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Recent analysis of treatment patterns and survival of newly diagnosed patients with glioblastoma in community settings in the USA has shown that the medical community rapidly adjusted to the new standard of treatment—the so-called 'Stupp regimen'. The findings are encouraging, but further research is needed to improve patient survival.
Diagnosis of dystonia—a syndrome of abnormal, involuntary movements—is difficult, given that many different underlying etiologies exist. Bertram and Williams review studies that investigated etiology in patients with various dystonic syndromes. On the basis of these data, the authors present an eight-question diagnostic approach that should enable both specialists and general neurologists to determine the appropriate diagnostic test for patients with a possible dystonic syndrome.
Recent guidelines, based on evidence of detrimental pharmacokinetic interactions between antiepileptic drugs (AEDs) and antiretroviral drugs, provide a new framework for the selection of AED medication for HIV-infected individuals. However, AED use, antiretroviral therapy and HIV infection all have overlapping nonpharmacokinetic outcomes, which the guidelines do not address.
Down syndrome (DS) is associated with early onset of neuropathology that is indistinguishable from Alzheimer disease (AD), and is typically followed by cognitive decline two decades later. A recent study has reported that the AD drug memantine failed to improve cognitive performance and function in middle-aged patients with DS.
The hippocampus is a dynamic structure that can change in size throughout life. Hippocampal atrophy, which is associated with cognitive decline and late-life dementia, can be exacerbated by a number of medical conditions. In this Review, Fotuhi and colleagues examine the modifiable factors that can affect hippocampal size, and discuss lifestyle and therapeutic interventions that might prevent or even reverse hippocampal atrophy.
Antiplatelet drugs are the treatment of choice for preventing recurrence of noncardioembolic ischaemic stroke, but numerous updates to clinical guidelines, most recently in 2011 in the USA, have made selection of the appropriate antiplatelet agent difficult. In their Review, Craig Williams and colleagues provide an overview of the evolving guidelines in the context of results from the many large clinical trials in this field.
Tourette syndrome is a complex neurobehavioural disorder that is believed to have a strong genetic component, but the exact aetiopathology of the disorder remains unclear. Denget al. provide an update on the genetics of Tourette syndrome, highlighting investigations into chromosomal aberrations and genetic mutations in patients with the disorder, and discussing how these studies have improved our understanding of the aetiology of Tourette syndrome.
An accepted classification system exists for ischaemic stroke in adults; however, this system is of limited use for categorizing strokes in children, as the aetiology of paediatric stroke is often different from that in adults. A new anatomically based classification system provides standardized criteria specifically for paediatric stroke.