Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.02.79
K. Fheodoroff, J. Jacinto, A. Geurts, F. Molteni, Jorge Hernandez Franco, T. Santiago, R. Rosales, J. Gracies
Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity. The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients℉ quality of life, by affecting their ability to perform normal activities. This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services. The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients℉ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.
{"title":"How Can We Improve Current Practice in Spastic Paresis?","authors":"K. Fheodoroff, J. Jacinto, A. Geurts, F. Molteni, Jorge Hernandez Franco, T. Santiago, R. Rosales, J. Gracies","doi":"10.17925/ENR.2016.11.02.79","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.02.79","url":null,"abstract":"Spastic paresis can arise from a variety of conditions, including stroke, spinal cord injury, multiple sclerosis, cerebral palsy, traumatic brain injury and hereditary spastic paraplegia. It is associated with muscle contracture, stiffness and pain, and can lead to segmental deformity. The positive, negative and biomechanical symptoms associated with spastic paresis can significantly affect patients℉ quality of life, by affecting their ability to perform normal activities. This paper – based on the content of a global spasticity interdisciplinary masterclass presented by the authors for healthcare practitioners working in the field of spastic paresis – proposes a multidisciplinary approach to care involving not only healthcare practitioners, but also the patient and their family members/carers, and improvement of the transition between specialist care and community services. The suggested treatment pathway comprises assessment of the severity of spastic paresis, early access to neurorehabilitation and physiotherapy and treatment with botulinum toxin and new technologies, where appropriate. To address the challenge of maintaining patients℉ motivation over the long term, tailored guided self-rehabilitation contracts can be used to set and monitor therapeutic goals. Current global consensus guidelines may have to be updated, to include a clinical care pathway related to the encompassing management of spastic paresis.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":"79"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67592080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.16
Tandokazi Quvile, J. Wilmshurst
Children with epilepsy commonly suffer additional and significant neurological co-morbidities. Epilepsy syndromes can be associated with specific cognitive and behavioural phenotypes which can aid diagnosis. Early recognition and intervention of both epilepsy and the associated comorbidities can lead to improved neurocognitive outcomes. Intrinsic connectivity networks are influenced by multiple modalities including the stage of brain maturation in early onset epilepsies and epileptiform activity with resultant impact on neurocognitive function.
{"title":"Comorbidities Affecting Children with Epilepsy – Not a Novel Entity but New Insights Could Improve Holistic Care","authors":"Tandokazi Quvile, J. Wilmshurst","doi":"10.17925/ENR.2016.11.01.16","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.16","url":null,"abstract":"Children with epilepsy commonly suffer additional and significant neurological co-morbidities. Epilepsy syndromes can be associated with specific cognitive and behavioural phenotypes which can aid diagnosis. Early recognition and intervention of both epilepsy and the associated comorbidities can lead to improved neurocognitive outcomes. Intrinsic connectivity networks are influenced by multiple modalities including the stage of brain maturation in early onset epilepsies and epileptiform activity with resultant impact on neurocognitive function.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.18
T. Reiff, C. Gumbinger, S. Mundiyanapurath, P. Ringleb
Carotid stenosis is a risk factor of ischaemic stroke and has an increasing prevalence with age. Stroke risk under optimised medical therapy, as well as recommendations of carotid artery endarterectomy/stenting, as therapy in high risk carotid stenosis, are discussed in consideration of recent research results.
{"title":"Update on Extracranial Carotid Stenosis","authors":"T. Reiff, C. Gumbinger, S. Mundiyanapurath, P. Ringleb","doi":"10.17925/ENR.2016.11.01.18","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.18","url":null,"abstract":"Carotid stenosis is a risk factor of ischaemic stroke and has an increasing prevalence with age. Stroke risk under optimised medical therapy, as well as recommendations of carotid artery endarterectomy/stenting, as therapy in high risk carotid stenosis, are discussed in consideration of recent research results.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.20
S. Agarwal, J. Fleisher
Much of the clinical and research attention for Parkinson's Disease (PD) has focused on mild to moderate stages. As the disease advances, it can become difficult for patients to attend clinical visits. These patients are often lost to follow-up, and consequently, vanish from the pool of potential research subjects who could inform our management of this understudied population. We aim to increase awareness about this population and potential interventions to improve continuity of care and foster research in advanced PD.
