SHARE:

Guideline Projects in Process

The AAN is currently developing guidelines on the following topics (as of June 2016):

Brain Injury and Brain Death

Brain Injury and Cardiac Arrest
  • In patients with cardiac arrest, does induced mild hypothermia improve outcome after CPR in adults who are comatose?
  • In patients with cardiac arrest, do putative neuroprotective drugs improve outcome after CPR in adults who are comatose?
  • In patients with cardiac arrest, do other medical interventions improve outcome after CPR in adults who are comatose?
Disorders of Consciousness (Update)
  • The diagnosis, prognosis, and treatment of VS and MCS
PREDICTION OF OUTCOME IN COMATOSE AFTER CARDIOPULMONARY RESUSCITATION (UPDATE)
  • Update to the 2006 guideline that addressed outcomes and predictors of death or unconsciousness in comatose survivors after cardiac arrest and cardiopulmonary resuscitation (CPR).

Child Neurology

Treatment of Autism
  • Do pharmacologic treatments reduce the effects of core symptoms and associated co-existent conditions?
  • Do behavioral treatments reduce the effects of core symptoms and associated co-existent conditions in this population?
  • Do complementary medicine treatments reduce the effects of core symptoms and associated co-existent conditions in this population?
  • Do pharmacologic and behavioral treatments reduce the effects of sleep disturbances in this population?
  • For individuals with ASD and epilepsy do pharmacologic treatments improve quality of life and control seizures?
  • For individuals with epilepsy, is the presence of concomitant ASD associated with different therapeutic or adverse effects of anti-epilepsy drugs?
PHARMACOLOGIC TREATMENT OF MIGRAINE HEADACHE IN CHILDREN
  • Questions currently under determination.
TREATMENT OF TICS IN INDIVIDUALS WITH TOURETTE SYNDROME AND CHRONIC TIC DISORDER
  • In children and adults with Tourette Syndrome or a Chronic Tic Disorder, which medical, behavioral and surgical interventions, as compared to placebo or other active interventions, improve tic severity and tic related disability?

Dementia

Detection of Dementia and Mild Cognitive Impairment (Update)
  • What is the evidence for the clinical diagnosis of mild cognitive impairment?
  • What is the outcome of the individuals?
  • Are there useful interventions, medications or otherwise?
  • Is this diagnosis useful to clinicians?
  • Is this diagnosis useful to patients?
BETA-AMYLOID IMAGING FOR ALZHEIMER’S DISEASE
  • Is there a quantitative description of the diagnostic accuracy of amyloid PET? What is its sensitivity and specificity of amyloid PET for determining if AD is the cause of a patient’s symptoms? Without this information, how is a clinician to interpret the results of a positive or negative study?
  • For the clinical indication(s) chosen, how likely is a positive test to be a false positive?
  • What is the quality of the evidence supporting the diagnostic accuracy of amyloid PET?
  • To help the clinician put the role of amyloid PET into perspective, how does the diagnostic accuracy of amyloid PET compare to the common imaging modalities already in routine use—CT or MRI? What is its added value?
  • Is the diagnostic accuracy of amyloid PET high enough to obviate the need to search for reversible etiologies of dementia?
DIAGNOSIS OF DEMENTIA (UPDATE)
  • Update to the 2001 guideline that addressed the accuracy and reliability of dementia diagnostic criteria, laboratory testing, and comorbidities in elderly patients undergoing an initial assessment for dementia.

