1,993 results match your criteria Neurologic Clinics [Journal]


Introduction to Neurology of Pregnancy.

Neurol Clin 2019 Feb;37(1):ix-x

Department of Neurology, Hale Building of Transformative Medicine, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ncl.2018.10.001DOI Listing
February 2019
9 Reads

Neuro-Ophthalmic Disorders in Pregnancy.

Neurol Clin 2019 Feb;37(1):85-102

Department of Neurology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA; Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114, USA. Electronic address:

The physiologic changes that accompany pregnancy can have important implications for neuro-ophthalmic disease. This article discusses pregnancy-related considerations for meningioma, pituitary disorders, demyelinating disease, myasthenia gravis, thyroid eye disease, idiopathic intracranial hypertension, cerebral venous sinus thrombosis, stroke, migraine, and cranial neuropathies. The article also details the potential neuro-ophthalmic complications of preeclampsia and eclampsia and reviews the use of common diagnostic studies during pregnancy. Read More

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February 2019
10 Reads

Pituitary Disorders in Pregnancy.

Neurol Clin 2019 Feb;37(1):63-83

Neuroendocrine/Pituitary Program, Division of Endocrinology, Diabetes and Metabolism, University of Florida, 1600 Southwest Archer Road, Room H2, PO Box 100226, Gainesville, FL 32610, USA. Electronic address:

Pregnancy is associated with alterations in pituitary hormonal function and enlargement of the pituitary gland. Pituitary dysfunction diagnosis can be challenging during pregnancy due to known alterations in hormonal status. Pituitary disorders are relatively common; with advancements in medical care, more women with pituitary disorders are becoming pregnant. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.009DOI Listing
February 2019
6 Reads

Epilepsy in Pregnancy.

Neurol Clin 2019 Feb;37(1):53-62

Department of Neurology, Mount Sinai Downtown, 10 Union Square East Suite 5D, New York, NY 10003, USA.

Epilepsy is a prevalent, chronic, and serious neurologic disease affecting many women of childbearing age. Specific concerns, including contraception, fertility, teratogenic risk of antiepileptic drugs, delivery, and breastfeeding, are addressed in this article. Evidence-based counseling and management strategies are provided to help clinicians and women with epilepsy through the different stages of pregnancy. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.008DOI Listing
February 2019
1 Read

Headache in Pregnancy and the Puerperium.

Authors:
Rebecca Burch

Neurol Clin 2019 Feb;37(1):31-51

Department of Neurology, John R. Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, 1153 Centre Street, Suite 4H, Jamaica Plain, Boston, MA 02130, USA. Electronic address:

Migraine is the most common cause of headache during pregnancy. Pregnancy increases risk for many causes of headache, including pathologic vascular processes. Headache associated with neurologic signs or symptoms or that is progressive and refractory to treatment; acute in onset; and severe, postural, or different from typical headaches should be evaluated. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.004DOI Listing
February 2019
7 Reads

Management of Demyelinating Disorders in Pregnancy.

Authors:
Tamara B Kaplan

Neurol Clin 2019 Feb;37(1):17-30

Department of Neurology, Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, 4th Floor, Boston, MA 02115, USA. Electronic address:

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are chronic inflammatory demyelinating disorders of the central nervous system that often affect women during childbearing years. Therefore, issues of conception, pregnancy, and delivery are of significant importance to patients and treating physicians. The current review provides updated information regarding the effects of pregnancy on MS and NMO, as well as the available safety data on immunomodulatory MS therapies for pregnant and lactating women. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.007DOI Listing
February 2019
24 Reads

Stroke in Pregnancy: An Update.

Neurol Clin 2019 Feb;37(1):131-148

Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, WACC 729-C, Boston, MA 02114, USA. Electronic address:

Pregnancy confers a substantially increased risk of stroke in women. The period of highest risk of stroke is the peripartum/postpartum phase, coinciding with the highest risk for hypertensive disorders of pregnancy and peak gestational hypercoagulability. Hemorrhagic stroke is the most common type of obstetric stroke. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.010DOI Listing
February 2019
18 Reads

Connective Tissue Disorders in Pregnancy.

