Seminars in neurology
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Epilepsy is equally prevalent in men and women. However, for women there are unique concerns related to hormone effects on seizures and the effects of seizures and antiepileptic drugs (AEDs) on reproductive health. Steroid hormones affect neuronal excitability and seizure frequency. ⋯ AEDs may alter reproductive hormones resulting in polycystic-appearing ovaries, anovulatory cycles, and infertility. Seizure frequency may change during pregnancy, seizures may cause pregnancy complications, some AEDs are teratogenic, and many cross into breast milk. The treatment of a woman with epilepsy must consider all these issues.
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Epilepsy is one of the most common neurological conditions encountered worldwide. The development of newer antiepileptic drugs (AEDs) has expanded over recent years, and the use of such drugs for indications other than epilepsy has also broadened. These factors insure that the majority of health care providers will be using an increasing number of AEDs in the care of their patients. Contained herein is a review of the mechanism of action of AEDs, individual drugs and their potential drug interactions, and general principles to guide the clinician in selection, implementation, and long-term monitoring of AEDs.
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Seminars in neurology · Jun 2002
Review Case ReportsNeuromuscular scoliosis: causes of deformity and principles for evaluation and management.
Scoliosis is commonly associated with a variety of neuromuscular disorders including conditions affecting upper and lower motor neurons as well as myopathies. Contained herein is a discussion of the spectrum of neuromuscular disorders that have been associated with scoliosis and related spinal deformities. Management, including surgical treatment in such patients, is summarized including indications, expectations, and impact on trunk balance, pulmonary function, and appearance.
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Seminars in neurology · Jun 2002
ReviewThe lumbar zygapophyseal (facet) joints: a role in the pathogenesis of spinal pain syndromes and degenerative spondylolisthesis.
The zygapophyseal joints in the lumbar spine are important structural components contributing to the stability of the lumbar motion segments. Pathology of the zygapophyseal joints in the lumbar spine may be a significant cause of low back pain and segmental instability within the lumbar spine. Management of pathology related to the zygapophyseal joints remains a difficult challenge for the physician caring for patients with spinal disorders. Future investigations with tissue engineering, ligamentous reconstructions, and intervertebral disc replacement or regeneration may have useful applications in the treatment of zygapophyseal joint pathology.
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Seminars in neurology · Jun 2002
ReviewIndications, techniques, and complications of lumbar interbody fusion.
Lumbar interbody arthrodesis is a surgical technique that results in fusion of the anterior column of the spine. The indications for this procedure have evolved over time, and current indications include spinal deformity, segmental instability, and discogenic low back pain. ⋯ Surgical approaches in performing an interbody arthrodesis can be complicated by nerve and vascular injury. Clinical outcome studies are important in better defining the role of lumbar interbody arthrodesis as a substitute for posterior fusion in the lumbar spine.