UNASSIGNED: The management of epilepsy is mainly based on antiseizure medications (ASMs). More than 20 ASMs have been introduced in clinical practice, providing a multitude of prescription choices. To date, there are no published data on the trends in ASMs prescriptions in Morocco. Therefore, we conducted a survey among practicing neurologists in seven tertiary referral hospitals in Morocco to study the current ASMs prescription preferences and their modifying factors.
UNASSIGNED: Our descriptive and analytical cross-sectional study was based on a survey sent between January and April 2022 to neurologists practicing in seven tertiary referral hospitals in Morocco. Information regarding the prescription of ASMs was collected using an exploitation form and analyzed using the SPSS version 13 software.
UNASSIGNED: Based on questionnaire responses, our results showed that Valproic acid (96.3%) and Lamotrigine (59.8%) were the two most prescribed ASMs for generalized seizure types. For focal seizure types, Carbamazepine (98.8%) and Levetiracetam (34.1%) were the most commonly prescribed drugs, whereas for combined focal and generalized seizure types, the combination of Valproic acid and Carbamazepine (38.55%) was the most prescribed. Phenobarbital was the most commonly prescribed ASM for status epilepticus (40.2%). These prescription preferences were mainly due to seizure types, cost, health insurance coverage, years of experience, and additional epileptology training (p < 0.05).
UNASSIGNED: Our results show a shift in the prescription of ASMs in Morocco. Similar to many other countries, valproic acid and carbamazepine are considered the first-line treatments for generalized and focal seizure types. Some factors remain as major challenges in enhancing epilepsy management in Morocco.

Artificial intelligence (AI) large language models (LLMs) now produce human-like general text and images. LLMs\' ability to generate persuasive scientific essays that undergo evaluation under traditional peer review has not been systematically studied. To measure perceptions of quality and the nature of authorship, we conducted a competitive essay contest in 2024 with both human and AI participants. Human authors and 4 distinct LLMs generated essays on controversial topics in stroke care and outcomes research. A panel of Stroke Editorial Board members (mostly vascular neurologists), blinded to author identity and with varying levels of AI expertise, rated the essays for quality, persuasiveness, best in topic, and author type. Among 34 submissions (22 human and 12 LLM) scored by 38 reviewers, human and AI essays received mostly similar ratings, though AI essays were rated higher for composition quality. Author type was accurately identified only 50% of the time, with prior LLM experience associated with improved accuracy. In multivariable analyses adjusted for author attributes and essay quality, only persuasiveness was independently associated with odds of a reviewer assigning AI as author type (adjusted odds ratio, 1.53 [95% CI, 1.09-2.16]; P=0.01). In conclusion, a group of experienced editorial board members struggled to distinguish human versus AI authorship, with a bias against best in topic for essays judged to be AI generated. Scientific journals may benefit from educating reviewers on the types and uses of AI in scientific writing and developing thoughtful policies on the appropriate use of AI in authoring manuscripts.

BACKGROUND: Functional Neurological Disorder (FND) is commonly encountered in clinical practice, causing functional impairment and poor quality of life. As there is limited data from Saudi Arabia, our study aims to explore the experience and opinions of Saudi neurologists and neurology trainees regarding FND.
METHODS: In our cross-sectional observational study, we included 100 neurology consultants and trainees. Data was collected using an online questionnaire from March to August 2023.
RESULTS: A total of one hundred neurologists participated in the survey. Although 41% of physicians encountered FND patients on a weekly basis or more frequently, only 41.7% of trainees reported receiving dedicated lectures on FND. Furthermore, only 46% of respondents felt comfortable providing a clear explanation of the FND diagnosis to their patients. While the majority (64%) used the term \"Functional Neurological Disorder\" in medical documentation, only 43% used this term when communicating the diagnosis to patients, with the terminology varying widely. Clinicians emphasized that inconsistent and variable neurological examinations were key indicators raising diagnostic suspicion, which aligns with the recommended reliance on detailed clinical history and neurological examination. Lastly, 61% of physicians stated that their approach to patients with FND lacked a structured management plan.
CONCLUSIONS: Our study findings emphasize that FND is commonly encountered in clinical practice and reveal a significant lack of targeted education on FND for neurology trainees. Enhancing educational programs for both trainees and practicing neurologists on this prevalent neurological condition is essential for improving patient care and outcomes.

