Tocilizumab treatment in severe recurrent anti-MOG-associated optic neuritis

Patients presenting with a clinical phenotype indicative of neuromyelitis optica spectrum disease (NMOSD) including its limited variants such as recurrent optic neuritis (ON) or longitudinally extensive transverse myelitis negative for AQP-4 antibodies may test positive for immunoglobulin G antibodies against myelin oligodendrocyte glycoprotein (MOG), a transmembrane protein expressed on oligodendrocytes and the outer layers of the myelin sheath. MOG antibody-associated autoimmunity has gained increasing attention over recent years due to its clinical overlap with NMOSD, despite the latter being considered an autoimmune astrocytopathy. Anti-MOG antibody-positive patients show a relapsing disease course that can lead to substantial visual loss and spinal cord involvement.^1–3 Data on therapy in MOG antibody-associated disease as of yet is limited, but similar to NMOSD, it appears critical to start an efficacious treatment early in order to prevent severe functional sequelae including blindness. Tocilizumab (TCZ), a humanized antibody targeting the interleukin-6 (IL-6) receptor, has shown promise in patients with breakthrough disease and highly active forms of AQP-4 antibody-positive NMOSD.^4,5 Prolonged treatment with TCZ has been reported both efficacious and safe⁵ and leading to a reduction of AQP-4 antibody titers.^4,5

from Neurology recent issues http://bit.ly/2Ikt2ZP

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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

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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...

What are the pitfalls and perils of intracranial pressure?

Crudely speaking, the nervous system is made up of two parts. The peripheral nervous system , composed of nerves and muscles , is rather robust and roams free, exposed to the elements. On the other hand, the central nervous system , consisting of the brain and spinal cord , is delicate and fragile. It is therefore protectively cocooned in a rigid skull and a hardy vertebral skeleton . But even this tough fortress isn’t secure enough for these dainty neurones ; they are, after all, the command and control system for the whole body. Therefore, to further insulate them from the physical and physiological perturbations that continuously threaten them, nature has further sequestered them within a very exquisitely regulated irrigation system, the cerebrospinal fluid (CSF) . Internet Archive book Images on Flickr. https://www.flickr.com/photos/internetarchivebookimages/14769907251/ The CSF is actually a fine filtrate of the blood that flows in the arteries. The sieve is the very for...

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