{"title":"Reaching Those Most in Need - A Call to Action for Advanced Parkinson's Disease.","authors":"S. Agarwal, J. Fleisher","doi":"10.17925/ENR.2016.11.01.20","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.20","url":null,"abstract":"Much of the clinical and research attention for Parkinson's Disease (PD) has focused on mild to moderate stages. As the disease advances, it can become difficult for patients to attend clinical visits. These patients are often lost to follow-up, and consequently, vanish from the pool of potential research subjects who could inform our management of this understudied population. We aim to increase awareness about this population and potential interventions to improve continuity of care and foster research in advanced PD.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1 1","pages":"20-21"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.22
J. Reuck
{"title":"Post-mortem Magnetic Resonance Imaging as an Additional Tool of the Neuropathological Examination of Neurodegenerative and Cerebrovascular Diseases","authors":"J. Reuck","doi":"10.17925/ENR.2016.11.01.22","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.22","url":null,"abstract":"","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.41
P. Vermersch, R. Gold, C. Holloway, À. Rovira, G. Giovannoni, M. Toumi
In Europe, despite recent therapeutic advances, there are many deficiencies in the management of multiple sclerosis (MS). Diagnostic and monitoring measures, guidelines, development of new treatments and best practice care are often suboptimal. These shortcomings were discussed at two MS multi-stakeholder colloquia that were convened in Brussels, Belgium in May 2014 and May 2015, and gathered experts from a range of different specialities to identify the key issues and propose means of tackling them. After considering all the testimony and discussion, the organising committee drew up a list of 10 calls to action, which included: increase awareness and understanding in the EU about the burden of MS; obtain better insights into the direct and indirect cost burden of MS; (re)define treatment goals and clinical study endpoints; develop new tools to better capture the total clinical burden of MS; develop a protocol to standardise magnetic resonance imaging (MRI); develop biomarkers of treatment response prediction and disability progression; integrate drug licensing and cost-effectiveness decision-making processes; develop separate European Medicines Agency guidelines for evaluating follow-on products of non-biological complex drugs and biologicals; implement a set of evidence-based standards of care and incentives to support people with MS to remain physically and mentally active. Addressing these ambitious calls to action requires cooperation from various health bodies and governments and some will require additional funding, but they are achievable and worthwhile. They would help minimise disease impact and would reduce disease progression and the consequent burden on people with MS, their caregivers, and on health budgets. These calls to action set out a strategy for future MS management and should be acted upon with urgency.
{"title":"Multi-stakeholder Colloquium – Opportunities and Challenges in Multiple Sclerosis Management","authors":"P. Vermersch, R. Gold, C. Holloway, À. Rovira, G. Giovannoni, M. Toumi","doi":"10.17925/ENR.2016.11.01.41","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.41","url":null,"abstract":"In Europe, despite recent therapeutic advances, there are many deficiencies in the management of multiple sclerosis (MS). Diagnostic and monitoring measures, guidelines, development of new treatments and best practice care are often suboptimal. These shortcomings were discussed at two MS multi-stakeholder colloquia that were convened in Brussels, Belgium in May 2014 and May 2015, and gathered experts from a range of different specialities to identify the key issues and propose means of tackling them. After considering all the testimony and discussion, the organising committee drew up a list of 10 calls to action, which included: increase awareness and understanding in the EU about the burden of MS; obtain better insights into the direct and indirect cost burden of MS; (re)define treatment goals and clinical study endpoints; develop new tools to better capture the total clinical burden of MS; develop a protocol to standardise magnetic resonance imaging (MRI); develop biomarkers of treatment response prediction and disability progression; integrate drug licensing and cost-effectiveness decision-making processes; develop separate European Medicines Agency guidelines for evaluating follow-on products of non-biological complex drugs and biologicals; implement a set of evidence-based standards of care and incentives to support people with MS to remain physically and mentally active. Addressing these ambitious calls to action requires cooperation from various health bodies and governments and some will require additional funding, but they are achievable and worthwhile. They would help minimise disease impact and would reduce disease progression and the consequent burden on people with MS, their caregivers, and on health budgets. These calls to action set out a strategy for future MS management and should be acted upon with urgency.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.14
