Abstract:
:Given our current knowledge, there is a need for the early institution of immunomodulatory therapy, especially for patients with poor prognostic factors (motor and cerebellar symptoms, frequent disease exacerbations, and a high level of activity on magnetic resonance imaging ). Patients who progress despite immunomodulatory therapy should be reevaluated in terms of diagnosis, development of neutralizing antibodies, or compliance. If a patient has a partial response to immunomodulatory therapy but his or her disease, as assessed by clinical and MRI criteria, remains very active, every effort should be made to modify disease progression by searching for an immunosuppressive therapy regimen before irreversible and considerable disability has accumulated. For the majority of patients, multiple sclerosis (MS) is a chronic condition. Therefore, until a curative treatment has been developed, the available repertoire of immunosuppressive or immunomodulatory treatments should be assessed with respect to the possibility of long-term use. This is particularly important for new immunosuppressive drugs, such as cladribine or mitoxantrone, or for invasive procedures, such as total lymphoid irradiation or autologous bone marrow transplantation. For the latter treatments, experience with long-term administration is not available or the potential side effects (eg, cardiotoxicity with mitoxantrone) limit the cumulative dose. These considerations may limit long-term administration and thus the general usefulness of some drugs. Even with proven efficacy, we need to define the next step once treatment has to be discontinued. We should also address whether exacerbating disease by discontinuing an effective therapy is a potential hazard. What other therapeutic options remain once the current treatment is discontinued? Answers are not readily available at the moment, but the question should influence our decisions in the selection of traditional, well-studied or new, potentially promising therapies.
journal_name
Curr Treat Options Neuroljournal_title
Current treatment options in neurologyauthors
Bielekova B,Martin Rdoi
10.1007/s11940-999-0004-xsubject
Has Abstractpub_date
1999-07-01 00:00:00pages
201-220issue
3eissn
1092-8480issn
1534-3138journal_volume
1pub_type
杂志文章abstract::Acute viral meningitis is the most common infection of the central nervous system. Most cases occur in children and young adults and are due to enteroviruses. Although the common causes of acute viral meningitis still lack treatment with an effective antiviral agent, management of patients is changing because of bette...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-008-0018-9
更新日期:2008-05-01 00:00:00
abstract::Cerebrovascular disorders are an important cause of mortality and chronic morbidity in children. Ischemic stroke is more common than cerebral venous thrombosis and hemorrhagic stroke in children. Several medical disorders have been associated with stroke in children, and a thorough evaluation of underlying causes is n...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-005-0047-6
更新日期:2005-11-01 00:00:00
abstract::After a patient has initiated an antiepileptic drug (AED) and achieved a sustained period of seizure freedom, the bias towards continuing therapy indefinitely can be substantial. Studies show that the rate of seizure recurrence after AED withdrawal is about two to three times the rate in patients who continue AEDs, bu...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-010-0083-8
更新日期:2010-09-01 00:00:00
abstract:OPINION STATEMENT:Kleine-Levin Syndrome [KLS] is often under-recognized and also misdiagnosed. When suspicion for KLS is raised, a thorough clinical evaluation should be performed, including detailed history from family members and a neurologic and psychiatric examination. Additional studies may include PSG, EEG, neuro...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-016-0409-2
更新日期:2016-06-01 00:00:00
abstract:OPINION STATEMENT:Status epilepticus is a neurologic emergency with significant potential morbidity and even mortality. It should be diagnosed and treated as quickly as possible, with concurrent rapid identification of the underlying cause. Nonconvulsive status epilepticus can be difficult to diagnose due to its protea...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-012-0179-4
更新日期:2012-08-01 00:00:00
abstract::Myasthenia gravis (MG) is an autoimmune disorder characterized clinically by proximal weakness and bulbar symptoms and pathologically by damage to the post-synaptic membrane at the neuromuscular junction. Ocular myasthenia gravis (ocular MG) is a form of myasthenia gravis whereby the patients' weakness is limited to t...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-005-0009-z
更新日期:2005-01-01 00:00:00
