Author: Jack Florin

A New Blood Test Can Detect Bleeding in the Brain after a Concussion

This is an important advance as it can dramatically reduce the use of CT scans after concussions. Not only do unnecessary CT scans waste health care dollars but they also expose young athletes to unnecessary radiation. Children and teens, compared to adults, are several times more susceptible to the effects of radiation. Emergency room personnel… Read more »

A New Vaccine for Prevention of Shingles Is a Major Advance.

Dermatomal herpes zoster (shingles) has a lifetime risk of over 30% and carries a high risk of post-herpetic neuralgia which can be excruciating and even permanent. Rarely, the virus can disseminate (spread) and may even result in stroke. Further, recent studies have shown that the virus may be the trigger for giant cell arteritis, a… Read more »

The FDA Should Approve Marijuana to Treat Spasticity in Multiple Sclerosis

Readers of a review article by Giacoppo and others in Multiple Sclerosis and Related Disorders, 2017, pages 22-31, will probably agree with this statement. Sativex is a branded oromucosal spray containing tetrahydrocannabinol and cannabidiol in a 1:1 ratio. It has been available for years in Canada and has been approved in several European countries since… Read more »

Noninvasive Vagal Nerve Stimulation for Cluster headaches

A new device provides noninvasive electrical stimulation of the vagus nerve in the neck to treat episodic cluster headaches. It is call gammaCore and was recently approved by the FDA and will probably be available by prescription in the United States in fall 2017. It is about the size of a cell phone, handheld, applied… Read more »

New Insights into Sudden Death in Epilepsy

A practice guideline, prepared by the American Academy of Neurology, was published recently in Neurology. SUDEP stands for sudden unexpected death in epilepsy. This has been recognized for many years but the specific risk has not been consistently established. People with epilepsy can die during a seizure, presumably from post- ictal respiratory depression. SUDEP, according… Read more »

Update On Migraine And Stroke

There is good evidence that patients with migraine with aura but not without aura have about a twofold increased risk of stroke. Why this is so, however, is not known. According to a new study, the cause may be cardiac embolism. Patients from the ARIC study of over 15,000 participants, aged 45 to 64 years… Read more »

New Insights Into Migraine And Risk Of Stroke

Patients who have migraine with aura, but not those who have migraine without aura, have been found in several studies to have higher risk of cardiovascular disorders, including stroke. That risk may be 2 times that of a control group though low in an absolute sense because patients are relatively young without cardiovascular risk factors…. Read more »

Nicotine Patches For Parkinson’s

Eight open-label studies and four placebo-controlled studies addressed this question. Seven of the eight open-label showed improvement in motor symptoms, but the placebo-controlled studies were all negative. A new study was presented at the 4th World Parkinson Congress by Gabriel Villafane. It involved high doses (90 mg per day) of transdermal nicotine and measured the… Read more »

A New Blood Test May Become A Biomarker For Multiple Sclerosis Progression

This measures neurofilament-light chain levels. They are a maker to neuroaxonal damage, as the neurofilaments function as a lattice for axons. In the past, lumbar puncture was needed. Now, a blood test has been developed. This studied patients undergoing treatment with fingolimod. Another study involved patients treated with natalizumab. With treatment, levels of the neurofilament-light… Read more »

A New Non-Invasive Treatment For Essential Tremor

Essential tremor is common, thought to affect 1 in 10 people over the age of 70, and may be severe, causing significant functional disability. It is difficult to treat. Available medications reduce tremor only partly and do not work in a significant number of patients. Further, they may have adverse effects. They include mainly beta-blockers,… Read more »