暂无摘要。

The prevalence of peripheral neuropathies has increased over the years, and novel treatments for management of several neuropathies have emerged over the past decade. Following a literature search of the ICHUSHI database, we observed that recent literature on peripheral neuropathy most frequently includes reports from the orthopedic specialty, followed by studies reported by the neurology service. Notably, the number of studies reported by the neurology departments has increased over the past decade. However, most patients with common peripheral neuropathies do not visit the neurology department. Therefore, it is necessary to highlight the role of neurologists for comprehensive evaluation and management of neuromuscular disorders. This may result in acknowledgement of neurology as the primary gatekeeper of peripheral neurological diseases.

Determination of indications for acute reperfusion therapy (intravenous recombinant tissue plasminogen activator administration and mechanical thrombectomy) and identification of stroke mimics and chameleons are essential components of effective stroke treatment. Moreover, neurologists select the appropriate medications and manage the patient\'s general condition. Therefore, a neurologist\'s solid diagnostic skills based on neurological symptomatology and an internist\'s broad knowledge and insight play key roles clinically.

The September 2013 issue of this journal contains an article titled \"The Role of Neurologists in Dementia Practice\" in which I have highlighted the contributions of neurologists to dementia care. I have emphasized the importance of proactive leadership within interdisciplinary teams that include general practitioners and psychiatrists. Following the implementation of the Basic Act on Dementia to Promote an Inclusive Society and advances in medical science, such as introduction of the anti-Alzheimer drug lecanemab, neurologists are expected to play a more active role in dementia management and require more specialized skills. The emergence of lecanemab has led to more direct involvement of neurologists in dementia practice, which has resulted in the emergence of \"novice\" dementia specialists. However, a shortage of neurologists who specialize in behavioral neurology remains a significant concern in Japan. This challenge is compounded by the inadequate education of general neurologists in this domain, because dementia management requires deep knowledge and skills in behavioral neurology. The most important and urgent issue is to promptly address this shortage. Although neurologists\' involvement in dementia practice is attributable to the introduction of lecanemab, I sincerely look forward to neurologists transitioning from \"novice\" to \"real\" experts in dementia. I reiterate this call as a recommendation to fellow neurologists, emphasizing the need to evolve into true specialists in the field.

UNASSIGNED: As newer, innovative neurology drugs enter the US health care system, neurologists should consider the cost of these treatments in addition to their efficacy, safety, and tolerability. To do so thoughtfully requires an understanding of how prescription drugs are priced in the United States. The process of drug pricing is linked to the distribution supply chain and the many stakeholders involved. Stakeholders include pharmaceutical manufacturers; wholesalers; pharmacies; pharmacy benefit managers; payers, including health insurers; hospital systems; neurologists and other clinicians; and patients. Drug pricing has taken center stage as the Inflation Reduction Act of 2022 has set maximum out-of-pocket expenses for Medicare beneficiaries for the first time in the program\'s history and limits drug price increases for a select group of Medicare Part D drugs. This article describes the US drug distribution supply chain and its stakeholders and introduces key drug pricing terms; a brief description of how rebates are generally estimated will also be discussed. Finally, as newer neurology outpatient drugs enter the market, the \"value\" of drugs will be described through cost-effectiveness terminology and their utility for the clinical neurologist.