abstract:OPINION STATEMENT:Cerebral vasospasm (cVSP) consists of the vasoconstriction of large and small intracranial vessels which can lead to cerebral hypoperfusion, and in extreme cases, delayed ischemic deficits with stroke. While most commonly observed after aneurysmal subarachnoid hemorrhage (aSAH), cVSP can also occur af...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-013-0278-x
更新日期:2014-01-01 00:00:00
abstract::Drug-induced parkinsonism (DIP) is condition that mimics Parkinson's disease. Characterized mainly by rigidity and bradykinesia, it has less prominent tremor and gait instability. DIP is generally caused by lipophilic drugs that "block" dopamine D2 receptors in the brain, although presynaptic dopamine depletion, false...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-009-0019-3
更新日期:2009-05-01 00:00:00
abstract:OPINION STATEMENT:Paroxysmal dyskinesia represents a group of uncommon movement disorders that are characterized by episodes of abnormal movements arising from a baseline of normal or nearly normal movement. Recent advances in the genetics of these disorders have helped provide some unification of classification scheme...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-015-0350-9
更新日期:2015-06-01 00:00:00
abstract::There has been a recent resurgence of interest in therapeutic modalities using transcranial weak electrical stimulation through scalp electrodes, such as trans-cranial direct current stimulation (tDCS), as a means of experimentally modifying and studying brain function and possibly treating psychiatric conditions. A r...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-008-0040-y
更新日期:2008-09-01 00:00:00
abstract::All patients who present with subarachnoid hemorrhage should be admitted to the intensive care unit for close neurologic and cardiorespiratory monitoring. Neurosurgical consultation should be obtained if external ventricular drain placement, arteriography, or surgical planning are considered. Seizure prophylaxis, anti...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-999-0010-z
更新日期:1999-05-01 00:00:00
abstract:OPINION STATEMENT:A patient presenting with suspected primary central nervous system (CNS) vasculitis is often difficult to manage. Once the diagnosis is suspected, the clinical course may already be severe and warrant timely aggressive treatment with potentially toxic drugs. Definitive diagnosis is often delayed, requ...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-013-0227-8
更新日期:2013-06-01 00:00:00
abstract::The neurorehabilitation program for cerebral palsy changes over time. During the first 2 years of life, an infant stimulation program with an emphasis on more than just improving motor deficits is emphasized. The importance of involvement of a knowledgeable therapist cannot be overemphasized. Realistic expectations mu...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-000-0011-4
更新日期:2000-03-01 00:00:00
abstract:OPINION STATEMENT:When treating a person with epilepsy, one must consider many factors in addition to the obvious need to treat the seizures. Both epilepsy itself and treatment with antiepileptic drugs (AEDs) subject one to numerous potential secondary long-term health concerns. Poor bone health is one of these concern...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-011-0133-x
更新日期:2011-08-01 00:00:00
abstract::Vision disturbances following traumatic brain injury (TBI) include anomalies of accommodation, version, vergence (nonstrabismic, as well as strabismic), photosensitivity, visual field integrity, and ocular health. Traumatic brain injury patients with complex diplopia patterns, noncomitant strabismic anomalies, and adv...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-002-0027-z
更新日期:2002-07-01 00:00:00
abstract:OPINION STATEMENT:CADASIL is a life-threatening and disabling disease. Despite the progress achieved so far, no therapies able to limit the disease progression have been found and only empiric treatments can be employed to relieve the main disease symptoms. Further in vivo studies as well as data aggregation and multi-...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-017-0468-z
更新日期:2017-09-01 00:00:00
abstract::The challenge for the neurologist in the treatment of Lyme neuroborreliosis is not in the treatment per se, but in the diagnosis. Neurological manifestations of Lyme disease can present in many forms, and diagnostic techniques which detect the spirochete directly; the culture or polymerase chain reaction of the spiroc...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-005-0026-y
更新日期:2005-03-01 00:00:00
abstract:OPINION STATEMENT:Parkinson's disease (PD) has been increasingly recognized as having a multitude of nonmotor symptoms including psychosis, cognitive impairment and dementia, mood disturbances, fatigue, apathy, and sleep disorders. Psychosis and dementia, in particular, greatly affect quality of life for both patients ...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-013-0281-2
更新日期:2014-03-01 00:00:00
