Patients with severe, progressive multiple sclerosis (MS) have complex physical and psychosocial needs, typically over several years. Few treatment options are available to prevent or delay further clinical worsening in this population. The objective was to develop an evidence‐based clinical practice guideline for the palliative care of patients with severe, progressive MS.

Charcot‐Marie‐Tooth (CMT) constitutes a group of heterogeneous hereditary motor and sensor neuropathies. Mutations in in the periaxin (PRX) gene cause CMT4F with an autosomal recessive (AR) early‐onset demyelinating neuropathy and are extremely rare in non Romani Caucasian population.

Multiple studies suggested an immunomodulatory role of cholesterol. We investigated whether cholesterol levels are associated with the risk of infectious complications (IC) in patients with acute ischemic stroke.

In December 2019 an epidemic outbreak of a new virus disease in the Chinese area of Wuhan was reported. The new disease caused primarily symptoms of a respiratory tract infection with cough, shortness of breath, and viral pneumonia. The clinical spectrum showed mostly mild symptoms with some patients developing bilateral pneumonia needing partly intensive care treatment and causing death(1). It became

We agree with Zheng and colleagues that a statistical measure of heterogeneity is an important consideration in selecting a fixed or random effects model. However, it should not be considered the sole criterion. In meta‐analyses that include small numbers of trials, such as ours, results of tests for heterogeneity should be interpreted with caution, as they may be underpowered. A fixed effects model

We read with great interest the article “COVID‐19: what if the brain had a role in causing the deaths?” by Tassorelli and co‐workers, in which the authors generate and summarize hypotheses how SARS‐CoV‐2 may enter the peripheral and central nervous system and cause life‐threatening complications [1]. With this letter we would like to contribute to this discussion by highlighting how different complications

BACKGROUND It is currently unknown whether mechanical thrombectomy (MT) for ischemic stroke patients with low initial Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is clinically beneficial or even harmful. The purpose of this study was to investigate whether failed or incomplete MT in acute LVO stroke with an initial ASPECTS≤5 is associated with worse clinical outcome compared to

We thank our colleagues for their constructive discussion on our recently published study1 . Regarding prevalence, indeed, growing literature yields a variable frequency of loss of smell (LOS) in Covid-19 patients, that may be hypothetically due to differences in the location and amount of viral load, to the different immune response between younger mild-symptomatic outpatients (higher prevalence)

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is rapidly spreading worldwide, and the WHO declared its pandemic nature on 11th March 20201 . The outbreak has hit Europe and, as of April 19, 2020, Italy has the third largest number of confirmed cases, namely a total of 175,925 cases and 23,227 deaths according to the John Hopkins University2 . This is the largest health and economic emergency

BACKGROUND AND PURPOSE The COVID epidemic is affecting individuals worldwide, and Alzheimer's disease (AD) and amnesic mild cognitive impairment (MCI) patients are at risk due to their characteristics and age. We analysed the impact of the pandemic on these patients' neuropsychiatric symptoms and their quality of life after five weeks of lockdown in Spain. METHODS We tested 40 subjects with a diagnosis

BACKGROUND Varicella-zoster virus (VZV) is a human neurotropic virus that remains in a latent state within ganglionic neurons throughout the entire neuroaxis after the primary infection. Whenever herpes zoster leads to trigeminal involvement, the ophthalmic division is the most implicated. COVID-19 emerged as a viral cause of severe acute respiratory syndrome that spread all over the world in the last

We read, with interest, the paper entitled "Acute-onset smell and taste disorders in the context of Covid-19: a pilot multicenter PCR-based case-control study". The authors observed that sudden loss of smell (LOS) was significantly more frequent in Covid-19 patients (39%) than those infected with influenza (12%). These data corroborated the results of Yan et al.

