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Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis
This article reviews the current evidence for the efficacy and safety, with dizziness and fatigue as the most common treatment-related adverse events, being mostly mild to moderate in severity. Results from both randomized controlled phase III studies involving about,1600 MS patients or 1500 patient-years and recently published studies on everyday clinical practice involving more than 1000 patients or more than,1000 patient-years are presented. (Source: Therapeutic Advances in Neurological Disorders)
Source: Therapeutic Advances in Neurological Disorders - December 18, 2015 Category: Neurology Authors: Zettl, U. K., Rommer, P., Hipp, P., Patejdl, R. Tags: Reviews Source Type: research

A comparison between plasmapheresis and intravenous immunoglobulin in children with Guillain-Barre syndrome in Upper Egypt
Conclusion: GBS is not uncommon in children of Upper Egypt, with AIDP the most prevalent type. Plasmapheresis is the best treatment modalities for GBS as it reduces the duration of hospital stay and hastens the recovery of those children. (Source: Therapeutic Advances in Neurological Disorders)
Source: Therapeutic Advances in Neurological Disorders - December 18, 2015 Category: Neurology Authors: Saad, K., Mohamad, I. L., Abd El-Hamed, M. A., Tawfeek, M. S. K., Ahmed, A. E., Abdel Baseer, K. A., El-Shemy, A. S., El-Houfey, A. A., Tamer, D. M. Tags: Original Research Source Type: research

Corrigendum
This article in the July 2015 issue contained errors from the authors. These are listed below. The sentence "Randomized, double-blind, controlled clinical trials..." Should be read as "A randomized, double-blind, controlled clinical trial has demonstrated...". Page 163, paragraph 3 as a whole should be read: "The findings of the phase III study by Goldstein et al mentioned above have also been republished with additional details in 2012 (Goldstein and Smith, 2012). Treatment-emergent AEs (mostly transient mild to moderate application-site reactions) were frequent in both groups, reported by 50% of patients receiving active...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Tags: Corrigendum Source Type: research

Low-dose fenfluramine in the treatment of neurologic disorders: experience in Dravet syndrome
In this paper, we review the experience with fenfluramine in epileptic and other paroxysmal disorders. Since the best available data are from the treatment of Dravet syndrome, we will focus primarily on this condition. Originally fenfluramine was launched as an anorectic agent. As early as 1985, seizure reduction in children could be demonstrated in a few cases with photosensitive, self-induced epilepsy. Hereafter, a small study was launched in patients with self-induced epilepsy. Results showed a significant seizure reduction, and review of the patient data showed that 5 of the 12 patients had Dravet syndrome. During that...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Schoonjans, A.-S., Lagae, L., Ceulemans, B. Tags: Reviews Source Type: research

Future perspectives in target-specific immunotherapies of myasthenia gravis
Myasthenia gravis (MG) is an autoimmune disease caused by complement-fixing antibodies against acetylcholine receptors (AChR); antigen-specific CD4+ T cells, regulatory T cells (Tregs) and T helper (Th) 17+ cells are essential in antibody production. Target-specific therapeutic interventions should therefore be directed against antibodies, B cells, complement and molecules associated with T cell signaling. Even though the progress in the immunopathogenesis of the disease probably exceeds any other autoimmune disorder, MG is still treated with traditional drugs or procedures that exert a non-antigen specific immunosuppressi...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Dalakas, M. C. Tags: Reviews Source Type: research

An update on the management of post-traumatic headache
Recent studies from the UK give the debate about how to deal best with patients suffering from whiplash injury new impetus. Following whiplash injury, about 90% of patients complain about head and/or neck pain, as well as dizziness, sleep problems and anxiety. These symptoms are often referred to as whiplash-associated disorders. In the majority of cases, these complaints develop within a few days or weeks following the accident. However, 30–50% of patients experience prolonged symptoms for more than 6 months, with headache as the main complaint. In accordance with the bio-psycho-social model of chronic post-traumati...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Obermann, M., Naegel, S., Bosche, B., Holle, D. Tags: Reviews Source Type: research

A practical approach to the diagnosis and management of sleep disorders in patients with multiple sclerosis
Patients with multiple sclerosis (MS) are at increased risk for comorbid sleep disturbances, which can profoundly contribute to poor functional status and fatigue. Insomnia, sleep-disordered breathing, and restless legs syndrome are among the most common sleep disorders experienced by patients with MS. Despite their impact, these underlying sleep disorders may escape routine clinical evaluations in persons with MS, thereby leading to missed opportunities to optimize functional status and quality of life in patients with MS. A practical, systematic approach to the evaluation and treatment of sleep disorders in MS, in the co...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Braley, T. J., Chervin, R. D. Tags: Reviews Source Type: research

