CONTINUUM Lifelong Learning in Neurology最新文献_第7页

Issue Overview. 问题概述。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/01.cont.0001191824.53490.b5

引用次数: 0

Postreading Self-Assessment and CME Test. 阅读后自我评估和CME测试。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001693

Nuri Jacoby, Joanne Lynn

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SELF-ASSESSMENT AND CME. 自我评估和继续教育。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001687

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Key Points for Issue. 问题的关键点。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/01.cont.0001191868.61114.16

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Neuromyelitis Optica Spectrum Disorder. 神经脊髓炎视谱障碍。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001682

Sara Mariotto, Romain Marignier

{"title":"Neuromyelitis Optica Spectrum Disorder.","authors":"Sara Mariotto, Romain Marignier","doi":"10.1212/cont.0000000000001682","DOIUrl":"10.1212/cont.0000000000001682","url":null,"abstract":"Objective: This article reviews the clinical features of and diagnostic and treatment approaches to neuromyelitis optica spectrum disorder (NMOSD), with additional focus on rare phenotypes and specific contexts. Pathogenesis and pathology, differential diagnoses, and the potential use of novel biomarkers are also discussed.Latest developments: A major advancement in the characterization of NMOSD was the discovery of serum antibodies targeting the water channel aquaporin-4 in the majority of patients, which also improved the characterization of disease pathogenesis. A proper diagnosis is fundamental to differentiating NMOSD from other central nervous system inflammatory conditions and starting prompt treatment. The recent development of dedicated clinical trials led to the approval of new targeted drugs and further emphasized the relevance of properly recognizing this disease. The ongoing revision of NMOSD diagnostic criteria will provide additional guidance.Essential points: Although rare, recognizing NMOSD is crucial for improving patient outcomes through correct diagnostic and treatment approaches. Reports of atypical forms and increasing knowledge of clinical, imaging, and laboratory-specific features are fundamental for the accurate recognition of this condition. Research on targeted therapies and biomarkers measuring and predicting disease activity will improve NMOSD management.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 2","pages":"513-540"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postreading Self-Assessment and CME Test-Preferred Responses. 阅读后自我评估和CME测试偏好反应。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001694

Nuri Jacoby, Joanne Lynn

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Adult-Onset Leukodystrophies Mimicking Multiple Sclerosis. 模拟多发性硬化症的成人发病脑白质营养不良。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001691

Gabrielle Macaron, Roberta La Piana

{"title":"Adult-Onset Leukodystrophies Mimicking Multiple Sclerosis.","authors":"Gabrielle Macaron, Roberta La Piana","doi":"10.1212/cont.0000000000001691","DOIUrl":"10.1212/cont.0000000000001691","url":null,"abstract":"Objective: Genetic white matter disorders may be difficult to distinguish from multiple sclerosis (MS). This article reviews the clinical and radiologic features of leukodystrophies in adults and how to differentiate them from MS.Latest developments: The rapid implementation of next-generation sequencing techniques in clinical practice has led to an increasing number of adult patients diagnosed with leukodystrophies, often with expanded clinical and radiologic phenotypes that include features mimicking MS. Advances in neuroimaging tools allow for the identification of radiologic features that distinguish between genetic and acquired white matter disorders.Essential points: Although individually rare, adult-onset leukodystrophies represent a non-negligible diagnostic challenge to clinicians assessing patients for MS. Patients with adult-onset leukodystrophies often present with multifocal white matter involvement that may mimic MS lesions. Their variable clinical presentation, often characterized by progressive spasticity, ataxia, and cognitive decline, can overlap with that of primary progressive MS, further adding to the diagnostic challenge of correctly identifying these rare disorders. The impact on patients is considerable and extends from potential exposure to inappropriate immunomodulatory treatments to missing timely genetic counseling and targeted leukodystrophy-specific therapies. Thus, it is crucial to know clinical and radiologic red flags for adult-onset leukodystrophies that can assist the differential diagnosis.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 2","pages":"456-480"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family Planning in Neuroinflammatory Disease. 神经炎性疾病中的计划生育。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001683

