Continuum : lifelong learning in neurology
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To discuss the clinical, laboratory, and histopathologic features and presumed pathogenic mechanisms of the four major categories of idiopathic inflammatory myopathy, namely dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, and inclusion body myositis. ⋯ The pattern of muscle weakness, other clinical features (eg, rash, concurrent interstitial lung disease), laboratory features (creatine kinase, autoantibodies), and muscle biopsies are useful in distinguishing subtypes of inflammatory myopathy and in guiding treatment. More research is necessary to unravel the exact pathogenic bases of these myopathies and identify better treatments.
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This review describes the main clinical features of psychogenic (functional) movement disorders and reports recent advances in diagnosis, pathophysiology, and treatment. ⋯ Psychogenic movement disorders represent a challenging disorder for neurologists to diagnose and treat. Recent advances have increased understanding of the neurobiological mechanism of psychogenic movement disorders. Treatment with cognitive strategies and physical rehabilitation can benefit some patients. As short duration of disease correlates with better prognosis, early diagnosis and initiation of treatment are critical.
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Continuum (Minneap Minn) · Jun 2013
Review Case ReportsNeurostimulation for drug-resistant epilepsy.
The purpose of this review is to provide an evidence-based update on the neurostimulation options available for patients with drug-resistant epilepsy in the United States and in European countries. ⋯ The exponential growth of the field of neuromodulation for epilepsy is an exciting development; these new devices provide physicians with new options for patients with drug-resistant epilepsy.
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This review presents the state of the art in the diagnosis and management of status epilepticus. ⋯ Despite recent advances, the management of status epilepticus remains a challenge. Rapid treatment, a written treatment protocol, early consideration of nonconvulsive seizures, and avoiding overtreatment and medical complications are the keys to successful management. This article summarizes the current evidence and guidelines.
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Epilepsy is a chronic disorder with several associated comorbidities requiring timely recognition and treatment. This article discusses aspects of cognitive impairment; psychiatric disorders including depression, anxiety, and psychosis; and health-related quality-of-life issues pertaining to patients with epilepsy. ⋯ Physicians who treat patients with epilepsy should be aware of the major impact that cognitive impairment and psychiatric comorbidities have on these patients. Identifying and treating these comorbidities in epilepsy patients is just as important as seizure treatment.