This week in Neurology® Highlights of the Current Issue
Generic antiepileptic drugs and associated medical resource utilization in the United States The authors observed patients with epilepsy treated with carbamazepine, gabapentin, phenytoin, primidone, or zonisamide (18,125 patients in the stable group, 15,500 patients in the unstable group). They found that generic antiepileptic drug use was associated with significantly greater medical utilization and risk of epilepsy-related medical events, compared to brand use. See p. 1566 ;and Editorial, p. 1562
Hippocampal abnormalities in malformations of cortical development: MRI study The authors identified 224 consecutive patients with epilepsy and malformations of cortical development, from the Epilepsy Units at Innsbruck Medical University, Austria (2002� 2008). They found that one-third of these patients had hippocampal abnormalities that may be related to malformations of cortical development or acquired during the course of epilepsy. See p. 1575
Tourette syndrome is associated with recurrent exonic copy number variants The authors performed a genome-wide screening of single nucleotide polymorphism using microarrays to identify recurrent or de novo rare exonic copy number variants (CNVs) in 111 patients with Tourette syndrome. They found rare, recurrent, exonic CNVs in a subset of patients with Tourette syndrome. See p. 1583;and Editorial, p. 1564
APOEε4 and the cognitive genetics of multiple sclerosis Using a case-control design, 50 patients with the ε4 allele (ε4+) and 50 ε4-negative (ε4-) patients were tested using a comprehensive battery of tests evaluating the cognitive domains most often affected in multiple sclerosis. This study reveals that the APOEε4 gene is not linked to cognitive problems in patients with multiple sclerosis. See p. 1611
Cerebrovascular hemodynamics, gait, and falls in an elderly population: MOBILIZE Boston Study This study consisted of 419 individuals from the MOBILIZE Boston Study who had transcranial Doppler ultrasound measures of cerebral blood flow velocity. The authors found that impaired cerebral blood flow regulation, as measured by cerebral vasoreactivity to CO2, was associated with slow gait speed and may lead to the development of falls in elderly people. See p. 1627
A cluster-randomized trial to improve stroke care in hospitals In this cluster-randomized controlled trial, 19 hospitals were randomized with a total of 1,211 acute ischemic stroke cases preintervention and 1,094 cases postintervention. The results found the potential fallacy of using historical controls for evaluating quality improvement interventions. See p. 1634CLINICAL/SCIENTIFIC NOTES: Giant cell arteritis of the basal cerebral arteries: Correlation of MRI, DSA, and histopathology A 59-year-old otherwise healthy woman without apparent vascular risk factors initially presented with moderate rightsided hemiparesis. The constellation in this case suggested another distinct manifestation of giant cell arteritis with predilection for the basal cerebral arteries.