MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Neurologic Clinics' source. Wed, 08 Feb 2012 20:43:28 +0100 http://www.medworm.com/index.php?rid=5639489&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001204%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639489 Mon, 30 Jan 2012 02:28:35 +0100 5639489 http://www.medworm.com/index.php?rid=5639488&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001125%2Fabstract%3Frss%3Dyes The prognosis of patients with altered consciousness is mainly determined by early diagnosis and appropriate therapeutic interventions and by the type of toxin. The potential causes of altered consciousness are many and may reflect systemic illness, isolated organ system dysfunction, drug intoxications or withdrawal, psychiatric illness, or neurologic disease. In this article, a comprehensive approach to patients with altered consciousness and suspected poisoning is discussed. This survey, however, does not intend to be a substitute for the need for consultation with a clinical toxicologist qualified in the diagnosis and treatment of poisoned patients. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639488 Mon, 30 Jan 2012 02:28:35 +0100 5639488 http://www.medworm.com/index.php?rid=5639487&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001101%2Fabstract%3Frss%3Dyes During the past 2 decades, the world has witnessed a significant improvement in the understanding of the pathogenesis and treatment of neurologic diseases, which presents emergencies. Every day neurologists are consulted for patients who present with neurologic emergencies to the emergency departments. In this article, we present a series of case reports about patients with acute neurologic and psychiatric problems and discuss their management briefly. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639487 Mon, 30 Jan 2012 02:28:35 +0100 5639487 http://www.medworm.com/index.php?rid=5639486&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000806%2Fabstract%3Frss%3Dyes This article discusses a general approach to assessment and treatment of some of the more common psychiatric disorders. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639486 Mon, 30 Jan 2012 02:28:35 +0100 5639486 http://www.medworm.com/index.php?rid=5639484&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000909%2Fabstract%3Frss%3Dyes Central nervous system (CNS) inflammatory demyelinating diseases are a group of disorders that include multiple sclerosis, acute disseminated encephalomyelitis, and neuromyelitis optica. These conditions may result in emergencies because of severe inflammatory destruction of CNS tissues or complications thereof. Most of these conditions are responsive to appropriate therapy and early diagnosis and treatment leads to better outcomes. We discuss the spectrum of emergencies associated with these disorders, as well as clinical features, investigations, and management. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639484 Mon, 30 Jan 2012 02:28:35 +0100 5639484 http://www.medworm.com/index.php?rid=5639482&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000788%2Fabstract%3Frss%3Dyes This article reviews aspects of management of traumatic brain and spinal cord injury. A discussion of management of intracranial pressure after traumatic brain injury is followed by a discourse on cerebrovascular trauma and pediatric injuries. Specific management methods are discussed, including medical and surgical management in intracranial hypertension. A special attempt is made to include the current recommendations for management of brain and spinal cord injuries. Spinal cord injuries are discussed in the final section. With an increasing number of patients surviving after devastating spinal cord injuries, the special issues in their management are evaluated. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639482 Mon, 30 Jan 2012 02:28:35 +0100 5639482 http://www.medworm.com/index.php?rid=5639481&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100079X%2Fabstract%3Frss%3Dyes This article addresses the diagnosis and general management of ICH and discusses specialized management for select ICH subtypes. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639481 Mon, 30 Jan 2012 02:28:35 +0100 5639481 http://www.medworm.com/index.php?rid=5639479&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000879%2Fabstract%3Frss%3Dyes Respiratory failure could result from a cardiopulmonary or a primary neurological disease. The latter could happen as a result of involvement of the central nervous system or a neuromuscular disease. Different neuromuscular diseases could result in respiratory failure by causing significant weakness of the respiratory and upper airways muscles. When confronted with a patient who presents with respiratory failure, the first task of the clinician is to secure the airways and stabilize the hemodynamic condition. The next step is the diagnostic approach and potentially a disease specific treatment, which is the focus of this review. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639479 Mon, 30 Jan 2012 02:28:35 +0100 5639479 http://www.medworm.com/index.php?rid=5639476&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000892%2Fabstract%3Frss%3Dyes This article reviews the approach to acute visual loss, the abnormal optic disc, double vision, and the neuro-ophthalmologic signs of neurologic emergencies, including hydrocephalus, herniation syndromes, vascular lesions, and trauma. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639476 Mon, 30 Jan 2012 02:28:35 +0100 5639476 http://www.medworm.com/index.php?rid=5639475&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000831%2Fabstract%3Frss%3Dyes This article discusses the most common causes of dizziness, how to use this approach, and management of these cases in the emergency room. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639475 Mon, 30 Jan 2012 02:28:35 +0100 5639475 http://www.medworm.com/index.php?rid=5639474&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000855%2Fabstract%3Frss%3Dyes Headaches are a common reason for visiting a health care provider. Headaches are at times symptomatic of an underlying process that requires prompt diagnosis and urgent treatment to reduce threats to life or limb. In this article, the authors review the 6 most common presentations for worrisome headache and discuss the differential diagnosis. Careful attention to patients’ history and physical examination and a thoughtful approach to the differential diagnosis will guide diagnostic work-up and management. Although benign causes of headache are much more common than malignant secondary processes, thorough management of the acute headache requires excluding malignant secondary processes. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639474 Mon, 30 Jan 2012 02:28:35 +0100 5639474 http://www.medworm.com/index.php?rid=5639473&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100082X%2Fabstract%3Frss%3Dyes Seizures and status epilepticus are epilepsy emergencies with high morbidity and mortality. Early treatment is crucial, and the identification of an underlying etiology informs both continued treatment and prognosis. Many patients have underdiagnosed nonconvulsive seizures or nonconvulsive status epilepticus, particularly the comatose or critically ill. Timely EEG can be useful for diagnosis, management, optimizing treatment response, and determining prognosis in these patients. Refractory conditions can be quite complicated with limited evidence-based guidance, but treatment should not be restricted by nihilism even in the most prolonged cases, especially if there is not widespread irreversible brain injury. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639473 Mon, 30 Jan 2012 02:28:35 +0100 5639473 http://www.medworm.com/index.php?rid=5639471&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001058%2Fabstract%3Frss%3Dyes Neurologists are often called to the emergency department to evaluate various acute primary central and peripheral nervous system disorders or neurological complications of multiple systemic illnesses. In these situations, prompt diagnosis can be lifesaving. Examples abound, but basilar thrombosis, aneurysmal subarachnoid hemorrhage, bacterial meningitis, and Guillain–Barre syndrome are just some illustrations. But the job of the neurologist is no longer restricted to being the master diagnostician. During the last three decades and with introduction of modern treatments, such as tissue plasminogen activator for treatment of acute ischemic stroke and the development of vascular interventional procedures, much can be offered to patients with acute neurological diseases in the emergency de... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639471 Mon, 30 Jan 2012 02:28:35 +0100 5639471 http://www.medworm.com/index.php?rid=5639470&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001198%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639470 Mon, 30 Jan 2012 02:28:35 +0100 5639470 http://www.medworm.com/index.php?rid=5639469&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001186%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639469 Mon, 30 Jan 2012 02:28:35 +0100 5639469 http://www.medworm.com/index.php?rid=5639468&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911001174%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639468 Mon, 30 Jan 2012 02:28:35 +0100 5639468 http://www.medworm.com/index.php?rid=5639478&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000880%2Fabstract%3Frss%3Dyes Nearly 70 years after the discovery of penicillin, neurologic infectious diseases (NIDs) remain an important worldwide source of morbidity and mortality. The clinician faced with a potential NID must urgently consider patient demographics, pace of illness and clinical syndrome, and laboratory data. In keeping with the topics of this issue, initial emergency diagnosis and management are emphasized, with appropriate references to relevant literature for subsequent longer-term interventions. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639478 Fri, 28 Oct 2011 04:00:00 +0100 5639478 http://www.medworm.com/index.php?rid=5349688&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000995%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349688 Thu, 27 Oct 2011 01:06:24 +0100 5349688 http://www.medworm.com/index.php?rid=5349687&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000533%2Fabstract%3Frss%3Dyes The medical care of patients in disordered states of consciousness, including vegetative and minimally conscious states, raises some of the most intricate ethical questions in medicine. There is inherent ambiguity and uncertainty involved in diagnosing such patients and evaluating their level of awareness and prognosis for recovery. The care of these patients requires the weighing of competing ethical values, including respect for personal autonomy, protection of vulnerable patients, nonmaleficence, and the just use of limited medical resources. We highlight some of the major ethical issues in caring for patients with severe brain injury. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349687 Thu, 27 Oct 2011 01:06:24 +0100 5349687 http://www.medworm.com/index.php?rid=5349685&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000570%2Fabstract%3Frss%3Dyes The causes of nontraumatic coma (NTC) vary by country, season and period of data collection. Infective diseases are among the major worldwide causes of NTC. Nonaccidental head injury must be in the differential diagnosis. Genetic and ethnic susceptibilities to causes of coma are being recognized. A systematic history and examination are essential for diagnosis, early recognition of herniation syndromes, and management. The management of NTC is discussed, with reference to clinical approach, treatment of seizures, and increased intracranial pressure. Public health measures, education, early diagnosis, and prompt appropriate treatment are the foundations needed to reduce incidence and improve outcome. