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Norris J.W.,Clinical Neurosciences
Journal of Neural Transmission | Year: 2013

There are no reliable data from randomised trials to decide whether anticoagulants or antiplatelet agents are better to prevent further thromboembolic events after cervical arterial dissection. Most neurologists favour anticoagulants based on the underlying pathology and the likely course of acute post-dissection thromboembolism © 2012 Springer-Verlag Wien.

Vezyroglou K.,Great Ormond Street Hospital for Children NHS Trust | Cross J.H.,Clinical Neurosciences
Current Treatment Options in Neurology | Year: 2016

The mainstay of treatment of epilepsy has been antiepileptic drugs; however, despite the emergence of new agents, a consistent proportion remain drug-resistant. Newer AEDs show promise. However, as it becomes clear that the epilepsies are a group of diseases rather than a single disorder the prospect of targeted treatment in some may become a reality. © 2016, The Author(s).

Angus-Leppan H.,Clinical Neurosciences | Rudge P.,The London Clinic | Mead S.,The London Clinic | Collinge J.,The London Clinic | Vincent A.,John Radcliffe Hospital
JAMA Neurology | Year: 2013

Importance The diagnosis of autoimmune and neurodegenerative conditions can be unclear. Treatments such as removing the associated tumor, if present, and immunosuppression can halt or often reverse the progression of autoimmune conditions, but there is no curative treatment for neurodegenerative conditions. The presence of autoantibodies can sometimes be misleading. This report illustrates potential difficulties in differentiating autoimmune encephalopathies from sporadic Creutzfeldt-Jakob disease. OBSERVATIONS In a clinical follow-up of an older man with rapidly evolving encephalopathy at a neuroscience center, unsuccessful treatment with immunosuppression based on the incorrect presumptive diagnosis of Morvan syndrome was followed by the correct histological diagnosis of sporadic Creutzfeldt-Jakob disease. CONCLUSIONS AND RELEVANCE Autoimmune encephalopathies raise important treatment options and potential for recovery. However, since neuronal antibodiesmay be positive in prion disease, interpretation can be complex and must be rooted in the clinical picture.

Viry L.,University of Wollongong | Moulton S.E.,University of Wollongong | Romeo T.,University of Wollongong | Suhr C.,Clinical Neurosciences | And 4 more authors.
Journal of Materials Chemistry | Year: 2012

In drug therapy, most therapeutic drugs are of low molecular weight and could freely diffuse in the biological milieu depending on the administration route applied. The main reason for the development of polymeric drug carriers is to obtain desired effects such as sustained therapy, local and controlled release, prolonged activity and reduction of side effects. Alternatively, polymeric carriers can be made bioerodible in order to be eliminated by natural ways after a certain time of therapy. Core-shell fibres from coaxial spinneret or emulsion electrospinning are good candidates for the development of such devices; however difficulties remain especially in controlling the release over a sustained period. Here, we present a novel technique combining coaxial and emulsion electrospinning to produce micro-structured core-shell fibres. The design of drug microreservoirs of variable size within the bulk of the fibre combined with a tailored diffusive barrier allows modulating the release kinetics of these novel carriers. A nearly constant and linear release of the model drug Levetiracetam (M w ≈ 170 g mol -1) from PLGA emulsion-coaxial electrospun fibres is observed over 20 days. This device is aimed to be implanted into the brain for the treatment of epilepsy and is an example of the new capabilities and the promising potential that emulsion-coaxial electrospinning can provide towards the development of future drug carriers. © 2012 The Royal Society of Chemistry.

Steiner I.,Rabin Medical Center | Schmutzhard E.,Innsbruck Medical University | Sellner J.,TU Munich | Chaudhuri A.,Clinical Neurosciences | Kennedy P.G.E.,University of Glasgow
European Journal of Neurology | Year: 2012

Background: Polymerase chain reaction (PCR) as a means to amplify nucleic acids has become an essential element in diagnosis of infections. It has evolved into a simple and rapid, easy- to- use approach. At present there are no published guidelines for the usage of PCR technology for the diagnosis of infections of the nervous system. Methods: We reviewed the advantages and pitfalls of PCR in order to guide neurologists and infectious diseases experts in its application for the diagnosis of infections of the nervous system. Medical reference systems were searched, and original papers, meta-analyses, review papers, book chapters and guidelines recommendations were reviewed. The final literature search was performed in May 2012. Recommendations were reached by consensus. Recommendations: The reliability of PCR technology for the diagnosis of neurological infections is currently based on the pathogens. The main contribution of PCR is to the diagnosis of viral infections followed by bacterial CNS infections with the notable exception of tuberculous meningitis. Efficacy for the diagnosis of protozoal infections and helminthic infestations has also been established in many instances. Unfortunately, current molecular PCR technology is far from becoming routine in resource-poor countries where such infections are prevalent. Despite the importance of fungal infections in the context of the immune-compromised host, there is not enough data to recommend the routine use of PCR. Conclusions: PCR technology is currently a reliable method for the diagnosis of viral and bacterial (except tuberculosis) infections, and only for some protozoal infections and helminthic infestations. © 2012 EFNS.

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