UNASSIGNED: Acute ischemic stroke is a leading cause of pediatric death and disability. A clinical scale adapted for children can ensure early detection of candidates for urgent acute ischemic stroke treatment. The Rapid Arterial Occlusion Evaluation (RACE) scale for adults, which scores 5 items (facial palsy 0-2; arm motor function 0-2; leg motor function 0-2; head/gaze deviation 0-1; and aphasia or agnosia 0-2), has good sensitivity and specificity in detecting large vessel occlusion.
UNASSIGNED: We adapted the previously validated RACE scale for use in children as the Pediatric RACE scale. This adapted scale was tested by prehospital/emergency room staff attending to patients covered by the Catalan Pediatric Stroke Code and child neurologists for its correlation with the Pediatric National Institutes of Health Stroke Scale and for interrater reliability.
UNASSIGNED: The study included 50 children, 18 with confirmed strokes (7 acute ischemic strokes and 11 hemorrhagic strokes). Prehospital/emergency staff and child neurologists agreed fully regarding 82% of patients and 100% regarding head/gaze deviation and agnosia. The Pediatric RACE scale correlated strongly with the Pediatric National Institutes of Health Stroke Scale in evaluations by child neurologists (Spearman ρ, 0.852; P<0.001) and prehospital/emergency staff (Spearman ρ, 0.781; P<0.001). The median Pediatric RACE score was significantly higher in patients with large vessel occlusion (6.5; interquartile range, 6-7) than with other etiologies.
UNASSIGNED: Pediatric RACE, showing good interrater reliability and correlation with the Pediatric National Institutes of Health Stroke Scale, is a simple scale to detect candidates for pediatric acute stroke treatment, designed for both prehospital and in-hospital use by non-neurologist medical staff.

BACKGROUND: The demand for chat messaging apps for communication between physicians, therapists and patients is increasing. The expectations for this form of communication and uncertainties regarding introduction and use are heterogeneous.
OBJECTIVE: The implementation of chat messengers in the care of patients with Parkinson\'s disease should be facilitated by recommendations regarding introduction and usage.
METHODS: Semi-structured interviews with neurologists and physiotherapists were conducted to capture the expectations and needs regarding the use of chat messengers. From the data analysis, recommendations were derived.
RESULTS: The expectations for technical functionality exceeded the chat messenger functions. This concerns, e.g., the connection of the chat messenger to the electronic patient file. There is a great deal of uncertainty, particularly when it comes to the applicable General Data Protection Regulations (GDPR). The recommendations relating to the use of chat messengers, data protection aspects, the design of such tools and methodological considerations can help to implement the tool as an additional communication channel.
CONCLUSIONS: Practical recommendations regarding functionality, the use of chat messengers in everyday life and in relation to data protection are derived from the results. By improving knowledge, physicians and therapists can contribute to the successful establishment of chat messengers as an additional communication tool.
UNASSIGNED: HINTERGRUND: Die Nachfrage nach Chat-Messengern für den Austausch zwischen Ärzten, Therapeuten und ihren Patienten steigt. Die Erwartungen an die Chat-Messenger und Unsicherheiten hinsichtlich Einführung und Nutzung sind heterogen.
UNASSIGNED: Die Implementierung eines Chat-Messengers in die Parkinson-Versorgung soll durch die Formulierung einführungs- und anwendungsrelevanter Empfehlungen vereinfacht werden.
METHODS: Semistrukturierte Interviews mit Neurologen und Physiotherapeuten wurden durchgeführt, um die Erwartungen an die Nutzung von Chat-Messengern zu erfassen, welche die Basis für die abgeleiteten Empfehlungen bildeten.
UNASSIGNED: Die Erwartungen an die technische Funktionalität übersteigen die Funktionen von Chat-Messenger. Das betrifft z. B. die Anbindung des Chat-Messengers an die elektronische Patientenakte. Insbesondere auch bei den anzuwendenden Regelungen der Datenschutz-Grundverordnung (DSGVO) herrscht große Unsicherheit. Die Empfehlungen, die sich auf die Nutzung der Chat-Messenger, auf die Aspekte des Datenschutzes, die Gestaltung dieser Technologien und methodische Überlegungen beziehen, sollen bei der Implementierung des Tools als zusätzlichen Kommunikationskanal helfen.
CONCLUSIONS: Aus den Ergebnissen leiten sich Empfehlungen zur Funktionalität, dem Umgang mit Chat-Messengern im Alltag und in Bezug zum Datenschutz ab. Durch Verbesserung der Kenntnisse bei den Gesundheitsberuflern und Beachtung dieser Handlungsanweisungen können Ärzte und Therapeuten zu einer erfolgreichen Etablierung des Chat-Messengers als zusätzliches Kommunikationstool beitragen.