Abstract：
OPINION STATEMENT:The timely implementation of immunotherapy is key to successful treatment of autoimmune encephalopathies or dementias (from here on will be referred to as autoimmune encephalopathies). There are different levels of diagnostic certainty which should guide the immunological treatment of autoimmune encephalopathies. There is a high level of diagnostic certainty for patients who have classic limbic encephalitis and have a neural antibody detected in serum or CSF (such as potassium channel complex antibody). For these patients, initiating high-dose corticosteroids or IVIg is indicated, with plasma exchange, rituximab or cyclophosphamide used as second-line therapy if first-line therapy proves only partially beneficial. There is a lower level of diagnostic certainty in patients with non-limbic atypical phenotypes (though rapidly progressive) when no neural antibody is detected in serum and CSF. A trial of corticosteroids or IVIg (or both sequentially) may be undertaken in these patients, but if no objective improvements occur, further immunotherapy is unlikely to be beneficial. Antiepileptic treatment also plays a critical role in those who have seizures as well as cognitive symptoms. Evaluation for and treatment of any underlying cancer is another component for those patients with a paraneoplastic cause of encephalitis. An individualized maintenance regimen needs to be designed for patients who do improve with immunotherapy. Individual factors that need to be considered when formulating a program of maintenance treatment include disease severity, antibody specificity and proclivity for disease relapse. Azathioprine and mycophenolate mofetil are frequently used for the purpose of remission maintenance, and should permit gradual withdrawal of steroids, IVIg or more toxic immunosuppressants. The duration of maintenance therapy is uncertain, but this author typically recommends 3-5 years of relapse-free maintenance treatment before discontinuing immunotherapy altogether.
journal_name
Curr Treat Options Neuroljournal_title
Current treatment options in neurologyauthors
McKeon Adoi
10.1007/s11940-013-0251-8subject
Has Abstractpub_date
2013-12-01 00:00:00pages
723-37issue
6eissn
1092-8480issn
1534-3138journal_volume
15pub_type
杂志文章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：: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：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：OPINION STATEMENT:The recognition of the diagnosis of migraine in the pediatric population is increasing. Early and aggressive treatment of migraine in children and adolescents with the use of over-the-counter medications has proven effective. In addition, the off-label use of many migraine-specific medications is ofte...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-010-0069-6
更新日期：2010-05-01 00:00:00
abstract：OPINION STATEMENT:The problem of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) management remains unsolved. Despite a myriad of therapeutic trials, no convincingly e...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-012-0211-8
更新日期：2013-02-01 00:00:00
abstract：:Subdural empyema represents loculated infection between the outermost layer of the meninges, the dura, and the arachnoid. The empyema may develop intracranially or in the spinal canal. Intracranial subdural empyema is most frequently a complication of sinusitis or, less frequently, otitis or neurosurgical procedures. ...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-003-0019-7
更新日期：2003-01-01 00:00:00
abstract：OPINION STATEMENT:Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, which can potentially increases the risk of stroke by five-fold, thus, resulting in high public healthcare burden. Stroke prevention is vital in the management of AF patients. Vitamin K antagonists (VKA, eg, warfarin) have ...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-014-0331-4
更新日期：2015-02-01 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：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：: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：:Neuralgic amyotrophy has a broad variety of clinical manifestations. Although it was initially thought to be a plexopathy, its diverse presentation can include isolated sensory nerves or even cranial nerves. Although neuralgic amyotrophy is usually a benign condition with a good recovery, pain can be a disabling featu...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-009-0011-y
更新日期：2009-03-01 00:00:00
abstract：PURPOSE OF REVIEW:People with epilepsy have an increased risk of mortality when compared to the general population. Sudden unexpected death in epilepsy (SUDEP) is the most common cause of epilepsy-related death in children and adults. The purpose of this review is to discuss SUDEP, with an emphasis on SUDEP risk factor...