Neurol Clin 2019 Feb;37(1):121-129

Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

Connective tissue disorders are now understood to include autoimmune and genetic diseases affecting organs, blood vessels, and surrounding fascia. Many of these diseases predominantly affect women in childbearing years and are associated with neurologic complications. Pregnancy can affect disease activity (such as flares of systemic lupus erythematosus), and the diseases can affect pregnancy outcome (such as increased risk of preterm labor). Read More

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February 2019
12 Reads

Management of Myasthenia Gravis in Pregnancy.

Authors:
Janet Waters

Neurol Clin 2019 Feb;37(1):113-120

Women's Neurology, University of Pittsburgh Medical Center, 3471 Fifth Avenue Suite 810, Pittsburgh, PA 15213, USA. Electronic address:

Myasthenia gravis is an autoimmune disorder characterized by fluctuating weakness of extraocular and proximal limb muscles. It occurs in 1 in 5000 in the overall population and is 2 times more common in women than men. The onset in women is most common in the third decade, and risk of severe exacerbation occurs most frequently in the year after presentation. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.003DOI Listing
February 2019
12 Reads

Lower Extremity Weakness and Numbness in the Postpartum Period: A Case-Based Review.

Neurol Clin 2019 Feb;37(1):103-111

Department of Neurology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA. Electronic address:

This article reviews the common lower extremity postpartum neuropathies, including their incidence, risk factors, clinical features, and treatment. In addition, the rarer complications from neuraxial anesthesia are also discussed. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.002DOI Listing
February 2019
4 Reads

Imaging Considerations in Pregnancy.

Neurol Clin 2019 Feb;37(1):1-16

Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address:

Pregnancy is a complex physiologic state with hormonal, hemodynamic, hematologic, and immunologic changes at both global and cellular levels affecting brain, heart, pituitary, thyroid, and kidney. There are many situations in which imaging can aid in diagnosis and subsequent treatment of neurologic conditions during pregnancy. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.09.005DOI Listing
February 2019
6 Reads

Neurology gone 'Viral'.

Neurol Clin 2018 Nov 20;36(4):xiii-xiv. Epub 2018 Sep 20.

Mayo Clinic College of Medicine, Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ncl.2018.08.001DOI Listing
November 2018

Prion Diseases.

Neurol Clin 2018 Nov;36(4):865-897

Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA. Electronic address:

Prions diseases are uniformly fatal neurodegenerative diseases that occur in sporadic, genetic, and acquired forms. Acquired prion diseases, caused by infectious transmission, are least common. Most prion diseases are not infectious, but occur spontaneously through misfolding of normal prion proteins or genetic mutations in the prion protein gene. Read More

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November 2018
8 Reads

Neurocysticercosis.

Authors:
Hector H Garcia

Neurol Clin 2018 Nov 20;36(4):851-864. Epub 2018 Sep 20.

Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Jr Ancash 1271, Lima 1, Peru; Center for Global Health, Universidad Peruana Cayetano Heredia, SMP, Lima 31, Peru. Electronic address:

Neurocysticercosis (NCC) is a major contributor to the burden of seizure disorders and epilepsy in most of the world. NCC encompasses a variety of clinical presentations, depending on number, location, size, evolutionary stage of lesions, and the inflammatory response of the host, with late-onset seizures, headache, and intracranial hypertension the most frequent manifestations. Diagnosis and therapy depend on the type of NCC, considering its location and stage of the lesions. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.07.003DOI Listing
November 2018
5 Reads

Diagnostic Approach to Chronic Meningitis.

Neurol Clin 2018 Nov 20;36(4):831-849. Epub 2018 Sep 20.

Department of Neurology, Geisinger Commonwealth School of Medicine, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA 17822, USA.

Chronic meningitis is defined as cerebrospinal fluid pleocytosis that persists for at least 4 weeks without spontaneous resolution. The differential diagnosis of chronic meningitis is broad, encompassing 4 main categories, including infectious, autoimmune, neoplastic, and idiopathic. Up to one-third of cases have no discernible cause, making chronic meningitis a diagnostic dilemma for many clinicians. Read More

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November 2018
16 Reads

Neuroborreliosis.

Authors:
John J Halperin

Neurol Clin 2018 Nov;36(4):821-830

Department of Neurosciences, Overlook Medical Center, 99 Beauvoir Avenue, Summit, NJ 07902, USA; Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut Street, Philadelphia, PA 19107, USA. Electronic address:

Neurologic manifestations of nervous system infection with Borrelia burgdorferi, Borrelia garinii, and Borrelia afzelii are qualitatively similar, and include lymphocytic meningitis, cranial neuritis, radiculoneuritis, and other focal or multifocal mononeuropathies. Parenchymal central nervous system (CNS) infection occurs rarely. Neurobehavioral changes are common, but are rarely evidence of CNS infection. Read More

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November 2018
3 Reads

Acute Community-Acquired Bacterial Meningitis.

