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News from the AAN Annual Meeting: IV Glyburide Shows Promise in Reducing Edema After Ischemic Stroke

Penn’s clinical laboratory, like many hospitals, was only offering testing for one such an-tibody, the anti-NMDA receptor. “What’s being done in the research laboratory had really been ahead of what we could do in clinical pathology,” said Eric Lancaster, MD, PhD, an assistant professor of neurology and an investigator in the Precision Medicine Project. The Precision Medicine Project developed a high-end “boutique shop” for assessing difficult auto-antibody encephalitis cases, facilitated by a series of interlocking consent protocols and institutional review boards. Today, when a patient at Penn is suspected of having autoimmune encephalitis, a panel of six antibodies is reviewed within two days. Additional studies can then be done on a research basis. “The patients who do best are the ones who are treated with appropriate, aggressive immunotherapy as soon as possible,” Dr. Lancaster said. “Every day that you accelerate the diagnosis and get them on the correct treatment is an equivalent day down the road, getting them out of the intensive care unit and out of the hospital.” One of the clearest illustrations of the benefits of precision medicine in neurology is in epilepsy, said Dr. Goldstein. “We have many genes discovered, almost monthly, that cause serious early-onset epilepsies that result in a variety of very poorly controlled symptoms. We know that the epileptic encephalopathies in particular are incredibly genetic and in a relatively tractable way. I think it’s now clear that all of these conditions really do need to be genetically investigated, as we frequently do find a very clear cause of disease in patient exomes. In the coming few years, we will see some very clear wins from this approach,” he predicts. • Precision Medicine, Neurology Continued from page 30