abstract:Purpose of Review:Giant cell arteritis (GCA), a medium and large vessel vasculitis occurring in the aged, remains a formidable disease, capable of taking both vision and life, through a multitude of vascular complications. Our understanding of the spectrum of its manifestations has grown over the years, to include limb...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-020-00660-2
更新日期:2021-01-01 00:00:00
abstract::OPINION STATEMENT: Anemia develops in about 50% of patients hospitalized with traumatic brain injury (TBI) and is recognized as a cause of secondary brain injury. This review examines the effects of anemia and transfusion on TBI patients through a literature search to identify original research on anemia and transfusi...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-012-0167-8
更新日期:2012-04-01 00:00:00
abstract:PURPOSE OF THE REVIEW:Psychosis is broadly defined as a disengagement from reality. It describes syndromes that impair both thought content and thought process. Psychosis negatively impacts an individual's quality of life, in addition to the families caring for them. Psychosis with different types of hallucinations and...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-019-0545-6
更新日期:2019-01-23 00:00:00
abstract::Vagus nerve stimulation is a unique therapy for epileptic seizures. Two randomized controlled trials in patients with medically refractory partial seizures have demonstrated efficacy, leading to US Food and Drug Administration approval of vagus nerve stimulation therapy in 1997. Extensive safety testing has not reveal...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-003-0002-3
更新日期:2003-03-01 00:00:00
abstract::Metabolic myopathies are disorders affecting utilization of carbohydrates or fat in the skeletal muscle. Adult patients with metabolic myopathies typically present with exercise-induced pain, contractures or stiffness, fatigue, and myoglobinuria. Symptoms are related to energy failure. Purpose of review In this review...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-017-0473-2
更新日期:2017-09-21 00:00:00
abstract:OPINION STATEMENT:Impaired sleep and alertness affect the majority of Parkinson's disease (PD) patients, negatively impacting safety and quality of life. The etiology of impaired sleep-wake cycle in PD is multifactorial and encompasses medication side effects, nocturnal PD motor symptoms, and presence of co-existent sl...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-017-0461-6
更新日期:2017-07-01 00:00:00
abstract::Spontaneous intracerebral hemorrhage (ICH) is a devastating neurological event with a 30-day mortality of approximately 40%. Recent research provides new insights into the pathophysiology of ICH-associated edema, with potential molecular and cellular targets for future therapy. Neuroimaging techniques such as gradient...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-006-0005-y
更新日期:2006-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Sleep-related movement disorders (SRMD) include several different motor activities during sleep. Few of them are well known and well classified, whereas others are minor motor disorders of sleep which are neither thoroughly characterized and classified nor have been extensively investigated to clarify...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-019-0543-8
更新日期:2019-01-19 00:00:00
abstract::Lysosomal storage disorders (LSDs), over 40 different diseases, are now considered treatable disorders. Only a few short years ago, Lysosomal storage disorders were seen as interesting neurodegenerative disorders without any potential for treatment. Effective treatment strategies such as bone marrow transplantation (B...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-001-0006-9
更新日期:2001-05-01 00:00:00
abstract::Progressive supranuclear palsy (PSP) is an atypical parkinsonian disorder that, in spite of its growing recognition, is still underdiagnosed. For management, prognosis, and research, an accurate and early diagnosis is essential. PSP is a relentlessly progressive neurodegenerative disorder, clinically characterized by ...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-006-0012-z
更新日期:2006-05-01 00:00:00
abstract:OPINION STATEMENT:Pervasive developmental disorders (PDDs), including autistic disorder (autism), Asperger's disorder, and pervasive developmental disorder not otherwise specified (PDD NOS), are neurodevelopmental disorders of childhood onset. These disorders persist throughout the lifespan of affected individuals and ...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-010-0091-8
更新日期:2010-11-01 00:00:00
abstract:OPINION STATEMENT:High-grade or malignant gliomas are aggressive cancers. The World Health Organization (WHO) grading system recognizes grade III and grade IV primary brain tumors of astrocytic, oligodendroglial, or mixed lineage. Identification of these tumors is prompted by symptoms such as insidious headaches, seizu...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-010-0077-6
更新日期:2010-07-01 00:00:00