Aim:The Mexican long-tongued bat (Choeronycteris mexicana), Mexican long-nosed bat (Leptonycteris nivalis) and lesser long-nosed bat (Leptonycteris yerbabuenae) (Phyllostomidae: Glossophaginae) undertake long-distance migrations from southcentral Mexico to the south-western United States. It is proposed that these bats migrate along a nectar corridor of columnar cacti and Agave species, but this has not been tested with independent data and the spatiotemporal nature of this relationship is poorly understood. Our goal was to test this nectar corridor hypothesis and determine the relative importance of food plant and abiotic variables to the distribution and seasonal movements of these migratory nectarivores.Location: Mexico and the south-western United States. Methods:We generated species distribution models (SDMs) of documented food plants for these bats. We then created SDMs for each bat following a model selection approach, using food plant and abiotic predictor variables. We modelled migration pathways for C. mexicana and L. yerbabuenae using circuit theory and seasonal SDMs based on seasonally available food plants. Main conclusions: Food plants were more important than climatic and topographic variables in shaping the distribution of these bats. The most important predictors of distribution were Agave, columnar cacti and species richness of food plants. Species richness of food plants was the most consistently important variable, but the components of this diversity varied by bat species: Choeronycteris mexicana was influenced by Agave and cacti; Leptonycteris nivalis was influenced solely by Agave; Leptonycteris yerbabuenae was influenced more generally by cacti, Agave and C3 plants. Migration models for C. mexicana and L. yerbabuenae provided independent support for the nectar corridor hypothesis and indicate shifts in relative importance of specific food plants throughout the year. These results suggest that conservation of these bats should focus more broadly on management for species richness of food plants, especially in tropical dry forests.

Central nervous system effects are predominant within the adverse event profiles of both ezogabine and perampanel. In addition, ezogabine exerts its inhibitory effects on potassium channels in the urogenital tract potentially resulting in urinary retention and related outcomes. Recent reports of blue discoloration of the skin and in the retinas of long-term ezogabine users have surfaced. Both drugs have demonstrated the ability to induce neuropsychiatric symptoms. Though both are welcome additions to the antiepileptic drug class, additional monitoring, appropriate counseling, and careful selection of patients are warranted to minimize adverse events.

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The FDA approved gabapentin enacarbil in 2011 as the first non-dopaminergic agent for the treatment of restless legs syndrome (RLS) symptoms. Although gabapentin enacarbil is a pro-drug of gabapentin, its pharmacokinetics differ. Absorption of gabapentin enacarbil is more predictable, and inter-patient variability in bioavailability is lower than that of gabapentin. Studies have demonstrated superiority of gabapentin enacarbil compared to placebo. Comparisons to currently available RLS treatments are lacking, but clinical trials demonstrate comparable improvement in RLS symptoms to the dopamine agonists ropinirole and pramipexole, which are usually considered first-line therapy for daily RLS symptoms. Gabapentin enacarbil was well tolerated in clinical trials. The role of the drug in RLS treatment remains undefined, although it will likely be used as an alternative for refractory RLS when other treatments have failed. Additionally, gabapentin enacarbil may be recommended for patients with daily RLS symptoms that are less intense or are associated with pain as an alternative to dopamine agonists.

Placebo-controlled trials of gabapentin enacarbil demonstrate considerable efficacy in the treatment of RLS. However, head-to-head trials comparing gabapentin enacarbil with other medications used in the treatment of RLS, including gabapentin, are lacking. Potential advantages with gabapentin enacarbil related to its pharmacokinetic profile are thus difficult to ascertain. Efficacy of gabapentin enacarbil appears comparable with that of the dopamine agonists, long considered the therapy of choice in patients with RLS. Given the lack of direct-comparison trials, and the significant cost differential of gabapentin enacarbil versus established therapies, the drug is likely to be used for patients who have failed other medication trials, or those who experience prolonged symptoms and prefer once-daily dosing.

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