Continuum Aloud 29(3) June 2023 (Neurology of Systemic Disease)

Contributors^a

Leticia Tornes, MD, FAAN, Guest Editor
Chief of Neurology, Bruce W. Carter Department of Veterans Affairs Medical Center; Associate Professor, Clinical Neurology Associate Program Director, Neurology Residency Program, Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida

Relationship Disclosure: Dr Tornes reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Tornes discusses the unlabeled/investigational use of acetazolamide, clobazam, depot-medroxyprogesterone, and progesterone for the treatment of catamenial epilepsy; plasma exchange and steroids for the treatment of multiple sclerosis relapse during pregnancy; medications, injectables, and neuromodulation devices including almotriptan, amitriptyline, aspirin, butalbital, carbamazepine, eletriptan, escitalopram, fluoxetine, frovatriptan, gabapentin, lamotrigine, lasmiditan, metoprolol, naratriptan, nortriptyline, occipital nerve stimulation, onabotulinumtoxinA, oxcarbazepine, prochlorperazine, promethazine, propranolol, riboflavin, rimegepant, rizatriptan, sertraline, single-pulse transcranial magnetic stimulation, sphenopalatine ganglion stimulation, sumatriptan, supraorbital nerve stimulation, transcutaneous vagal nerve stimulation, ubrogepant, verapamil, and zolmitriptan for the treatment of headache in pregnancy and lactation, none of which are approved by the US Food and Drug Administration (FDA) for use in pregnancy or lactation; alteplase and tenecteplase for the treatment of acute ischemic stroke in pregnant women, and medications including apixaban, aspirin, bile acid sequestrants, cilostazol, clopidogrel, dabigatran, ezetimibe, fibrates, niacin, PCSK9 inhibitor, rivaroxaban, and ticagrelor, none of which are approved by the FDA for use in pregnancy or lactation.

Tracey A. Cho, MD, FAAN
Clinical Professor of Neurology, University of Iowa Carver College of Medicine; Director, Neuroimmunology Division, University of Iowa Healthcare, Iowa City, Iowa

Relationship Disclosure: Dr Cho has received personal compensation in the range of $500 to $4999 for serving as a consultant for Horizon Therapeutics plc and on a data safety monitoring board for the National Institutes of Health and has received publishing royalties from a publication relating to health care. The institution of an immediate family member of Dr Cho has received research support from the National Institutes of Health.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Cho reports no disclosures.

T. Scott Diesing, MD, FHM
Associate Professor; Chief, Neurohospital Medicine and General Neurology, Department of Neurological Sciences, University of Nebraska Medical Center; Medical Director, Neurosciences Unit, Nebraska Medicine, Omaha, Nebraska

Relationship Disclosure: Dr Diesing has received personal compensation in the range of $10,000 to $49,999 for serving as an expert witness for Union Pacific Railroad.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Diesing reports no disclosure.

Shivani Ghoshal, MD
Assistant Professor of Neurology, Division of Critical Care and Hospitalist Neurology, New York Presbyterian- Columbia University; Associate Program Director, Neurocritical Care Fellowship, New York Presbyterian-Columbia/Weill Cornell, New York, New York

Relationship Disclosure: Dr Ghoshal reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Ghoshal reports no disclosure.

Christine Gill, MD
Clinical Assistant Professor of Neurology, University of Iowa Carver College of Medicine; Neuroimmunology Division, University of Iowa Healthcare, Iowa City, Iowa

Relationship Disclosure: Dr Gill reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Gill reports no disclosures.

Shraddha Mainali, MD
Associate Professor, Division of Vascular and Critical Care Neurology, Department of Neurology, Virginia Commonwealth University, Richmond, Virginia

Relationship Disclosure: Dr Mainali has received personal compensation in the range of $500 to $4999 for serving as a consultant for Marinus Pharmaceuticals, Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Mainali reports no disclosure.

Erika Marulanda, MD, MS
Assistant Professor of Clinical Neurology, Associate Program Director, Neurology Residency Program, Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida

Relationship Disclosure: Dr Marulanda reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Marulanda discusses the unlabeled/investigational use of acetazolamide, clobazam, depot-medroxyprogesterone, and progesterone for the treatment of catamenial epilepsy; plasma exchange and steroids for the treatment of multiple sclerosis relapse during pregnancy; medications, injectables, and neuromodulation devices including almotriptan, amitriptyline, aspirin, butalbital, carbamazepine, eletriptan, escitalopram, fluoxetine, frovatriptan, gabapentin, lamotrigine, lasmiditan, metoprolol, naratriptan, nortriptyline, occipital nerve stimulation, onabotulinumtoxinA, oxcarbazepine, prochlorperazine, promethazine, propranolol, riboflavin, rimegepant, rizatriptan, sertraline, single-pulse transcranial magnetic stimulation, sphenopalatine ganglion stimulation, sumatriptan, supraorbital nerve stimulation, transcutaneous vagal nerve stimulation, ubrogepant, verapamil, and zolmitriptan for the treatment of headache in pregnancy and lactation, none of which are approved by the US Food and Drug Administration (FDA) for use in pregnancy or lactation; alteplase and tenecteplase for the treatment of acute ischemic stroke in pregnant women, and medications including apixaban, aspirin, bile acid sequestrants, cilostazol, clopidogrel, dabigatran, ezetimibe, fibrates, niacin, PCSK9 inhibitor, rivaroxaban, and ticagrelor, none of which are approved by the FDA for use in pregnancy or lactation.

