title: [American Academy of Neurology, Washington, 18-25 April 2015].
abstract: The benefit of the thrombectomy using stents retrievers in the acute stroke phase is now demonstrated when there is a proximal occlusion of an intracranial artery, whatever its mechanism. The place of the anticoagulants in the management of cervical artery dissections remains uncertain, while the benefit of the blood pressure control in the secondary prevention of deep and lobar intracerebral hemorrhages is critical. The development of cardiac MRI, prolonged cardiac monitoring and transcranial doppler seems to improve the diagnosis of cardio-embolic sources of stroke.
  A specialized urgent-access single seizure clinic represents a model which reduces wait-times and improves patient access after a first fit. Co-locating a psychiatrist within outpatient epilepsy center leads to a reduction in psychiatric symptoms and people with psychogenic non-epileptic seizures. When neurologists around the world assess identical case scenarios for the diagnosis of epilepsy, concordance is between moderate and poor, showing that epilepsy diagnosis remains difficult. More than one third of elderly with new-onset epilepsy of unknown etiology exhibit temporal lobe atrophy on brain imaging.
  There is no major progress in the therapeutic approach of Parkinson's disease but the discovery of new genetic markers such as glucocerebrosidase mutations may greatly change our knowledge of the disease process and may induce new therapeutic strategies in the future. The natural history of the disease is also better understood from the prodromal phase to the post-mortem analysis of the brain and the classification of the processes based on abnormal protein deposits.
  The respective value of biomarkers (amyloid imaging versus CSF biomarkers) for in vivo diagnosis of Alzheimer's disease (AD) has been detailed. Therapeutic expectations mainly rely on anti-Aβ immunization trials performed in preclinical (and no longer prodromal) stages of AD, with the aim of slowing the evolution of neuronal loss. Besides a lot of communications on dementia genetics or physiopathogeny, fascinating and promising results were presented on deep brain stimulation for depression resistant to medical treatment.
  Ibudilast, administered with riluzole, is safe and tolerable in patients with amyotrophic lateral sclerosis (ALS), improves ALS function and delays progression. Patients with painful small fiber neuropathy have a high rate of mutations in the SCN9A gene, coding for Nav1.7 voltage-gated sodium-channels. Peripheral nerve lymphoma (NL) is a multifocal painful neuropathy that causes endoneurial inflammatory demyelination: primary NL is less severe than secondary NL, which occurs after remission, suggesting that nerve may be considered a "safe lymphoma haven".
  Biotin in progressive forms of MS and daclizumab in relapsing-remitting forms appear to be promising treatments. In case of failure of current first-line and/or second-line therapeutics, alemtuzumab may be an interesting alternative treatment. Teriflunomide, dimethyl fumarate and fingolimod are oral treatments with confirmed efficacy and acceptable safety. Besides vitamin D insufficiency and smoking, which are confirmed risk factors for the disease, testosterone insufficiency (in males) and obesity are emerging risk factors, which could also be corrected.
authors.affiliation: Unité neurovasculaire, hôpital Pellegrin, CHU de Bordeaux, place Amelie-Rabat-Léon, 33000 Bordeaux, France.
authors.forename: I
authors.initials: I
authors.lastname: Sibon
authors.affiliation: Service de neurologie et de neurophysiologie clinique, 2, boulevard Tonnelé, 37044 Tours, France.
authors.forename: B
authors.initials: B
authors.lastname: de Toffol
authors.affiliation: Service de neurologie et pathologie du mouvement, hôpital de la Timone, 265, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Azulay
authors.affiliation: Département de neurologie et CMRR de Strasbourg-Colmar, hôpitaux civils de Colmar, 68024 Colmar cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Sellal
authors.affiliation: Plein Ciel, EA3082 Laboratoire EMC, université Lyon 2, 69008 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Thomas-Antérion
authors.affiliation: Centre national de référence neuro-musculaire, hôpital de la Salpêtrière, bâtiment Babinski, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Léger
authors.affiliation: Département de neurologie 1, hôpital de la Salpêtrière, 47, boulevard de l'Hôpital, 75651 Paris cedex 13, France. Electronic address: cp.deseilligny@psl.aphp.fr.
authors.forename: C
authors.initials: C
authors.lastname: Pierrot-Deseilligny
mesh_terms: D002561:Cerebrovascular Disorders / Q000235:genetics; D006801:Humans; D009069:Movement Disorders / Q000235:genetics; D009103:Multiple Sclerosis / Q000235:genetics; D009462:Neurology / Q000639:trends*; D010523:Peripheral Nervous System Diseases / Q000235:genetics
keywords: Cerebrovascular diseases; Dementia; Démences; Epilepsy; Mouvements anormaux; Movement disorders; Multiple sclerosis; Neuropathies périphériques; Pathologies cérébrovasculaires; Peripheral neuropathy; Sclérose en plaques; Épilepsie