February 2019
In this Issue
Multiple Sclerosis & Demyelinating Disorders
A Coming of Age for Neuroimmunology
GUEST MEDICAL EDITOR’S PAGE
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
COVER FOCUS: MULTIPLE SCLEROSIS & DEMYELINATING DISORDERS

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
COLUMNS
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
SPOTLIGHT TOPIC: PRACTICE MANAGEMENT

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 REPORTS

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.