Articles related to NEUROLOGICAL DISORDERS

The split-hand sign, one of the first physical symptoms of ALS, refers to a loss of the pincer grasp caused by weakening and wasting of two hand muscles placed on the side of the thumb: the abductor pollicis brevis (APB) and the first dorsal interosseous (FDI). Hand muscles on the side of the little finger, such as the abductor digiti minimi (ADM), are typically spared, hence the term “split.” Several studies have attempted to develop split-hand indexes (SIs) based on a measure of muscle conduction known as compound muscle action potentials (CMAP) of affected and unaffected hand muscles over the years. The CMAP and F-wave persistence (FP) of three important groups of hand muscles — APB, FDI, and ADM — were assessed in 83 ALS patients and 50 age- and height-matched healthy individuals (controls) in this study. The sensitivity and specificity of SIFP and SICMAP in identifying ALS patients from healthy participants were compared using statistical analysis. When compared to controls, both SIFP and SICMAP tended to have very low values in people with ALS.

The diagnosis of FND can be made accurately based on positive clinical signs. Nevertheless, people with FND continue to suffer from discrimination across the spectra of clinical and research medicine. This review presents the evidence and outlines the causes of discrimination and suggests solutions.

Consider immunosuppressive therapy in patients on adequate acetylcholinesterase inhibitor therapy who do not demonstrate significant benefit. This article discusses the assessment of therapeutic failure, steroidal therapy, when to consider nonsteroidal anti-inflammatory therapy, and recommendations for monitoring treatment.

Leukodystrophies, deficiency-related metabolic diseases, genetic and acquired toxic/metabolic causes, and mitochondrial diseases were identified as the genetic and metabolic disorders of adulthood producing spinal cord signal changes. A number of adult metabolic and genetic illnesses that cause spinal cord atrophy without signal changes have also been discovered. The classification based on spinal MRI results is also offered, along with suggestions for the diagnostic process and alternative diagnoses.

This neurology news roundup from MedPage Today includes four highlights of note: First, a JAMA Internal Medicine article pointing out that gabapentin will not solve the opioid crisis in the US. Second, ublituximab, approved for relapsing MS at the end of December, has been included in the Institute for Clinical and Economic Review’s report on comparative effectiveness. Third, the same organization says that the newly approved Alzheimer’s drug lecanemab will need to be priced below $21,000 per year to be cost effective. And finally, a link to Neurology‘s crystal ball view into neurology education in the coming decade.

Although the relationship between preceding viral illness and subsequent Guillain-Barre isn’t proven, it is a commonly observed pattern. The severity of GBS ranges from mild sensory disturbances to life-threatening loss of function requiring intubation.