Clinical Neurology News RSS feed: Current Issue. http://www.clinicalneurologynews.com/?rss=yesElsevier Inc.en © 2012 Elsevier Inc. All rights reserved. Clinical Neurology News1553-321281January 2012 © 2012 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.clinicalneurologynews.com/article/PIIS1553321212700018/abstract?rss=yesBALTIMORE – In utero exposure to valproate appears to increase the risk of significant adverse effects on fetal brain development that persist into childhood. In two separate studies, children whose mothers took valproate during pregnancy had a higher risk for lower IQ and other cognitive deficiencies, as well as autism and other disorders along the autistic spectrum. “All women with epilepsy of childbearing potential should be informed of the risks. I feel that valproate should not be a first choice antiepileptic drug in women of childbearing potential,” Dr. Kimford J. Meador, director of the Emory Epilepsy Center and professor of neurology at Emory University, Atlanta, said in an interview.Evidence for Risks Of Valproate GrowsMIRIAM E. TUCKER10.1016/S1553-3212(12)70001-8Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8News11http://www.clinicalneurologynews.com/article/PIIS155332121270002X/abstract?rss=yesBALTIMORE – Cyclical natural progesterone appears to reduce the frequency of catamenial seizures in some women, a placebo-controlled study has found. Women with a large number of perimenstrually exacerbated seizures who used progesterone experienced a significant decrease in their number of catamenial seizures. The higher the seizure count, the stronger the association became, Dr. Andrew G. Herzog reported during the meeting.Seizures Decline In Some Women On Progesterone: Perimenstrual activity found relevant.MICHELE G. SULLIVAN10.1016/S1553-3212(12)70002-XClinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8News11http://www.clinicalneurologynews.com/article/PIIS1553321212700031/abstract?rss=yesBALTIMORE – A novel implantable device has demonstrated potential for predicting seizure onset in a preliminary analysis of 15 adult patients with medically refractory complex partial seizures.Implanted Device Predicts Seizures in Pilot StudyMIRIAM E. TUCKER10.1016/S1553-3212(12)70003-1Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8News22http://www.clinicalneurologynews.com/article/PIIS1553321212700043/abstract?rss=yes DR. CASELLI is medical editor of Clinical Neurology News and is a professor of neurology at the Mayo Clinic in Scottsdale, Ariz. For a long time I have felt that before I die, I would like to understand the brain, the material basis of thought, to the extent that it is understood. In medical school, I realized that to specialize was to not only gain greater knowledge of one area, but also to lose or never gain much more knowledge of all others. That (plus the lectures of Dr. Eric Kandel who I was fortunate to have as a neuroscience professor) is what led me into neurology, the one thing I could not stand to lose. As a neurologist, I find peace in knowing there is an order to our mental universe, and I have tried to convey a sense of that in my editorials on creativity in our 2011 issues of Clinical Neurology News.The Ways Creativity Can FailRICHARD J. CASELLI10.1016/S1553-3212(12)70004-3Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Evoked Potentials33http://www.clinicalneurologynews.com/article/PIIS1553321212700055/abstract?rss=yesFor the first time, doctors will have the opportunity for formal training and certification in the field of brain injury medicine as a result of the American Board of Medical Specialties' decision last September to create a new subspecialty.Subspecialty Arises From Interest in Care of Athletes, SoldiersFRANCES CORREA10.1016/S1553-3212(12)70005-5Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8News33http://www.clinicalneurologynews.com/article/PIIS1553321212700067/abstract?rss=yesThe article “‘Shocking Percentage’ of Patients on Triptans Despite Risks” (November/December 2011, p. 12) should have stated that the MORE2 registry comprises the records of more than 77 million people of all ages. Merck Sharp & Dohme funded the study's analysis of data from 2.5 million records of patients aged 18-64 years in the registry.Correction10.1016/S1553-3212(12)70006-7Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Erratum33http://www.clinicalneurologynews.com/article/PIIS1553321212700079/abstract?rss=yesBALTIMORE – Despite the very real chance