Ruth Dobson, Kerstin Hellwig

{"title":"Family Planning in Neuroinflammatory Disease.","authors":"Ruth Dobson, Kerstin Hellwig","doi":"10.1212/cont.0000000000001683","DOIUrl":"10.1212/cont.0000000000001683","url":null,"abstract":"Objective: This article provides evidence-based advice to facilitate early, explicit, and continuous consideration of family planning, enabling effective treatment selection and allowing people living with neuroinflammatory disorders to balance disease control with optimal pregnancy outcomes.Latest developments: There has been a paradigm shift in treatment approaches for women living with active neuroinflammatory disease who are considering pregnancy. Women with active multiple sclerosis are at risk of disabling relapse if immunosequestering therapy is withdrawn for pregnancy, making it essential that pregnancies are well planned. For those taking CD20-antibody or induction therapies, relapse rates remain suppressed during pregnancy with low postpartum relapse risk, even when treatment is discontinued during pregnancy and not directly restarted after birth. In patients with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), CD20 antibodies are increasingly used around pregnancy, with additional promising early data regarding the safety of eculizumab and interleukin-6 antibodies. All monoclonal antibodies used in multiple sclerosis, NMOSD, and MOGAD are potentially suitable for use during breastfeeding, particularly in women with more active prepregnancy disease, due to low rates of breakthrough relapses combined with an absence of breastmilk transfer.Essential points: Balancing disease control with pregnancy and neonatal considerations in people with neuroinflammatory disease throughout the family planning, pregnancy, and postpartum periods is crucial. Modern treatment paradigms enable women to safely become pregnant and breastfeed alongside effective disease management. Shared decision-making is an important part of this process.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 2","pages":"619-640"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of Multiple Sclerosis. 多发性硬化的治疗。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001679

Ellen M Mowry, Darin T Okuda, Daniel Ontaneda

{"title":"Treatment of Multiple Sclerosis.","authors":"Ellen M Mowry, Darin T Okuda, Daniel Ontaneda","doi":"10.1212/cont.0000000000001679","DOIUrl":"10.1212/cont.0000000000001679","url":null,"abstract":"Objective: This article addresses the evidence basis for treating acute multiple sclerosis (MS) relapses and choosing disease-modifying therapies in patients with relapsing MS, radiologically isolated syndrome, and progressive MS.Latest developments: Symptoms related to MS relapses occur as a result of new acute focal inflammatory demyelination and may improve more quickly with the use of high-dose corticosteroids. However, these treatments must not be given when symptoms are instead due to systemic issues (eg, non-neurologic illness, sleep deprivation, infection) that lead to transient worsening of symptoms attributed to old areas of MS-related damage. While trials are ongoing to establish whether an optimal treatment strategy exists for newly diagnosed, active, or relapsing MS, clinicians and people with MS must currently use shared decision-making to select a higher-efficacy therapy or embark on an escalation approach. Screening for specific contraindications to various MS therapies must occur before beginning therapy, and ongoing monitoring for effectiveness and safety concerns is indicated. Emerging data indicate that, on average, MS therapy is beneficial for people identified in the presymptomatic phase of MS. However, people with slowly worsening progressive MS may not experience as much benefit from currently approved MS therapies in the absence of active disease (relapses or new lesions on MRI).Essential points: There are many treatment options for people with relapsing MS. Patients should be carefully monitored to assess treatment response, and a change in treatment approach should be considered if safety concerns emerge.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 2","pages":"541-564"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Palliative Care in Multiple Sclerosis. 多发性硬化症的姑息治疗。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001680

Penelope Smyth, Janis M Miyasaki

{"title":"Palliative Care in Multiple Sclerosis.","authors":"Penelope Smyth, Janis M Miyasaki","doi":"10.1212/cont.0000000000001680","DOIUrl":"10.1212/cont.0000000000001680","url":null,"abstract":"Objective: This article reviews palliative care concepts valuable to neurologists caring for people with multiple sclerosis (MS), describes the three stages of palliative principles in care delivery, and suggests triggers to refer for specialized palliative care interventions.Latest developments: Advances in disease-modifying therapies have extended life expectancy and reduced disability progression in patients with multiple sclerosis. However, palliative care remains underutilized in addressing persistent symptoms, care partner burden, and psychosocial challenges.Essential points: Palliative care strategies in MS can be divided into three stages: early-stage palliative care needs and screening after diagnosis; midstage palliative care needs, including symptom management and quality-of-life optimization; and late-stage palliative care needs, including managing severe MS and end-of-life care. Additional foci of specialist palliative care may include end-of-life care, advance care planning, care partner support, and patient consideration of medically assisted death. Neurologists, neurology care teams, and primary care providers can serve as generalist palliative care providers, with referral to specialist palliative care teams when needed. Patient-reported outcome measures and screening symptom scales can aid in the periodic assessment of people with MS and their care partners.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 2","pages":"596-618"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0