ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BACKGROUND- Chronic daily headache (CDH) is a disorder commonly encountered in clinical practice. Despite its prevalence, CDH has been poorly characterized, and relatively little is known regarding its biology and optimal medical management.REVIEW SUMMARY- We present a review of the data that support the need to develop a new classification system for the CDH syndromes. The clinical and biological characteristics of chronic tension-type headache, transformed migraine, hemicrania continua, and new daily persistent headache with migrainous features are discussed, and recommendations concerning the medical management of these patients are offered.CONCLUSIONS- CDH is a heterogeneous clinical entity with characteristics and subtypes that require further definition and validation. An accurate classification of CDH may assist the clinician in diagnosis and, likely, reduce the incidence of unnecessary and costly ancillary testing. Preliminary evidence suggests that more careful diagnostic discrimination among the subtypes of CDH will assist in directing pharmacologic intervention.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BACKGROUND- Insomnia is a symptom or set of symptoms, not a disease. It is the most common symptom in sleep medicine. Although psychiatric problems may cause such symptoms, other causes are common, particularly among older patients. It is important that neurologists know how to approach the statement, “Doctor, I can't sleep.”REVIEW SUMMARY- Normal sleep physiology is discussed with basic insights into mechanisms of homeostatic and circadian rhythms and sleep electrophysiology. Diagnostic aids to sleep medicine are described and include the sleep log, the polysomnogram, and the multi-sleep latency test. The causes of insomnia and the relevant questions to ask in the sleep history are given. More detailed discussion of the epidemiology, clinical features, and management issues are presented for psychophysiological insomnia, sleep-wake cycle disorders, restless legs syndrome, periodic leg movements in sleep, and sleep apnea. In the final section, special attention is paid to problems of sleep in the elderly and in patients with Parkinson's disease and dementia.CONCLUSION- This review allows the neurologist to better understand the potential causes of insomnia. This knowledge will enable the neurologist to approach the symptoms of insomnia with a clearer understanding of what questions to ask, how to sort out the differential, and what investigations are appropriate. Neurologists should feel more comfortable in treating and managing their own patients with physiological insomnia, restless legs syndrome, periodic leg movements of sleep, and sleep-wake cycle disturbances.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BACKGROUND- Recent advances in intracranial vascular catheterization along with new microballoon technology have led to an increasing interest in using interventional techniques to treat cerebrovascular disease.REVIEW SUMMARY- Interventional techniques including percutaneous transluminal angioplasty and intra-arterial thrombolysis have shown great promise in stroke prevention and treatment. Multicenter clinical trials are in progress.CONCLUSIONS- Interventional neurovascular techniques may prevent strokes and improve stroke recovery.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BACKGROUND- Internal carotid artery (ICA) dissections are among the common causes of ischemic strokes in young and middle-aged adults. Most patients with ICA dissections, however, present with a variety of other manifestations and never develop strokes. The disease is much more common than was initially thought.REVIEW SUMMARY- In this article, the following features of spontaneous ICA dissections are reviewed: incidence, pathology and pathogenesis, terminology, etiologic factors, clinical manifestations, angiographic and imaging findings, treatment options, outcome, and rate of recurrence. Multiple diagrammatic, angiographic, magnetic resonance imaging, and pathologic figures are assembled to demonstrate correlation between pathologic observations and the angiographic as well as imaging findings.CONCLUSIONS- Spontaneous ICA dissections are diagnosed with increasing frequency as a result of the increased familiarity of clinicians and radiologists with clinical, angiographic, and imaging features of the disease. A wider spectrum of clinical presentation is recognized. Death from massive cerebral infarct and edema can occur, but this is quite uncommon. Marked neurologic residuals are infrequent. The outcome is quite good in the majority of the patients, and the rate of recurrence is low.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

BACKGROUND- The various off-label applications of clonazepam in neurology are summarized to provide an accessible source of clinical information for the neurology practitioner.REVIEW SUMMARY- Although clonazepam is only approved by the Food and Drug Administration as an anti-epileptic drug, it can be prescribed for the treatment of movement disorders, neuropathic pain, sleep-associated disorders, and nystagmus-induced oscillopsia. The pharmacology of clonazepam, the doses used in these various unapproved indications, and the side effect and drug interaction profile are also summarized.CONCLUSIONS- Knowledge of clonazepam off-label indications would enable practitioners to prescribe it as an alternative in the management of these neurologic disorders.

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:1074-7931    

出版商:OVID    

年代:1997

数据来源: OVID