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349685 Thu, 27 Oct 2011 01:06:24 +0100 5349685 http://www.medworm.com/index.php?rid=5349682&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100048X%2Fabstract%3Frss%3Dyes The incidence of serious neurologic complications after organ and stem cell transplantation can be as high as 20% to 30%, with most occurring in the early posttransplant period. Encephalopathy often results from metabolic disturbances and immunosuppressant drug neurotoxicity but can also occur with central pontine myelinolysis and other lesions of the central nervous system (CNS). Seizures are also common and can be related to drug toxicity or herald CNS disorders. A thorough evaluation of any patient who develops seizures or mental status changes after transplantation is warranted to distinguish transient reversible causes from serious CNS disorders. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349682 Thu, 27 Oct 2011 01:06:24 +0100 5349682 http://www.medworm.com/index.php?rid=5349680&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100051X%2Fabstract%3Frss%3Dyes is a common presenting symptom, and is often a challenging diagnostic dilemma because of its various underlying causes. A careful initial clinical assessment with directed investigations is crucial in arriving at a presumptive diagnosis. Prolonged cardiac monitoring technologies have improved diagnostic accuracy in the more difficult cases. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349680 Thu, 27 Oct 2011 01:06:24 +0100 5349680 http://www.medworm.com/index.php?rid=5349678&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000740%2Fabstract%3Frss%3Dyes This article focuses on common causes of metabolic encephalopathy, and reviews common causes, clinical presentations and, where relevant, management. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349678 Thu, 27 Oct 2011 01:06:24 +0100 5349678 http://www.medworm.com/index.php?rid=5349676&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000727%2Fabstract%3Frss%3Dyes Recent advances have shown much in common between epilepsy and other disorders of consciousness. Behavior in epileptic seizures often resembles a transient vegetative or minimally conscious state. These disorders all converge on the “consciousness system” —the bilateral medial and lateral fronto-parietal association cortex and subcortical arousal systems. Epileptic unconsciousness has enormous clinical significance leading to accidental injuries, decreased work and school productivity, and social stigmatization. Ongoing research to better understand the mechanisms of impaired consciousness in epilepsy, including neuroimaging studies and fundamental animal models, will hopefully soon enable treatment trails to reduce epileptic unconsciousness and improve patient quality of life. (Sour... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349676 Thu, 27 Oct 2011 01:06:24 +0100 5349676 http://www.medworm.com/index.php?rid=5349675&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000752%2Fabstract%3Frss%3Dyes Death determined by neurologic criteria or brain death is better understood as brain arrest or the final clinical expression of complete and irreversible neurologic failure. Despite widespread national, international, and legal acceptance of the concept, substantial variation exists in the standards and their application, and there remains a need to clarify and standardize terminology (eg, ancillary and supplementary testing, brain death, or neurologic determination of death). The aim of this article is to review the specific criteria and requirements of brain death, paying special attention to areas of controversy and practice inconsistency. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349675 Thu, 27 Oct 2011 01:06:24 +0100 5349675 http://www.medworm.com/index.php?rid=5349674&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000557%2Fabstract%3Frss%3Dyes Severe acquired brain injury has profound impact on alertness, cognition, and behavior. Among those who survive the initial injury, a significant minority fail to fully recover self and environmental awareness, and go on to experience prolonged disorders of consciousness (DOC) that can last a lifetime. Although there are no standards of care to guide clinical management, a growing body of empirical evidence is beginning to accrue to inform clinical decision making. In this article, we review the state of the science as it pertains to diagnosis, prognosis, and treatment of patients with DOC. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349674 Thu, 27 Oct 2011 01:06:24 +0100 5349674 http://www.medworm.com/index.php?rid=5349672&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000764%2Fabstract%3Frss%3Dyes Delirium occurs commonly in both general medical and intensive care unit (ICU) patients, with prevalence rates of up to 80% reported. A common expression of acute brain dysfunction, it is related to wide-ranging untoward outcomes such as prolonged hospitalization, increased costs, higher mortality, and, potentially long-term cognitive impairment. Different risk factors are associated with delirium, including sedation, which has implications for patient management. Multicomponent interventions to prevent delirium, developed in the non-ICU setting, can be adapted to critically ill patients with the purpose of reducing its incidence. Future studies should evaluate target interventions to prevent delirium in the ICU. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349672 Thu, 27 Oct 2011 01:06:24 +0100 5349672 http://www.medworm.com/index.php?rid=5349669&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000776%2Fabstract%3Frss%3Dyes Neurologists and neurosurgeons are practical people. We don’t often gaze at our navels and wonder if consciousness is “real or an illusion.” We accept that “being conscious” includes an essential alertness and an awareness of ourselves and the world, however imperfectly we do this, and that such awareness arises as a function of brain activity. Admittedly, we do not fully understand how awareness and awareness that we are aware happen, but presumably such functions are the net result of neuronal processing and integration of activity of numerous modules and centers. The “whole is more than the sum of its parts” is probably a fair statement. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349669 Thu, 27 Oct 2011 01:06:24 +0100 5349669 http://www.medworm.com/index.php?rid=5349668&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000983%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349668 Thu, 27 Oct 2011 01:06:24 +0100 5349668 http://www.medworm.com/index.php?rid=5349667&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000971%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349667 Thu, 27 Oct 2011 01:06:24 +0100 5349667 http://www.medworm.com/index.php?rid=5349666&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100096X%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349666 Thu, 27 Oct 2011 01:06:24 +0100 5349666 http://www.medworm.com/index.php?rid=5639483&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000922%2Fabstract%3Frss%3Dyes This article discusses the acute neurologic effects of certain drugs as well as associated treatments and guidelines to management. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639483 Wed, 26 Oct 2011 04:00:00 +0100 5639483 http://www.medworm.com/index.php?rid=5639480&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000910%2Fabstract%3Frss%3Dyes The past 40 years have seen the evolution of acute ischemic stroke management from unproven therapies du jour, such as steroids, heparin for stroke in evolution, and hypervolemic-hemodilution, to more of a scientific basis for our decision-making process. This evolution is directly related to the advancements in imaging of stroke. It is also related to carefully designed, controlled clinical trials of potential therapies, which have led to the recognition of the benefits of thrombolytic therapy in the acute setting but have also caused confusion and frustration over the lack of benefit for potential neuroprotective agents that once seemed promising. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639480 Mon, 24 Oct 2011 04:00:00 +0100 5639480 http://www.medworm.com/index.php?rid=5639477&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000818%2Fabstract%3Frss%3Dyes This article reviews the common neurologic emergencies affecting patients with cancer and discusses epidemiology, clinical presentation, diagnosis, and treatment modalities. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639477 Mon, 17 Oct 2011 04:00:00 +0100 5639477 http://www.medworm.com/index.php?rid=5639485&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000843%2Fabstract%3Frss%3Dyes This article focuses on diagnosis and management of acute-onset movement disorders occurring secondary to prescription drug use, illicit drug abuse, and drug withdrawal syndromes. In addition, drug-induced emergencies occurring in patients with movement disorders are reviewed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639485 Thu, 13 Oct 2011 04:00:00 +0100 5639485 http://www.medworm.com/index.php?rid=5639472&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000867%2Fabstract%3Frss%3Dyes This article provides a comprehensive overview of the management of patients with coma. The article begins with a discussion of the emergency management of patients presenting with an acute alteration in the level of consciousness. It then reviews concepts on supportive care that are necessary to reduce secondary neurologic injury. A third section addresses management according to the underlying cause of coma, with emphasis on diagnoses that are frequently encountered. Issues related to the long-term management of patients in coma and outcome prediction are briefly discussed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5639472 Thu, 13 Oct 2011 04:00:00 +0100 5639472 http://www.medworm.com/index.php?rid=5349670&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000739%2Fabstract%3Frss%3Dyes Human consciousness requires brainstem, basal forebrain, and diencephalic areas to support generalized arousal, and functioning thalamocortical networks to respond to environmental and internal stimuli. Disconnection of these interconnected systems, typically from cardiac arrest and traumatic brain injury, can result in disorders of consciousness. Brain injuries can also result in loss of motor output out of proportion to consciousness, resulting in misdiagnoses. The authors review pathology and imaging studies and derive mechanistic models for each of these conditions. Such models may guide the development of target-based treatment algorithms to enhance recovery of consciousness in many of these patients. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349670 Mon, 26 Sep 2011 04:00:00 +0100 5349670 http://www.medworm.com/index.php?rid=5349677&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000478%2Fabstract%3Frss%3Dyes Coma due to global or focal ischemia or hemorrhage is reviewed. Impaired consciousness due to anoxic-ischemic encephalopathy after cardiac arrest is common but prognostically problematic. Recent guidelines need to be refined for those patients who have received therapeutic hypothermia. Strokes, both ischemic and hemorrhagic, can affect the level of consciousness by damaging specific brain structures involved in alertness because of widespread cerebral injury or secondary cerebral or systemic complications. