Expert clinicians offer their perspectives on developmental milestones for children, the NMSOD patient perspective, effective treatments for insomnia, ALS, diabetic and inflammatory neuropathies, and lecanemab in early Alzheimer disease.
The NeurologyLive® team has been as busy as ever collecting expert insight on the latest clinical news and research updates in neurology over the course of the past month by conducting several interviews across various topics of neurological care.
Among these included conversations about the changes in practice and developmental milestones for children, the patient perspective on neuromyelitis optica spectrum disorder (NMSOD), the state of insomnia and the effective treatment strategies, the role of human endogenous retroviruses in amyotrophic lateral sclerosis (ALS), the changing treatment of diabetic and inflammatory neuropathies, and lecanemab’s effect in early Alzheimer disease (AD).
Click through the slides to see and read more from each expert’s exclusive conversation with NeurologyLive® in September 2022.
"While parents were having concerns, the professional didn’t have a good foundation to steer them towards the next steps in the process. That next step in the process ends up being really critical for the healthcare professional, for the child neurologist, and for the specialty pediatrician, because that means that will begin a cascade of further interventions, further evaluations, [and] further treatments in one way or another."
To learn how clinicians traditionally approached child developmental milestones, and how new guidelines could change the clinical space, NeurologyLive® sat down with Paul Lipkin, MD. Lipkin, the director of outpatient services at the Kennedy Krieger Institute, and a member of the expert group, discussed how children who fail to meet these milestones have been typically assessed.
“What was scarier to me was my acuity had gotten so bad, almost overnight. I went from being 20/20 in both eyes—even with the visual field deficit—in a period of 2 days, I was 20/600 and 20/120. I couldn’t even identify the ‘E’ on a Snellen chart.”
In a conversation with NeurologyLive®, Sumaira Ahmed, the founder and executive director of the Sumaira Foundation, told her diagnostic story that led to her to found the Sumaira Foundation, and offered up her experience as a patient, highlighting the difficulties she faced from a disease burden perspective as well as in getting the correct diagnosis of NMOSD. She also spoke about her motivation for starting the Sumaira Foundation and her goals to raise awareness.
"A lot of people will push sleep hygiene on people and give them medications they may or may not be familiar with. I don’t feel like it’s tailored to the patient’s needs, and things are not considered in terms of what other medications they’re on."
Ashgan A. Elshinawy, DO, a pulmonologist at Penn Medicine, has been caring for patients with sleep disorders for nearly 2 decades. In an interview with NeurologyLive®, Elshinawy provided insight on the current state of care for insomnia, whether treatment options are sufficient, and why clinicians need to continue to take an effort to understand effective therapeutic approaches such as cognitive behavioral therapy.
"The same thing that is so important in our survival as humans, and so important in embryogenesis, can also lead to our own demise, ultimately. The laws of nature are very simple, even when we make them complicated."
Avindra Nath, MD, clinical director of the National Institute of Neurological Disorders and Stroke, was a senior author of 2 papers on human endogenous retroviruses (HERVs) and their role in ALS disease processes and decided to sit down and share his insight. In a conversation with NeurologyLive®, Nath provided context on the background of this research, what had been previously observed, and how this further explains certain cases of sporadic ALS.
"Something like diabetic neuropathy isn’t talked about enough by people because it doesn’t usually lead to death or something super morbid; although, it can lead to amputations and things less common. What’s important about it is that it’s the most common neuropathy by far, and we have to pay attention to things that are super common, even if they’re not the worst diseases to have."
In an interview with NeurologyLive®, Brian Callaghan, MD, MS, an associate professor at the University of Michigan, provided insight on the most significant changes in treatment approaches to neuropathy, and why there is an urgent push to do away with opioids. He also discussed complexities with the diagnosis of painful neuropathies such as Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy.
"I was very pleased and encouraged by these results. They’re strong, they’re consistent, and they tell a story that is not easy to poke holes into. And we need that in our field."
Ahead of the 15th Clinical Trials on Alzheimer’s Disease Congress, planned for November 29 to December 2, 2022, Eisai and Biogen announced topline findings from Clarity AD, which showed that lecanemab met its primary and secondary end points with highly statistically significant results. To learn more about new findings and their clinical implications, NeurologyLive® sat down with study investigator Sharon Cohen, MD. Cohen, a neurologist and assistant professor at the University of Toronto, provided her reaction to the findings, as well as described the most notable data points and surprises of which the clinical community should be aware.