journal_title：Current treatment options in neurology
pub_type： 杂志文章,评审
doi：10.1007/s11940-019-0547-4
更新日期：2019-02-13 00:00:00
abstract：:The treatment of progressive myoclonus epilepsy (PME) remains a major therapeutic challenge in neurology. Generalized convulsive seizures are often well controlled through classic antiepileptic drugs (AEDs) like valproate and clonazepam, whereas myoclonus, the main symptom that is affecting patients most in their dail...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-002-0001-9
更新日期：2002-01-01 00:00:00
abstract：:Multiple pharmacologic treatments have been studied, but propranolol and primidone have proven to be the most effective medications. It is unlikely that a patient will respond miraculously to another medication if his or her response to propranolol and primidone is minimal. Some subsets of essential tremor, however, s...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-999-0027-3
更新日期：1999-03-01 00:00:00
abstract：:The epidemiologic link between increased low-density-lipoprotein (LDL) cholesterol and ischemic stroke is controversial. However, recent trials make it clear that LDL reduction by statin agents in high-risk patients reduces the risk of ischemic stroke. The risk of first stroke is reduced within 1 to 2 years of statin ...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-006-0039-1
更新日期：2006-11-01 00:00:00
abstract：OPINION STATEMENT:Triptans, selective serotonin receptor agonists, were developed almost 20 years ago and represented a major breakthrough in the treatment of acute migraine attacks. Since then, the triptans have become first-line agents for most patients with migraine, both with and without aura, unless contraindicate...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-010-0082-9
更新日期：2010-09-01 00:00:00
abstract：OPINION STATEMENT:Magnetic resonance imaging (MRI) is the gold standard guiding diagnostic and therapeutic management in glioma with its high resolution and possibility to depict blood-brain-barrier disruption when contrast medium is applied. In light of the shifting paradigms revealing distinct tumor subtypes based on...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-015-0384-z
更新日期：2016-01-01 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：:There is no controlled study for the best treatment or management of cervico-cerebral artery dissection (CAD). Rationale initial empiric treatment in acute CAD to prevent secondary embolism is partial thromboplastin time (PTT)-guided anticoagulation by intravenous heparin followed by anticoagulation with warfarin. Car...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-001-0034-5
更新日期：2001-09-01 00:00:00
abstract：:Classic maple syrup disease can be managed to allow a benign neonatal course, normal growth, and low hospitalization rates. The majority of affected infants that are prospectively managed have good neurodevelopmental outcome; however, acute metabolic intoxication and neurologic deterioration can develop rapidly at any...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-003-0039-3
更新日期：2003-07-01 00:00:00
abstract：:Despite increasing recognition of childhood obstructive sleep apnea syndrome (OSAS) as a significant public health problem, treatment of the condition remains inconsistent. Some children are screened using polysomnography and treated only when objective respiratory disturbances are identified. Many others receive aden...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-005-0028-9
更新日期：2005-09-01 00:00:00
abstract：OPINION STATEMENT:Infantile spasms (IS) represent a major therapeutic challenge, as cessation of spasms and normalization of the electroencephalogram (elimination of hypsarrhythmia) are mandatory to prevent cognitive deterioration in previously healthy infants, or to preserve neurocognitive function among those neurolo...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-012-0181-x
更新日期：2012-08-01 00:00:00
abstract：:Acute hearing loss (AHL) is a medical urgency. The management of patients presenting with sudden deafness involves detecting the causal mechanism and administering emergency therapeutic drugs to restore hearing by minimizing the period of cellular ischemia to the inner ear. Acute management of AHL consists of administ...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-004-0039-y
更新日期：2004-01-01 00:00:00
abstract：OPINION STATEMENT:Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is a common condition characterized by an irresistible urge to move the legs, concomitant with an unpleasant sensation in the lower limbs, which is typically relieved by movement. Symptoms occur predominantly at rest and prevail in the afternoon or...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-015-0390-1
更新日期：2016-02-01 00:00:00
abstract：:Standard therapy does not exist for the treatment of primary central nervous system lymphoma. This is because of low patient numbers, slow accrual to clinical trials, and the absence of phase III randomized clinical trials. Neuro-oncologists agree that whole brain irradiation alone is no longer the best treatment opti...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-003-0012-1
更新日期：2003-05-01 00:00:00
abstract：OPINION STATEMENT:Restless legs syndrome (RLS) is a common, sensorimotor, circadian sleep disorder characterized by the urge to move the legs, particularly at nighttime. It is important to differentiate primary and secondary RLS from other conditions, which can mimic the symptoms of RLS, in particular neuropathy and cr...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-013-0241-x
更新日期：2013-08-01 00:00:00
abstract：:Although estimates vary, the nervous system appears to be involved in 10% to 15% of patients infected with Borrelia burgdorferi. The resulting disorders, known collectively as neuroborreliosis or nervous system Lyme disease, generally respond well to antimicrobial therapy. Definitive treatment of nervous system infect...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-007-0035-0
更新日期：2007-03-01 00:00:00
abstract：:Spinal muscular atrophy (SMA) is an autosomal recessive disease characterized by degeneration of spinal cord motor neurons and muscular atrophy. Advances in recent research have led to understanding of the molecular genetics of SMA. Therapeutic strategies have been developed according to the unique genomic structure o...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-008-0044-7
更新日期：2008-11-01 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：: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
