Fortschritte der Neurologie-Psychiatrie
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Fortschr Neurol Psychiatr · Feb 2012
Review[Expert opinions in German statutory accident insurance].
German statutory accident insurance covers employees and trainees against occupational accidents, employers bear the inherent charges. Expert opinion is obtained, in particular, for discussing causality questions and for rating accidental health disorders. Causality has to be estimated based on the "theory of essential condition", health disorders have to be substantiated without any reasonable doubt. Reduction in earning capacity due to an accident may not consider the individual kind of occupation and has to be rated by an abstract approach.
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Fortschr Neurol Psychiatr · Feb 2012
[Psychosocial functioning of adults with late diagnosed autism spectrum disorders--a retrospective study].
The first time diagnosis of autism spectrum disorder (ASD) after passing childhood and adolescence is still considered a rare event. However, in recent years an increasing demand for diagnostic clarifications with suspected ASD in adulthood challenges this view. There is insufficient knowledge about the neuropsychological characterisation and psychosocial outcome of this adult subgroup in the autistic spectrum. ⋯ The majority of ASD diagnosed late in lifetime turned out to be HFA/AS, presenting with high psychosocial adjustment with regard to independent living, educational status and partnerships. The high level of global intelligence supports the hypothesis of cognitively compensated autistic disturbances leading to the diagnosis comparably late in lifetime. The lifetime rate of psychiatric consultations is high, reflecting the importance to consider a diagnosis of ASD even late in life.
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Fortschr Neurol Psychiatr · Jan 2012
Review Case Reports[Anti-NMDA receptor encephalitis: a neurological and psychiatric emergency].
Anti-NMDA receptor encephalitis is a severe autoimmune disease, first described in 2007. Since then a number of cases have been published, suggesting that to date the disease is a considerably underdiagnosed entity. The clinical picture develops over a relatively long period of time and is initially characterised by psychiatric symptoms such as decreased levels of consciousness and hallucinations as well as paranoid behaviour. In the course of the disease neurological symptoms occur, in particular, seizures, autonomic dysfunction and dyskinesias. ⋯ Nonetheless, the clinical outcome is highly dependent on an early diagnosis and immunotherapy without delay. In the case of a malignancy, tumour removal is also crucial. Taken together, an interdisciplinary approach including neurologists, psychiatrists, oncologists and gynaecologists is essential in order to detect and effectively treat this disorder.
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Fortschr Neurol Psychiatr · Jan 2012
Review[Use of amino acid PET in the Diagnostic and Treatment Management of cerebral gliomas].
Structural as well as functional imaging methods are of special importance in neurooncology. Improvements of radionuclide and magnetic resonance-based imaging modalities over the past decade have enabled clinicians to non-invasively assess the dynamics of disease-specific processes at the molecular level in patients with malignant gliomas. To date, a range of complementary imaging parameters have been established in the diagnostic work-up of patients with brain tumours. ⋯ Taken together, MRI and PET provide complementary information about tumour biology and activity, thereby resulting in an improved understanding of the kinetics of tumour growth and therefore allow new insights into the pathophysiology of malignant brain tumours. However, multimodal imaging studies comparing the value of amino acid PET and functional methods of MRI (e. g., perfusion and diffusion weighted imaging) are needed. From these studies, surrogate MRI and PET imaging techniques need to be derived to gain complementary structural and functional information of brain tumours that can be placed into common clinical practice which will optimise the clinical management of patients with malignant gliomas.