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349677 Mon, 12 Sep 2011 04:00:00 +0100 5349677 http://www.medworm.com/index.php?rid=5349684&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000521%2Fabstract%3Frss%3Dyes Unresponsive patients with or without catatonic motor signs are etiologically heterogeneous, and all require a comprehensive neurodiagnostic assessment to rule out organic causes. Most cases prove to be due to primary psychiatric disorders, mostly mood disorders, especially mania, rather than schizophrenia. These patients respond to lorazepam administered by any route and, failing this, electroconvulsive therapy. Those patients with associated fever and autonomic instability are medical emergencies and need urgent treatment. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349684 Fri, 02 Sep 2011 04:00:00 +0100 5349684 http://www.medworm.com/index.php?rid=5349681&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000594%2Fabstract%3Frss%3Dyes This article examines disorders of consciousness that may be caused by a septic encephalopathy, bacterial meningoencephalitis, viral encephalitis, tick-borne bacterial disease, fungal meningitis, tuberculous meningitis, a focal infectious mass lesion, such as a brain abscess, or an autoimmune-mediated disorder as a complication of infection. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349681 Fri, 19 Aug 2011 04:00:00 +0100 5349681 http://www.medworm.com/index.php?rid=5349671&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000491%2Fabstract%3Frss%3Dyes This article elucidates a stepwise approach to the patient with an acute alteration in the content or level of consciousness. The article begins with a discussion of the spectrum of diminished responsiveness. It then details which aspects of the history are important in obtaining an evaluation of these patients and reviews the neurologic examination of the comatose patient. A brief overview of the neuroanatomical localization of consciousness is provided. The differential diagnosis of diminished responsiveness is explored, followed by a discussion of the order and importance of laboratory, neuroimaging, and other ancillary tests. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349671 Fri, 19 Aug 2011 04:00:00 +0100 5349671 http://www.medworm.com/index.php?rid=5349679&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000582%2Fabstract%3Frss%3Dyes This article discusses brain trauma and impaired consciousness. It reviews the various states of impaired consciousness related to trauma, with an historical and current literature viewpoint. The causes and pathophysiology of impaired consciousness in concussion, diffuse axonal injury, and focal brain lesions are discussed and management options evaluated. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349679 Tue, 16 Aug 2011 04:00:00 +0100 5349679 http://www.medworm.com/index.php?rid=5349686&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000508%2Fabstract%3Frss%3Dyes Transient global amnesia syndrome was initially described more than a century ago. Although the clinical syndrome is easily recognized and highly consistent in its characteristic features, the underlying pathophysiology has remained elusive. Proposed mechanisms include focal ischemic lesions or local nonischemic energy failures. Diffusion-weighted imaging has been able to demonstrate focal areas of restricted diffusion. Nonetheless, the mechanism of this diffusion restriction is uncertain and does not necessarily indicate ischemia, leaving the exact nature of this seemingly benign disorder in doubt. This review summarizes the pertinent clinical features, proposed pathophysiology, epidemiology, imaging, and future directions in understanding transient global amnesia. (Source: Neurologic Cli... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349686 Mon, 08 Aug 2011 04:00:00 +0100 5349686 http://www.medworm.com/index.php?rid=5349683&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000569%2Fabstract%3Frss%3Dyes Treating coma in the mother also means treating the fetus. Pregnant women are subject to causes of coma that may also arise from the effects of pregnancy on organ systems: vascular, cardiac, pulmonary, renal, endocrine, and others. With coma, no investigations are categorically excluded when the mother's health and life are at risk. Pregnancy and hormonal effects on blood volume, blood vessels, and changes in blood pressure explain some special causes of stroke in pregnancy. Others include intracranial hemorrhage and venous occlusive disease, as well as worsening of underlying vessel disease during pregnancy, delivery, and the postpartum period. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349683 Mon, 08 Aug 2011 04:00:00 +0100 5349683 http://www.medworm.com/index.php?rid=5349673&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000545%2Fabstract%3Frss%3Dyes This article reviews alterations in consciousness related to intracranial mass lesions. Such lesions can produce impairment of consciousness by their strategic location within components of the ascending reticular activating system or secondarily by compressing or distorting this system, interfering with its synaptic and neurochemical functions. This review concentrates principally on this secondary mechanism. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5349673 Mon, 08 Aug 2011 04:00:00 +0100 5349673 http://www.medworm.com/index.php?rid=5081425&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000673%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081425 Sun, 31 Jul 2011 23:00:00 +0100 5081425 http://www.medworm.com/index.php?rid=5081424&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000442%2Fabstract%3Frss%3Dyes The cause of sporadic amyotrophic lateral sclerosis (ALS) is not known. Studies associate toxic, dietary, infectious, neoplastic, and physical factors as underlying, predisposing, or pathogenic influences. Historical, conventional, and novel disease mechanisms, acting solely or in concert, convert previously healthy individuals into terminally ill patients. Despite intensive investigations in the previous decades, the underlying cause and effective treatments elude researchers. Discovering causative mechanisms in sporadic ALS will facilitate effective treatments and cures for this disorder. After a brief review of the disease process itself, this article discusses potential environmental influences on the development of ALS. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081424 Sun, 31 Jul 2011 23:00:00 +0100 5081424 http://www.medworm.com/index.php?rid=5081422&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000454%2Fabstract%3Frss%3Dyes Pesticides represent one of the largest classes of toxic chemicals produced, stored, and used in the United States and abroad. These chemicals are designed to be toxic and many, besides being toxic to the pests they are intended to control, are also toxic to nontarget species including humans. The article gives a brief review of their toxicity to humans with emphasis on their effects on the nervous system. Examples of case studies are included to illustrate their toxicity. A discussion of the possible contribution of occupational and other pesticide exposures to neurologic diseases and disorders is also included. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081422 Sun, 31 Jul 2011 23:00:00 +0100 5081422 http://www.medworm.com/index.php?rid=5081419&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000417%2Fabstract%3Frss%3Dyes Manganese-induced parkinsonism has been recognized since 1837. It has been reported primarily in miners, grinders, and smelters since that time. More recently, isolated case reports involving welders have appeared in the medical literature. Manganism can be distinguished from other forms of parkinsonism by clinical presentation with support from laboratory and radiologic findings. The controversy regarding the risk of parkinsonism in welders is reviewed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081419 Sun, 31 Jul 2011 23:00:00 +0100 5081419 http://www.medworm.com/index.php?rid=5081417&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000399%2Fabstract%3Frss%3Dyes This article details three of the best-defined toxic leukoencephalopathies: delayed posthypoxic leukoencephalopathy, including delayed neurologic sequelae after carbon monoxide poisoning; heroin inhalation leukoencephalopathy; and posterior reversible encephalopathy syndrome. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081417 Sun, 31 Jul 2011 23:00:00 +0100 5081417 http://www.medworm.com/index.php?rid=5081413&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000466%2Fabstract%3Frss%3Dyes There are stages in the evolution of medical care for specific conditions as described by Christensen, Grossman, and Hwang in The Innovator’s Prescription—A Disruptive Solution for Health Care. Typically, a medical disorder emerges in the intuitive stage. At this stage only the most skilled, cutting-edge practitioners are able to offer reasonably accurate diagnoses based on a murky amalgam of history, ambiguous exam findings, non-standardized laboratory data, anecdotal case reports in the literature, and elusive personal experience. Treatment in the intuitive medicine arena is typically empiric, utilizing trial and error methods with limited success. Later, as research accumulates and care is standardized, the disorder may move into the precision stage. Here, precise diagnosis is possi... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081413 Sun, 31 Jul 2011 23:00:00 +0100 5081413 http://www.medworm.com/index.php?rid=5081412&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000661%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081412 Sun, 31 Jul 2011 23:00:00 +0100 5081412 http://www.medworm.com/index.php?rid=5081411&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100065X%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081411 Sun, 31 Jul 2011 23:00:00 +0100 5081411 http://www.medworm.com/index.php?rid=5081410&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000648%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081410 Sun, 31 Jul 2011 23:00:00 +0100 5081410 http://www.medworm.com/index.php?rid=5081423&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000430%2Fabstract%3Frss%3Dyes This article focuses on some of the more recent toxic neuropathies and myopathies that have emerged from the medical literature. Among these are toxic myopathies caused by statins, daptomycin, imatinib, hydroxychloroquine, and highly active antiretroviral therapy; neuromuscular junction toxicity caused by tandutinib; toxic peripheral neuropathies caused by bortezomib, angel's trumpet, cisplatin, oxaliplatin, tumor necrosis factor α antagonists, cobalt-chromium, and ixabepilone; and a unique syndrome reported in workers exposed to aerosolized porcine neural tissue. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081423 Thu, 14 Jul 2011 23:00:00 +0100 5081423 http://www.medworm.com/index.php?rid=5081421&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000351%2Fabstract%3Frss%3Dyes Multiple genetic and environmental etiologies have been implicated in the pathogenesis of idiopathic Parkinson disease. Recent observations have suggested an association between chronic exposure to trichloroethylene (TCE) and development of clinical parkinsonism. Animal models of TCE exposure have shown nigrostriatal degeneration and the development of parkinsonian features. Animal and cell culture models indicate mitochondrial dysfunction as the probable mechanism, most likely mediated by TaClo, a potential TCE metabolite. These observations endorse the hypothesis that a variety of environmental risk factors may cause nigrostriatal degeneration and clinical parkinsonism in genetically predisposed individuals. