This edition of US Neurology covers a variety of themes important to practicing clinicians. Management matters involving multiple sclerosis (MS), stroke, Parkinson’s disease (PD), and brain trauma are emphasized.
Maintaining mobility is a major goal in MS treatment. In the first article in this issue, mobility concerns of patients with MS relevant to nurses are presented in detail based on US patient populations surveys. This chapter provides a framework for considering the management and interventions that follow. Management of motor symptoms in MS involves assessment and treatment of spasticity, weakness, and cerebellar disorders. These are thoroughly considered in the chapter on Management of Motor Symptoms in Multiple Sclerosis. Falls are a major worry in patients with MS and fall prevention is a central theme of the third article of this volume. Finally, symptomatic treatment of MS has made substantial progress in recent years and is emphasized in the final section of the MS discussions. Treatment of motor symptoms, bladder symptoms, and neuropsychiatric complications are among the salient symptomatic management challenges.
Stroke is a major threat to an aging population. Cognitive syndromes are particularly common with stroke; stroke may be a predecessor of a progressive dementia syndrome and combined cerebrovascular and neurodegenerative disorders are often seen. Cognitive impairment with lacunar strokes are considered in the first chapter on the section on stroke in this edition. Critical to minimizing the risk and consequences of stroke is proper nutrition. This often overlooked area is discussed in the second stroke article of US Neurology.
PD is a major area of study among neurodegenerative disorders. Biomarkers have emerged as critical to early diagnosis, tracking disease progression, and drug development in neurodegenerative conditions. The first chapter on the section of movement disorders presents advances in magnetic resonance imaging biomarkers and their contribution in characterizing PD. This is followed by a discussion of dopamine agonists and impulse control disorders in PD. Disturbances in impulse control have been associated with dopamine agonists and with other therapies for PD and have been an increasing focus of attention in PD management.
Autoimmune encephalitis provides an insight into the relationship between immune function, antibodies, and immunotherapy for neurologic disorders. The chapter on antibody targets and their potential pathogenicity in immunotherapy-responsive syndromes is discussed and provides insight into the relationship between autoimmune disorders and immunotherapy.
Mild traumatic brain injury (TBI) in combat is common among military personnel. Many individuals serving in Afghanistan, Iraq, and other theaters of war suffer mild TBI in association with blast-related concussion injuries. The phenomenology associated with these blast injuries is receiving careful scrutiny and visual dysfunction associated with them is presented in the final section of this journal.
Together, these chapters provide a comprehensive update on advances in understanding a variety of neurologic disorders and will assist physicians in their patient assessment and management decisions.
US Neurology would like to take this opportunity to thank all participants on this edition, from organizations to individuals. A special thanks goes to our editorial board for their continuing support and invaluable guidance and the biggest thanks is reserved for the expert authors, who spared precious time and effort to produce a perceptive selection of articles. This expert discussion and the wide variety of topics covered ensure there is much of interest for every reader and we hope you find this edition as useful and insightful as those before it.