Michelle L. Mauermann, MD, FAAN
Chair of Division of Neuromuscular Medicine, Professor of Neurology, Mayo Clinic, Rochester, Minnesota

Relationship Disclosure: Dr Mauermann has received publishing royalties from a publication relating to health care. The institution of Dr Mauermann has received research support from Alnylam Pharmaceuticals, Inc, and Ionis Pharmaceuticals.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Mauermann discusses the unlabeled/investigational use of IV immunoglobulin and rituximab for the treatment of anti–myelin-associated glycoprotein IgM neuropathy and CANOMAD (chronic ataxic neuropathy, ophthalmoplegia, IgM paraprotein, cold agglutinins, and disialosyl antibodies) and thrombolytic agents for the treatment of sickle cell disease in adults.

Nicholas A. Morris, MD
Associate Professor, Department of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland

Relationship Disclosure: The institution of Dr Morris has received research support from the American Board of Psychiatry and Neurology, University of Maryland Baltimore Institute for Clinical & Translational Research through the National Institutes of Health National Center for Advancing Translational Sciences and Clinical and Translational Science Awards (1UL1TR003098,) and University of Maryland Medical Center.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Morris reports no disclosure.

Alyx B. Porter, MD, FAAN
Associate Professor of Neurology; Co-Chair Central Nervous System Disease Group, Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Phoenix, Arizona

Relationship Disclosure: Dr Porter has a noncompensated relationship as a board member with the American Brain Foundation that is relevant to American Academy of Neurology interests or activities.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Porter reports no disclosure.

Haatem Reda, MD
Senior Clinical Neurologist, Department of Neurology, Massachusetts General Hospital; Instructor in Neurology, Harvard Medical School, Boston, Massachusetts

Relationship Disclosure: Dr Reda reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Reda reports no disclosure.

Aarti Sarwal, MD, FAAN, FCCM, FNCS, RPNI
Professor, Department of Neurology, Atrium Wake Forest School of Medicine, Winston Salem, North Carolina

Relationship Disclosure: Dr Sarwal has received personal compensation in the range of $0 to $499 for serving as a subject expert for thesis review with the University of Technology; in the range of $500 to $4999 for serving as a research participant in a clinical trial funded by the Agency for Healthcare Research and Quality with MedStar Health Research Institute and for serving as a speaker for the European Society of Intensive Care Medicine, the Indian Academy of Neurology, the Indian Society of Critical Care, the Intensive Care Society, and the Society of Critical Care Medicine; in the range of $5000 to $9999 for serving as the social media editor for Critical Care Medicine; and in the range of $10,000 to $49,999 for serving as a consultant for Lungpacer Medical Inc. Dr Sarwal has noncompensated relationships as a member of the board of directors for the American Society of Neuroimaging, as the president-elect for the Association of Indian Neurologists in America, and as a social media editor with Neurocritical Care that are relevant to AAN interests or activities. The institution of Dr Sarwal has received research support from Biogen, Butterfly Network, Inc, C. R. Bard, Inc, CVR Global, Inc, the National Institutes of Health/National Institute on Aging (R01 AG066910-01), and Novartis Pharmaceuticals Corporation.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Sarwal reports no disclosure.

Andrew M. Southerland, MD, MSc, FAAN
Harrison Distinguished Teaching Professor of Neurology, University of Virginia, Charlottesville, Virginia

Relationship Disclosure: Dr Southerland has received personal compensation in the range of $10,000 to $49,999 for serving as an expert witness for plaintiffs and defense cases related to stroke and vascular neurology and has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr Southerland has received research support from AbbVie Inc, the American Heart Association, Diffusion Pharmaceuticals Inc, the National Science Foundation, and the National Institutes of Health.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Southerland discusses the unlabeled/investigational use of IV immunoglobulin and rituximab for the treatment of anti–myelin-associated glycoprotein IgM neuropathy and CANOMAD (chronic ataxic neuropathy, ophthalmoplegia, IgM paraprotein, cold agglutinins, and disialosyl antibodies) and thrombolytic agents for the treatment of sickle cell disease in adults.

Derek Stitt, MD
Assistant Professor, Mayo Clinic Department of Neurology, Division of Neurology Education, Rochester, Minnesota

Relationship Disclosure: Dr Stitt reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Stitt reports no disclosure.

Michel Toledano, MD
Chair of Inpatient Neurology Practice, Assistant Professor of Neurology, Department of Neurology, Division of Critical Care and Hospital Neurology, Mayo Clinic, Rochester, Minnesota

Relationship Disclosure: Dr Toledano reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Toledano discusses the unlabeled/investigational use of immunotherapies to treat rheumatologic disease.

Self-Assessment and CME Test Writers

Adam G. Kelly, MD, FAAN
Associate Professor of Neurology; Director of Teleneurology and Regional Neurology, University of Rochester, Rochester, New York

Relationship Disclosure: Dr Kelly has received personal compensation in the range of $500 to $4999 for serving as a consultant for Included Health, Inc, and a CME question writer for the American Academy of Neurology and in the range of $5000 to $9999 for serving as a CME editor for the American Academy of Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Kelly reports no disclosure.

Allison L. Weathers, MD, FAAN
Associate Chief Medical Information Officer, Cleveland Clinic; Assistant Professor, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio

Relationship Disclosure: Dr Weathers has a noncompensated relationship as chair of the adult neurosciences specialty steering board for Epic and as co-chair of the neurology leadership council for Cerner Corporation and has received personal compensation in the range of $0 to $499 for serving as a consultant for Dent Neurologic Institute and in the range of $500 to $4999 for serving as an associate editor and as a CME question writer and presenter with the American Academy of Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Weathers reports no disclosure.

^AAll relevant financial relationships have been mitigated.

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