Neurol Clin 2018 Nov 20;36(4):809-820. Epub 2018 Sep 20.

Amsterdam UMC, University of Amsterdam, Neurology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, 1105 AZ Amsterdam, The Netherlands. Electronic address:

Community-acquired bacterial meningitis remains a disease with high impact. The epidemiology of this disease changed substantiality to large-scale introduction of conjugated vaccines. Streptococcus pneumoniae and Neisseria meningitidis are the main causative pathogens outside the neonatal age. Read More

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November 2018
15 Reads

Infectious Myelopathies.

Neurol Clin 2018 Nov;36(4):789-808

Department of Neurology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242, USA. Electronic address:

Infectious diseases are an important cause of spinal cord dysfunction. Infectious myelopathies are of growing concern given increasing global travel and migration and expanding prevention and treatment with vaccinations, antibiotics, and antiretrovirals. Clinicians must recognize these pathologies because outcomes can dramatically improve with prompt diagnosis and management. Read More

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November 2018
7 Reads

Zika Virus and Neurologic Disease.

Neurol Clin 2018 Nov;36(4):767-787

Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Medical Center, Milstein Hospital, 177 Fort Washington Avenue, 8GS-300, New York, NY 10032, USA. Electronic address:

Zika virus (ZIKV) is an arthropod-borne virus that belongs to the Flaviviridae family. Although most cases are mild or go undetected, rare severe neurologic effects, including congenital ZIKV syndrome (CZS) and Guillain-Barré syndrome, have been identified. The serious neurologic complications associated with ZIKV prompted the declaration of the public health emergency of international concern by the World Health Organization. Read More

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November 2018
10 Reads

Human Immunodeficiency Virus and the Nervous System.

Neurol Clin 2018 Nov;36(4):751-765

Department of Neurology, HIV Medicine, Neurosciences Program, Peter Duncan Neurosciences Unit, St Vincent's Hospital, St Vincent's Centre for Applied Medical Research, University of New South Wales, University of Notre Dame, Level 4 Xavier Building, Victoria Street, Darlinghurst, Sydney, Australia. Electronic address:

In the era of combination antiretroviral therapy, the diagnosis and management of HIV-associated neurocognitive disorders (HANDs) has arisen. Traditionally, severe HAND was seen in those with untreated HIV infection and had a guarded prognosis. Antiretroviral therapy has provided longevity and viral control to many living with the disease, revealing an increase in prevalence of less severe forms of HAND. Read More

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November 2018
13 Reads

Progressive Multifocal Leukoencephalopathy.

Neurol Clin 2018 Nov;36(4):739-750

Multiple Sclerosis Division, The Department of Neurology, Perelman School of Medicine, The University of Pennsylvania, 3400 Convention Avenue, Philadelphia, PA 19104, USA.

Progressive multifocal leukoencephalopathy (PML) is a rare opportunistic infection that occurs in patients whose immune system is compromised either because of an underlying illness or an immunosuppressive medication. John Cunningham virus, prevalent in 60% or more of the adult population as a latent or persistent infection, is responsible for the syndrome of PML. This article reviews PML in association with the most common immunotherapies and discusses risk mitigation and monitoring strategies. Read More

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November 2018
8 Reads

Manifestations of Herpes Virus Infections in the Nervous System.

Neurol Clin 2018 Nov;36(4):725-738

Department of Neurology, Felsenstein Medical Research Institut, Rabin Medical Center, Beilinson Hospital, Beilinson Campus, Petach Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.

The 3 neurotropic human herpes viruses, herpes simplex virus (HSV) type 1 and 2, and varicella-zoster virus (VZV) are capable of establishment of latent viral infection in trigeminal and dorsal root ganglia. HSV-1, and more rarely HSV-2, carries the potential to cause meningoencephalitis, with devastating clinical consequences. Immediate diagnosis, based on clinical presentation, MRI imaging, and molecular diagnosis by polymerase chain reaction, and initiation of therapy are mandatory to reduce mortality and neurologic permanent sequelae. Read More

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November 2018
18 Reads

Viral Encephalitis.

