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Tarnished 'Gold Standard' Trials: Mycophenolate in Myasthenia

By Daniel B. Drachman, MD, FAAN - Two clinical trials of treatment of myasthenia gravis (MG) with mycophenolate mofetil (MMF) in Neurology® report lack of efficacy. Unfortunately, both trial protocols were flawed, with relatively short durations of treatment, unexpectedly good responses to concomitant steroid treatment, and problems in the efficacy measure. However, excellent results, and a favorable profile of side effects, observed in numerous myasthenic patients treated by experienced clinicians require that these published trials be considered in context. In the meantime, MMF must remain available for treatment of MG. Future trial designs should consider prolonged time course, interactions of other immunosuppressive agents, and a more appropriate outcome method.
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04-28-2008

Science Editorials and Reviews
Title Category Date
Antiangiogenic Therapy For Glioblastomas Review and Editorials 04-04-08
Update on the International Subarachnoid Aneurysm Trial (ISAT) and the Clip versus Coil Controversy Review and Editorials 03-14-08
Perfusion imaging in acute ischemic stroke: utile or futile? Review and Editorials 02-27-08
Emerging Concepts: Treatment-Responsive Autoimmune Limbic Encephalitis Review and Editorials 02-19-08
Shooting the Messenger (RNA) in the Neurology Clinic: The Promise of Therapeutic RNA Interference Review and Editorials 01-11-08
Urgency for TIA: Push Turns to Shove Review and Editorials 12-21-07
A New Choice on the Menu: Five Years of the Modified Atkins Diet for Epilepsy Review and Editorials 12-10-07

Science at the Annual Meeting

The AAN Annual Meeting brings together more than 10,000 neuroscience professionals for one of the world's largest neurology gatherings. It has long been a leading showcase for the latest developments in scientific research, and the place to honor peers at the forefront of the work.

View 2008 Scientific Abstracts

Science Press Releases from the AAN

Late-Breaking Science

The deadline for submitting a late-breaking science abstract for the 60th Annual Meeting has passed. Applicants will be notified in early March of their status.

Major Lectures From 2007

Amyotropic Lateral Sclerosis: From Mutations to Mechanisms and Medicines
Robert H. Brown, Jr., MD, DPhil - Tuesday, May 1, 2007 10:45 - 11:15 a.m.

Neural Interfaces to Restore Function
John P. Donoghue, PhD - Tuesday, May 1, 2007 5:15 - 5:30 p.m.

Progranulin Mutations in FTDP-17: Genetic and Clinical Implications
Michael Hutton, PhD - Tuesday, May 1, 2007 5:30 - 5:45 p.m.

Waking up to Sleep: Implications for Neurology
Clifford B. Saper, MD, PhD, FAAN - Tuesday, May 1, 2007 5:45 - 6:00 p.m.

Inhibition of B Cell Functions: Implications for Neurology
Marinos C. Dalakas, MD, FAAN - Tuesday, May 1, 2007 6:00 - 6:15 p.m.

Genetic Correlates of Brain Aging on MRI and Cognitive Test Measures: Genome Wide Associated Analysis in the Framingham Heart Study
Sudha Seshadri, MD - Wednesday, May 2, 2007 9:05 - 9:30 a.m.

The Neurochemical Aftermath of Amateur Boxing
Max Albert Hietala, MD, PhD - Wednesday, May 2, 2007 9:30 - 9:55 a.m.

Secondary Analysis of Hemorrhagic Stroke in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Study
Larry B. Goldstein, MD, FAAN - Wednesday, May 2, 2007 9:05 - 9:30 a.m.

Sodium Channels as Targets for Pain Management: Lessons from Inherited Pain Syndromes
C. Geoffrey Woods, MD - Wednesday, May 2, 2007 10:30 - 10:50 a.m.

Idebenone Treatment for Friedreich's Ataxia
Kenneth H. Fischbeck, MD, FAAN - Wednesday, May 2, 2007 10:50 - 11:10 a.m.

How Should We Treat the Patient with Persistent Painful Lumbosacral Radiculopathy?
J.D. Bartleson, MD, FAAN - Wednesday, May 2, 2007 11:10 - 11:30 a.m.

Parkinson's Disease: Beyond the Decade of the Brain
Anthony E. Lang, MD, FAAN - Thursday, May 3, 2007 9:05 - 9:30 a.m.

Channels, Genes, Hormones, and Migrane
Michael A. Moskowitz, MD, FAAN - Thursday, May 3, 2007 9:30 - 10:00 a.m.

The Alzheimer-Frontotemporal Spectrum: A Molecular Approach
Christine Van Broeckhoven, PhD, DSc - Thursday, May 3, 2007 10:00 - 10:30 a.m.

Autonomic Neuropathy: Progress in Pathogenesis and Treatment
Phillip A. Low, MBBS, MD, FRACP, FRCP (Hon) - Thursday, May 3, 2007 10:30 - 11:00 a.m.

For More Information
Kevin Heinz

Scientific Manager
kheinz@aan.com
(651) 695-2773

John W. Henson MD, FAAN

Science Editor
scienceeditor@aan.com

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A 55-year-old man with presumed alcohol-toxic liver cirrhosis is referred to the neurology outpatient clinic because of rapidly progressing extrapyramidal and cerebellar symptoms accompanied by disorientation. On examination a diagnosis of hepatic encephalopathy is made and the patient is treated with lactulose and neomycin. Unenhanced T1 weighted brain MRI imaging shows bilateral basal ganglia hyperintensities as depicted. In this setting, the MRI abnormality is considered to represent changes due to which of the following entities?

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