Clinical trials in neurology

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  • Advances in the diagnosis, prevention, treatment and cure of neurological diseases are based upon scientific discovery. The journey from discovery to treatment is often arduous and involves both basic and clinical science. Over the ages, multiple intertwined paths of discovery connect the recognition of distinct diseases of the nervous system to exquisite diagnostic descriptions, which, when coupled with the scientific understanding of the disease, have allowed the development of effective treatments and interventions...

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  • Corticosteroids are often used as an adjunct in the treatment of various forms of tuberculosis (TB) and for the prevention of complications, such as constrictive pericarditis, hydrocephalus, focal neurological deficits, pleural adhesions, and intestinal strictures. Notwithstanding, they have been proven in clinical trials to improve the following outcomes only — death or disability in human immunodeficiency virus (HIV)-seronegative patients with tubercular meningitis and tubercular pericarditis.

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  • Second, it should not be forgot that several neuroprotectant have failed not because they lacked efficacy, but because they revealed unexpected side effects. Many NMDAreceptor antagonists were discarded because in clinical trials they showed psychedelic unwanted effects. Tirilazad, an antioxidant belonging to the “lazaroid” class of antioxidants, unexpectedly worsened outcome of ischemic stroke, a fact very likely explained by some unexpected toxic action(s) that offset its neuroprotective ability.

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