of living a seizure-free life, many epilepsy patients with an excellent surgical prognosis continue to walk away from the procedures. Researchers at the meeting agreed: It's not always easy to convince a patient with refractory seizures that removing part of his or her brain could be the best treatment option.Patients Balk at Surgery Despite Good PrognosisMICHELE G. SULLIVAN10.1016/S1553-3212(12)70007-9Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Epilepsy & Spells67http://www.clinicalneurologynews.com/article/PIIS1553321212700080/abstract?rss=yesSAN DIEGO – Neurocardiogenic injury was surprisingly common in a series of patients treated for status epilepticus in a retrospective study conducted by investigators at the Mayo Clinic in Rochester, Minn.Cardiac Disease Often Seen in Status EpilepticusBETSY BATES10.1016/S1553-3212(12)70008-0Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Epilepsy & Spells77http://www.clinicalneurologynews.com/article/PIIS1553321212700092/abstract?rss=yes Major Finding: Seizures while using contraceptives were reported by 18% of women using hormonal contraceptives, compared with 3% of those using nonhormonal contraceptives.Contraception Affects Seizures in Women With EpilepsyHEIDI SPLETE10.1016/S1553-3212(12)70009-2Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Epilepsy & Spells88http://www.clinicalneurologynews.com/article/PIIS1553321212700109/abstract?rss=yesData Watch: NIH Epilepsy Funding Low Despite Prevalence10.1016/S1553-3212(12)70010-9Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Epilepsy & Spells88http://www.clinicalneurologynews.com/article/PIIS1553321212700110/abstract?rss=yes Major Finding: Among 44 children in an epilepsy center, 77% had some sort of developmental delay, and 36% screened positive for autism.Screening May Catch Autism in Epilepsy PatientsMICHELE G. SULLIVAN10.1016/S1553-3212(12)70011-0Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Pediatric Neurology99http://www.clinicalneurologynews.com/article/PIIS1553321212700122/abstract?rss=yesTwo different approaches to treating spinocerebellar ataxia type 1 – aerobic exercise or delivery of vascular endothelial growth factor – appeared to halt or slow the dysfunction of vulnerable cerebellar and brain stem cells in separate studies of a mouse model that closely mirrors the human disease.Discoveries Could Slow Dysfunction in Spinocerebellar Ataxia Type 1JEFF EVANS10.1016/S1553-3212(12)70012-2Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Neuroscience Today, Neurology Tomorrow1010http://www.clinicalneurologynews.com/article/PIIS1553321212700134/abstract?rss=yes DR. CARTER is an associate professor of medicine at the Mayo Clinic in Scottsdale, Ariz., and has a clinical interest in multiple sclerosis, optic neuritis, transverse myelitis, and neuroimmunology. He is on the data safety monitoring board of an MS clinical trial for Ono Pharmaceuticals and receives research support from funds paid to the Mayo Clinic by Actelion, EMD Serono, Biogen Idec, Genzyme, and Sanofi-Aventis.The Road Ahead for MS TherapiesJONATHAN L. CARTER10.1016/S1553-3212(12)70013-4Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Frontal Matter1111http://www.clinicalneurologynews.com/article/PIIS1553321212700146/abstract?rss=yesAMSTERDAM – Treatment with the investigational oral drug dimethyl fumarate reduced the risk of relapse by up to 50%, compared with placebo, without significant safety concerns in patients with relapsing-remitting multiple sclerosis in two phase III trials.Dimethyl Fumarate Halved Two-Year MS Relapse RatesSARA FREEMAN10.1016/S1553-3212(12)70014-6Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Multiple Sclerosis1112http://www.clinicalneurologynews.com/article/PIIS1553321212700158/abstract?rss=yes Major Finding: The annualized relapse rate at 1 year was 0.21 for 150 mg daclizumab and 0.23 for 300 mg, compared with 0.46 for placebo (P less than .0001 and .0002, respectively).Daclizumab Slashed Relapse Rate in MS TrialSARA FREEMAN10.1016/S1553-3212(12)70015-8Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Multiple Sclerosis1212http://www.clinicalneurologynews.com/article/PIIS155332121270016X/abstract?rss=yes Major Finding: The 2-year annualized relapse rate was not significantly different between laquinimod and placebo (0.28 vs. 0.34, respectively), but tipped in favor of laquinimod (0.29 vs. 0.37, P = .03) only after adjustment for certain baseline characteristics.Laquinimod Halted