Neurol Clin 2018 Nov 20;36(4):705-724. Epub 2018 Sep 20.

Division of Neuroimmunology and Neuroinfectious Diseases, Department of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD 21287, USA.

Viruses are a frequent cause of encephalitis. Common or important viruses causing encephalitis include herpesviruses, arboviruses, enteroviruses, parechoviruses, mumps, measles, rabies, Ebola, lymphocytic choriomeningitis virus, and henipaviruses. Other viruses may cause an encephalopathy. Read More

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November 2018
14 Reads

Diagnostic Testing of Neurologic Infections.

Neurol Clin 2018 Nov;36(4):687-703

Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, NS212A, Campus Box 3206, San Francisco, CA 94158, USA. Electronic address:

Neuroinfectious diseases continue to cause morbidity and mortality worldwide, with many emerging or reemerging infections resulting in neurologic sequelae. Careful clinical evaluation coupled with appropriate laboratory investigations still forms the bedrock for making the correct etiologic diagnosis and implementing appropriate management. The treating physician needs to understand the individual test characteristics of each of the many conventional candidate-based diagnostics: culture, pathogen-specific polymerase chain reaction, antigen, antibody tests, used to diagnose the whole array of neuroinvasive infections. Read More

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November 2018
12 Reads
1.610 Impact Factor

The Interface Between Neurology and Oncology.

Neurol Clin 2018 Aug 13;36(3):xiii-xiv. Epub 2018 Jun 13.

Center for Neuro-Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, D2, Boston, MA 02215, USA; Division of Cancer Neurology, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ncl.2018.05.001DOI Listing
August 2018
1 Read

Paraneoplastic Neurologic Syndromes.

Neurol Clin 2018 Aug 18;36(3):675-685. Epub 2018 Jun 18.

Neurology, Hospital Clínic and Neuroimmunology, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Casanova 143, Barcelona, Spain 08036; University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19107, USA. Electronic address:

Paraneoplastic neurologic syndromes (PNS) are mostly immune-mediated disorders that occur in patients with cancer. Because the same neurologic syndromes may occur without a cancer association it is important to know the likelihood of PNS, which is based in part on the syndrome and the patient's demographics and risk factors for cancer. The presence of specific antineuronal antibodies can facilitate the diagnosis and suggest treatment strategies. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.015DOI Listing
August 2018
11 Reads

Neurocognitive Function in Adult Cancer Patients.

Neurol Clin 2018 Aug;36(3):653-674

Section of Neuropsychology, Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 0431, Houston, TX 77030, USA.

Impaired neurocognitive function is an increasingly recognized morbidity in patients who have cancer. Cancer treatments, psychosocial stressors, and the malignancy itself can alter brain function. The mechanisms by which this occurs are under active investigation. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.014DOI Listing
August 2018
2 Reads

Neurologic Complications of Systemic Anticancer Therapy.

Neurol Clin 2018 Aug;36(3):627-651

Stephen E. and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Harvard Medical School, Yawkey 9E, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Neurologic complications of systemic cancer therapy encompass a range of symptoms that can affect the central nervous system (CNS), peripheral nervous system (PNS), or both. Their incidence will likely increase as novel agents, such as targeted therapy and immunotherapy, become incorporated into standard treatment regimens, and the number of long-term cancer survivors rises. Recognizing the common adverse effects of treatment is important to avoid misdiagnosis of cancer recurrence in the nervous system or paraneoplastic disease. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.013DOI Listing
August 2018
1 Read

Neurologic Complications of Radiation Therapy.

Neurol Clin 2018 Aug 15;36(3):599-625. Epub 2018 Jun 15.

Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 420 Brookline Avenue, Boston, MA 02215, USA.

Cranial radiation therapy (CRT) is used to treat a wide range of malignant and benign conditions and is associated with a unique set of risks and complications. Early complications from CRT include fatigue, skin reaction, alopecia, headaches, anorexia, nausea/vomiting, exacerbation of neurologic symptoms, serous otitis media, parotitis, and encephalopathy. Delayed complications include pseudoprogression, radiation necrosis, neurocognitive changes, cerebrovascular effects, migrainelike disorders, cataracts, xerophthalmia, optic neuropathy, hearing loss, tinnitus, chronic otitis, endocrinopathy, and secondary malignancy. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.012DOI Listing
August 2018
11 Reads

Metastatic Complications of Cancer Involving the Central and Peripheral Nervous Systems.

