Dravet syndrome (DS), also known as severe myoclonic epilepsy of infancy (SMEI), is one of the rare early childhood intractable epileptic encephalopathies associated with pleomorphic seizure activity, cognitive decline, motor, and behavioral abnormalities. The convulsive seizure is the most common type seen in DS. After the first episode of seizure-like activity, behavioral disorders and cognitive decline are progressive and long-lasting. The most common etiology identified in patients with DS is a de-novo genetic mutation alpha-1 subunit of voltage-gated calcium channel gene (SCN1A). DS is diagnosed clinically and if unclear, genetic testing is recommended. DS treatment options include anti-epileptic drugs and cannabinoids; ketogenic diet therapy and surgical options such as the deep brain and vagal nerve stimulation. Due to drug-refractory epilepsy in DS, many more therapies are being investigated to increase the longevity of patients.

Introduction The USA is a diverse society with representation from different ethnic and racial backgrounds, resulting in under-represented minorities (URMs) in various specialties of medicine. Our objective was to find the statistical ratio of URMs in the academic faculty of neurology. Methods This was a retrospective analysis of the American Association of Medical College database. The database covered neurology faculty members from 2006 to 2017. Results This study shows a significant change in racial representation in faculty ranks over the last 12 years. At chairperson rank, white people decreased from 86.4% to 79.8% whereas Asian, Hispanic and multiple races (non-Hispanic) simultaneously increased from 6.4% to 9.3%, 0.9% to 3.1% and 1.8% to 4.7%, respectively. At the professor rank, white people decreased from 87.4% to 81.6%, while Asians and Hispanics increased from 7.1% to 10.5% and from 0.7% to 2.1%, respectively. At the rank of associate professor, white people decreased from 81.1% to 68.3% whereas Asians, Hispanics and unknown races increased from 10.3% to 19.0%, 1.6% to 3.1% and from 2.1% to 3.5%, respectively. For the rank of assistant professor, white people decreased from 64.7% to 56.9% and Asians increased from 20.5% to 25.9%. Gender differences (men vs women) for the ranks of chairperson, professor, associate professor, assistant professor and instructors were 90.3% and 9.7%, 83.1% and 16.9%, 67.1% and 32.9%, 56.8% and 43.2%, and 48.1% and 51.9%, respectively. Conclusion Over a period of 12 years the racial proportion in academic neurology has changed, but it is not proportionate to their respective increase in the population of the USA. Moreover, the portion of female faculty increased, but they are still under-represented in leadership roles. This racial and gender disparity can be addressed by well-planned interventions.

Multiple sclerosis (MS) is a chronic disorder of the central nervous system (CNS). MS affects 2.1 million individuals every year and is also considered a major cause of economic health burden around the world. Genetics and environmental factors both play a role in the pathogenesis of MS by activating the immune response and causing inflammation. Patients with MS can have various clinical courses, but the most common pattern seen is relapsing-remitting multiple sclerosis (RRMS). Multiple therapeutic options have been studied to prevent RRMS patients from frequent relapses. The oldest and most frequently used medication for MS is interferon beta, either used alone or as add-on therapy with other drugs. Newer treatment options that have been recently approved to control MS symptoms and suppress the inflammation are glatiramer acetate and siponimod. Infusion therapies consisting of monoclonal antibodies and immunosuppressive drugs have also been studied in the recent past. Some trials have been conducted on the use of stem cells for RRMS patients. We have briefly discussed all treatment options and the response of RRMS patients in multiple trials.

Lambert-Eaton Myasthenic Syndrome (LEMS) is an autoimmune-mediated neurological disorder that manifests as muscle fatigue, diminished tendon reflexes, with symptoms of cholinergic overactivity. It can be associated with certain neoplastic conditions, the most common being small cell lung carcinoma (SCLC). The basic pathophysiology involved is antibody-mediated targeting of voltage-gated calcium channels (VGCC), which decreases the release of acetylcholine in the synaptic junction. Multiple treatment options have been introduced in the past and, recently, a new drug, amifampridine, has been approved by the Food and Drug Administration (FDA) for the treatment of weakness associated with these patients. We summarize this newly introduced drug with a brief description of other treatment options available.