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Volume 4, Number 3 - 2007

Volume 4, Number 3 - 2007

Table of Contents

The Endothelium, Platelets, and Brain Ischemia Treatment Review
Knowledge of the contribution of blood platelets and white and red thrombi in occlusive cerebrovascular disease and brain ischemia and infarction provides the present rationale for the use of antithrombotic treatment. There are now 4 general strategies for reducing the formation of white platelet–fibrin clots: 1) administration of agents whose function is predominantly on platelets (aspirin, clopidogrel); 2) administration of agents that affect platelets and the endothelium (dipyridamole, cilostazol); 3) administration of agents that affect the attachment of platelets to fibrinogen (abciximab and other glycoprotein IIb/IIIa inhibitors); and 4) reducing fibrinogen levels and activity. The clinical situations that require antithrombotic treatment vary. In patients in whom stents have been placed in coronary, peripheral, or brain-supplying arteries, agents acting predominantly on platelets have theoretical advantages. In patients with penetrating artery disease, agents with substantial endothelial effects have a theoretical advantage. [Rev Neurol Dis. 2007;4(3):113-121] © 2007 MedReviews, LLC
Temporal Lobe Epilepsy: A Progressive Disorder? Management Update
Temporal lobe epilepsy (TLE) can be a progressive disorder, potentially resulting in structural damage and a decline of cognitive abilities over time. This is particularly evident in cases that are refractory to medication. This review examines the changes that occur in refractory TLE over time and the factors associated with these changes. Imaging and histologic studies on the brains of patients with TLE reveal anatomic and metabolic changes associated with continued seizures. These changes can impair cognitive and behavioral function. Seizure control may help minimize or prevent these changes. [Rev Neurol Dis. 2007;4(3):122-127] © 2007 MedReviews, LLC
The Diagnosis of Giant Cell Arteritis Diagnosis Update
Giant cell arteritis (GCA) is the most common primary vasculitis in adults older than 50 years. The potential of GCA to cause bilateral, sequential vision loss makes it often a true neuro-ophthalmic emergency. Approximately one fifth of patients with GCA will present with ophthalmic complaints alone. The diagnosis of GCA requires a high index of suspicion and a systematic approach to diagnostic testing. The combination of abnormal laboratory markers of systemic inflammation and unilateral temporal artery biopsy is usually diagnostic. Additional testing with other diagnostic modalities may be required in cases in which clinical suspicion remains high despite a negative initial workup. We systematically review the diagnostic modalities used in suspected GCA patients who present with neuro-ophthalmic symptoms and signs. [Rev Neurol Dis. 2007;4(3):128-142] © 2007 MedReviews, LLC
The Neurology of Insomnia Series: Preface to the Third Article
[Rev Neurol Dis. 2007;4(3):143-144] © 2007 MedReviews, LLC
Fatal Familial Insomnia and Agrypnia Excitata Diagnosis Update
This review summarizes the pioneering steps culminating in the identification of a novel disease, fatal familial insomnia (FFI), a hereditary prion disease. Together with Morvan’s chorea and delirium tremens, FFI is characterized by an inability to sleep associated with motor and autonomic overactivation. We named this pattern agrypnia excitata, a syndrome caused by a dysfunction in thalamolimbic circuits. This review highlights the strategic role of the limbic thalamus in the central autonomic network running from the limbic cortex to the lower brainstem and regulating sleep and wakefulness. [Rev Neurol Dis. 2007;4(3):145-152] © 2007 MedReviews, LLC
MRI Findings in Isolated Spontaneous Thrombosis of the Superior Ophthalmic Vein
We report the case of a 40-year-old woman with systemic lupus erythematosus who presented with spontaneous thrombosis of the superior ophthalmic vein resulting in permanent vision loss. The diagnosis was established by noncontrast CT scanning, gadolinium-enhanced MRI, and conventional catheter angiography. [Rev Neurol Dis. 2007;4(3):161-165] © 2007 MedReviews, LLC
Update on Idiopathic Intracranial Hypertension
[Rev Neurol Dis. 2007;4(3):166-167] © 2007 MedReviews, LLC
Magnetoencephalography in Epilepsy
[Rev Neurol Dis. 2007;4(3):172-173] © 2007 MedReviews, LLC
Recent Articles From the Neuromuscular Literature
[Rev Neurol Dis. 2007;4(3):173-176] © 2007 MedReviews, LLC