Volume 7 Issue 9, September 2011

Othello syndrome, as demonstrated by Shakespeare's fictional character of that name, describes individuals with severe delusional jealousy. Retrospective analysis of data from patients with this syndrome suggests that it is frequently associated with neurological disorders, particularly those affecting the right frontal lobe. What are the implications of these findings?

The diagnosis of rapidly progressive dementias (RPDs), particularly sporadic Jakob–Creutzfeldt disease (sCJD), can prove challenging. Treatable RPDs can mimic sCJD, which is currently untreatable. A recent review of a large cohort of patients with suspected CJD highlights the extent of misdiagnosis and possible sources of error.

Subthalamic nucleus deep brain stimulation (STN DBS) is an effective treatment for Parkinson disease. Although the breadth and severity of neurobehavioral changes with STN DBS is debated, the frequency of serious adverse events is probably low. New research has identified patient characteristics that predict cognitive and emotional morbidity after STN DBS.

Early supported discharge (ESD) is a model of stroke care that decreases the inpatient length of stay and provides superior functional benefit compared with inpatient rehabilitation. Recently published consensus guidelines from a panel of ESD trialists provide a practical blueprint for implementing the ESD model and measuring its effectiveness.

As the mortality rates of premature and newborn babies have decreased, the incidence of neurological morbidity in these neonates has increased. Bonifacio et al. highlight advances in the care of neonates who have sustained a neurological insult, discussing available treatments and therapies, and the utility of brain monitoring techniques to predict long-term neurological outcomes. They also present a new model of care for the treatment of neonates with brain injury.

Brain tumors are among the most common childhood cancers and are the leading cause of cancer-related childhood mortality. In this Review, Pollack and Jakacki describe the clinical presentation, diagnosis and management of childhood brain tumors, with a particular focus on how treatment of the most common subtypes of childhood brain tumors has evolved over time, and the future approaches that could lead to improved outcome for these pediatric patients.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic autoimmune neuropathy. In this Review, Marinos Dalakas provides an update on the diagnosis of this disease, including recently devised consensus criteria. CIDP treatments—primarily corticosteroids, intravenous immunoglobulin and plasmapheresis—and ongoing challenges in trial design are discussed, together with potential therapeutic approaches that are emerging from advances in our understanding of the underlying immunopathology of this disease.

Pain is common in patients with multiple sclerosis (MS) and can be difficult to diagnose and manage. Solaro and Messmer Uccelli provide a summary of the available data on pharmacological approaches to pain management in MS, including the different treatment options for neuropathic and nociceptive pain, and highlight the need for further clinical trials in this field.

Many individuals with Parkinson disease (PD) adopt a sedentary lifestyle as a result of the motor and nonmotor complications associated with the disease. In this article, Speelman et al. discuss 10 reasons why exercise may be of benefit to patients with PD, suggesting that increased levels of physical activity can have disease-specific and, potentially, disease-modifying effects. The limitations and obstacles to changing the sedentary lifestyles of patients with PD are also discussed.