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081421 Thu, 07 Jul 2011 23:00:00 +0100 5081421 http://www.medworm.com/index.php?rid=5081418&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000363%2Fabstract%3Frss%3Dyes This article focuses on the use, and misuse, of chelation in the diagnosis and management of metal intoxication. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081418 Sun, 03 Jul 2011 23:00:00 +0100 5081418 http://www.medworm.com/index.php?rid=5081414&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000405%2Fabstract%3Frss%3Dyes This article reviews 4 categories of neurotoxic emergency: drug-induced and toxin-induced seizures, acute depressed mental status, acute excited mental status, and peripheral neurotoxic agents. Selected xenobiotics, representing the frontiers of neurotoxic emergencies, are discussed in detail based on the major neurotransmitters involved. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081414 Sun, 03 Jul 2011 23:00:00 +0100 5081414 http://www.medworm.com/index.php?rid=5081420&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000387%2Fabstract%3Frss%3Dyes This article focuses on these disorders, such as neurocognitive disorders and mental illness, including drug-induced psychosis; motor disorders, including the possible risk of Parkinson's disease, the development of choreoathetoid movements, and punding; and changes in the physical appearance of the methamphetamine users, including dental caries. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081420 Sun, 26 Jun 2011 23:00:00 +0100 5081420 http://www.medworm.com/index.php?rid=5081416&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000429%2Fabstract%3Frss%3Dyes Among commercial and industrial chemicals, cosmetics, food additives, pesticides, and medicinal drugs, there are more than 50,000 substances distributed. Neurotoxic insults to the brain can manifest in many different ways, especially involving cognition. Given many possible differences in the pathophysiology of neurotoxic exposure and related cognitive sequelae, a systematic method of cognitive assessment is important for appropriate management of neurotoxic exposure. In the context of Neurotoxicology, this article briefly reviews the contemporary literature and the utility of cognitive assessment tools that are used in neuropsychology. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081416 Sun, 26 Jun 2011 23:00:00 +0100 5081416 http://www.medworm.com/index.php?rid=5081415&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000375%2Fabstract%3Frss%3Dyes Antidepressants are the most commonly prescribed class of medications in the United States. The clinician should be mindful of the many antidepressants that can produce seizures following an accidental exposure or an overdose. A broader understanding of the seizure potential of antidepressants, combined with the ability to recognize individuals at risk for a seizure after an overdose, can aid clinicians in determining the need for inpatient monitoring, and help facilitate their treatment decisions. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=5081415 Sun, 26 Jun 2011 23:00:00 +0100 5081415 http://www.medworm.com/index.php?rid=4646166&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000181%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646166 Tue, 29 Mar 2011 18:20:04 +0100 4646166 http://www.medworm.com/index.php?rid=4646165&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001568%2Fabstract%3Frss%3Dyes In this article, the nature and course of cognitive dysfunction in MS are reviewed, particularly in the context of recent advances in our understanding of the diffuse nature of neuropathology in MS, and in the context of specific factors that may confer risk or protection for the development of cognitive impairment. In addition, assessment and screening approaches of MS-related cognitive dysfunction are discussed. MS is a condition not only restricted to the adult population, and this article includes a brief description of cognition in pediatric-onset MS. Finally, promising intervention approaches to treat cognitive problems in MS are summarized. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646165 Tue, 29 Mar 2011 18:20:04 +0100 4646165 http://www.medworm.com/index.php?rid=4646164&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000053%2Fabstract%3Frss%3Dyes This article summarizes the current state of knowledge on pediatric MS and discusses future avenues of investigation. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646164 Tue, 29 Mar 2011 18:20:04 +0100 4646164 http://www.medworm.com/index.php?rid=4646163&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001593%2Fabstract%3Frss%3Dyes Complementary and alternative medicine (CAM) is used by one-half to three-fourths of multiple sclerosis (MS) patients. Although it is used widely, CAM may not be discussed during a conventional medical visit. In MS, CAM therapies exhibit a broad range of risk-benefit profiles; some of these therapies are low risk and possibly beneficial, whereas others are ineffective, dangerous, or unstudied. Health professionals who provide objective and practical information about the risks and benefits of CAM therapies may improve the quality of care for those with MS. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646163 Tue, 29 Mar 2011 18:20:04 +0100 4646163 http://www.medworm.com/index.php?rid=4646162&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000090%2Fabstract%3Frss%3Dyes This article reviews strategies of symptom management in patients with MS. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646162 Tue, 29 Mar 2011 18:20:04 +0100 4646162 http://www.medworm.com/index.php?rid=4646161&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000041%2Fabstract%3Frss%3Dyes This article reviews the proposed mechanisms of action of the anticipated treatments, their efficacy, and risks associated with their use. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646161 Tue, 29 Mar 2011 18:20:04 +0100 4646161 http://www.medworm.com/index.php?rid=4646160&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100003X%2Fabstract%3Frss%3Dyes This article reviews magnetic resonance imaging and clinical data that show that progression may occur early in the course of MS and specific subsets of progressive patients may respond to disease modifying drugs. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646160 Tue, 29 Mar 2011 18:20:04 +0100 4646160 http://www.medworm.com/index.php?rid=4646159&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001581%2Fabstract%3Frss%3Dyes Conventional disease-modifying agents are only moderately effective, so breakthrough disease activity is commonly seen. The evidence from randomized clinical trials and real-world observational data supporting the use of the second-line agents natalizumab, mitoxantrone, and cyclophosphamide are reviewed. Potential future treatment options are also discussed. Management algorithms for breakthrough disease are outlined. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646159 Tue, 29 Mar 2011 18:20:03 +0100 4646159 http://www.medworm.com/index.php?rid=4646158&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000089%2Fabstract%3Frss%3Dyes Relapsing-remitting multiple sclerosis is highly variable in its presentation and disease course. The approach to initiating first-line preventative therapies must focus on individualizing treatment strategies. Careful discussion of available treatment options and appropriate expectations regarding outcomes is important to ensure a successful start. Early treatment is recommended, as is on-going monitoring of patients who may choose to forego therapy. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646158 Tue, 29 Mar 2011 18:20:03 +0100 4646158 http://www.medworm.com/index.php?rid=4646157&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001659%2Fabstract%3Frss%3Dyes The understanding of the mechanisms that lead to MS exacerbations continues to produce novel treatments for patients with relapsing forms of MS. However, even with the most potent agents available, the exacerbations remain a distinct possibility and a source of concern for patients and clinicians. Therefore, the treatment of acute MS exacerbations remains an indispensable element of MS care. Reviewed here are the available treatment options, their implementation, side effects, and evidence supporting their efficacy in promoting recovery from MS relapses. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646157 Tue, 29 Mar 2011 18:20:03 +0100 4646157 http://www.medworm.com/index.php?rid=4646156&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001544%2Fabstract%3Frss%3Dyes This article presents the most recent guidelines for using clinical, radiological, and other paraclinical information and the red flags that should alert the clinician to investigate other diagnostic possibilities. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646156 Tue, 29 Mar 2011 18:20:03 +0100 4646156 http://www.medworm.com/index.php?rid=4646155&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001647%2Fabstract%3Frss%3Dyes MRI has rapidly become a leading research tool in the study of multiple sclerosis (MS). Conventional imaging is useful in diagnosis and management of the inflammatory stages of MS but has limitations in describing the degree of tissue injury and cause of progressive disability seen in later stages. Advanced MRI techniques hold promise for filling this void. These imaging tools hold great promise to increase understanding of MS pathogenesis and provide greater insight into the efficacy of new MS therapies. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646155 Tue, 29 Mar 2011 18:20:03 +0100 4646155 http://www.medworm.com/index.php?rid=4646154&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000065%2Fabstract%3Frss%3Dyes Magnetic resonance imaging (MRI) of the brain and spinal cord plays a central role in establishing the diagnosis of multiple sclerosis (MS), in monitoring disease activity, and as a key outcome measure in clinical trials of new MS therapies. Conventional MRI continues to evolve, reflecting advances in imaging hardware and software. These advances have led to important new insights into MS disease pathophysiology and can be used to improve patient management. Despite these improvements, standard MRI continues to capture only a small portion of the underlying changes that occur during the course of the disease. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646154 Tue, 29 Mar 2011 18:20:03 +0100 4646154 http://www.medworm.com/index.php?rid=4646153&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191000157X%2Fabstract%3Frss%3Dyes As with susceptibility to disease, it is likely that multiple factors interact to influence the phenotype of multiple sclerosis and long-term disease outcomes. Such factors may include genetic factors, socioeconomic status, comorbid diseases, and health behaviors, as well as environmental exposures. An improved understanding of the influence of these factors on disease course may reap several benefits, such as improved prognostication, allowing us to tailor disease management with respect to intensity of disease-modifying therapies and changes in specific health behaviors, in the broad context of coexisting health issues. Such information can facilitate appropriately adjusted comparisons within and between populations. Elucidation of these factors will require careful study of well-charact... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646153 Tue, 29 Mar 2011 18:20:03 +0100 4646153 http://www.medworm.com/index.php?rid=4646152&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001611%2Fabstract%3Frss%3Dyes Since the mid-1990s several disease-modifying drugs (DMDs), such as β-interferons and glatiramer acetate, have become available to treat patients with relapse-remitting multiple sclerosis (MS). These therapies have known short- and medium-term benefit in reducing relapses, disability progression, and accrual of new inflammatory lesions. However, the short duration of the randomized pivotal MS trials have provided little to no information about benefit from such treatment over periods of extended (>5 years) use. Whether DMDs may significantly alter the development of long-term disability remains uncertain, thus it remains challenging how to best approach the issue of long-term benefits from these treatments. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646152 Tue, 29 Mar 2011 18:20:03 +0100 4646152 http://www.medworm.com/index.php?rid=4646151&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000077%2Fabstract%3Frss%3Dyes Several prognostic factors of long-term irreversible disability, mainly demographic and clinical, have been described in multiple sclerosis (MS). Most predictors have a minor influence on the long-term prognosis, and efforts are currently shifting toward finding relevant paraclinical predictors. By contrast, the study of prognostic factors has given some insights into the pathogenesis of MS, notably regarding the relation between relapses and long-term disability, and has emphasized the need to elucidate the exact mechanisms underlying neurodegeneration for the development of new therapeutic targets. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646151 Tue, 29 Mar 2011 18:20:03 +0100 4646151 http://www.medworm.com/index.php?rid=4646150&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000028%2Fabstract%3Frss%3Dyes Multiple sclerosis is a heterogeneous disease, and predicting its course is difficult at the individual level. In this article, clinical, demographic, and additional features that are associated with the risk of relapses and of intermediate-term disability are reviewed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646150 Tue, 29 Mar 2011 18:20:03 +0100 4646150 http://www.medworm.com/index.php?rid=4646149&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001623%2Fabstract%3Frss%3Dyes This article preferentially focuses on MS rather than animal models of the disease, such as experimental autoimmune encephalomyelitis. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646149 Tue, 29 Mar 2011 18:20:03 +0100 4646149 http://www.medworm.com/index.php?rid=4646148&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191000160X%2Fabstract%3Frss%3Dyes In this review, the evidence for the leading environmental and lifestyle factors thought to play a role in multiple sclerosis (MS) onset, including Epstein-Barr virus, sun exposure or vitamin D, and smoking, will be discussed. The Causal Pie Model is used as a conceptual framework to understand the causation. Given that no single factor leads to the development of MS, the joint action or interaction of these factors, along with genetic factors, most particularly the HLA-DR15*1501 genotype, is a primary focus. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646148 Tue, 29 Mar 2011 18:20:03 +0100 4646148 http://www.medworm.com/index.php?rid=4646147&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001556%2Fabstract%3Frss%3Dyes This article summarizes the new knowledge gained from this experimental approach. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646147 Tue, 29 Mar 2011 18:20:03 +0100 4646147 http://www.medworm.com/index.php?rid=4646146&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001635%2Fabstract%3Frss%3Dyes This articlediscusses the epidemiology of MS. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646146 Tue, 29 Mar 2011 18:20:03 +0100 4646146 http://www.medworm.com/index.php?rid=4646145&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000107%2Fabstract%3Frss%3Dyes The face of multiple sclerosis (MS) has changed considerably over the past 10 years; thus, a special issue focusing on the disease was in order. Several conceptual shifts have occurred in the past decade that have resulted in improved understanding of disease processes that in turn have ultimately advanced patient care. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646145 Tue, 29 Mar 2011 18:20:03 +0100 4646145 http://www.medworm.com/index.php?rid=4646144&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191100017X%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646144 Tue, 29 Mar 2011 18:20:03 +0100 4646144 http://www.medworm.com/index.php?rid=4646143&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000168%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646143 Tue, 29 Mar 2011 18:20:03 +0100 4646143 http://www.medworm.com/index.php?rid=4646142&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861911000156%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4646142 Tue, 29 Mar 2011 18:20:03 +0100 4646142 http://www.medworm.com/index.php?rid=4297216&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001490%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297216 Thu, 30 Dec 2010 02:08:53 +0100 4297216 http://www.medworm.com/index.php?rid=4297215&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001374%2Fabstract%3Frss%3Dyes This article summarizes current data on the epidemiology, diagnosis, and treatment of major depression, with special emphasis on the diagnosis and treatment of depression in medical and neurologic patients. We reviewed the role of pharmacotherapies, psychotherapies, somatic treatments, and alternative remedies and we included practical advice for clinician regarding the timing and sequence of these treatments, the role of standardized depression scales, and the criteria for referrals to specialty consultants. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297215 Thu, 30 Dec 2010 02:08:51 +0100 4297215 http://www.medworm.com/index.php?rid=4297214&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001404%2Fabstract%3Frss%3Dyes Ictal and postictal panic and interictal and primary panic attacks share common symptoms but differ with respect to duration and association with other symptoms. Acareful history is often sufficient to distinguish these events. When necessary, electroencephalography and neuroimaging studies, estimation of prolactin levels can be a helpful tool in establishing an accurate diagnosis. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297214 Thu, 30 Dec 2010 02:08:50 +0100 4297214 http://www.medworm.com/index.php?rid=4297213&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001325%2Fabstract%3Frss%3Dyes This article provides clues to differentiating FLE from PNES so that neurologists and mental health providers are better equipped to offer treatments for PNES. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297213 Thu, 30 Dec 2010 02:08:50 +0100 4297213 http://www.medworm.com/index.php?rid=4297212&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001295%2Fabstract%3Frss%3Dyes Drug-induced movement disorders have dramatically declined with the widespread use of second-generation antipsychotics, but remain important in clinical practice and for understanding antipsychotic pharmacology. The diagnosis and management of dystonia, parkinsonism, akathisia, catatonia, neuroleptic malignant syndrome, and tardive dyskinesia are reviewed in relation to the decreased liability of the second-generation antipsychotics contrasted with evidence from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial. Data from the CATIE trial imply that advantages of second-generation antipsychotics in significantly reducing extrapyramidal side effects compared with haloperidol may be diminished when compared with modest doses of lower-potency first-gen... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297212 Thu, 30 Dec 2010 02:08:50 +0100 4297212 http://www.medworm.com/index.php?rid=4297211&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001283%2Fabstract%3Frss%3Dyes The physician must explain the treatment or procedure in detail including risks, benefits, and alternative options; the patient's choice must be voluntary; the patient must demonstrate his or her ability to understand the risks and benefits of their choice; and the patient must be able to manipulate information in a logical way. These criteria must be met in order for the process of informed consent to be valid. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297211 Thu, 30 Dec 2010 02:08:50 +0100 4297211 http://www.medworm.com/index.php?rid=4297210&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001362%2Fabstract%3Frss%3Dyes The phenotypic expression of neuropsychological deficits can have very different genotypic etiologies. Understanding the causes of various neuropsychological deficits is tantamount in developing the appropriate treatments. The literature on mood disorders as a risk factor for dementia is reviewed as well as common neuropsychological patterns in dementia and mood disorders. A brief discussion on chronic traumatic encephalopathy is provided. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297210 Thu, 30 Dec 2010 02:08:50 +0100 4297210 http://www.medworm.com/index.php?rid=4297209&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001301%2Fabstract%3Frss%3Dyes The complex phenomenology of white matter dementia and many neuropsychiatric disorders implies that they originate from involvement of distributed neural networks, and white matter neuropathology is increasingly implicated in the pathogenesis of these network disconnection syndromes. White matter disorders produce functional asynchrony of interdependent cerebral regions subserving normal cognitive and emotional functions. Accumulating evidence suggests that white matter dementia primarily reflects disturbed frontal systems connectivity, whereas disruption of frontal and temporal lobe systems is implicated in the pathogenesis of neuropsychiatric disorders. Continued study of normal and abnormal white matter promises to help resolve challenging problems in behavioral neurology and neuropsyc... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297209 Thu, 30 Dec 2010 02:08:50 +0100 4297209 http://www.medworm.com/index.php?rid=4297208&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001313%2Fabstract%3Frss%3Dyes Headache, and in particular, migraine, is often associated with comorbid psychiatric illness. The complex relationships between these disorders are slowly becoming understood. Successful management requires an integrated approach of neurologic and psychiatric management. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297208 Thu, 30 Dec 2010 02:08:50 +0100 4297208 http://www.medworm.com/index.php?rid=4297207&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001337%2Fabstract%3Frss%3Dyes Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or psychiatric disorders. A comprehensive patient evaluation is needed. Treatment options include pharmacotherapy as well as nonpharmacologic interventions, both of which need to be individualized to the patient. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297207 Thu, 30 Dec 2010 02:08:50 +0100 4297207 http://www.medworm.com/index.php?rid=4297206&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001350%2Fabstract%3Frss%3Dyes The neurobehavioral sequelae of TBI consist of a spectrum of somatic, neurologic, and psychiatric symptoms. The challenge for clinicians lies in understanding the interface of the various symptoms and how they interrelate with other entities. Specifically, the challenge is differentiating post-TBI–related symptoms from preexisting or de novo psychiatric, neurologic, and/or systemic disorders. A comprehensive evaluation and a multidisciplinary approach to evaluating patients are essential to be able to develop the differential diagnosis needed to design a management plan that maximizes recovery. