders has been enhanced by the study of anterior temporal lobectomy outcomes. In this Review, Bell and colleagues examine the changing view of TLE, and explore the anatomical abnormalities that underlie cognitive impairments that extend beyond memory function.

Monoclonal antibodies are being used to treat a variety of autoimmune disorders, including multiple sclerosis, neuromuscular diseases and rheumatoid arthritis, but neurological adverse effects have been reported in a substantial number of patients. Bosch et al. describe the characteristics, pathogenesis and outcomes of neurological disorders associated with monoclonal antibody therapy, and make recommendations regarding their management.

Much is still to be learned regarding how nociceptive stimuli, genes and various other factors influence the generation and maintenance of pain. In this article, Irene Tracey examines possible neuroimaging endophenotypes of pain that could act as measurable markers of this condition. Such markers would assist both the management of and research into acute and chronic pain.