摘要:

BACKGROUND–Constraint-induced (CI) movement therapy (also calledforced useby some investigators and clinicians) has gained increasing popularity as a treatment mode for restoring function in the upper extremities of patients with stroke. The purpose of this article is to review the concept of constraint-induced movement therapy and provide a critical analysis of the existing data.REVIEW SUMMARY–The evidence to date offers encouragement for the application of this procedure for patients who have some movement recovery out of synergy. Success may be contingent on patient cooperation and intense repetitive use with applications of retraining through practice and shaping. The extent to which each of the latter elements influences the magnitude of recovery is still unclear. However, task novelty and challenge seem important to recovery of function. There are several methods used to map cortical changes after stroke. At this time, transcranial magnetic stimulation is the primary vehicle used to assess motor cortical reorganization after CI therapy in humans.CONCLUSIONS–Accumulating data indicate that the size of a cortical area representative of a muscle does expand and its center of gravity does change with CI therapy.

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUND–The herpes zoster rash occurs when a dormant varicella zoster virus reactivates in dorsal root and cranial nerve ganglia. Pain that persists in the region where this rash occurred after the cutaneous lesions have healed is termed postherpetic neuralgia (PHN). A wide variety of therapies has been used with varying degrees of success to prevent the occurrence of PHN and to reduce pain with established PHN.REVIEW SUMMARY–In this review, we discuss the clinical presentation of PHN, current strategies for the prevention and management of this disease, and observations that have increased our understanding of the neural mechanisms involved in PHN.CONCLUSIONS–Several classes of drugs are effective in attenuating the pain and hyperalgesia caused by PHN, but no single drug leads to the complete relief of symptoms. Additional research is needed to improve treatment strategies and define the role of invasive pain management techniques in cases where PHN is associated with intractable pain.

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUND-Multiple sclerosis (MS) is primarily a disease of premenopausal women. Interactions between the disease and the reproductive cycle are important to consider for optimal patient management.REVIEW SUMMARY-Sex hormones are potent immunomodulators, and their actions may help explain the gender distribution seen in MS and other immune-mediated diseases. Preliminary data suggest that immune function may vary cyclically as a function of hormonal milieu. MS does not affect fertility or the ability to bear children, and pregnancy generally has a salutary effect on the disease. Possible teratogenic actions of drugs used for symptom management and prophylactic treatment must be reviewed when managing patients.CONCLUSIONS-Additional studies are needed to delineate the roles of sex hormones as etiologic (and possibly therapeutic) agents in MS. Pharmacologic treatment of MS may impact reproductive function. Neurologists need to be familiar with these issues to assist their patients in choosing therapies and family planning.

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUND–Chiari type I malformations (Chiari I) are congenital deformities where caudal migration of the cerebellar tonsils through the foramen magnum compresses the cerebellum and cervicomedullary junction (lower brainstem and upper cervical spinal cord). Associations with chronic fatigue syndrome, fibromyalgia, orthostatic intolerance, and other neurologic syndromes have been proposed along with the current plethora of known symptoms of this disease process. In advanced cases, Chiari I malformations can lead to significant neurologic deficit and be the cause of permanent nervous system damage.REVIEW SUMMARY–This article focuses on the clinical diagnosis and treatment of patients with Chiari I, including a discussion on the possible mechanisms of Chiari I with a review of present diagnostic tests, indications for treatment, and appraisal of surgical outcome.CONCLUSIONS–Future radiological advances and research will undoubtedly be directed to better understanding of the pathology of the Chiari malformation and more effective medical and surgical treatment.

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

BACKGROUND-Drug-induced parkinsonism is common but often unrecognized. In addition to neuroleptics, many medications of diverse chemical nature may induce or exacerbate parkinsonismREVIEW SUMMARY-Reports in the literature of drug-induced parkinsonism or of an underlying parkinsonian disorder exacerbated by a medication were located using MEDLINE, and pertinent bibliographies were reviewed. The range of medications that may induce or exacerbate parkinsonism spans the medical specialties. Along with neuroleptics, selective-serotonin reuptake inhibitors, lithium, valproic acid, calcium channel blockers, antiarrhythmics, procholinergics, chemotherapeutics, amphotericin B, estrogens, and others have been implicated.CONCLUSIONS-This review seeks to enhance clinicians’ knowledge of potential medications producing iatrogenic parkinsonism and encourage their vigilance in recognizing it.

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:2002

数据来源: OVID