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Arch Neurol. 1998;55:15.

Carotid Endarterectomy 1990-1995
Holloway and colleagues (SEE ARTICLE) have measured patient outcomes for carotid endarterectomy from 1990 to 1995. They provide a rigorous assessment to guide future inpatient management "particularly in conditions when the margin of error is so low and the stakes are so high."

Magnetic Resonance Imaging in Machado-Joseph Disease
Quantitative assessment of magnetic resonance imaging scans in patients with Machado-Joseph disease is provided to characterize the typical neuroanatomical changes in this most common of dominantly inherited ataxias. The findings of Murata et al (SEE ARTICLE) correlate, in large measure, with the histopathological characteristics of this disease.

HIV Encephalopathy Treated With Peptide T
Heseltine and colleagues (SEE ARTICLE) examined the effect of peptide T in patients with human immunodeficiency virus encephalopathy. Their assessment was rigorous, but peptide T was not found to be efficacious on the study's primary end points.

Tiagabine for Complex Partial Seizures
The new antiepileptic drug tiagabine, which inhibits uptake of -aminobutyric acid, was evaluated for use in complex seizures and was shown to be highly effective in a well-designed study by Uthman and colleagues (SEE ARTICLE) .

Mood Disorders and Multiple Sclerosis: Role of Cerebral Inflammation
Fassbender et al (SEE ARTICLE) have investigated the association between affective and neuroendocrine changes in multiple sclerosis (MS) with inflammatory activity. Scores of depression and anxiety in patients with MS were associated with a failure of suppression of cortisol release after pretreatment with dexamethasone. A careful discussion about hypothalamic-pituitary-adrenal gland function in MS is reviewed as a potential link between cerebral inflammation and mood.

Balance and Magnetic Resonance Imaging Changes
Falling is a major cause of disability in older adults. Balance in elderly patients was studied in relation to changes demonstrated on magnetic resonance imaging scans. It appears that older adults with balance problems have a greater prevalence of brain abnormalities identified by magnetic resonance imaging, as presented by Tell and colleagues (SEE ARTICLE) .

Sense of Smell in Alzheimer's Disease and Parkinson's Disease
Mesholam et al (SEE ARTICLE) found a pervasive impairment in olfactory function in patients with Alzheimer's disease and Parkinson's disease. No discriminating olfactory defects were seen between patient groups or among the 3 olfactory domains. It appears the olfactory system participates in the degenerative process in these 2 common neurological disorders.

Selegiline in Amyotrophic Lateral Sclerosis
Lange and colleagues (SEE ARTICLE) have studied the use of selegiline hydrochloride, a monoamine oxidase-B inhibitor, in patients with amyotrophic lateral sclerosis. Unfortunately, no significant effect on the rate of clinical progression or outcome of disease was found.