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297206 Thu, 30 Dec 2010 02:08:50 +0100 4297206 http://www.medworm.com/index.php?rid=4297205&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001349%2Fabstract%3Frss%3Dyes Emerging research in neuroscience is bridging the gap between mind and body. Thought is brain based and influences brain function. The continuum and bidirectionality of mind and body, thought and brain, emotions and physiology forms the basis of understanding neuropathic pain, a neuropsychiatric condition with myriad clinical manifestations. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297205 Thu, 30 Dec 2010 02:08:50 +0100 4297205 http://www.medworm.com/index.php?rid=4297204&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001386%2Fabstract%3Frss%3Dyes This article provides practical advice on making an accurate diagnosis, options for explaining the diagnosis to the patient, and considering further treatment. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297204 Thu, 30 Dec 2010 02:08:50 +0100 4297204 http://www.medworm.com/index.php?rid=4297203&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001416%2Fabstract%3Frss%3Dyes It is with great pleasure that I accepted the role of editor for this issue of Neurologic Clinics on “Psychiatry for the Neurologist.” As a psychiatrist and a neurologist, with a strong interest in the neurobehavioral sequelae of neurological disease, in particular as it pertains to seizures and traumatic brain injury, I found this project exciting and challenging. I am firmly convinced that the fields of psychiatry and neurology cannot exist as two separate disciplines, but rather are intimately intertwined. Indeed, in my opinion, a comprehensive approach to the neurologic and psychiatric assessment, to diagnostic testing, and to behavioral and pharmacologics interventions is needed to maximize patient outcomes. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297203 Thu, 30 Dec 2010 02:08:49 +0100 4297203 http://www.medworm.com/index.php?rid=4297202&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001489%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297202 Thu, 30 Dec 2010 02:08:49 +0100 4297202 http://www.medworm.com/index.php?rid=4297201&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001477%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297201 Thu, 30 Dec 2010 02:08:49 +0100 4297201 http://www.medworm.com/index.php?rid=4297200&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910001465%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=4297200 Thu, 30 Dec 2010 02:08:49 +0100 4297200 http://www.medworm.com/index.php?rid=3931041&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000964%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931041 Sat, 04 Sep 2010 06:36:56 +0100 3931041 http://www.medworm.com/index.php?rid=3931040&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000630%2Fabstract%3Frss%3Dyes Parasomnias are undesirable physical or experiential events that occur in and around sleep. Treatments include reassurance in some cases, various forms of cognitive-behavioral therapy (CBT), and pharmacologic agents. Cognitive restructuring, imagery rehearsal, relaxation, hypnosis, desensitization, and anticipatory awakenings are some of the common CBT and nonpharmacologic interventions. Medications that are used belong to a wide variety of pharmacologic classes, such as α-blockers (prazosin), tricyclic antidepressants (imipramine and clomipramine), selective serotonin reuptake inhibitors, benzodiazepines (diazepam and clonazepam), anticonvulsants (topiramate and gabapentin), desmopressin acetate, and anticholinergic agents (oxybutynin and tolterodine). Data on efficacy are only available... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931040 Sat, 04 Sep 2010 06:36:56 +0100 3931040 http://www.medworm.com/index.php?rid=3931039&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000617%2Fabstract%3Frss%3Dyes Meningitis (inflammation of the pia, arachnoid, and sometimes dura) has diverse causes and presentations. Although viruses are the most common cause of acute meningitis, bacterial meningitides are more severe and important to exclude because morbidity and mortality are high. Chronic meningitis has a broader range of causes, including atypical bacteria, fungi, and noninfectious causes. Presentation is more insidious but, if untreated, significant damage or death may ensue. Recurrent meningitis has many of the same causes as chronic meningitis, but manifestations occur in discrete episodes. Distinguishing between acute, chronic, and recurrent meningitis is essential for proper diagnostic testing and treatment approaches. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931039 Sat, 04 Sep 2010 06:36:55 +0100 3931039 http://www.medworm.com/index.php?rid=3931038&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000605%2Fabstract%3Frss%3Dyes World Health Organization grade II gliomas (GIIG) are diffuse, slow-growing, primary neuroectodermal tumors that occur in the central nervous system. They are generally seen in young individuals and are slightly more common in Whites and males. Most patients present with seizures but neurologic deficits are rare. Magnetic resonance imaging best detects GIIG and they are most frequently located in the frontal and temporal lobes. An accurate pathologic diagnosis is essential because the natural history of a GIIG may be unpredictable. In recent years, the emphasis has been on surgically removing as much tumor as safely possible to obtain an accurate diagnosis, improve symptoms, reduce tumor burden, and determine the need for adjuvant therapies. Radiation and chemotherapy are integral to the m... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931038 Sat, 04 Sep 2010 06:36:55 +0100 3931038 http://www.medworm.com/index.php?rid=3931037&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000575%2Fabstract%3Frss%3Dyes This article reviews several common neuro-ophthalmic disordersdoutlining their features and treatmentsdfrom retinal vascular disorders to eye movements and blepharospasm. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931037 Sat, 04 Sep 2010 06:36:55 +0100 3931037 http://www.medworm.com/index.php?rid=3931036&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000551%2Fabstract%3Frss%3Dyes This article is a review of recent developments related to diagnosis and treatment of various common and uncommon nerve entrapment disorders. When combined with classical peripheral nerve examination techniques, innovations in imaging modalities have led to more reliable diagnoses. Moreover, innovations in conservative and surgical techniques have been controversial as to their effects on patient outcome, but randomized controlled trials have provided important information regarding common operative techniques. Treatment strategies for painful peripheral neuropathies are also reviewed. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931036 Sat, 04 Sep 2010 06:36:55 +0100 3931036 http://www.medworm.com/index.php?rid=3931035&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000654%2Fabstract%3Frss%3Dyes A syndrome of generalized weakness, areflexia, and difficulty with weaning from a ventilator is a common clinical presentation in the critically ill patient, especially in the setting of sepsis, multiorgan failure, and hyperglycemia. At first believed to be a manifestation of nerve (critical illness neuropathy, CIN) or muscle (critical illness myopathy, CIM) dysfunction, our current conceptualization is as a spectrum (critical illness neuromuscular abnormalities, CINMA) that varies in extent and site(s) of involvement, but often a similar clinical presentation. Signs and symptoms of CINMA must be identified early to foster recovery and limit morbidity and mortality. The medical history is crucial in excluding preexisting neuromuscular conditions and electrodiagnostic testing helps to estab... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931035 Sat, 04 Sep 2010 06:36:54 +0100 3931035 http://www.medworm.com/index.php?rid=3931032&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000526%2Fabstract%3Frss%3Dyes Motor fluctuations and dyskinesias are common motor complications that manifest within the first few years from the initiation of therapy in patients with Parkinson disease. These complications negatively affect the quality of life and represent an important source of disability. A growing number of therapeutic options including treatments aimed at prolonging the efficacy of levodopa (eg, selective monoamine oxidase-B inhibitors and catechol-O-methyltransferase inhibitors), administration of longer-acting dopamine agonists (eg, rotigotine, sustained-release ropinirole), and continuous administration of intraduodenal levodopa exist or will soon become available. Patients who maintain a good response to levodopa but continue to experience disabling motor complications despite the best medica... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931032 Sat, 04 Sep 2010 06:36:53 +0100 3931032 http://www.medworm.com/index.php?rid=3931031&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000514%2Fabstract%3Frss%3Dyes Classification, pathophysiology, and endovascular treatment of intracranial dural arteriovenous fistulas are discussed. Risk for neurologic deterioration is based on the presence and extent of cortical venous reflux. Previous endovascular techniques relied heavily on transvenous coil embolization. Recent advances in endovascular materials have facilitated the treatment and cure of many of these lesions via transarterial approaches. Penetration of liquid embolic agent into the nidus and foot of the draining vein is crucial for long-term angiographic cure. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931031 Sat, 04 Sep 2010 06:36:53 +0100 3931031 http://www.medworm.com/index.php?rid=3931030&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000563%2Fabstract%3Frss%3Dyes Over the last 2 decades, there have been dramatic advancements in our understanding of and the ability to treat brainstem cavernous malformations (BCMs). Once thought untreatable, BCMs are now being more aggressively and safely treated microsurgically as a result of advances in monitoring and imaging technologies, as well as refinement of surgical techniques. BCMs deemed inoperable are being treated with radiosurgery, and experience with dosing and targeting has improved the safety of this treatment modality as well. Much work remains to be done, and prospective randomized trials would undoubtedly further existing knowledge. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931030 Sat, 04 Sep 2010 06:36:52 +0100 3931030 http://www.medworm.com/index.php?rid=3931027&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000642%2Fabstract%3Frss%3Dyes In the past 2 decades, 12 new antiepileptic drugs (AED) have been approved by the Food and Drug Administration for the treatment of epilepsy, making the selection process more complex. When choosing an AED several factors are considered including its relative efficacy, tolerability, serious toxicity, ease of use (determined by the pharmacokinetic profile and the drug-drug interaction potential), the presence of comorbid conditions, and cost. Age and gender are also important considerations. The tradition of recognizing a first-choice drug for a certain seizure type or epilepsy syndrome is no longer a practical concept. With so many AED available, depending on several factors, different patients with a similar type of epilepsy may be prescribed entirely different AED. The newer AED have sho... