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We appreciate the readers' interest in our paper  and we encourage the open scientific debate on the complexity of glatiramer acetate and the comparability of follow-on glatiramer acetate products. Below we provide responses to the points raised by the readers.
Schwannomatosis is a genetic disorder that belongs to NF family. The mutation of SMARCB1 gene has been related to this entity and Coffin-Siris syndrome, as well. We reported a case of a female patient with SMARCB1 mutation who has developed a spontaneuous spleen rupture.
To determine the sociodemographic characteristics, clinical findings and outcome by HIV status in a series of adult patients presenting with neurological disorders (NDs) and admitted to a consultant hospital in Northern Tanzania.
We read with interest the article by Melamed-Gal et al.  addressing the question how to establish similarity between an originator and a follow-on drug for non-biological complex drugs, here for glatiramer acetate (GA). They call for further assessment of links between compositional and functional differences of such products and their potential impact on long-term efficacy and safety, including substitution.
Immune-checkpoint inhibitors (ICIs) represent a novel therapeutic approach for numerous tumors. However, checkpoint blockade may be complicated by a unique spectrum of immune-related adverse events (irAEs), even severe (grade 3–4) in 5–24% of patients treated with ipilimumab and nivolumab . Various neurological irAEs that involve the central and peripheral nervous systems have been reported, including polyneuropathy (3%), myasthenia gravis (0.2%) and necrotizing myositis, predominantly after nivolumab .
IgG4-related hypophysitis, which is the pituitary gland inflammation caused by IgG4 positive lymphocytes, can affect cavernous sinus and orbital apex leading to developing cranial nerve related symptoms such as orbital apex syndrome (OAS). Here we report a case of hypopituitarism associated with OAS caused by pituitary metastasis of the breast cancer with elevated serum IgG4 level, who initially resembled to IgG4-related hypophysitis. Although this case had some features in common with igG4-related hypophysitis.
Takotsubo syndrome (TTS) is a transient transient left ventricular dysfunction, predominantly affecting elderly women and often preceded by emotional or physical stress. TTS may be the cause as well as the consequence of stroke. We report a 82-years old female with a history of long-standing untreated arterial hypertension who was hospitalized because of a left-sided tongue paralysis and dysarthria. Cerebral magnetic resonance imaging showed ischemic lesions in the territory of the right middle cerebral artery affecting the capsula interna and gyrus praecentralis.
Spinal epidural abscess (SEA) is an uncommon infection, and a neurological emergency that may leads to marked neurological dysfunction and devastating consequences. The typical clinical manifestations of SEA are the classic triad of back pain, neurological deficits, and fever . The most common causative bacteria of SEA is Staphylococcus aureus. In general, management for SEA is surgical decompression and antibiotic therapy . However, it remains controversial whether patients with an extensively spreading abscess should be treated by surgery or medicated by antibiotics alone 2.
Fat embolism syndrome (FES) is a known complication of sickle cell disease (SCD) that occurs secondary to vaso-occlusive crises, bone marrow infarction, and the subsequent release of fat globules into the venous circulation. Although neurologic involvement is common, the pathophysiology of cerebral fat emboli remains controversial. While fat microemboli can enter the arterial circulation through right-to-left shunts, the systemic release of free fatty acids may also cause indirect endothelial damage and disruption of the blood-brain-barrier.