Neurol Clin 2018 Aug 15;36(3):579-598. Epub 2018 Jun 15.

Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Electronic address:

Neurologic complications of cancer may involve both the central nervous system and peripheral nervous system manifesting as brain, leptomeningeal, intramedullary, intradural, epidural, plexus, and skull base metastases. Excluding brain involvement, neurologic complications affecting these other sites are relatively infrequent, but collectively they affect more than 25% of patients with metastatic cancer causing significant morbidity and mortality. Early diagnosis and intervention optimize quality of life and improve survival. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082424PMC
August 2018
16 Reads

Brain Metastases.

Neurol Clin 2018 Aug 18;36(3):557-577. Epub 2018 Jun 18.

Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Center for Neuro-Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA; Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA. Electronic address:

Brain metastases from solid tumors are associated with increased morbidity and mortality. Standard treatment is local therapy with surgery and/or radiation therapy although there is increasing interest in systemic therapies that can control both intracranial and extracranial disease. We review the most recent data for local therapy and systemic therapy options. Read More

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August 2018
1 Read

Pediatric Brain Tumors.

Neurol Clin 2018 Aug;36(3):533-556

The Brain Tumor Institute, Center for Neuroscience and Behavioral Medicine, Children's National Health System, 111 Michigan Avenue Northwest, Washington, DC 20010, USA; The Brain Tumor Institute, Gilbert Family Neurofibromatosis Institute, Children's National Medical Center, 111 Michigan Avenue Northwest, Washington, DC 20010, USA. Electronic address:

Pediatric central nervous system (CNS) tumors are the most common solid tumors in children and comprise 15% to 20% of all malignancies in children. Presentation, symptoms, and signs depend on tumor location and age of the patient at the time of diagnosis. This article summarizes the common childhood CNS tumors, presentations, classification, and recent updates in treatment approaches due to the increased understanding of the molecular pathogenesis of pediatric brain tumors. Read More

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August 2018
15 Reads

Primary Central Nervous System Lymphoma.

Neurol Clin 2018 Aug;36(3):517-532

Department of Neurology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Division of Hematology and Oncology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Primary central nervous system lymphoma (PCNSL) is an aggressive form of non-Hodgkin lymphoma restricted to the central nervous system. Stereotactic biopsy is the gold-standard for diagnosis of PCNSL. Extent of disease evaluation for newly diagnosed PCNSL patients includes brain imaging, eye examination, cerebrospinal fluid assessment, body imaging, and bone marrow biopsy. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.008DOI Listing
August 2018
13 Reads

Benign Intracranial Tumors.

Neurol Clin 2018 Aug;36(3):501-516

Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Yawkey 9E, Boston, MA 02114, USA. Electronic address:

Meningiomas are the most common primary intracranial tumor in adults. With schwannomas, these tumors account for almost all intracranial benign tumors. Despite the benign histologic nature, patients suffer from neurologic symptoms and require treatment. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.007DOI Listing
August 2018
13 Reads

Understanding and Treating Glioblastoma.

Neurol Clin 2018 Aug;36(3):485-499

Department of Neurology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; Clinical Cooperation Unit Neuroimmunology and Brain Tumor Immunology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.

For newly diagnosed patients, the standard has remained largely unchanged for the past decade and concept-driven approaches like anti-angiogenic therapies or use of molecularly targeted drugs in all-comers populations have failed. Tumor-treating fields appear as a new option. Most current immunotherapy or molecularly targeted, precision medicine trials are also focusing on this newly diagnosed patient population. Read More

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Grade II and III Oligodendroglioma and Astrocytoma.

Neurol Clin 2018 Aug 15;36(3):467-484. Epub 2018 Jun 15.

Department of Neurosurgery, University of California, San Francisco, Box 0112, 505 Parnassus Avenue M779, San Francisco, CA 94143, USA.

In the 2016 WHO classification of diffuse glioma, the diagnosis of an (anaplastic) oligodendroglioma requires the presence of both an IDH mutation (mt) and 1p/19q codeletion, whereas (anaplastic) astrocytoma are divided in IDH wild-type and IDHmt tumors. Standard of care for grade II and III glioma consists of resection. For patients with tumors that require postoperative treatment, radiotherapy and chemotherapy are recommended. Read More

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August 2018
12 Reads

Neurologic and Medical Management of Brain Tumors.

