A single-centre study examined drug response in pediatric patients to determine retrospectively the predictive factors for intractable epilepsy (Seker et al. Pediatr Neurol 2013;48:52-55). Intractable epilepsy was defined as continued seizures following adequate treatment with >2 antiepileptic drugs for >18 months.
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West Nile virus: the season is upon us
May 22, 2013West Nile virus (WNV) is an RNA viral pathogen of the Flaviviridae family that is genetically related to CNS viral pathogens such as dengue, yellow fever, Japanese encephalitis and tick-borne encephalitis. The virus is maintained in the bird population and transmitted through a mosquito vector. When first described in 1940 (Smithburn et al. Am J Trop Med Hyg 1940;1:471-492) in a patient in Uganda, WNV infection produced a mild fever. But the virulence appeared to change in the 1990s with descriptions of severe WNV-associated neurological disease (Hubalek & Halouzka. Emerging Infect Dis 1999; 5:643-650).
Apathy in Alzheimer’s disease a mortality risk factor
May 15, 2013Apathy in Alzheimer’s disease is characterized as diminished motivation lasting for at least four weeks, with reduced goal-directed behaviour, goal-directed cognitive activity and emotions, and accompanied by functional impairments (Robert et al. Eur Psychiatry 2009;24:98-104).
First-episode schizophrenia: two reports from the EUFEST study
May 8, 2013The European First Episode Schizophrenia Trial (EUFEST) was initiated in 2005 as a multicentre open-label trial comparing treatment with amisulpride, quetiapine, olanzapine or ziprasidone to low-dose haloperidol in patients with schizophrenia who had minimal prior exposure to antipsychotics (Fleischhacker et al. Schizophr Res 2005;78:147-156).
The EUFEST group reported that 12-month remission rates were higher with second-generation antipsychotics (amisulpride 40%; olanzapine 41%; quetiapine 24%, ziprasidone 28%) compared to haloperidol (17%) (Boter et al. Schizophr Res 2009;115:97-103). A subsequent finding was that the likelihood of remission at 12 months was correctly predicted at the week 2 assessment in 61% of cases (positive predictive power 0.61, negative predictive power 0.58), although accuracy was improved with the addition of 4-week (63%; PPP 0.67, NPP 0.55) and 6-week assessments (68%; PPP 0.73, NPP 0.61) (Derks et al. J Clin Psychopharmacol 2010;30:176-180).
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