REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The AAN annual meeting coincided with the publication of new guidelines on preventive treatment of migraine by the AAN and the American Headache Society (Silberstein et al. Neurology 2012;78:1337-1345; free full text at www.neurology.org/content/78/17/1337.full.pdf+html).
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Breastfeeding not a sustainable therapy
July 11, 2012REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – Studies to determine if exclusive breastfeeding reduces relapse frequency postpartum have produced conflicting results (Langer-Gould et al. Arch Neurol 2009;66:958-963; Portaccio et al. Neurology 2011;77:145-150; Nelson et al. JAMA 1988;259:3441-3443).
Langer-Gould and colleagues have now followed 72 women with MS through their pregnancy and for 12 months postpartum to examine this issue further (Hellwig et al. AAN 2012; abstract P06.186).
Exploratory study of higher carbidopa dosing
July 11, 2012REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The recommended doses of carbidopa (CD) to increase levodopa availability are in the range of 75-200 mg/day. A small double-blind crossover trial has explored whether higher carbidopa doses are clinically useful (Nutt et al. AAN 2012; abstract S02.006).
The caveat is that higher carbidopa doses have the potential to inhibit amino acid decarboxylase and reduce dopamine formation in the striatum.
Flunarizine, topiramate effective in migraine prophylaxis
June 6, 2012A one-year study reports that topiramate and flunarizine are both effective in migraine prophylaxis, although combining the two agents does not produce significantly greater efficacy (Luo et al. Pain Med 2012;13:80-86).