Neurol Clin 2018 Aug 29;36(3):449-466. Epub 2018 May 29.

Division of Neuro-Oncology, University of Virginia Health System, 1300 Jefferson Park Avenue, West Complex, Room 6225, Charlottesville, VA 22903-0156, USA. Electronic address:

Patients with brain tumor encounter a wide spectrum of tumor and treatment-related complications during their disease course. Tumors may serve as seizure substrates, are associated with a hypercoagulable state that results in thromboembolic complications, and may influence mood and cognition. Antitumor and supportive therapies may also have deleterious effects. Read More

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August 2018
1 Read

World Health Organization 2016 Classification of Central Nervous System Tumors.

Neurol Clin 2018 Aug;36(3):439-447

MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, 101 College Street, 14-601, Toronto, Ontario M5G 1L7, Canada. Electronic address:

The recent update of the World Health Organization (WHO) classification of tumors of the central nervous system represents a paradigm shift. Previous iterations of the classification relied on morphologic features for classification. In the 2016 update, the definitions of specific neoplastic entities tumors now include precise molecularly defined entities. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.003DOI Listing
August 2018
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Evolving Insights into the Molecular Neuropathology of Diffuse Gliomas in Adults.

Neurol Clin 2018 Aug;36(3):421-437

The Jackson Laboratory for Genomic Medicine, 10 Discovery Drive, Farmington, CT 06032, USA. Electronic address:

Recent advances in molecular analysis and genome sequencing have prompted a paradigm shift in neuropathology. This article discusses the discovery and clinical relevance of molecular biomarkers in diffuse gliomas in adults and how these biomarkers led to revision of the World Health Organization classification of these tumors. We relate progress in clinical classification to an overview of studies using molecular profiling to study gene expression and DNA methylation to categorize diffuse gliomas in adults and issues dealing with intratumoral heterogeneity. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322909PMC
August 2018
2 Reads

Epidemiology of Brain Tumors.

Neurol Clin 2018 Aug 15;36(3):395-419. Epub 2018 Jun 15.

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, 60 Fenwood Road, Boston, MA 02115, USA.

Incidence, prevalence, and survival for brain tumors varies by histologic type, age at diagnosis, sex, and race/ethnicity. Significant progress has been made in identifying potential risk factors for brain tumors, although more research is warranted. The strongest risk factors that have been identified thus far include allergies/atopic disease, ionizing radiation, and heritable genetic factors. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338619183119
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http://dx.doi.org/10.1016/j.ncl.2018.04.001DOI Listing
August 2018
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Fifty Key Publications on Myasthenia Gravis and Related Disorders.

Neurol Clin 2018 May;36(2):xiii-xvii

Gertrude and Dewey Ziegler Professor of Neurology, University Distinguished Professor Vice Chancellor for Research, President of the Research Institute, Director, Frontiers: University of Kansas Clinical, & Translational Science Institute, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ncl.2018.03.001DOI Listing
May 2018
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Lambert-Eaton Myasthenic Syndrome.

Neurol Clin 2018 May;36(2):379-394

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.

Lambert-Eaton myasthenic syndrome is a paraneoplastic or primary autoimmune neuromuscular junction disorder characterized by proximal weakness, autonomic dysfunction and ariflexia. The characteristic symptoms are thought to be caused by antibodies generated against the P/Q-type voltage-gated calcium channels present on presynaptic nerve terminals and by diminished release of acetylcholine. More than half of Lambert-Eaton myasthenic syndrome cases are associated with small cell lung carcinoma. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.008DOI Listing
May 2018
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Congenital Myasthenic Syndromes.

Neurol Clin 2018 May;36(2):367-378

Department of Neurology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35233, USA.

The congenital myasthenic syndromes (CMS) are a group of rare genetic conditions characterized by abnormal neuromuscular transmission. Typically, these conditions have been the result of a dysfunctional protein that is present in the presynaptic terminal, the synaptic cleft, or the postsynaptic terminal. Many of these syndromes present within the first few years of life with fluctuating and fatiguable weakness in a distribution similar to myasthenia gravis, although a limb-girdle distribution and late onset are also seen in certain specific types of CMS. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338619183000
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http://dx.doi.org/10.1016/j.ncl.2018.01.007DOI Listing
May 2018
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An Update: Myasthenia Gravis and Pregnancy.

