EXCITING RECENT ADVANCES IN NEUROLOGY

DR SUDHIR KUMAR MD DM

CONSULTANT NEUROLOGIST

APOLLO HOSPITALS, HYDERABAD

Cerebroprotein hydrolysate is a neurotrophic drug, which helps in nerve repair and regeneration,

Given as IV/IM injection for 10-20 days,

Useful in ischemic stroke, traumatic brain injury, Alzheimer’s disease and vascular dementia,

Post-treatment, memory and other higher cognitive functions improve.

CEREBROPROTEINS

TENECTEPLASE

20 years after the launch of ALTEPLASE, we have a new drug

Similar efficacy and safety, longer acting

Higher fibrin specificity

Lower cost

Bolus dose

Tenecteplase offers greater recanalization in cases with complete vessel occlusion.

NEW DRUG FOR STROKE THROMBOLYSIS

SMA is a genetic disease, resulting in severe motor disability and death in most children.

NUSINERSEN, a novel antisense oligonucleotide- was approved in Dec 2016 for treating SMA.

Results in improvement in motor functions in children of all age groups and improves survival.

A NEW HOPE FOR SPINAL MUSCULAR ATROPHY

SAFINAMIDE: First new drug in 10 years to get approval in treating PD,

Maximum trial patients recruited from India,

Reduces “off” time and increases “on” time in PD patients with motor fluctuations.

NEW “INDIAN” DRUG FOR PARKINSON’S DISEASE

Levodopa is traditionally given in the form of oral tablets or intestinal gel form,

Now, an inhalational form is available, which can be used “SOS” by patients, when in “off” phase.

Action starts within 10 minutes.

LEVODOPA INHALATIONAL POWDER

PIMAVANSERIN- antipsychotic drug; works only on serotonin system, without interfering on dopamine systems; no motor side effects

DROXIDOPA- Improves orthostatic hypotension

MRI guided FUS thalamotomy- an alternative for functional surgery.

OTHER NEW DRUGS/PROCEDURES IN PD

BOTOX injection- approved by FDA in 2010 for treating “tablet” refractory chronic migraine (chronic daily headache).

An Indian surgical technique appears promising-removal of parts of frontal and temporal muscles relieves headache >50%. (Ideal for those who fail medications and botox).

LATEST IN MIGRAINE

Earlier, only interferon injections were available,

Oral medicines such as dimethylfumarate, fingolimodand terifluonamide have come in the past few years to prevent disease relapses,

Ocrelizumab is the first drug approved for progressive form of multiple sclerosis.

Treatment with cladribine involves tablets for 10-20 days ONLY, for disease control for four years!

NEW IN MULTIPLE SCLEROSIS

Stem cell treatment for stroke and spinal cord injury,

Success noted in small case series, success needs replication in larger clinical trials

COMING IN NEAR FUTURE!

Almost every organ in the body can be transplanted except the brain,

The main limitation in brain transplantation is the formation of scar tissue, which does not transmit impulses normally,

The maximum achieved so far- a brain transplanted on a headless monkey worked, however, monkey lived only for 9 days.

HOW ABOUT BRAIN TRANSPLANT?

Whatsapp: 9866193953

Email: drsudhirkumar@yahoo.com

Facebook: https://facebook.com/bestneurologist/

THANKS

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