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Continuum: Lifelong Learning in Neurology

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https://read.qxmd.com/read/30707200/learning-objectives-and-core-competencies
#1
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707196/prescribing-antipsychotic-medications-to-patients-with-dementia-boxed-warnings-and-mitigation-of-legal-liability
#2
Rachel V Rose, Joseph S Kass
Clinicians caring for patients with dementia are often at a loss when trying to manage dementia-related behavioral disturbances pharmacologically because no drugs have been proven effective for this indication. Antipsychotics are commonly prescribed for these patients despite a US Food and Drug Administration (FDA)-mandated boxed warning about the heightened risk of death in patients with dementia treated with antipsychotic drugs. This boxed warning does not prevent clinicians from prescribing antipsychotics to patients with dementia...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707195/reversible-dementias
#3
Gregory S Day
PURPOSE OF REVIEW: This article describes the clinical features that suggest a reversible cause of dementia. RECENT FINDINGS: Substantial variability exists in the presenting features and clinical course of patients with common neurodegenerative causes of dementia, but the response to available therapies and eventual outcomes are often poor. This realization has influenced the evaluation of patients with dementia, with diagnostic approaches emphasizing routine screening for a short list of potentially modifiable disorders that may exacerbate dementia symptoms or severity but rarely influence long-term outcomes...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707194/hippocampal-sclerosis-argyrophilic-grain-disease-and-primary-age-related-tauopathy
#4
Gregory A Jicha, Peter T Nelson
PURPOSE OF REVIEW: Hippocampal sclerosis, argyrophilic grain disease, and primary age-related tauopathy are common Alzheimer disease mimics that currently lack clinical diagnostic criteria. Increased understanding of these pathologic entities is important for the neurologist who may encounter patients with an unusually slowly progressive degenerative dementia that may appear to meet criteria for Alzheimer disease but who progress to develop symptoms that are unusual for classic Alzheimer disease RECENT FINDINGS: Hippocampal sclerosis has traditionally been associated with hypoxic/ischemic injury and poorly controlled epilepsy, but it is now recognized that hippocampal sclerosis may also be associated with a unique degenerative disease of aging or may be an associated pathologic finding in many cases of frontotemporal lobar degeneration...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707193/chronic-traumatic-encephalopathy
#5
Katherine W Turk, Andrew E Budson
PURPOSE OF REVIEW: This article provides a discussion on the current state of knowledge of chronic traumatic encephalopathy (CTE), with an emphasis on clinical features and emerging biomarkers of the condition. RECENT FINDINGS: The results of several large brain bank case series among subjects with a history of contact sports or repetitive head trauma have indicated that a high frequency of CTE may exist in this population. However, the true prevalence of CTE among individuals with a history of head trauma remains unknown, given that individuals who experienced cognitive, behavioral, and mood symptoms during life are more likely to have their brains donated for autopsy at death and epidemiologic studies of the condition are lacking...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707192/normal-pressure-hydrocephalus
#6
Neill R Graff-Radford, David T Jones
PURPOSE OF REVIEW: Since it was first described in 1965, normal pressure hydrocephalus (NPH) has been a controversial subject. New studies have shed light on its epidemiology and pathogenesis and provided objective ways to measure outcome in patients with NPH. Neuroimaging has improved and allows better recognition of both NPH and the presence of overlapping diseases RECENT FINDINGS: Several recent epidemiologic studies confirm that NPH is a rare disease, but the presence of large ventricles is a common finding with aging...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707191/vascular-cognitive-impairment
#7
Jonathan Graff-Radford
PURPOSE OF REVIEW: This article provides an overview of vascular cognitive impairment; discusses its epidemiology, subtypes, and associations with other neurodegenerative diseases; and reviews the diagnostic evaluation and management of these disorders. RECENT FINDINGS: Cerebrovascular disease is a common cause of dementia and frequently coexists with neurodegenerative causes. The heterogeneity of mechanisms leading to vascular cognitive impairment makes developing unifying clinical and research criteria difficult...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707190/lewy-body-dementias
#8
Melissa J Armstrong
PURPOSE OF REVIEW: This article describes current diagnostic criteria relating to the diagnosis of Lewy body dementia, highlights diagnostic controversies, and reviews treatment approaches. RECENT FINDINGS: Clinical diagnostic criteria for both Parkinson disease and dementia with Lewy bodies have been recently updated. These criteria result in overlap between individuals diagnosed with Parkinson disease and those with dementia with Lewy bodies. Although clinical features and symptomatic treatment overlap, differences remain in epidemiology and expected progression...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707189/primary-progressive-aphasias-and-apraxia-of-speech
#9
Hugo Botha, Keith A Josephs
