Notable in Neurology® this week
This issue features an article that evaluates the possible relationship between Guillain-Barré syndrome and recent surgery; another characterizes the clinical features of spinocerebellar ataxias 1–3 and assesses patients' oculomotor dysfunction to see if it can function as a sensitive marker. A featured Views & Reviews article examines cognitive impairment incidence in patients with spinal cord injury.
Articles
The relationship between deficit in digit span and genotype in nonsense mutation Duchenne muscular dystrophy
The relationship between working memory and genotype in Duchenne muscular dystrophy (DMD) is unknown. In this study, forward and backward digit span were lower in nonsense mutations downstream of DMD exon 45, showing correlation between specific cognitive deficits and genotype. Combining cognitive testing with genetic information can improve clinical care in DMD.
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Antiepileptic drug clearances during pregnancy and clinical implications for women with epilepsy
This study of pregnant women with epilepsy demonstrated increased maximal antiepileptic drug clearances in the first and second trimester, with seizure frequency worsening when ratio-to-target blood level concentrations fell by >35%. Neurologists can use medication levels to adjust doses proactively to maintain seizure stability and improve pregnancy outcomes.
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Left atrial diameter and vascular brain injury on MRI: The Cardiovascular Health Study
Left atrial dilation (LAD) has an association with ischemic stroke risk, but less is known about left atrial size and MRI-defined vascular brain injury. In this study, LAD was independently associated with prevalent brain infarcts, particularly nonlacunar infarcts, but not leukoaraiosis. Understanding the association between LAD and brain injury may improve stroke prevention strategies.
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Contemporary Issues: Innovations in Education
Incorporating sleep medicine content into medical school through neuroscience core curricula
In this article, the authors highlight the current state of and need for sleep education in medical school; opportunities for curricula to incorporate sleep medicine education, primarily through neuroscience/neurology courses, are presented. Neurology curricular champions are important in order to incorporate sleep medicine into the education of health professionals.
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From editorialist Smith: “Our ability to provide the best patient-centered care to the 1 in 6 individuals with a brain disease may depend on successfully implementing this type of team-based curricular approach across multiple neurology subspecialties.”
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NB: “Spinal tuberculosis masquerading lung malignancy,” p. 632. To check out other Resident & Fellow Section Mystery Cases, point your browser to Neurology.org/N and click on the link to the Resident & Fellow Section. At the end of the issue, check out the Clinical/Scientific Note discussing a rare case of myasthenia gravis presentation after alemtuzumab therapy for multiple sclerosis. This week also includes a NeuroImage titled “Late Lyme neuroborreliosis with chronic encephalomyelitis.”
Editor's Summary: NPub.org/edsum
- © 2018 American Academy of Neurology
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