February 2019


In this Issue

Multiple Sclerosis & Demyelinating Disorders

A Coming of Age for Neuroimmunology



A Coming of Age for Neuroimmunology

Increasingly complex diagnostics and highly effective disease-modifying therapy come with challenges in clinical decision making.

By Aaron M. Carlson, MD


Multiple Sclerosis Misdiagnosis

Accurate diagnosis requires correspondence to typical clinical syndromes, correct interpretation of radiologic and CSF data, and thorough evaluation for mimics.

By Alexandra Galati, MD; and Marwa Kaisey, MD

POINT-COUNTERPOINT: Natalizumab Extended-Interval Dosing

Optimism vs caution for using extended-interval dosing to prevent progressive multifocal leukoencephalopathy.

By David B. Clifford, MD; and John F. Foley, MD

Emerging Therapies for Progressive Multiple Sclerosis

A number of agents with putative neuroprotective effects have shown promise in recent clinical trials.

By Matthew Tremblay, MD, PhD

Maintaining Ambulation

Physical therapy, exercise, physical activity, and medications adapted to individual needs can all help maintain the ability to walk.

By Michelle H. Cameron, MD, PhD, MCR; and Ylva E. Nilsagård, PT, PhD

Immunopathogenesis of Multiple Sclerosis

Disruption of immune tolerance, inflammation, and blood-brain–barrier breach lead to demyelination and axonal injury.

By Ye Hu, MD; Neeta Garg, MD; and Kottil W. Rammohan, MD

Pediatric-Onset Multiple Sclerosis

Information from clinical trials in children with MS is furthering understanding and improving treatment options for this rare presentation.

By Duriel I. Hardy, MD; and Brenda L. Banwell, MD

Neuromyelitis Optica Spectrum Disorders

It is critical to maintain a high index of suspicion for these conditions when evaluating a patient with demyelination to avoid delays in treatment.

By Michael J. Bradshaw, MD; and Dorlan Kimbrough, MD


Hometown Highlights: Congenital Myasthenic Syndromes

With careful diagnosis, treatment can improve symptoms of congenital myasthenic syndromes.

By Andrew G. Engel, MD

Headache Horizons: Migraine Work in Translation

From discovery of CGRP to the monoclonal antibodies of today and -gepants of tomorrow, basic science has been translated to clinical progress over just 3 decades.

With Richard B. Lipton, MD

Epilepsy Essentials: New-Onset Refractory Status Epilepticus

Recognizing NORSE as a clinical presentation is meant to lead to improved research and communication that hopefully may improve outcomes eventually.

By Michelle L. Doughtery, MD, FAAN, FAES

Stroke Snapshot: Patient Triage in the Era of Thrombectomy

Stroke systems of care need to advance as stroke care has.

By Digvijaya Navalkele, MD, MPH; and Sheryl Martin-Schild, MD, PhD


Maintenance of Certification

Do we have a certified crisis in medicine?

By Paul G. Matthew, MD, DNBPAS, FAAN, FAHS

A Neurologist Goes to Business School

How I addressed a relative lack of training in practice management and business aspects of providing health care to better help the patients I serve.

By Eddie Patton, Jr, MD, MBA, MS


Case Challenge: Behavior Changes, Seizures, and Hyponatremia

Extensive workup is necessary when evaluating individuals with seizures and behavioral changes.

By Elena Grebenciucova, MD

Case Report: A Woman with Tinnitus and Tongue Atrophy

Glomus tumors, the great masquerader, have variable presentation and multiple treatment options.

By Jason A. Ellis, MD; Tejaswi D. Sudhakar; Asif Rahman; Rafael A. Ortiz, MD; David J. Langer, MD; John A. Boockvar, MD; and Steven Mandel, MD

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About Practical Neurology

Launched in 2002, Practical Neurology is a publication uniquely dedicated to presenting current approaches to patient management, synthesis of emerging research and data, and analysis of industry news with a goal to facilitate practical application and improved clinical practice for all neurologists. Our straightforward articles give neurologists tools they can immediately put into practice.