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 claudication, aortitis, and cardiac disease, in addition to the more classic visual complications resulting from of ischemia to branches of the external and internal carotid arteries. While a clinical presentation of headache, jaw claudication, scalp tenderness, fever and other systemic symptoms and serum markers are together highly suggestive of the disease, diagnosis can be challenging in those cases in which classic symptoms are lacking. The purpose of this review is to update the reader on advances in the diagnosis and treatment of giant cell arteritis and to review our evolving understanding of the immunological mechanism underlying the disease, which have helped guide our search for novel therapies. Recent Findings:There is increasing evidence supporting the use of Doppler ultrasound, dedicated post-contrast T1-weighted spin echo MRI of the scalp arteries and PET scan, which can together improve our diagnostic accuracy in cases in which temporal artery biopsy is either inconclusive or not feasible. Advances in our understanding of the immunological cascades underlying the disease have helped guide our search for steroid-sparing treatments for the GCA, the most important of which has been the IL-6 receptor antibody inhibitor tocilizumab, which has been shown to reduce cumulative steroid dose in a large multicenter, placebo-controlled prospective study. Other biologic agents, such as abatacept and ustekinumab have shown promise in smaller studies. Summary:GCA is no longer a disease whose diagnosis is based exclusively on temporal artery biopsy and whose complications are prevented solely with the use of corticosteroids. Modern vascular imaging techniques and targeted immunologic therapies are heralding a new era for the disease, in which practitioners will hopefully be able to diagnosis it with greater accuracy and treat it with less ischemic complications and iatrogenic side effects.
journal_name
Curr Treat Options Neuroljournal_title
Current treatment options in neurologyauthors
Dinkin M,Johnson Edoi
10.1007/s11940-020-00660-2subject
Has Abstractpub_date
2021-01-01 00:00:00pages
6issue
2eissn
1092-8480issn
1534-3138pii
660journal_volume
23pub_type
杂志文章,评审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::Non-rapid eye movement parasomnias are unique physical or experiential phenomena that disrupt sleep. Non-rapid eye movement parasomnias are common in children, but they typically outgrow them. Sleep-stage shifts caused by sleep-disordered breathing and associated arousals may be precipitating events for episodes of pa...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-004-0032-5
更新日期:2004-07-01 00:00:00
abstract:OPINION STATEMENT:Treatment of myoclonus requires an understanding of the physiopathology of the condition. The first step in treatment is to determine if there is an epileptic component to the myoclonus and treat accordingly. Secondly, a review of medications (e.g., opiates) and comorbidities (e.g., hepatic or renal f...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-016-0404-7
更新日期:2016-05-01 00:00:00
abstract::Migraine is a chronic paroxysmal neurological disorder characterized by multiphase attacks of head pain and a myriad of neurological symptoms. Chronic migraine causes a great personal and societal burden. Many patients are poorly responsive to, or non-compliant with, conventional migraine preventive therapies. For thi...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-019-0555-4
更新日期:2019-03-14 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to summarize the current evidence regarding the impact of the exposure to anesthetic and sedative agents on neurodevelopment during the period of rapid brain growth in the first 3 years of life. Though much of the definitive data demonstrating anesthesia-induced neurotoxi...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-018-0536-z
更新日期:2018-10-13 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:OPINION STATEMENT:The treatment of anaplastic glioma (AG) varies depending on histopathology of the tumor, molecular markers, and individual patient characteristics. Maximal surgical resection is desirable for all types of AG if technically feasible, with an acceptable level of risk, and with the goal of preserving neu...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-012-0177-6
更新日期:2012-08-01 00:00:00
abstract:Purpose of review:The purpose of this paper is to comprehensively evaluate secondary causes of inflammatory myopathies (myositis) and to review treatment options. Recent findings:This review highlights recent advancements in our understanding of known causes of myositis, including newer drugs that may cause myositis s...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-020-00646-0
更新日期:2020-01-01 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::The mainstay of treatment of amyotrophic lateral sclerosis (ALS) is management of symptoms. Health care providers involved in the care of ALS patients should be armed with the most current knowledge about symptomatic management of these patients so that an aggressive approach to controlling symptoms can be undertaken ...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-008-0009-x