A. Sauerbier
{"title":"European Academy of Neurology – What Has Happened Since the FirstConference in 2015 Conference in 2015?","authors":"A. Sauerbier","doi":"10.17925/ENR.2016.11.01.14","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.14","url":null,"abstract":"","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-01DOI: 10.17925/ENR.2016.11.01.1B
A. Ward, W. Jost, R. Jech, J. Gracies
Spastic paresis is a frequent complication of lesions to central motor pathways. Patients who develop spasticity require specialised rehabilitation programmes to alleviate their symptoms, help them to relearn motor skills and regain some independence. Long-term management of patients with spastic paresis requires a comprehensive approach that addresses the patient’s physical needs and mental wellbeing, and continues throughout all stages of the rehabilitation process. There are three pillars of success for long-term rehabilitation programmes in spastic paresis. Since most human behaviour is goal-directed, the first is to employ patient-centred goal setting to engage and motivate patients to play an active part in their own rehabilitation. Goals should be meaningful for and achievable by the patient, and revised as necessary. The second foundation of success is to ensure detailed clinical assessment, using appropriate spasticity assessment scales to inform Botulinum toxin treatment plans -doses and muscles to be injected. Lastly, the use of guided self-rehabilitation programmes encourages an active role for patients in their treatment and maximises outcomes. This paper summarises proceedings from the Comprehensive Care of Patients with Spastic Paresis: A Long-Term Commitment symposium, at the International Society of Physical and Rehabilitation Medicine World Congress, 2015.
{"title":"Comprehensive Care of Patients with Spastic Paresis – A Long-Term Commitment","authors":"A. Ward, W. Jost, R. Jech, J. Gracies","doi":"10.17925/ENR.2016.11.01.1B","DOIUrl":"https://doi.org/10.17925/ENR.2016.11.01.1B","url":null,"abstract":"Spastic paresis is a frequent complication of lesions to central motor pathways. Patients who develop spasticity require specialised rehabilitation programmes to alleviate their symptoms, help them to relearn motor skills and regain some independence. Long-term management of patients with spastic paresis requires a comprehensive approach that addresses the patient’s physical needs and mental wellbeing, and continues throughout all stages of the rehabilitation process. There are three pillars of success for long-term rehabilitation programmes in spastic paresis. Since most human behaviour is goal-directed, the first is to employ patient-centred goal setting to engage and motivate patients to play an active part in their own rehabilitation. Goals should be meaningful for and achievable by the patient, and revised as necessary. The second foundation of success is to ensure detailed clinical assessment, using appropriate spasticity assessment scales to inform Botulinum toxin treatment plans -doses and muscles to be injected. Lastly, the use of guided self-rehabilitation programmes encourages an active role for patients in their treatment and maximises outcomes. This paper summarises proceedings from the Comprehensive Care of Patients with Spastic Paresis: A Long-Term Commitment symposium, at the International Society of Physical and Rehabilitation Medicine World Congress, 2015.","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-06-01DOI: 10.17925/ENR.2015.10.01.28
M. Relja, J. Jacinto, J. Jankovic, A. Albanese
{"title":"Botulinum neurotoxin revisited – An individualised, patient-centric approach for the treatment of dystonia and spasticity","authors":"M. Relja, J. Jacinto, J. Jankovic, A. Albanese","doi":"10.17925/ENR.2015.10.01.28","DOIUrl":"https://doi.org/10.17925/ENR.2015.10.01.28","url":null,"abstract":"","PeriodicalId":12047,"journal":{"name":"European neurological review","volume":"10 3 1","pages":"28-34"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67591297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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