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Introduction: The aims of the study were to document the characteristics of amyotrophic lateral sclerosis (ALS) patients in Queensland, to examine factors influencing age of onset, and survival, and to study those with early-onset (<45 years) disease and those with long (>5 years) survival. Methods: We studied subjects seen at the ALS Clinic at the Royal Brisbane and Women's Hospital. We recorded sex, age of onset, region of onset, length of survival, presence of family history, type of disease, and evidence of cognitive involvement. We analysed the influence of these features on age of onset and survival. We analysed the features of patients with early onset of disease and patients with long survival. Results: There were 855 ALS patients (505 males) in the cohort. The age of onset was lower in males than females, in patients with a family history of ALS compared to those without, and in patients with spinal onset compared to bulbar onset. Early-onset disease was seen in 10% of patients, and had a greater proportion of males, spinal onset, and classical ALS phenotype compared to late-onset disease. Survival was shorter in females, in patients with bulbar onset, and in patients with classical ALS. Long survival was seen in 18% of patients. Patients with long survival had younger age of onset, greater proportion of males, spinal onset, and fewer patients with classical ALS. Conclusion: Our study confirms that ALS is more prevalent in males and that spinal onset is more common than bulbar onset. Males have earlier onset but longer survival. We found that overall, patients with classical ALS have worse survival than ALS variants, but some patients who were considered to have classical ALS had long survival. This study confirms the similarity of ALS in our region to ALS in other geographical regions. [ABSTRACT FROM AUTHOR]

Introduction: Autoimmune encephalitis is a disorder associated with antibodies directed against central nervous system proteins with variable clinical features. This study aims to add to knowledge of the disease by reporting the details of a cohort of patients with autoimmune encephalitis in Queensland, Australia. Methodology: We surveyed patients with autoimmune encephalitis diagnosed and managed through public hospitals in Queensland, Australia between 2010 and the end of 2019. Cases were identified via case detection through a centralized diagnostic neuroimmunology laboratory (Division of Immunology, HSQ Pathology Queensland Central Laboratory, Brisbane, Queensland, Australia) and a survey of neurologists. Data including demographic details, clinical presentation, investigation results, treatments including immune therapy and outcomes was collected. Results: Sixty cases of antibody positive autoimmune encephalitis were identified. Twenty-eight were of anti-NMDA-receptor encephalitis with other cases associated with antibodies against LGi1, Caspr2, glycine receptor, DPPX, GABAB receptor, IgLON5, GFAP, and SOX1. The number of diagnosed cases, especially of anti-NMDA-receptor encephalitis has markedly increased over the period 2017 to 2019. Clinical presentations were marked by heterogeneous symptom complexes and prolonged hospital admissions. Imaging studies were largely normal or non-specific. There was a response to immune therapy and a low mortality rate. Most cases affected by this disorder were left with ongoing symptoms associated with mild disability. Conclusion: Autoimmune encephalitis in Queensland, Australia is an increasingly common but complex clinical entity marked by heterogeneous presentations, response to immune therapy and outcome results marked by low mortality and incomplete recovery. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to determine whether patients with amyotrophic lateral sclerosis (ALS) exhibit higher plasma levels of formaldehyde (FA) than controls, and to look for alterations in levels of FA precursors., Methods: We studied 40 heathy controls and 50 ALS patients from the Motor Neuron Disease clinic at the Royal Brisbane & Women's Hospital. Plasma FA levels were quantified using a FA detection assay. Trimethylamine (TMA) and trimethylamine oxide (TMAO) in plasma were quantified by multiple reaction monitoring (MRM) mass spectrometry. Plasma levels in patients and controls were compared using Mann-Whitney U test and Spearman's correlation test was used to assess the correlation between levels of FA, TMA, TMAO and other variables., Results: The levels of plasma FA were significantly greater in ALS subjects than controls. TMA and TMAO levels were not significantly different between healthy controls and patients, but were greater in ALS subjects with elevated FA levels than those with normal levels. Of note, levels of TMA and TMAO demonstrated a significant positive correlation with plasma FA levels (spearman's correlation coefficients of TMA with FA [r = 0.451, p = 0.010] and TMAO [r = 0.401, p = 0.023]). There was no association of FA levels with disability measured with the ALS functional rating scale, with the duration of disease or with the age of the subjects., Conclusion: Elevated FA is found in some patients with ALS. FA is neurotoxic and could contribute to disease pathogenesis., Competing Interests: Declaration of Competing Interest The authors report no conflict of interest. The authors alone are responsible for the content and paper writing., (Copyright © 2019 Elsevier B.V. All rights reserved.)