Septic cavernous sinus thrombosis is a rare but serious complication of infection of the cavernous sinuses. There are no randomised, controlled trials of management of this condition and existing reviews of the literature are somewhat dated. The authors report a case with a favourable outcome and then present the findings of a literature review of the management of this condition. Outcome data suggest that corticosteroids are of equivocal benefit whereas antibiotics and anticoagulation are beneficial.

Optic neuritis is a common problem and most neurologists are familiar with it. Recent studies have suggested that it can be overdiagnosed in as many as 10% of cases. The major reasons for this relate to confusion regarding terminology and lack of familiarity with common mimics. This article covers typical 'idiopathic' demyelinating optic neuropathy (IDON) and several possible variations in the way it can present (chameleons). We then discuss several conditions that can mimic IDON, including neuromyelitis optica, sarcoidosis, chronic relapsing inflammatory optic neuropathy, anterior ischaemic optic neuropathy, infectious/parainfectious optic neuropathy, neuroretinitis, Leber's hereditary optic neuropathy, and some 'ocular' mimics including autoimmune retinopathy and central serous choroidoretinopathy.

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Hyperpolarization-activated cyclic-nucleotide-gated (HCN) channels mediate differences in sensory and motor axonal excitability at different thresholds in animal models. Importantly, HCN channels are responsible for voltage-gated inward rectifying () currents activated during hyperpolarization. The currents exert a crucial role in determining the resting membrane potential and have been implicated in a variety of neurological disorders, including neuropathic pain. In humans, differences in biophysical properties of motor and sensory axons at different thresholds remain to be elucidated and could provide crucial pathophysiological insights in peripheral neurological diseases. Consequently, the aim of this study was to characterize sensory and motor axonal function at different threshold. Median nerve motor and sensory axonal excitability studies were undertaken in 15 healthy subjects (45 studies in total). Tracking targets were set to 20, 40, and 60% of maximum for sensory and motor axons. Hyperpolarizing threshold electrotonus (TEh) at 90-100 ms was significantly increased in lower threshold sensory axons times ( = 11.195, < 0.001). In motor axons, the hyperpolarizing current/threshold (/) gradient was significantly increased in lower threshold axons ( = 3.191, < 0.05). The minimum / gradient was increased in lower threshold motor and sensory axons. In conclusion, variation in the kinetics of HCN isoforms could account for the findings in motor and sensory axons. Importantly, assessing the function of HCN channels in sensory and motor axons of different thresholds may provide insights into the pathophysiological processes underlying peripheral neurological diseases in humans, particularly focusing on the role of HCN channels with the potential of identifying novel treatment targets. Hyperpolarization-activated cyclic-nucleotide-gated (HCN) channels, which underlie inward rectifying currents (), appear to mediate differences in sensory and motor axonal properties. Inward rectifying currents are increased in lower threshold motor and sensory axons, although different HCN channel isoforms appear to underlie these changes. While faster activating HCN channels seem to underlie changes in sensory axons, slower activating HCN isoforms appear to be mediating the differences in conductances in motor axons of different thresholds. The differences in HCN gating properties could explain the predilection for dysfunction of sensory and motor axons in specific neurological diseases.

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Immunotherapy is a treatment strategy that has demonstrated survival benefit for metastatic melanoma. Ipilimumab and nivolumab are examples of immunotherapy, in which monoclonal antibodies antagonize cytotoxic T-lymphocyte-associated protein 4 and programmed death-ligand 1 receptors, respectively, resulting in upregulation of the host immune response to cancer cells. There is increasing recognition of immune-mediated adverse events associated with immune therapies in patients with cancer. We present a case report of a patient who developed Miller Fisher syndrome associated with these therapies for metastatic melanoma along with a discussion of its management.

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Introduction/Aims: Foot drop is common in chronic inflammatory demyelinating polyneuropathy (CIDP), but its prognosis is uncertain.Methods: CIDP patients with less than anti-gravity strength (<3/5 power) of ankle dorsiflexion (ADF) on Medical Research Council manual muscle testing on presentation at our center were identified by retrospective review. After initiation of standard treatment, ADF power was serially tabulated, and predictors of recovery were determined.Results: Of the 27 identified patients, ADF power at presentation was <3/5 in 48/54 legs. At 1 y after treatment, ADF power improved to >/= 3/5 in 17/27 patients in one (N = 6) or both (N = 11) legs. On multi-variate analysis, predictors of recovery of ADF power were tibialis anterior compound muscle action potential amplitude at presentation, shorter disease duration, and female gender.Discussion: Foot drop improves to anti-gravity power in most treated CIDP patients depending in part on the severity of fibular motor axon loss at onset of treatment.