Reader response: Clinical Reasoning: A 56-year-old woman with acute vertigo and diplopia

There are wider implications of the treatments described by Sharma et al.¹ Bortezomib works by promoting apoptosis in long-lived and short-lived plasma cells responsible for long-lived immunity. These cells produce background levels of vaccine-induced protective antibodies. Therefore, there may be reduced titers of immunoglobulins against measles, mumps, and tetanus after bortezomib treatment of systemic lupus erythematosus.² Bortezomib is now also considered treatment in many antibody-mediated chronic autoimmune diseases. It may provide a rapid reduction in antibody titers in treatment-refractory neurologic antibody–mediated diseases, such as NMDAR encephalitis, if standard immunotherapies are ineffective.³ Standard immunotherapies, such as methylprednisolone, rituximab, and cyclophosphamide, do not target these long-lived and short-lived plasma cells⁴; however, as some patients do not respond when these antibody-secreting cells are targeted, there is clearly more complexity to the immunopathogenesis than is currently understood.⁵ Neurologists should be aware of the potential pan-immunodeficient risks, particularly when it comes to vaccination-induced immunity, and also the potential therapeutic options in antibody-mediated neurologic conditions.

from Neurology recent issues http://bit.ly/2Wp5ZAW

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Menopause Symptoms Reduced by Cold Water Swimming

Cold water swimming significantly eases menopausal symptoms. Surveying 1114 women, with 785 experiencing menopause, researchers found improvements in anxiety, mood swings, low mood, and hot flushes among participants. from Neuroscience News https://ift.tt/9AqHsEa

UPI: Kids with psych disorders most likely to take dangerous viral challenges

The “choking game” — and other clearly ill-advised and dangerous internet challenges — leave many parents wondering what drives teens to take the bait and participate. Now, a new study suggests that an underlying psychological disorder may be one reason why some kids jump at online dares such as the “Bird Box” challenge, where people walk around blindfolded, and the Tide Pod challenge, daring people to eat laundry detergent. (January 28, 2019) Read the full article here from Brain Health Daily http://bit.ly/2DIWHbD

The emerging influential role of microglia in neurology

In her most catchily titled book, The Angel and the Assassin , Donna Jackson Nakazawa highlighed nerve cells which have hitherto been very little acknowledged – microglia . Long ignored as bit players in the big league of the nervous system, Nakazawa colourfully illustrated what many neuroscientists are beginning to realise: the small size of microglia belies their huge influence ; m icroglia are, after all, the defence force of the nervous system, protecting the brain from microbial invaders . In keeping with their small size, their role is to surreptitiously present the antigens of invading bugs to T cells , the toffs who actually carry out the final hatchet job . It is therefore not surprising that any dysfunction of microglia will come with significant clinical consequences . By GerryShaw – Own work , CC BY-SA 3.0 , Link The most important clinical fallout of dysfunctional microglia appears to be the emergence of dementia. It is indeed spec...

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