BACKGROUND Little evidence exists to describe incidence and risk factors for dementia in developing countries. This study aimed to examine the incidence and factors associated with therisk of developing dementia in a Thai general population. METHODS Data on 206,073 men and women aged ≥50 years participating in the Health Check Ubon Ratchathani Project in 2006 were merged with diagnostic information

OBJECTIVE To clarify the causal associations of interleukin-1 receptor antagonist and interleukin-2 receptor alpha subunit with the risk of amyotrophic lateral sclerosis. METHODS A two-sample Mendelian randomization study design was employed. Single-nucleotide polymorphisms associated with interleukin-1 receptor antagonist (n=2) and interleukin-2 receptor alpha subunit (n=1) at the genome-wide significance

OBJECTIVE As a major antioxidant, uric acid (UA) is known to be associated with the clinical progression of Parkinson's disease (PD). This study investigated whether baseline UA levels are associated with the risk for levodopa-induced dyskinesia (LID) in PD in a sex-dependent manner. METHODS We enrolled 152 patients with de novo PD (78 males and 74 females) who were followed up for > 2 years. The effect

With great interest, we read the article by Costello M et al. entitled "Effect of non-vitamin-K oral anticoagulants on stroke severity compared to warfarin: a meta-analysis of randomized controlled trials." published in the March 2020 issue of European Journal of Neurology 1 . The study is of profound academic importance, and there are some points we would like to address. In the section "Statistical

BACKGROUND The differentiation of Alzheimer's disease (AD) dementia from vascular dementia (VaD), and mixed-type dementia requires stepwise analysis and usually occurs late in the disease process. Early diagnosis and therapy monitoring would benefit greatly from the identification of biomarkers of neurodegeneration, especially blood biomarkers. To this end, the aim of this pilot study was to investigate

BACKGROUND To reduce the diagnostic gap of dementia, 3 strategies can be employed for case-finding of cognitive impairment in ambulatory-care-settings, namely using informant-report, brief-cognitive-test, or combination of informant-report and brief-cognitive-test. The right strategy to adopt-across different healthcare settings-remains unclear. This diagnostic study compared the performance of the

BACKGROUND Neurological manifestations have been identified in the context of autoimmune hepatitis (AIH). Previous case reports highlighted the association between AIH and sensory neuronopathy (SN). Despite that, little is known about the frequency of AIH-related SN and its clinical/neurophysiological profile. Moreover, it is not clear whether SN is an AIH-specific manifestation or related to chronic

BACKGROUND Malignant MCA infarction (MMI) is a severe complication of acute ischemic stroke (AIS). The aim of our study was to assess whether successful reperfusion after endovascular therapy (EVT) in AIS with clinical and imaging predictors of MMI decreased its occurrence. METHODS Data were collected between January 2014 and July 2018 in a monocentric prospective AIS registry of patients treated with

OBJECTIVE Amyotrophic lateral sclerosis (ALS) is a motor neuron disorder, although extramotor degeneration is well recognized, especially in frontotemporal regions manifest as ALS with frontotemporal dementia (ALS-FTD). Previous neuroimaging studies of brains of ALS-FTD patients have measured abnormalities of either grey matter (GM) or white matter (WM) structures but not of both together. Therefore

BACKGROUND Acute ischemic stroke (AIS) is a vital cause of mortality and morbidity in China. Many AIS patients develop early neurological deterioration (END). This study was aimed to construct a nomogram to predict END in AIS patients. METHODS AIS patients in Nanjing First Hospital were recruited as the training cohort. Additional patients in Nantong Third People's Hospital were enrolled as the validation

BACKGROUND The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication-overuse headache (MOH). METHODS Based on the available literature in this guideline, the first step in patient management is education and counselling. RESULTS Patients with MOH should be managed by a multidisciplinary team of neurologists or pain specialists and

BACKGROUND AND PURPOSE The intracerebral hemorrhage ( ICH) score is the most widely used and validated prognostic model for estimating 30-day mortality in ICH. However, the score was developed and validated in a ICH population probably not using oral anticoagulants (OAC). The aim of this study was to determine the performance of the ICH score for predicting 30-day mortality rate in the full range of

Since the COVID-19 pandemic stormed into the healthcare systems worldwide, protected stroke pathways have been suggested, in order not to spread the viral infection and ensure hyper-acute treatment. Noteworthy, patients with acute ischemic stroke are at high-risk for contracting SARS-CoV-2 virus, particularly the severe form, because COVID-19 and cerebrovascular diseases share common risk factors.

