Neurological and psychiatric emergencies

Recent trials showed no significant difference in efficacy between IVIG and plasmapheresis in the treatment of severe Myasthenia gravis. Rituximab is efficacious in refractory myasthenia. In case of GBS no significant superiority can be found for treatment with IVIG or plasmapheresis. Corticosteroids might delay recovery of patients with GBS. Due to extensive travel activity "emerging viruses" like West Nile virus, Japanese encephalitis virus or Dengue virus are increasingly frequent causes of viral encephalitis. In patients with TGA focal diffusion lesions can be selectively detected in the CA1 field of the hippocampal cornu ammonis by use of thin slice MRI. Magnetic resonance spectroscopy studies showed corresponding metabolic changes in CA 1 neurons. Recent large trials showed no benefit of Magnesium or Clazosentan in the management of subarachnoidal hemorrhage. In 2012 S3 guidelines for diagnosis and therapy of bipolar affective disorders were published, S3 guidelines for diagnosis and therapy of schizophrenic disorders are expected to be published this year. Trazodon might be effective in the management of neuroleptic-induced acute akathisia.