Disability, but Not RelapsesSARA FREEMAN10.1016/S1553-3212(12)70016-XClinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Multiple Sclerosis1515http://www.clinicalneurologynews.com/article/PIIS1553321212700171/abstract?rss=yes Major Finding: Alemtuzumab significantly reduced the relapse rate after 2 years of treatment by 49%-55%, compared with IFNB-1a.Alemtuzumab Bests Interferon for Preventing MS RelapseSARA FREEMAN10.1016/S1553-3212(12)70017-1Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Multiple Sclerosis1516http://www.clinicalneurologynews.com/article/PIIS1553321212700183/abstract?rss=yes Major Finding: The estimated percentage of patients who had a clinical relapse or MRI scan meeting rescue criteria was 61% for placebo, 60% for glatiramer acetate, 55% for methylprednisolone, 29% for IFNB-1a, and 5% for natalizumab continuation.MS Activity Returns After Stopping NatalizumabSARA FREEMAN10.1016/S1553-3212(12)70018-3Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Multiple Sclerosis1616http://www.clinicalneurologynews.com/article/PIIS1553321212700195/abstract?rss=yes DR. COHEN is in general pediatric practice and a board member of Children's Primary Care Medical Group, Inc. of San Diego, and assistant professor of pediatrics at the University of California, San Diego. He said he had no relevant financial disclosures.Medicaid Primer 2012: Avoiding the RACSTUART A. COHEN10.1016/S1553-3212(12)70019-5Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Commentary2020http://www.clinicalneurologynews.com/article/PIIS1553321212700201/abstract?rss=yesThe National Committee on Quality Assurance has launched a program to accredit accountable care organizations. The program offers three levels of accreditation based on the readiness of the ACO. As with the NCQA's recognition program for patient-centered medical homes, achieving accreditation at each level is based on accruing a certain number of points by meeting standards and fulfilling some “must-pass” criteria.Accreditation Launches for Accountable Care OrganizationsMARY ELLEN SCHNEIDER10.1016/S1553-3212(12)70020-1Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Practice Trends2020http://www.clinicalneurologynews.com/article/PIIS1553321212700213/abstract?rss=yesFederal officials are requiring health plans to give consumers more information about how they are spending their premium dollars. In a final rule, the Health and Human Services department made changes to its existing regulations governing health plans' medical-loss ratio (MLR). Under the Affordable Care Act, health plans must spend at least 80% of their premium dollars on medical care and quality improvement activities. For large group plans, the threshold is 85%. If plans spend more than the allowed amount on other costs, such as overhead and marketing, they must provide rebates to consumers.Feds Tweak Medical-Loss Ratio Requirements: Health plans must inform members what fraction of premium dollars goes to medical care.MARY ELLEN SCHNEIDER10.1016/S1553-3212(12)70021-3Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Practice Trends2222http://www.clinicalneurologynews.com/article/PIIS1553321212700225/abstract?rss=yesData Watch: Neurologists' Median Ambulatory Encounters Dropped 6.5% From 2007 to 201010.1016/S1553-3212(12)70022-5Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Practice Trends2222http://www.clinicalneurologynews.com/article/PIIS1553321212700237/abstract?rss=yesSports-related concussions in children may be different from those of adults, according to a small study published in Pediatrics. The study of nine boys and three girls aged 11-15 years showed that sports-related concussions were primarily a physiologic injury, affecting cerebral blood flow. There were no measurable structural, metabolic, neuronal, or axonal injuries, the researchers found. Compared with a control group of 12 children, the young athletes with concussions had a significantly different initial total symptom score and reaction time. The reaction time improved in 27% of athletes at 14 days, and in 64% at more than 30 days. “Further study of [cerebral blood flow] mechanisms is needed to explain patterns of recovery,” the authors wrote.Policy & Practice: Want More Health Reform News? Subscribe To Our Podcast – Search ‘Policy & Practice’ In The itunes StoreNaseem S. Miller10.1016/S1553-3212(12)70023-7Clinical Neurology News 8, 1 (2012)2012-01-01Clinical Neurology News2012-01-0181S1553-3212(12)X7001-8Practice Trends2323