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Many issues surround the treatment of patients with idiopathic normal pressure hydrocephalus by use of shunting. In this Viewpoint, Sachin Batra and Daniele Rigamonti advise on how to achieve the best results with this procedure—including use of appropriate patient selection methods, and accurate monitoring after surgery. They believe that many patients can have good outcomes from shunting but urge physicians to actively work to maintain high standards.
Over the past few years, there has been increasing interest in the use of complementary and alternative therapies to treat multiple sclerosis. Dietary supplementation with polyunsaturated fatty acids, which are thought to have anti-inflammatory properties, has been cited as a potential treatment for multiple sclerosis. However, as Mehta et al. discuss in this article, clinical trials have so far provided only limited evidence for the efficacy of this approach.
The cranial movement disorders constitute a diverse group of disorders that can be specific to the facial muscles or part of a generalized movement disorder. A lack of diagnostic tests and biomarkers for the cranial movement disorders means that their differential diagnosis can be difficult. In this Review, Fabbrini et al. summarize the available information pertaining to the clinical features, pathophysiologies and therapies of the main disorders within this group, with a view to aiding their diagnosis and treatment
Zinc overload is an unusual cause of copper-deficiency myeloneuropathy, in which affected patients have low serum copper and ceruloplasmin levels and high serum zinc levels. This Case Study describes a patient whose copper-deficiency myeloneuropathy was secondary to long-term use of a denture cream that contained high levels of zinc.
Dinakar and Höke report on the case of a woman who presented to a neuromuscular clinic with a history of progressive stiffening and painful spasms of the lower extremities. The patient was diagnosed with paraneoplastic fasciitis–panniculits syndrome associated with recurrence of gastric adenocarcinoma. The symptoms improved on initiation of chemotherapy and worsened on discontinuation of chemotherapy.
