Der Nervenarzt
-
Epidural lipomatosis is a rare but severe complication of long-term corticoid treatment. A female who was treated with oral corticoids for more than 4 years developed progressive paraparesis over the course of 2 years. As causal for the clinical symptoms we found a massive epidural lipoma of the thoracic spine. Neurosurgical intervention was necessary.
-
Review Case Reports
[Generalized anxiety disorder with comorbidity. Treatment with pregabalin].
The efficacy of pregabalin in treating generalized anxiety disorder (GAD) has been shown in recent studies. Our experience and case reports in the present publication indicate that pregabalin can be an effective therapeutic option for patients with GAD and comorbid psychiatric disorders. Treatment with pregabalin should also be considered in patients with partial remission of GAD or intolerability of SSRI or SNRI.
-
Results of a nationally representative study in 2,694 patients reveal that most physicians (n=223) involved in substitution treatment of opioid-dependent patients are general practitioners, while only 16% have a psychiatric/psychotherapeutic background and only 21% of the addictive patients are treated by psychiatrists. This contrasts with the remarkably complex pattern of co- and multimorbidity with other mental disorders in such patients. Most psychiatrists engaged in substitution treatment work in specialized outpatient wards (51.3%), and few were operative in their own or private practice (7.2%). Implications of these critical findings are discussed.
-
Randomized Controlled Trial
[Central and peripheral deafferent pain: therapy with repetitive transcranial magnetic stimulation].
This study evaluates the effects of repeated sessions of low- and high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex on central and phantom limb pain. ⋯ At present, rTMS can not be recommended as a standard therapy for central and phantom limb pain.
-
Twin and family studies provide evidence of a genetic component in migraine, in particular migraine with aura (MA). Familial hemiplegic migraine (FHM) is a rare monogenic subtype of MA for which three causative genes have been identified: CACNA1A (FHM1), ATP1A2 (FHM2), and SCN1A (FHM3). ⋯ This review summarizes recent developments in the genetics of migraine and their implications for molecular genetic testing. We further discuss the roles of CACNA1A, ATP1A2, and SCN1A in the pathophysiology of cortical spreading depression, which is the likely correlate of migraine aura.