Volume 8 Issue 5, May 2012

Neurological morbidity is common in children who have undergone convulsive status epilepticus (CSE), so a recent study evaluating the utility of MRI in determining the extent of brain lesions following CSE is welcome. How might imaging results from children with CSE influence diagnostic, prognostic, and therapeutic decisions?

Recent analysis of treatment patterns and survival of newly diagnosed patients with glioblastoma in community settings in the USA has shown that the medical community rapidly adjusted to the new standard of treatment—the so-called 'Stupp regimen'. The findings are encouraging, but further research is needed to improve patient survival.

Despite the proven favourable risk–benefit ratio, thrombolytic therapy for acute stroke is perceived to carry a grave risk. A simple risk-rating system, the SEDAN score, allows clinicians to quantify elevated risk. Whether effective thrombolytic therapy should be withheld from any particular patient requires further study, including randomized trials of patients with elevated risk scores.

Promising results on newborn testing for Duchenne muscular dystrophy indicate that widespread screening could become routinely available. Nevertheless, newborn testing raises ethical, social and scientific concerns that need careful consideration to maximize benefit for patients, their families and health-care providers.

Two new studies provide strong evidence for the link between mutations in the C9orf72 gene and familial frontotemporal dementia or amyotrophic lateral sclerosis. One of the papers presents some unique associations between clinical features and C9orf72 mutation, and raises questions regarding the specificity of some previously reported pathological findings.

The success of clinical trials in Huntington disease (HD) will depend to a large degree on the quality of the outcome measures. Using data from the TRACK-HD study, a recent publication proposes a battery of assessments that could be used as outcomes in future clinical trials in patients with early HD.

Psychiatric disorders in epilepsy have been considered a consequence of the seizure disorder. In recent years, however, a bidirectional relationship has been suggested. Two new studies have examined recent epidemiological data that further supports this hypothesis, highlighting common pathogenic mechanisms that operate in both conditions.

The higher incidence of multiple sclerosis (MS) in women than in men is widely acknowledged in the literature. The role of sex-related factors is, therefore, an important avenue for further investigation and for the development of novel therapeutic strategies for MS. In this Review, Voskuhl and Gold examine the effects of sex-related factors on MS susceptibility, activity and progression, and identify important areas for future research.

Pain is a frequent complication that is experienced by elderly individuals, including those with dementia. Corbett et al. highlight how pain might represent an unmet need in patients with cognitive impairment and review the best available evidence for tools and interventions to assess and treat pain in the context of dementia.

Diagnosis of dystonia—a syndrome of abnormal, involuntary movements—is difficult, given that many different underlying etiologies exist. Bertram and Williams review studies that investigated etiology in patients with various dystonic syndromes. On the basis of these data, the authors present an eight-question diagnostic approach that should enable both specialists and general neurologists to determine the appropriate diagnostic test for patients with a possible dystonic syndrome.

Pain is a nonmotor symptom that substantially affects the quality of life of many patients with Parkinson disease (PD). In this Review, the authors propose a taxonomy to distinguish between the different types of pain in PD. Following classification using this taxonomy, effective treatment strategies that are targeted at the specific type of pain can be established.