The Medical clinics of North America
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Status epilepticus is a time-sensitive neuro-emergency, linked to poor functional outcomes and higher mortality rates. Prompt diagnosis and treatment are crucial to reduce its morbidity and mortality. ⋯ A standardized treatment protocol should include prompt and adequately dosed first benzodiazepines as line therapy. Treatment approaches for second-line and third-line management continue to evolve as new anti-seizure medications become available.
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Med. Clin. North Am. · Mar 2025
ReviewAlzheimer's Disease Diagnosis and Management in the Age of Amyloid Monoclonal Antibodies.
Alzheimer's disease (AD) is the most common neurodegenerative disorder, and for providers the term AD is often avoided, favoring generic terms like memory loss or dementia. This is partly not only by limitations in using diagnostics and busy clinics but also by a sense that an AD diagnosis will not lead to a meaningful change in management. ⋯ Additionally, AD prevention therapies are not too far into the future. This review will cover AD clinical presentation and symptomatic management with focus on AD diagnostics and disease-modifying therapies.
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A clinician's goal when encountering acute headaches is to distinguish primary and secondary headache disorders. A comprehensive history, screening for warning signs of secondary headache, and a physical examination can help determine if further workup is necessary. ⋯ Secondary headaches should be treated for their underlying cause. Primary headache disorders have specific evidence-based treatments that can help with acute pain relief.
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Movement disorder urgencies present as an acute-to-subacute-onset primary movement disorder. Emergencies can lead to patient morbidity or mortality if not readily recognized. Many of these presentations have no standard diagnostic criteria or definitive laboratory tests, and thus relying on phenomenology is a clinician's best way to approach these challenging disorders. This section describes the phenomenology, presentation, complications, and management of movement disorder urgencies and emergencies.
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Neuromuscular emergencies can be anxiety provoking for neurologist and nonneurologist alike. This review will discuss common causes of neuromuscular respiratory failure and how to treat them. An algorithmic approach to neuromuscular neurology will be employed to help the nonneurologist be more comfortable with acute neuromuscular emergencies.