Epilepsy

Efficacy and Tolerability of the New AEDs: Treatment of new-onset epilepsy (Update)
  • For adults and children with newly diagnosed epilepsy, are FBM, GBP, LTG, OXC, TGB, TPM, LEV, ZNG, PGB, LCM, RFN, EZG, VGB, and CLB effective as monotherapy, and how does their efficacy and tolerability compare with those of older AEDs?
Efficacy and Tolerability of the New AEDs: Treatment-resistant epilepsy (Update)
  • For adult patients with TR focal epilepsy are these AEDs when used as adjunctive therapy (relative to no adjunctive therapy) effective in reducing seizure frequency?
  • For adult patients with TR focal epilepsy are these AEDs when used as monotherapy effective in reducing seizure frequency?
  • For adult and pediatric patients with TR idiopathic generalized epilepsy (IGE) are these AEDs when used as adjunctive therapy effective in reducing seizure frequency?
  • For adult and pediatric patients with LGS are these AEDs when used as adjunctive therapy effective in reducing seizure frequency?
  • For pediatric patients with TR focal epilepsy are these AEDs when used as adjunctive therapy (relative to no adjunctive therapy) effective in reducing seizure frequency?
  • For pediatric patients with TR focal epilepsy are these AEDs when used as monotherapy effective in reducing seizure frequency?
  • Have new serious adverse events (AEs) been identified in these AEDs?
Risk Factors for Sudden Unexplained Death in Epilepsy
  • What is the incidence of SUDEP in specific epilepsy populations?
    • Intractable epilepsy patients
    • The general epilepsy population from time of diagnosis
    • Children vs. Adults
  • What are non-modifiable risk factors for SUDEP?
Timing of AED withdrawal in seizure-free patients with epilepsy
  • For children with epilepsy, is there a preferred time for attempting drug discontinuation in patients who are seizure free?
  • For adults with epilepsy, is there a preferred time for attempting drug discontinuation in individuals who are seizure free?
  • Are there risk factors making it more or less likely an individual will have seizure recurrence on medication withdrawal?
  • Are there specific counseling recommendations that would help the patient make an informed decision about the risk and benefits of drug discontinuation?

Movement Disorders

Treatment of Restless Legs Syndrome
  • What are safe and effective therapies for the symptoms and clinical consequences (disturbed sleep, pain, PLMS, depression/anxiety, and quality of life) of restless legs syndrome?
Treatment of cerebellar motor dysfunction and ataxia
  • For patients with cerebellar motor dysfunction, do pharmacologic therapies compared to no (or alternative) treatments improve motor symptoms with acceptable safety and tolerability?
  • For patients with cerebellar motor dysfunction, do surgical or other interventional therapies (e.g. physical training) improve motor symptoms with acceptable safety and tolerability?
  • For patients with cerebellar motor dysfunction, does magnetic stimulation compared to no (or alternative) treatments improve motor symptoms with acceptable safety and tolerability?
Treatment of Parkinson’s Disease with motor fluctuation and dyskinesia (update)
  • Which medications reduce off time?
  • What is the relative efficacy of medications in reducing off time?
  • Which medications reduce dyskinesia?
  • Does deep brain stimulation (DBS) of the subthalamic nucleus (STN), globus pallidus interna (GPi), or ventral intermediate (VIM) nucleus of the thalamus reduce off time, dyskinesia, and antiparkinsonian medication usage and improve motor function?
  • Which factors predict improvement after DBS?
TREATMENT OF TICS IN INDIVIDUALS WITH TOURETTE SYNDROME AND CHRONIC TIC DISORDER
  • In children and adults with Tourette Syndrome or a Chronic Tic Disorder, which medical, behavioral and surgical interventions, as compared to placebo or other active interventions, improve tic severity and tic related disability?

Multiple Sclerosis

Immunization and MS (update)
  • Are vaccine-preventable infectious diseases more frequent in patients with MS than in the general population?
  • Do vaccine-preventable infectious diseases increase the risk of MS exacerbations?
  • Does vaccination increase the risk of developing MS?
  • Does vaccination increase the risk of exacerbations of MS?
  • Are live attenuated vaccines as effective in patients with MS as in the general population?
  • Are inactivated vaccines as effective in patients with MS as in the general population?
  • Does immunomodulating treatment of MS with corticosteroids, interferons, glatiramer acetate, mitoxantrone, natalizumab, alemtuzumab, or fingolimod reduce effectiveness of vaccinations in MS?
DISEASE MODIFYING THERAPY FOR MS
  • This guideline addresses starting, switching and stopping disease modifying therapy in MS patients. All questions will be answered by MS disease subgroup- relapsing-remitting MS, primary progressive MS, and secondary progressive MS with and without relapses. In addition, data on patients with clinically isolated syndromes of demyelination will be included where applicable.