BACKGROUND The silent progression of patients with multiple sclerosis (MS) has been reported. The aim of this study was to investigate the association between brain atrophy rates and disease-modifying drugs (DMDs) in patients with MS during their relapse-free period. METHODS Patients with relapsing-remitting MS were classified into two groups on the basis of clinical records: a 1st -generation DMD

BACKGROUND OnabotulinumtoxinA is an effective preventive treatment for chronic migraine. In chronic migraine, besides a reduction in headache frequency, a decreased reliance on oral prophylactics is also indicative of treatment effectiveness. This study aimed to quantify the change in the use of oral prophylactics after treatment with onabotulinumtoxinA in patients with chronic migraine. METHODS This

BACKGROUND The best therapeutic approach for aggressive relapsing-remitting multiple sclerosis (RRMS) remains unknown. OBJECTIVE To compare efficacy and safety of autologous haematopoietic stem cell transplantation (aHSCT) and alemtuzumab in aggressive RRMS. METHODS Time-to-first relapse, time-to-confirmed disability worsening, time-to-first evidence of MRI activity and time-to-first evidence of disease

Each year, between 1.1 and 1.5 million Europeans have a stroke1 . Two to three out of 10 patients die as a consequence of it and about one third remains functionally dependent2 . As we know, the likelihood of a favourable outcome in this disease relies heavily on patients presenting promptly after symptoms onset and on hospitals providing immediate access to optimized stroke care.

The burden of neurological disorders is increasing at a fast pace due to population growth and ageing. Therefore, the mission of the European Academy of Neurology (EAN) to foster and support the development of neurological excellence in Europe and across the world, leading to better patient care and outcomes, is urgent. This requires continuing medical education and professional development for all

INTRODUCTION Infections with coronaviruses are not always confined to the respiratory tract and various neurological manifestations have been reported. The aim of this study was to perform a review to describe neurological manifestations in patients with COVID-19 and possible neuro-invasive mechanisms of Sars-CoV-2. METHODS Pubmed, WebOfScience and Covid-dedicated databases were searched for the combination

BACKGROUND Posthypoxic movement disorders and chronic posthypoxic myoclonus are rare complications after cardiac arrest in adults. Our study investigates the clinical spectrum, neuroimaging results, therapy and prognosis of these debilitating posthypoxic sequelae. METHODS This retrospective study included 72 patients from the neurological intensive care unit at a University Hospital, who were diagnosed

BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) is a clinical entity without established pathological hallmarks. Previous autopsy studies reported that patients with an ante-mortem diagnosis of iNPH had different post-mortem diagnosis, commonly progressive supranuclear palsy (PSP). Disproportionately enlarged subarachnoid space hydrocephalus (DESH) has been reported as a characteristic feature

In the article [1] by Lorscheider et al., the affiliation of Alessandra Lugaresi should be amended in accordance with administrative changes in the institution. Her correct affiliation should be: cDepartment of Biomedical and Neuromotor Sciences, University of Bologna and IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

BACKGROUND Autoimmune encephalitis (AE) represents a complex syndrome with diverse clinical manifestations and therapeutic outcomes. Aim of this study is to report the clinical characteristics and the long-term outcome of patients with paraneoplastic and idiopathic AE. METHODS All patients with subacute encephalopathy admitted to the Neurology Department of our Institution from January 2012 to May

The first international Neurological Congress took place in Bern, Switzerland, in 1931 with the participation of 42 countries from 4 continents1 . The World Federation of Neurology was founded in 1957, while the European Neurological Society (ENS, 1986) and the European Federation of Neurological Societies (EFNS, 1991) came much later2 .

