Spotlight on the January 29 Issue

Provocation of migraine with aura using natural trigger factors

Of 27 patients with migraine with aura (MA) provoked by either photo stimulation, exercise, or both, 3 patients reported attacks of MA and 3 others reported migraine attacks without aura. Following exercise, 4 of 12 patients reported migraine; no patients developed attacks following photo stimulation. Natural triggers provoked attacks in only a small proportion of patients.

See p. 428

From editorialists Goadsby & Silberstein: “If migraine is a disorder of habituation of the brain to ordinary sensory signals, should one try to train the brain to habituate rather than avoid the trigger? Many questions are unresolved and require continued careful, bedside approaches to studying this common, disabling brain disorder.”

See p. 424

Nonmydriatic ocular fundus photography among headache patients in an emergency department

The authors obtained nonmydriatic ocular fundus photography on 497 patients presenting to the emergency department with a chief complaint of headache and found 42 (8.5%) had relevant ocular fundus abnormalities (e.g., papilledema). Their findings emphasize the importance of ocular fundus examination in patients with headache, particularly in the emergency setting.

See p. 432

Birth hospitalization in mothers with multiple sclerosis and their newborns

This study compared the duration of birth hospitalization in mothers with multiple sclerosis (MS) and their newborns relative to the general population to investigate the effect of MS-related clinical factors on the length of birth hospitalization. Maternal MS was not associated with adverse perinatal outcomes or longer hospital stays.

See p. 447

CNS vasculitis in a subject with MS on daclizumab monotherapy

A patient with multiple sclerosis developed CNS vasculitis after treatment with daclizumab, which was discontinued after 21 doses because of a vascular pattern of contrast enhancement on brain and spine MRI. This case provides a potential imaging biomarker that may be used to implement preventive safety measures.

See p. 453

Mutations in the gene encoding p62 in Japanese patients with amyotrophic lateral sclerosis

The authors found two novel mutations on sequencing the SQSTM1 gene encoding p62 in 61 Japanese patients with amyotrophic lateral sclerosis (ALS). Mutation-positive patients had typical disease characteristics, suggesting that p62 plays an essential role in typical ALS pathogenesis and is not just a general neurodegenerative disease marker protein.

See p. 458

Predictors of recovery of responsiveness in prolonged anoxic vegetative state

Prognostic markers, recorded in the chronic phase, were identified in 43 patients with prolonged anoxic vegetative state (VS) (23 women; age range: 12–83 years). Clinical features and evoked potentials are useful predictors of long-term recovery of responsiveness in patients with prolonged postanoxic VS.

See p. 464

Cause-specific mortality of 1-year survivors of subarachnoid hemorrhage

Investigators indentified and followed 437 subarachnoid hemorrhage (SAH) cases, 233 1-year SAH survivors, and controls. One-year SAH survivors had excess mortality, attributed to a risk of deadly cerebrovascular events. By intervening on risk factors, secondary prevention of cerebrovascular events may prevent early deaths of SAH survivors.

See p. 481

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