Spotlight on the November 27 Issue

Regulated microRNAs in the CSF of patients with multiple sclerosis: A case-control study

CSF-based microRNAs were differentially regulated in 53 patients with multiple sclerosis (MS), as compared to 39 patients with other neurologic diseases, varying with MS disease courses. Disease-associated microRNA adds to known MS pathogenetic factors, raising the question of whether these microRNAs were causative or released in response to inflammation/neurodegeneration. 

See p. 2166; Editorial, p. 2162

Surfers’ myelopathy: A case series of 19 novice surfers with nontraumatic myelopathy

A review of electronic medical records was performed in 19 patients who had sudden onset of low back pain while surfing, followed by bilateral leg numbness and paralysis. Although the cause of surfers’ myelopathy was unclear, the rapid onset and presence of restricted diffusion suggested ischemic injury.

See p. 2171

Dexamethasone and long-term survival in bacterial meningitis

In this trial, 301 patients with bacterial meningitis were randomly assigned to receive adjunctive dexamethasone or placebo. Follow-up was obtained for 228 of 246 evaluable patients, with median follow-up of 13 years. In adult community-acquired bacterial meningitis, the survival benefit from adjunctive dexamethasone therapy occurred in the acute disease phase and remained for years.

See p. 2177

Acute EEG findings in children with febrile status epilepticus: Results of the FEBSTAT study

The authors recruited 199 children with febrile status epilepticus (FSE) who had a detailed history, physical examination, MRI, and EEG within 72 hours of presentation. Focal EEG slowing or attenuation was present in EEGs and associated with MRI imaging evidence of acute hippocampal injury, and may therefore be an obtainable marker of acute injury associated with FSE.

See p. 2180

Epidermal nerve fibers: Confidence intervals and continuous measures with nerve conduction

Ten serial skip sections of 3-mm punch skin biopsies of thigh and leg were evaluated in 67 controls and 23 patients with diabetes to assess epidermal nerve fibers (ENFs) so as to develop narrow 95% confidence intervals in health and disease. This study also developed a methodology to combine ENFs/mm and nerve conductions, a score useful for therapeutic trials.

See p. 2187

From editorialists Burns & Smith: “While these results suggest use of CIs may enhance reproducibility…they may not warrant an immediate change in practice.”

See p. 2164

New immunohistochemical method for improved myotonia and chloride channel mutation diagnostics

The authors examined muscle biopsies in 18 patients with dystrophic myotonia, 5 asymptomatic carriers of recessive CLCN1 mutations, and 6 controls. The findings helped develop a robust immunohistochemical assay that detected loss of sarcolemmal CIC-1 protein on muscle sections, which, in combination with gene sequencing, achieved a final diagnosis of nondystrophic myotonia.

See p. 2194

SPECIAL ARTICLE

NB: “Resident & Fellow Mystery Case: EEG FOLDer,” see p. e187. To check out other Resident & Fellow submissions, point your browser to www.neurology.org and click on the link to the Resident & Fellow Section.