In the last few weeks Italy first, and then several other countries across the world, have been swept up by the deadly wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the illness named COVID-19, from the acronym CO (corona) VI (virus) D (disease) and 19 (year of the virus identification). The medical community is working day and night to assist affected people

STUDY OBJECTIVES The objective of the study was to investigate the relationship between IL1R2 rs34043159 and Alzheimer's disease (AD) in Chinese population. METHODS A total of 500 AD patients and 500 healthy controls were recruited. SNaPshot technique were used to detect IL1R2 rs34043159. RESULTS The dominant and recessive model of IL1R2 rs34043159 were associated with AD with or without adjustment

BACKGROUND Argyrophilic grain disease (AGD) is a limbic-predominant 4R-tauopathy. AGD is thought to be an age-related disorder and is frequently detected as concomitant pathology with other neurodegenerative conditions. There is a paucity of data on the clinical phenotype of pure AGD. In elderly patients, however, AGD pathology frequently associates with cognitive decline, personality changes, urine

Coronavirus disease 2019 (CoViD-19) pandemic is strongly impacting all domains of our healthcare systems, including rehabilitation. In Italy, the first hit European country, medical activities were postponed to allow shifting of staff and facilities to intensive care, with neurorehabilitation limited to time-dependent diseases,1 including CoViD-19 complications.2,3 Hospital access to people with chronic

BACKGROUND Systematic research on the effect of Charcot-Marie-Tooth (CMT) disease on the outcome of pregnancy and conversely the effect of pregnancy on neuropathy is still sparse. METHODS A clinical cohort study and cross-sectional study within the German CMT NET was conducted between 2016 and 2019. Inclusion criteria were a confirmed diagnosis of CMT and at least one completed pregnancy after 1990

BACKGROUND Acute vestibular symptoms have a profound impact on patients' well-being. In this study, health-related quality of life (HRQoL) and functional impairment were investigated prospectively in patients with different peripheral and central vestibular disorders during the acute symptomatic stage to decipher the most relevant underlying factors. METHODS 175 patients with acute vestibular disorders

BACKGROUND Despite Labrune syndrome is a well-known disorder characterized by a typical neuroradiological triad, namely leukoencephalopathy, intracranial calcifications and cysts, there are no reports of systemic involvement in such disorder. This paper attempts to describe a peculiar clinical manifestation related to a novel mutation in SNORD118 gene. METHODS Clinical examination, brain and total-body

BACKGROUND AND PURPOSE A recently proposed pre-dementia syndrome, motoric cognitive risk (MCR) syndrome, is characterized by cognitive complaints and slow gait, and increases the risk of dementia and mortality. The aim of the present study was to explore the prevalence of and factors associated with MCR syndrome in elderly community-dwelling Chinese subjects. METHODS The Ningbo Community Study on Aging

BACKGROUND AND PURPOSE Trimethylamine-N-oxide (TMAO) is a biomarker of the gut microbiome and correlates with the risk of cardiovascular diseases. However, conflicting data exist on the specific role of TMAO in ischaemic stroke patients. We aimed to analyze the time course of TMAO levels in stroke patients compared with controls. METHODS In this prospective, case-control study, patients suffering from

Coronaviridae (CoVs) are single stranded RNA viruses. βeta-CoVs encompasses Bat coronavirus (BCoV), the human Severe Acute Respiratory Syndrome (SARS) virus and the Middle Eastern Respiratory Syndrome (MERS) virus. In December 2019, a new βeta-CoVs was identified in Wuhan, China, SARS-CoV-2. The genome sequencing demonstrated a 79.5% and 96.2% identity to SARS-CoV and a bat CoV genome, respectively

BACKGROUND A wide variety of metabolic changes, including an increased incidence of diabetes mellitus (DM) and dyslipidaemia, has been described in amyotrophic lateral sclerosis (ALS). The aim of this study was to investigate the associations of statin use and history of DM with onset of disease and survival in patients with ALS. METHODS 501 patients (mean age: 65.2 ± 10.9 years; 58.5% male) from the

OBJECTIVE Essential tremor (ET) is a movement disorder primarily characterized by upper limb postural and kinetic tremor. Although still under-investigated, bradykinesia may be part of the phenotypic spectrum of ET. We aimed to evaluate bradykinesia features in ET through clinical examination and kinematic analysis of repetitive finger movements. We compared data collected in ET patients with those