PURPOSE OF REVIEW: This article reviews two of the primary progressive aphasias (PPAs), disorders characterized by the early and predominant impairment of language, and primary progressive apraxia of speech, a degenerative motor speech disorder that is closely related to PPA. An outline of the history and controversy surrounding how these disorders are classified is provided before the article focuses on each disorder's clinical and imaging features. RECENT FINDINGS: Over the past decade, the classification of degenerative speech and language disorders has been refined...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707188/behavioral-variant-frontotemporal-dementia
#10
William W Seeley
PURPOSE OF REVIEW: This article describes the clinical, anatomic, genetic, and pathologic features of behavioral variant frontotemporal dementia (bvFTD) and discusses strategies to improve diagnostic accuracy, emphasizing common pitfalls to avoid. Key aspects of management and the future of diagnosis and care for the disorder are highlighted. RECENT FINDINGS: BvFTD is a clinical syndrome, not a disease. Patients with the syndrome share core symptoms that reflect degeneration within the most consistently affected brain regions, but accompanying features vary and reflect the precise topography of regional degeneration...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707187/posterior-cortical-atrophy
#11
Jonathan M Schott, Sebastian J Crutch
PURPOSE OF REVIEW: This article presents an overview of the clinical syndrome of posterior cortical atrophy (PCA), including its pathologic underpinnings, clinical presentation, investigation findings, diagnostic criteria, and management. RECENT FINDINGS: PCA is usually an atypical form of Alzheimer disease with relatively young age at onset. New diagnostic criteria allow patients to be diagnosed on a syndromic basis as having a primary visual (pure) form or more complex (plus) form of PCA and, when possible, on a disease-specific basis using biomarkers or underlying pathology...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707186/early-onset-alzheimer-disease-and-its-variants
#12
Mario F Mendez
PURPOSE OF REVIEW: Early-onset Alzheimer disease (AD) is defined as having an age of onset younger than 65 years. While early-onset AD is often overshadowed by the more common late-onset AD, recognition of the differences between early- and late-onset AD is important for clinicians. RECENT FINDINGS: Early-onset AD comprises about 5% to 6% of cases of AD and includes a substantial percentage of phenotypic variants that differ from the usual amnestic presentation of typical AD...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707185/late-onset-alzheimer-disease
#13
Gil D Rabinovici
PURPOSE OF REVIEW: Alzheimer disease (AD) is the most common cause of late-onset dementia. This article describes the epidemiology, genetic and environmental risk factors, clinical diagnosis, biomarkers, and treatment of late-onset AD, defined by age of onset of 65 years or older. RECENT FINDINGS: An estimated 5.7 million Americans are living with AD dementia, with the number of affected individuals growing rapidly because of an aging population. Vascular risk factors, sleep disorders, and traumatic brain injury are associated with an increased risk of AD, while increased cognitive and physical activity throughout the lifespan reduce the risk of disease...
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30707184/dementia-untangled
#14
Steven L Lewis
No abstract text is available yet for this article.
February 2019: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30516615/learning-objectives-and-core-competencies
#15
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30516614/errata
#16
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30516613/appendix-b
#17
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30516612/appendix-a
#18
(no author information available yet)
No abstract text is available yet for this article.
December 2018: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30516608/neurocritical-care-coding-for-neurologists
#19
Marc R Nuwer, Paul M Vespa
Coding specifies the work performed when providing patient care. Critical care services mostly use code 99291, and other codes specify additional time and procedures. Current Procedural Terminology defines critically ill as "a high probability of imminent or life-threatening deterioration in the patient's condition," a condition necessary for use of the critical care code. A patient may be critically ill for neurologic reasons even when stable from a cardiorespiratory status. Rules govern who can use these codes, whether they can be used by more than one physician, the locations where the code may be used, and what services are included and excluded...
December 2018: Continuum: Lifelong Learning in Neurology
https://read.qxmd.com/read/30516607/end-of-life-considerations-and-shared-decision-making-in-neurocritical-care
#20
Christos Lazaridis
The goal of shared decision making in the neurocritical care setting is to form plans of care that are consistent with best medical practice and are respectful of the patient's values. Close cooperation and meaningful interaction must be achieved with family members so that the patient's "person can emerge" through discussions. This article highlights several caveats that can subvert this complex process, including the cognitive biases that affect both clinicians and surrogates. Impact, optimism, and gain-framing biases may be particularly relevant when considering patients who are receiving neurocritical care...
December 2018: Continuum: Lifelong Learning in Neurology
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