Der Nervenarzt
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Improved tumor and epilepsy treatment requires long-term care of patients with symptomatic epilepsies caused by tumors. Pathophysiology, epidemiology, prognosis, drugs, and surgical treatment are discussed with special emphasis on seizure control, side effects, and quality of life. Because of the long-term course -- often 10 to 20 years -- optimal treatment strategies have to be selected individually. These should consider possibilities of new techniques of co-registering imaging and electrophysiology, surgery, and the interaction of anticonvulsive and chemotherapeutic drugs, cognition, and mood.
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Controlled Clinical Trial
[Symptoms, risk factors, and etiology of transient ischemic attack and stroke].
It is unclear whether clinical signs and symptoms differ in the presentation of transient ischemic attack (TIA) and stroke, apart from temporal dynamics. ⋯ Transient ischemic attack needs special attention and intensive diagnostic workup, because it bears a considerable risk of death and disability but presents less often with classic signs and symptoms and its etiology often remains undetermined.
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For about 5,000 years, cannabis has been used as a therapeutic agent. There has been growing interest in the medical use of cannabinoids. This is based on the discovery that cannabinoids act with specific receptors (CB1 and CB2). ⋯ Until now, cannabinoids were used as antiemetic agents in chemotherapy-induced emesis and in patients with HIV-wasting syndrome. Evidence suggests that cannabinoids may prove useful in some other diseases, e.g. movement disorders such as Gilles de la Tourette's syndrome, multiple sclerosis, and pain. These new findings also explain the acute adverse effects following cannabis use.
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Historical Article
[Perspectives of forensic psychiatry. A historical and current review].
Major lines of thought within the development of forensic psychiatry are discussed. The historical perspective will be helpful in creating a solid theoretical framework for the ongoing debate on the objectives and methods of forensic psychiatry as a scientific field and will support arguments against uncritical shortcomings and simplifications, so often met in recent years. ⋯ Significant neurobiological and neurophilosophical approaches to the mind-brain relationship in general and to the etiology of mental disorders in particular are outlined. Although to some psychiatrists they appear provoking or even threatening in a way, they offer the opportunity to rethink major conceptual issues within clinical and forensic psychiatry.
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The group of autoimmune neuropathies includes the Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuritis, multifocal motor neuropathy, neuropathies associated with monoclonal gammopathies, and vasculitic neuropathies. This educational review first addresses diagnostic pathways that facilitate more rational diagnostic decisions. Many therapies are effective for treating immune neuropathies. ⋯ The list of long-term therapies includes azathioprine, cyclosporine, cyclophosphamide, and immunoglobulins. The therapeutic mechanisms involved are not clear for most of these compounds. Modern immunotherapy has to consider medical aspects, available therapeutic evidence, and long-term economic burden.