BACKGROUND Data on rates of newly diagnosed depression after multiple sclerosis (MS) diagnosis are sparse. Here, we describe incident, treated depression in MS patients after diagnosis compared with matched non-MS patients. METHODS We conducted a matched cohort study in two separate electronic medical databases: United States Department of Defense (US-DOD) military health care system and United Kingdom's

BACKGROUND To investigate whether female reproductive factors are associated with dementia. METHODS We identified 4,696,633 postmenopausal women without dementia using the Korean National Health Insurance System database. Data on reproductive factors were collected using self-administered questionnaire. Dementia was determined using dementia diagnosis codes and anti-dementia drugs prescription. Cox

BACKGROUND To date, no study attempted to quantify the impact of the Covid-19 outbreak on incidence and treatment of acute stroke. MATERIALS AND METHODS Retrospective review of acute stroke pathway parameters in all three stroke units in the Alsace region during the first month of the outbreak (1-31 March 2020), using the similar period from 2019 as a comparator. A secondary detailed analysis of all

Functional neurological disorder (FND), is the second most common reason for referral to a neurologist. Despite being potentially treatable, FND remains underdiagnosed and associated with high levels of disability and distress. In this article, we address ten common myths about FND that continue to obstruct the diagnosis and treatment for these patients, and present them with accompanying lessons for

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulting in severe acute respiratory syndrome in a substantial number of patients. Approximately 5% to 10% of patients need intensive care unit (ICU) admission and mechanical ventilation [1]. The primary symptoms of COVID-19 include fever, dry cough and fatigue [2]. However

One relevant feature of the Covid-19 disease is the absence of dyspnea, described as 'shortness of breath' or 'an unpleasant urge to breathe'. The lack of dyspnea is observed even in the most severe cases, in which subjects present tachypnea and tachycardia. In the Wuhan cohort, 62.4% of severe cases and 46.3% of those who ended up intubated, ventilated or dead did not present dyspnea[1,2].

BACKGROUND AND PURPOSE Distal hereditary motor neuropathies (dHMNs) are a clinically and genetically heterogeneous group of disorders. The purpose of this study was to identify the genetic distribution of dHMNs in a large cohort of Chinese patients and provide insight into the underlying common pathophysiology of dHMNs. METHODS Multi-gene panel testing or whole-exome sequencing was performed in 70

BACKGROUND AND PURPOSE The objective of this study was to investigate the association between body mass index (BMI) and both initial stroke severity at presentation and functional outcomes after acute ischemic stroke (AIS) in patients with non-valvular atrial fibrillation (NVAF). METHODS Patients were categorized on the basis of their BMI into underweight (BMI<18.5, n=111), normal (18.5≤BMI<25, n=1036)

BACKGROUND Intracerebral hemorrhage (ICH) is a devastating presentation of Cerebral Amyloid Angiopathy (CAA), but mechanisms leading from vascular amyloid deposition to ICH are not well known. We investigated whether amyloid burden and MRI markers of small vessel disease (SVD) are increased in the ICH-affected hemisphere compared to ICH-free hemisphere in patients with a symptomatic CAA-related ICH

BACKGROUND Nerve tissue alterations have been rarely quantified in Charcot Marie Tooth type 1A (CMT1A) patients. The aim of the present study was to quantitatively assess the MRI anomalies of the sciatic and tibial nerves in CMT1A disease using quantitative neurography MRI (qMRI). We also intended to seek for correlations with clinical variables. METHODS qMRI was used in order to assess differences

BACKGROUND AND PURPOSE Clinical decision making is facilitated by healthcare professionals' and patients' adequate knowledge of the adverse events. This is especially important for biologicals used for treating multiple sclerosis (MS). So far, little is known about whether different information sources report adverse events consistently. METHODS Biologicals authorized by the European Medicines Agency

BACKGROUND Diagnosis of rare movement disorders (MD) is difficult and specific management programs are not well defined. Thus, in order to capture and assess care needs, the European Reference Network for Rare Neurological Diseases (ERN-RND) has performed an explorative care need survey across all European Union (EU) countries. METHODS This is a multicenter, cross-sectional study. A survey about the