Tuesday, October 14, 2014

[Review] Epilepsy surgery in children and adults

[Review] Epilepsy surgery in children and adults
The Lancet Neurology

Epilepsy surgery is the most effective way to control seizures in patients with drug-resistant focal epilepsy, often leading to improvements in cognition, behaviour, and quality of life. Risks of serious adverse events and deterioration of clinical status can be minimised in carefully selected patients. Accordingly, guidelines recommend earlier and more systematic assessment of patients' eligibility for surgery than is seen at present. The effectiveness of surgical treatment depends on epilepsy type, underlying pathology, and accurate localisation of the epileptogenic brain region by various clinical, neuroimaging, and neurophysiological investigations.

Original Article: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(14)70156-5/abstract?rss=yes
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[Review] Controversies in HIV-associated neurocognitive disorders

[Review] Controversies in HIV-associated neurocognitive disorders
The Lancet Neurology

Cross-sectional studies show that around half of individuals infected with HIV-1 have some degree of cognitive impairment despite the use of antiretroviral drugs. However, prevalence estimates vary depending on the population and methods used to assess cognitive impairment. Whether asymptomatic patients would benefit from routine screening for cognitive difficulties is unclear and the appropriate screening method and subsequent management is the subject of debate. In some patients, HIV-1 RNA can be found at higher concentrations in CSF than in blood, which potentially results from the poor distribution of antiretroviral drugs into the CNS.

Original Article: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(14)70137-1/abstract?rss=yes
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Monday, October 13, 2014

Tinnitus: don’t just “live with it”, let’s do something about it

Tinnitus: don't just "live with it", let's do something about it
JNNP blog

Of the many conditions in medicine that are thrown into the 'too hard basket', tinnitus, that perception that there is constant noise in your ear even when there is no clear source, would have to be one of the most prevalent. I see a lot of GP referral letters that provide an electronically generated list of medical conditions that the patient has experienced since the day they first took breath on this earth, and on those occasions when I have enough left in the tank to sit down and read this long and all too frequently inaccurate list, I will often see a mention of tinnitus at some stage in the past. This is not entirely unexpected as it affects a significant proportion of the population. In my experience as a neurologist, I have never actually seen anyone receive any treatment for tinnitus and it is tempting to assume that there is simply nothing you can do about it.

In this issue of the journal, Minen and colleagues from Harvard have provided an outstanding review that explores management of tinnitus http://jnnp.bmj.com/content/85/10/1138.abstract . They have approached this condition from a neuropsychiatric perspective, highlighting the psychiatric disorders that often develop in patients who are forced to live with this condition. In addition to providing a through overview of the clinical features that may occur in this patient group, they provide sound advice on the various treatment possibilities, both pharmacological and non-pharmacological, that are available for patients with tinnitus.



Original Article: http://blogs.bmj.com/jnnp/2014/10/07/tinnitus-dont-just-live-with-it-lets-do-something-about-it/
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Creativity is not improved through cannabis use, claims study

Creativity is not improved through cannabis use, claims study
Neurology News & Neuroscience News from Medical News Today

Researchers from Leiden University in the Netherlands say that contrary to popular belief, smoking cannabis - particularly in high doses - does not improve creativity.

Original Article: http://www.medicalnewstoday.com/articles/283718.php
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Neurology mission(s) impossible

Neurology mission(s) impossible
Neurology recent issues

Neurologists have become increasingly engaged in global health.1 Historically, infectious disease specialists were among the first global health practitioners due to associations with tropical medicine and the prevalence of infectious diseases in resource-limited settings. This led to programs focused on individual diseases (e.g., malaria, polio, HIV, tuberculosis), often called vertical programs.2 Horizontal programs subsequently emerged, seeking to augment primary care infrastructure for the world's poorest patients and improve the conditions of poverty intimately intertwined with their diseases.2 Superimposed upon these systemic programs have been medical missions: isolated efforts in particular places for discrete time periods. While medical missions can provide beneficial contributions, they have been criticized as unsustainable, or worse, undermining local infrastructure and causing more harm than good.3–9 Such critiques note that missions may actually reinforce the health disparities and cycles of poverty they intend to ameliorate, as inadequately trained volunteers may provide ineffective, culturally irrelevant, or disparaging care that is below recognized public health standards and burdensome to local health facilities.3,4,10



Original Article: http://www.neurology.org/cgi/content/short/83/16/1450?rss=1
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