更新日期:2008-03-01 00:00:00
abstract:OPINION STATEMENT:To date, there are no approved and established pharmacologic treatment options for tauopathies, a very heterogenous group of neuropsychiatric diseases often leading to dementia and clinically diagnosed as atypical Parkinson syndromes. Among these so-called Parkinson plus syndromes are progressive supr...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-012-0168-7
更新日期:2012-04-01 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: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::The initial treatment for trigeminal neuralgia is medical. Carbamazepine is the drug of choice. If the patient proves to be intolerant of carbamazepine, a number of second-line drugs are available, though data on their relative efficacy are nonexistent. Phenytoin, baclofen, clonazepam, and sodium valproate are all wor...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-996-0009-7
更新日期:1999-11-01 00:00:00
abstract::Arteriovenous malformations (AVM) are a leading cause of intracerebral hemorrhage, especially among the young. Because they pose a lifelong risk of serious bleeding, definitive treatment to obliterate the AVM should be pursued in the majority of patients. Microsurgical resection of a small AVM located in the superfici...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-002-0011-7
更新日期:2002-11-01 00:00:00
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::Autistic spectrum disorders (ASD) are an often-disabling continuum of disorders affecting two to four in 1000 children. These disorders have a core set of defining features including impaired verbal and nonverbal communication, impaired social interaction, and restricted or repetitive patterns of behavior. The cause o...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-996-0030-x
更新日期:2004-09-01 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:PURPOSE OF REVIEW:Idiopathic normal pressure hydrocephalus (iNPH) is a surgically treatable neurological disorder of the elderly population that is characterized by abnormal ventricular enlargement due to cerebrospinal fluid (CSF) accumulation and gait disturbance, cognitive impairment, or urinary incontinence. The obj...
journal_title:Current treatment options in neurology
pub_type: 杂志文章,评审
doi:10.1007/s11940-019-0604-z
更新日期:2019-12-03 00:00:00
abstract::Migraine is a common, chronic neurologic disorder that affects approximately 12% of the adult population in Western countries. Once migraine is diagnosed, illness severity must be assessed. Clinicians and patients should then work together to develop a treatment plan based on patient needs and preferences. The goals o...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-996-0011-0
更新日期:2003-11-01 00:00:00
abstract::Dystonia is a neurologic disorder that can occur at any age and often results in significant disability. The therapeutic application of botulinum toxin has revolutionized the treatment of this disorder, particularly for the adult-onset focal forms such as cervical dystonia and blepharospasm. The two available commerci...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/BF02938412
更新日期:2007-05-01 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::The primary goal of treatment in nonepileptic seizures (NES) is to improve the patient's quality of life by terminating seizure production or reducing seizure frequency. Initial treatment consists of explaining the diagnosis and its psychological nature to patients without judging them or giving the NES excessive atte...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-000-0034-x
更新日期:2000-11-01 00:00:00
abstract::There is no known way to cure multiple system atrophy or even to slow its insidious progression, but there are opportunities to treat many of its symptoms and complications. Of all the autonomic disturbances it causes, orthostatic hypotension is associated with one of the better chances for successful intervention. Mi...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-000-0005-2
更新日期:2000-05-01 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: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:Neurofibromatosis type 1 (NF1) is a genetic multisystemic disorder involving the skin, the central and peripheral nervous systems, bones, and the cardiovascular and endocrine systems. This condition is caused by inherited or de novo mutations of the NF1 gene at the 17q11.2 chromosomal region, a gene t...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-015-0355-4
更新日期:2015-06-01 00:00:00
abstract::Antiepileptic drug (AED) treatment is associated with multiple short- and long-term side effects. Effects on endocrine function, including weight change, reproductive function, thyroid function, and bone health are examples of these side effects. Some AEDs affect weight, resulting in weight gain or loss. Levetiracetam...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-005-0037-8
更新日期:2005-07-01 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::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 immunomodu...
journal_title:Current treatment options in neurology
pub_type: 杂志文章
doi:10.1007/s11940-999-0004-x
更新日期:1999-07-01 00:00:00