Monoclonal antibody therapies for the treatment of relapsing-remitting multiple sclerosis: differentiating mechanisms and clinical outcomes
Monoclonal antibody (mAb) therapies for relapsing-remitting multiple sclerosis (MS) target immune cells or other molecules involved in pathogenic pathways with extraordinary specificity. Natalizumab and alemtuzumab are the only two currently approved mAbs for the treatment of MS, having demonstrated significant reduction in clinical and magnetic resonance imaging disease activity and disability in clinical studies. Ocrelizumab and daclizumab are in the late stages of phase III trials, and several other mAbs are in the early stages of clinical evaluation. mAbs have distinct structural characteristics (e.g. chimeric, humaniz...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Lycke, J. Tags: Reviews Source Type: research

Progressive multifocal leukoencephalopathy: current treatment options and future perspectives
Progressive multifocal leukoencephalopathy (PML) is a rare but debilitating and frequently fatal viral disease of the central nervous system, primarily affecting individuals with chronically and severely suppressed immune systems. The disease was relatively obscure until the outbreak of HIV/AIDS, when it presented as one of the more frequent opportunistic infections in this immune deficiency syndrome. It attracted additional attention from the medical and scientific community following the discovery of significant PML risk associated with natalizumab, a monoclonal antibody used for treatment of relapsing–remitting mu...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Pavlovic, D., Patera, A. C., Nyberg, F., Gerber, M., Liu, M., for the Progressive Multifocal Leukeoncephalopathy Consortium Tags: Reviews Source Type: research

The case for dosing dabigatran: how tailoring dose to patient renal function, weight and age could improve the benefit-risk ratio
Dabigatran is increasingly being used in clinical practice for the thromboprophylaxis in atrial fibrillation as a convenient therapy that needs no drug level monitoring. However, analysis of the data of the same clinical trial that led to the adoption of dabigatran in fixed-dosing regimens has indicated a small subgroup of patients that could be either over-treated, risking bleeding, or under-treated, risking embolism. Additional post-marketing data lends support to the favorable therapeutic profile of dabigatran but at the same time raises doubts about patient characteristics such as weight, age, renal function and their ...
Source: Therapeutic Advances in Neurological Disorders - October 27, 2015 Category: Neurology Authors: Safouris, A., Triantafyllou, N., Parissis, J., Tsivgoulis, G. Tags: Reviews Source Type: research

Tumefactive multiple sclerosis lesions in two patients after cessation of fingolimod treatment
Conclusion: We propose that a good therapeutic response to FTY might be predisposing for a severe rebound after withdrawal. Consequently, therapy switches should be planned carefully with a short therapy free interval. (Source: Therapeutic Advances in Neurological Disorders)
Source: Therapeutic Advances in Neurological Disorders - October 7, 2015 Category: Neurology Authors: Faissner, S., Hoepner, R., Lukas, C., Chan, A., Gold, R., Ellrichmann, G. Tags: Reviews Source Type: research

Optimizing the initial choice and timing of therapy in relapsing-remitting multiple sclerosis
With 12 available US Food and Drug Administration approved medications for the treatment of relapsing multiple sclerosis (MS), choosing an initial therapy is no longer a straightforward task. Each disease-modifying therapy (DMT) has a distinct risk–benefit profile and each patient is an individual. Therefore, the development of a simple algorithm to apply in selecting initial therapy is not feasible. Instead, the prescribing physician must consider many factors related to the treatments themselves, such as efficacy, safety, and tolerability, while also taking into account a particular patient’s disease characte...
Source: Therapeutic Advances in Neurological Disorders - October 7, 2015 Category: Neurology Authors: Farber, R. S., Sand, I. K. Tags: Reviews Source Type: research

Biomechanical analysis of spasticity treatment in patients with multiple sclerosis
Conclusion: A simple biomechanical analysis of voluntary movements revealed a significant reduction of spasticity after 30 days of baclofen therapy in patients with MS that was not detected by clinical assessments. (Source: Therapeutic Advances in Neurological Disorders)
Source: Therapeutic Advances in Neurological Disorders - October 7, 2015 Category: Neurology Authors: Wininger, M., Craelius, W., Settle, J., Robinson, S., Isaac, B., Maloni, H., Moradi, M., Newby, N. A., Wallin, M. Tags: Original Research Source Type: research

The effect of disease-modifying therapies on brain atrophy in patients with clinically isolated syndrome: a systematic review and meta-analysis
Conclusions: DMDs appear to attenuate brain atrophy over time in patients with CIS. The effect of DMDs on brain-volume loss is evident after the first year of treatment. (Source: Therapeutic Advances in Neurological Disorders)
Source: Therapeutic Advances in Neurological Disorders - October 7, 2015 Category: Neurology Authors: Tsivgoulis, G., Katsanos, A. H., Grigoriadis, N., Hadjigeorgiou, G. M., Heliopoulos, I., Papathanasopoulos, P., Dardiotis, E., Kilidireas, C., Voumvourakis, K., on behalf of HELANI (Hellenic Academy of Neuroimmunology) Tags: Original Research Source Type: research

Intravenous fosphenytoin for acute exacerbation of trigeminal neuralgia: case report and literature review
(Source: Therapeutic Advances in Neurological Disorders)
Source: Therapeutic Advances in Neurological Disorders - June 19, 2015 Category: Neurology Authors: Vargas, A., Thomas, K. Tags: Letter to the Editor Source Type: research