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931027 Sat, 04 Sep 2010 06:36:52 +0100 3931027 http://www.medworm.com/index.php?rid=3931025&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191000068X%2Fabstract%3Frss%3Dyes Great therapeutic strides in the clinical neurosciences have been made in the past decades. It is likely that subsequent decades will bring even greater advances in neurologically oriented therapies. The task of maintaining competence is enormous. This wide assortment of therapeutically oriented articles, meant to be neither encyclopedic nor a primer, was organized to assist experienced and novice neurologists with recent therapeutic advances in the field. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931025 Sat, 04 Sep 2010 06:36:52 +0100 3931025 http://www.medworm.com/index.php?rid=3931024&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000952%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931024 Sat, 04 Sep 2010 06:36:52 +0100 3931024 http://www.medworm.com/index.php?rid=3931023&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000940%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931023 Sat, 04 Sep 2010 06:36:52 +0100 3931023 http://www.medworm.com/index.php?rid=3931022&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000939%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931022 Sat, 04 Sep 2010 06:36:52 +0100 3931022 http://www.medworm.com/index.php?rid=3759950&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000769%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759950 Sat, 17 Jul 2010 06:04:11 +0100 3759950 http://www.medworm.com/index.php?rid=3759949&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000666%2Fabstract%3Frss%3Dyes This article reviews the key anatomic concepts, clinical presentation, differential diagnosis, and management of ocular motor nerve palsies. Dysfunction of an ocular motor nerve must be distinguished from other causes of abnormal eye movements, such as myasthenia gravis or thyroid eye disease, which are outside the scope of this article. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759949 Sat, 17 Jul 2010 06:04:10 +0100 3759949 http://www.medworm.com/index.php?rid=3759948&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000502%2Fabstract%3Frss%3Dyes Neurologists frequently evaluate patients complaining of vision loss, especially when the patient has been examined by an ophthalmologist who has found no ocular disease. A significant proportion of patients presenting to the neurologist with visual complaints have nonorganic or functional visual loss. Although there are examination techniques that can aid in the detection and diagnosis of functional visual loss, the frequency with which functional visual loss occurs concomitantly with organic disease warrants substantial caution on the part of the clinician. Furthermore, purely functional visual loss is never a diagnosis of exclusion and must be supported by positive findings on examinations that demonstrate normal visual function. The relationship of true psychological disease and functi... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759948 Sat, 17 Jul 2010 06:04:10 +0100 3759948 http://www.medworm.com/index.php?rid=3759947&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000496%2Fabstract%3Frss%3Dyes The modern imaging era has introduced a variety of techniques that aid in the evaluation of complex neurologic problems. To optimize the yield of neuroimaging the clinician must, first and foremost, determine the nature of the neuro-ophthalmic disorder; and then localize the lesion. Once the localization of the neuro-ophthalmic problem is understood, the optimal imaging modality can be directed toward the anatomic region of interest. In this article the approach to neuroimaging is discussed, with emphasis on the anatomic localization of lesions affecting afferent and efferent visual function. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759947 Sat, 17 Jul 2010 06:04:10 +0100 3759947 http://www.medworm.com/index.php?rid=3759946&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000484%2Fabstract%3Frss%3Dyes Thyroid eye disease (TED) is the most common cause of proptosis in adults, and should always be a consideration in patients with unexplained diplopia, pain, or optic nerve dysfunction. At least 80% of TED is associated with Graves disease (GD), and at least 50% of patients with GD develop clinically evident symptomatic TED. The most confusing patients for doctors of all subspecialties are the patients with eye symptoms and signs that precede serum evidence of a thyroid imbalance. Management of TED may include immunosuppressive medications, radiation, or surgery. Although the prognosis for optic nerve function is excellent, the restrictive dysmotility can result in permanent disability. Orbit and eyelid reconstruction are reserved for stable, inactive patients and are the final steps in min... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759946 Sat, 17 Jul 2010 06:04:10 +0100 3759946 http://www.medworm.com/index.php?rid=3759945&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000472%2Fabstract%3Frss%3Dyes Vascular neuro-ophthalmology includes visual symptoms and signs found in stroke patients as well as numerous primary vascular disorders involving the eye and the optic nerves. Cerebrovascular diseases are commonly associated with neuro-ophthalmologic symptoms or signs, which mostly depend on the type, size, and location of the vessels involved, and the mechanism of the vascular lesion. Funduscopic examination allows direct visualization of the retinal circulation, which shares many common characteristics with the cerebral microcirculation, and can be used as a marker of vascular disease. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759945 Sat, 17 Jul 2010 06:04:10 +0100 3759945 http://www.medworm.com/index.php?rid=3759944&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000460%2Fabstract%3Frss%3Dyes This article focuses on those disorders more commonly encountered or that come with more serious consequences if misdiagnosed. Orbital trauma, hemorrhage, neoplasm, and inflammation are covered in some detail. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759944 Sat, 17 Jul 2010 06:04:10 +0100 3759944 http://www.medworm.com/index.php?rid=3759943&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000459%2Fabstract%3Frss%3Dyes Neurologists are frequently consulted because of a pupillary abnormality. An unequal size of the pupils, an unusual shape, white colored pupils, or a poorly reactive pupil are common reasons for referral. A directed history and careful observation of the iris and pupil movements can bear out ocular pathology such as congenital or structural anomalies as the cause of abnormal pupils. Thereafter, it is important to evaluate the neurologic causes of anisocoria and poor pupil function. The first part of this article emphasizes pupillary abnormalities frequently encountered in infants and children and discusses some of the more common acquired iris structural defects. The second part focuses on evaluation of lesions in the neural pathways that result in pupillary dysfunction, with particular at... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759943 Sat, 17 Jul 2010 06:04:10 +0100 3759943 http://www.medworm.com/index.php?rid=3759942&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000447%2Fabstract%3Frss%3Dyes Patients with multiple sclerosis commonly describe visual symptoms that result from several eye movement abnormalities that occur from disruption of critical pathways in the brainstem, cerebellum, and cerebral hemispheres. These abnormalities include internuclear ophthalmoplegia, ocular motor palsy, ocular misalignment, pathologic nystagmus, impaired saccades, saccadic intrusions, and impaired pursuit. Detailed knowledge of these problems and their neuroanatomic localization will aid the physician by guiding diagnosis and therapeutic decision making. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759942 Sat, 17 Jul 2010 06:04:10 +0100 3759942 http://www.medworm.com/index.php?rid=3759939&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000411%2Fabstract%3Frss%3Dyes Idiopathic intracranial hypertension ((IIH) is characterized by increased cerebrospinal fluid pressure of unknown cause. It is predominantly a disease of women in the childbearing years. Although the cause of IIH remains obscure, it has become clear that loss of visual function is common and patients may progress to blindness if untreated. Diagnosis should adhere to the modified Dandy criteria and other causes of intracranial hypertension sought. IIH patient management should include serial perimetry and optic disc grading or photography. The proper therapy can then be selected and visual loss prevented or reversed. Although there are no evidence-based data to guide therapy, there is an ongoing randomized double-blind controlled treatment trial of IIH investigating diet and medical therapy... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759939 Sat, 17 Jul 2010 06:04:10 +0100 3759939 http://www.medworm.com/index.php?rid=3759937&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000393%2Fabstract%3Frss%3Dyes Optic neuritis usually presents with painful monocular vision loss in younger patients. Spontaneous improvement in vision occurs over weeks, and treatment with high-dose intravenous steroids increases the rate but not extent of visual recovery. Risk of progression to multiple sclerosis (MS) is largely dictated by baseline brain magnetic resonance imaging (MRI). Those with a normal MRI finding at the time of optic neuritis diagnosis have a lower rate of progression to multiple sclerosis than those with T2 hyperintense white matter lesions on MRI. High-dose intravenous steroids should be considered acutely in optic neuritis, and disease-modifying therapy should be considered in patients at high risk of MS as defined by MRI. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759937 Sat, 17 Jul 2010 06:04:09 +0100 3759937 http://www.medworm.com/index.php?rid=3759936&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000678%2Fabstract%3Frss%3Dyes Neuro-ophthalmology is a subspecialty of neurology and ophthalmology that bridges the gap between eye and brain. This issue of Neurologic Clinics describes the key features and latest information on topics in neuro-ophthalmology of interest to practicing neurologists and, in particular, highlights areas for which referral might be reasonable to neuro-ophthalmologists. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759936 Sat, 17 Jul 2010 06:04:09 +0100 3759936 http://www.medworm.com/index.php?rid=3759935&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000757%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759935 Sat, 17 Jul 2010 06:04:09 +0100 3759935 http://www.medworm.com/index.php?rid=3759934&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000745%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759934 Sat, 17 Jul 2010 06:04:09 +0100 3759934 http://www.medworm.com/index.php?rid=3759933&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000733%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759933 Sat, 17 Jul 2010 06:04:09 +0100 3759933 http://www.medworm.com/index.php?rid=3931033&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000587%2Fabstract%3Frss%3Dyes This article briefly reviews the clinical features, pathophysiology, and classification of dystonia before reviewing current therapeutic options. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931033 Wed, 14 Jul 2010 23:00:00 +0100 3931033 http://www.medworm.com/index.php?rid=3931029&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000599%2Fabstract%3Frss%3Dyes It is essential to control arterial blood pressure (BP) in both hemorrhagic and ischemic stroke patients to decrease morbidity following an acute event and decrease the long-term risk of stroke recurrence. Pathophysiology of BP control is dependent on understanding key relationships of cerebral blood flow and cerebral perfusion pressure. In the long term, hypertensive control decreases the rate of incident and recurrent hemorrhagic and ischemic stroke. In the acute setting, neither when to start antihypertensive medication nor the optimal BP target goals for short- and long-term control are well defined. There are several different drug classes available for BP control, with considerable debate as to which drugs are preferred for stroke patients. Medication selection and target BP depend o... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931029 Wed, 14 Jul 2010 23:00:00 +0100 3931029 http://www.medworm.com/index.php?rid=3931034&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000629%2Fabstract%3Frss%3Dyes Syndromes from antibodies to voltage-gated potassium channels include neuromyotonia (NMT), limbic encephalitis (LE) and Morvan syndrome (MVS). There are distinct clinical features for NMT (cramps, stiffness, fasciculations, myokymia, hyperhidrosis; afterdischarges and continuous motor activity on electromyogram), LE (encephalopathy with seizures, deficient recent memory; hyponatremia, temporal lobe magnetic resonance imaging and electroencephalographic abnormalities) and MVS (NMT plus hyperhidrosis, dysautonomia, encephalopathy, severe insomnia, and sleep disorders). There may be associated myasthenia gravis or thymoma, and rarely lung cancer (small cell or adenocarcinoma), mandating that chest imaging be part of the evaluation. Most cases respond favorably to immunosuppression with plasma... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931034 Sun, 04 Jul 2010 23:00:00 +0100 3931034 http://www.medworm.com/index.php?rid=3931028&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191000054X%2Fabstract%3Frss%3Dyes This article expands on these principles and summarizes current knowledge on the definition, classification, diagnosis, and treatment of SE. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931028 Sun, 06 Jun 2010 23:00:00 +0100 3931028 http://www.medworm.com/index.php?rid=3931026&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000538%2Fabstract%3Frss%3Dyes Although headache is a common ailment, its more severe manifestations such as intractable migraine, and trigeminal autonomic cephalagias including cluster headaches have a debilitating effect on patients resulting in chronic pain and severe functional impairment. Neurostimulation has been explored as a possible treatment option in selective drug-resistant primary headache disorders, in conducting clinical trials involving neurostimulation of deep brain structures, occipital nerves, and vagal nerves as treatment methods for refractory primary headache disorders, the selection of patients should be strictly based on pre-defined clinical criteria. The trials should be well designed, taking into account the potential risks and complications associated with such therapies. (Source: Neurologic C... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3931026 Mon, 17 May 2010 23:00:00 +0100 3931026 http://www.medworm.com/index.php?rid=3759940&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000423%2Fabstract%3Frss%3Dyes Transient monocular visual loss is an important clinical complaint and has a number of causes, of which the most common is retinal ischemia. A practical approach is to perform a careful examination to determine whether there are any eye abnormalities that can explain the visual loss. Despite the transient nature of the symptom, there may be clues to the diagnosis on the examination even after the visual loss has recovered. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759940 Mon, 17 May 2010 23:00:00 +0100 3759940 http://www.medworm.com/index.php?rid=3759938&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS073386191000040X%2Fabstract%3Frss%3Dyes Giant cell arteritis is a systemic vasculitis with a wide clinical spectrum, and it represents a medical emergency. Visual loss is the most feared complication, and when it happens, it tends to be profound and permanent. Prompt diagnosis and treatment are imperative to minimize potentially devastating visual loss and neurologic deficits. A temporal artery biopsy should be performed on every patient in whom the diagnosis is suspected. The mainstay of therapy remains corticosteroids. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759938 Mon, 17 May 2010 23:00:00 +0100 3759938 http://www.medworm.com/index.php?rid=3759941&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000435%2Fabstract%3Frss%3Dyes Optic atrophy is a clinical term used to describe an optic disc thought to be paler than normal. Optic atrophy is not a diagnosis but an ophthalmoscopic sign. Evidence of visual loss (acuity, color vision, peripheral vision) should be present. Most optic atrophy is diffuse and nonspecific, but historical and examination clues exist that help differentiate the many causes of optic atrophy. Patients with unexplained optic atrophy should be evaluated with magnetic resonance imaging. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3759941 Sun, 09 May 2010 23:00:00 +0100 3759941 http://www.medworm.com/index.php?rid=3455632&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861910000307%2Fabstract%3Frss%3Dyes (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455632 Sat, 10 Apr 2010 13:43:30 +0100 3455632 http://www.medworm.com/index.php?rid=3455631&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001145%2Fabstract%3Frss%3Dyes For the past 200 years, neurology has been deeply rooted in the history and neurologic examination, but 21st century advances in neurosurgery, endovascular techniques, and neuropathology, and an explosion in basic neuroscience research and neuroimaging have added exciting new dimensions to the field. Neurology residency training programs face intense governmental regulatory changes and economic pressures, making it difficult to predict the number of neurology residents being trained for the future. The future job outlook for neurologists in the United States, based on recent survey and trends, suggests an increased demand because of the prevalence of neurologic diseases within the aging population, particularly in underserved urban and rural areas. Telemedicine and “teleconsultation” o... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455631 Sat, 10 Apr 2010 13:43:30 +0100 3455631 http://www.medworm.com/index.php?rid=3455630&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001108%2Fabstract%3Frss%3Dyes Patient education is an important component of quality patient care and offers many potential benefits. Health care providers are responsible for giving patients the education they want and need to optimize their health and make health decisions. This review provides a definition of patient education; examines the potential benefits and effectiveness of patient education; builds a general framework for approaching patient education as it pertains to patient knowledge, behaviors, attitudes, and skills; and summarizes representative studies of patient education in selected neurologic conditions. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455630 Sat, 10 Apr 2010 13:43:30 +0100 3455630 http://www.medworm.com/index.php?rid=3455629&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001212%2Fabstract%3Frss%3Dyes Pay-for-performance (P4P) initiatives are receiving significant attention in the media and throughout all parts of health care. To improve quality, hundreds of private payers have initiated P4P programs over the past decade. Recently, the federal government has followed suit with its Physicians Quality Reporting Initiative (PQRI). These programs have several potential shortcomings, and questions arise as to their value in truly improving health outcomes. Nevertheless, momentum continues to gather in both the public and private sectors for P4P to serve as a catalyst for health care reform. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455629 Sat, 10 Apr 2010 13:43:29 +0100 3455629 http://www.medworm.com/index.php?rid=3455628&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001182%2Fabstract%3Frss%3Dyes This article covers the basics of critical appraisal and an introduction to statistics that will help clinicians, patients, and policymakers make sense of scientific evidence. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455628 Sat, 10 Apr 2010 13:43:29 +0100 3455628 http://www.medworm.com/index.php?rid=3455627&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001194%2Fabstract%3Frss%3Dyes This article discusses the current and future state of neurology training. A priority is to attract sufficient numbers of qualified candidates for the existing residency programs. A majority of neurology residents elects additional training in a neurologic subspecialty, and programs will have to be accredited accordingly. Attempts are being made to standardize and strengthen the existing general residency and subspecialty programs through cooperative efforts. Ultimately, residency programs must comply with the increasing requirements and try to adapt these requirements to the unique demands and realities of neurology training. An effort is underway to establish consistent competency-testing methods. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455627 Sat, 10 Apr 2010 13:43:29 +0100 3455627 http://www.medworm.com/index.php?rid=3455626&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001157%2Fabstract%3Frss%3Dyes The requirement that doctors obtain valid consent from patients before providing medical treatment has long been ingrained in both legal doctrine and medical ethics. We summarize the foundations of the informed consent doctrine and discuss the recent evolution in thinking about consent and medical decision making. We show how consent has evolved from physicians merely providing patients information to shared decision making between patients and physicians. We then address three specific examples of situations common in neurological practice that pose challenges in obtaining valid consent: the administration of intravenous tPA following ischemic stroke, consideration of carotid endarterectomy for carotid artery stenosis, and implementation of do-not-resuscitate orders. (Source: Neurologic C... Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455626 Sat, 10 Apr 2010 13:43:29 +0100 3455626 http://www.medworm.com/index.php?rid=3455625&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001169%2Fabstract%3Frss%3Dyes This article provides an overview of the current neurological malpractice trends, and outlines management strategies for several common recurring claims involving headache, stroke, and epilepsy. Selected nonmalpractice liability issues are reviewed, focusing on the unique risks engendered by the forensic expert. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455625 Sat, 10 Apr 2010 13:43:29 +0100 3455625 http://www.medworm.com/index.php?rid=3455624&cid=s_33237_25_f&fid=33237&url=http%3A%2F%2Fwww.neurologic.theclinics.com%2Farticle%2FPIIS0733861909001133%2Fabstract%3Frss%3Dyes This article provides a brief survey of the areas of obtaining informed consent, treatment of acute stroke with tissue plasminogen activator, reporting drivers with dementia or epilepsy, and assessing the capacity to vote for those with dementia. (Source: Neurologic Clinics) Neurologic Clinics journals http://www.medworm.com/rss/comments.php?id=3455624 Sat, 10 Apr 2010 13:43:29 +0100 3455624