Neuromuscular

Muscular Dystrophy: Myotonic
  • In patients with DM, what interventions improve clinical myotonia?
  • Do patients with DM1 and DM2 have increased anesthesia/analgesia or other drug-related complications as compared with control subjects?
  • Do patients with DM1 and DM2 have CNS abnormalities as determined by neuropsychological testing, brain MRI, and brain autopsy?
  • Do patients with DM1 and DM2 have increased risks for cardiac complications?
  • Do patients with DM1 and DM2 have increased risks for respiratory complications?
  • In patients with DM, what is the frequency of important gastrointestinal symptoms (such as constipation, diarrhea, abdominal pain, and dysphagia) and serious complications (such as nonmechanical ileus, volvulus, intestinal necrosis, gall bladder diseases, and aspirations) in comparison with control subjects?
  • In patients with DM, how common is excessive daytime sleepiness (EDS)?
  • In patients with DM what interventions improve EDS?

Stroke and Vascular Neurology

Recurrent Stroke with Patent Foramen Ovale and Atrial Septal Aneurysm (Update)
  • What is the risk of recurrent stroke in patients with patent foramen ovale (PFO) and/or atrial septal aneurysm (ASA)?
  • What is he optimal management to prevent recurrent stroke in patients with PFO and/or ASA: medical therapy (antiplatelets or anticoagulation) or endovascular closure plus medical therapy?
PREVENTION OF STROKE IN PATIENTS WITH CLINICALLY SIGNIFICANT INTRACRANIAL ATHEROSCLEROSIS
  • Questions currently under determination.
TPA AND IA THROMBECTOMY
  • Scoping in progress

Technology Assessments

Functional MRI in Neurology
  • Is fMRI a valid indicator of language lateralization?
  • Can fMRI predict postsurgical language outcomes in patients undergoing brain surgery?
  • Is fMRI a valid indicator of memory lateralization?
  • Can fMRI predict postsurgical verbal memory outcomes in patients undergoing temporal lobectomy?
  • Can fMRI predict postsurgical nonverbal (visuospatial) memory outcomes in patients undergoing temporal lobectomy?
UTILITY OF EEG THETA/BETA POWER RATIO IN THE DIAGNOSIS OF ADHD
  • For patients with ADHD, does the combination of a clinical examination and an examination of the EEG theta/beta power ratio increase diagnostic certainty compared to clinical examination alone?
  • For patients with a possible but uncertain diagnosis of ADHD, how accurately does the EEG theta/beta ratio identify patients with ADHD, as compared to the reference standard of a clinical evaluation?

Other

Lyme Disease
  • The Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the American College of Rheumatology (ACR) are jointly developing a systematic review and clinical practice guideline on the treatment of Lyme disease. The author composition is made up of representatives from IDSA, AAN, and ACR with representation from the American Academy of Family Physicians (AAFP), American Academy of Pediatrics - Committee on Infectious Diseases (AAP-COID), American Academy of Pediatrics - Section on Emergency Medicine (AAP-EM), American College of Physicians (ACP), Association of Medical Microbiology and Infectious Diseases - Canada (AMMI-CA), Child Neurology Society (CNS), Pediatric Infectious Diseases Society (PIDS), Entomological Society of America (ESA), and European Society of Clinical Microbiology and Infectious Diseases (ESCMID). Members representing the disciplines of cardiology, microbiology, pathology, and a methodologist with expertise in GRADE are also included. Finally, the panel includes a healthcare consumer representative, three patients with confirmed Lyme disease, and a parent of a pediatric patient with confirmed Lyme disease. See more at http://www.idsociety.org/Lyme_Response_Public_Comment/
Vestibular Testing (Update)
  • For patients with suspected superior canal dehiscence syndrome (SCD), does cVEMP accurately identify patients with SCD compared to other methods?
  • For patients with suspected vestibular symptoms, does cVEMP accurately identify the presence of underlying vestibular dysfunction?
  • For patients with suspected CNS disorders affecting the vestibulospinal tracts, does cVEMP identify the presence of underlying disease affecting these brainstem and spinal cord pathways?
NEUROLOGIC RISK OF IMMUNIZATION (UPDATE)
  • Questions currently under determination.
USE OF EPIDURAL STEROID INJECTIONS TO TREAT RADICULAR LUMBOSACRAL PAIN (UPDATE)
  • Questions currently under determination.

Suggest a Topic

On a quarterly basis, the Guideline Development, Dissemination, and Implementation Subcommittee will review and approve guideline topics. If you have an interest in suggesting a topic, please complete the topic nomination form and submit to guidelines@aan.com for consideration.

Previous Manual Versions

Related Content

Log On

MEMBER LOG IN

Forgot password?