Neurol Clin 2018 May;36(2):355-365

University of Rochester Medical Center, University of Rochester, 601 Elmwood Avenue, PO Box 673, Rochester, NY 14642, USA.

Myasthenia gravis presents a risk factor for pregnancy and delivery, and can affect the newborn. In return, pregnancy can affect the course of myasthenia and worsen the disease during pregnancy requiring treatment modifications. Treatment optimization and drug safety should be addressed before conception. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.005DOI Listing
May 2018
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Measuring Clinical Treatment Response in Myasthenia Gravis.

Neurol Clin 2018 May;36(2):339-353

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

In this article we provide an overview of health-related outcome measurement-to better understand what different outcomes used in myasthenia actually measure-and to provide some guidance when choosing measures based on the clinical context and question. In myasthenia, the most commonly used outcome measures are aimed at assessing the signs and symptoms. In this review, we provide a summary of the most commonly used outcome measures. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.006DOI Listing
May 2018
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Treatment of Myasthenia Gravis.

Neurol Clin 2018 May;36(2):311-337

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.

With specialized care, patients with myasthenia gravis can have very good outcomes. The mainstays of treatment are acetylcholinesterase inhibitors, and immunosuppressive and immunomodulatory therapies. There is good evidence thymectomy is beneficial in thymomatous and nonthymomatous disease. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.011DOI Listing
May 2018
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Muscle-Specific Tyrosine Kinase and Myasthenia Gravis Owing to Other Antibodies.

Neurol Clin 2018 May;36(2):293-310

Department of Neuroscience and Regenerative Medicine, Augusta University, 1120 15th Street, CA-2014, Augusta, GA 30912, USA.

Around 20% of patients with myasthenia gravis are acetylcholine receptor antibody negative; muscle-specific tyrosine kinase antibodies (MuSK) were identified as the cause of myasthenia gravis in 30% to 40% of these cases. Anti MuSK myasthenia gravis is associated with specific clinical phenotypes. One is a bulbar form with fewer ocular symptoms. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051709PMC
May 2018
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Nature and Action of Antibodies in Myasthenia Gravis.

Neurol Clin 2018 May;36(2):275-291

Department of Neurology, Wayne State University School of Medicine, 8D University Health Center, 4201 St Antoine, Detroit, MI 48201, USA; Department of Biochemistry, Microbiology and Immunology, Wayne State University, Detroit, MI, USA. Electronic address:

This article discusses antibodies associated with immune-mediated myasthenia gravis and the pathologic action of these antibodies at the neuromuscular junctions of skeletal muscle. To explain how these antibodies act, we consider the physiology of neuromuscular transmission with emphasis on 4 features: the structure of the neuromuscular junction; the roles of postsynaptic acetylcholine receptors and voltage-gated Na channels and in converting the chemical signal from the nerve terminal into a propagated action potential on the muscle fiber that triggers muscle contraction; the safety factor for neuromuscular transmission; and how the safety factor is reduced in different forms of autoimmune myasthenia gravis. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.001DOI Listing
May 2018
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Diagnosis of Myasthenia Gravis.

Neurol Clin 2018 May;36(2):261-274

Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.

Myasthenia gravis (MG) diagnosis is primarily clinically based. By the end of the clinical evaluation, clinicians have a sense as to whether presenting symptoms and elicited signs are weakly or strongly supportive of MG. Diagnostic tests can reaffirm the clinicians' impression. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.010DOI Listing
May 2018
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Generalized Myasthenia Gravis: Classification, Clinical Presentation, Natural History, and Epidemiology.

Neurol Clin 2018 May;36(2):253-260

Department of Neurology, University at Buffalo Jacobs School of Medicine & Biomedical Sciences, 1010 Main Street, Buffalo, New York 14202, USA.

Myasthenia gravis (MG) is a rare disease, but the most common disorder of the neuromuscular junction. It is the prototypic autoimmune disease most commonly caused by antibodies to the acetylcholine receptor (AChR) leading to characteristic fatigable weakness of the ocular, bulbar, respiratory, axial, and limb muscles. The majority of patients with MG first present with ocular symptoms. Read More

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http://dx.doi.org/10.1016/j.ncl.2018.01.002DOI Listing
May 2018
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