Abstract:
:Excessive daytime sleepiness (EDS) or somnolence is common in our patients and in society in general. The most common cause of EDS is "voluntary" sleep restriction. Other common causes include sleep-fragmenting disorders such as the obstructive sleep apnea syndrome. Somewhat less familiar to the clinician are EDS conditions arising from central nervous system dysfunction. Of these so-called primary disorders of somnolence, narcolepsy is the most well known and extensively studied, yet often misunderstood and misdiagnosed. Idiopathic hypersomnia, the recurrent hypersomnias, and EDS associated with nervous system disorders also must be well-understood to provide appropriate evaluation and management of the patient with EDS. This review summarizes the distinguishing features of these clinical syndromes of primary EDS. A brief overview of the pharmacological management of primary EDS is included. Finally, in view of the tremendous advances that have occurred in the past few years in our understanding of the pathophysiology of canine and human narcolepsy, we also highlight these discoveries.
journal_name
Semin Neuroljournal_title
Seminars in neurologyauthors
Black JE,Brooks SN,Nishino Sdoi
10.1055/s-2004-835069subject
Has Abstractpub_date
2004-09-01 00:00:00pages
271-82issue
3eissn
0271-8235issn
1098-9021journal_volume
24pub_type
杂志文章,评审abstract::Myelopathy refers to a spinal cord disorder that presents with motor and/or sensory deficits. Infectious agents that cause myelopathy do so by either direct infection of neural structures (e.g., polio), a parainfectious mechanism (with a presumed autoimmune pathogenesis), or as a result of involvement of structures ad...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1322588
更新日期:2012-04-01 00:00:00
abstract::Immunotherapy of multiple sclerosis (MS) will continue to benefit from an increasing understanding of this disease. This knowledge results in newly defined targets for novel therapies. In this article the development of future immunotherapies will be discussed by classifying the approaches into three main types: (1) a...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-41137
更新日期:2003-06-01 00:00:00
abstract::With the increasing acceptance of the right of patients to refuse life-sustaining treatment, some have argued that terminally ill patients have a corollary right to physician-assisted suicide (PAS) on request. However, there are important moral and legal distinctions between patients' refusals of therapy and requests ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040939
更新日期:1997-01-01 00:00:00
abstract::Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a disease primarily affecting obese women of child-bearing age, typically presenting with positional headaches, diplopia from abducens nerve palsies, pulse-synchronous tinnitus, and visual disturbances related to papilledema, including t...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-3399506
更新日期:2019-12-01 00:00:00
abstract::Parkinson's disease (PD) is a significant neurodegenerative disease of the elderly, affecting 1 to 2% of those over 60 years of age. The disorder is characterized by resting tremor, bradykinesia, rigidity, postural instability, and pathologically by alpha-synuclein-positive Lewy bodies. For most, the etiology is unkno...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2006-951621
更新日期:2006-11-01 00:00:00
abstract::Pain is common but often underrecognized after stroke. Poststroke pain (PSP) hinders recovery, impairs quality of life, and is associated with the psychological state of patients with stroke. The most common subtypes of PSP include central PSP, complex regional pain syndrome, shoulder pain, spasticity-related pain, an...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1722641
更新日期:2021-01-14 00:00:00
abstract::Over the past decade, there has been a dramatic evolution of genetic methodologies that can be used to identify genes contributing to disease. Initially, the focus was primarily on classical linkage analysis; more recently, genomewide association studies, and high-throughput whole genome and whole exome sequencing hav...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0033-1359313
更新日期:2013-09-01 00:00:00
abstract::The accumulation of fibrillar α-synuclein protein is the pathological hallmark occurring in both multiple system atrophy (MSA) and diffuse Lewy body disease (DLBD). The oligodendrocytes are especially involved in MSA, while subtypes of neurons are the targets in DLBD. In both instances, the changes are widespread with...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1381732
更新日期:2014-04-01 00:00:00
abstract::Epilepsy is one of the most common neurological conditions encountered worldwide. The development of newer antiepileptic drugs (AEDs) has expanded over recent years, and the use of such drugs for indications other than epilepsy has also broadened. These factors insure that the majority of health care providers will be...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2002-36645
更新日期:2002-09-01 00:00:00
abstract::Both general neurologists and neurologists with a broad spectrum of subspecialty interests are often asked to evaluate patients with disorders of the spinal cord. Over the past decade, there have been significant advances in our understanding of a wide spectrum of immune-mediated, infectious, metabolic, hereditary, pa...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0029-1244993
更新日期:2010-02-01 00:00:00
abstract::Fungal central nervous system infections present in a myriad of clinical manifestation and remain a significant diagnostic challenge. Presenting symptoms, cerebrospinal fluid analysis, conventional fungal serum markers and imaging correlates of disease are seldom sensitive or specific; fungal culture growth or histopa...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1688916
更新日期:2019-06-01 00:00:00
abstract::Pregnancy can precipitate new neurological diseases as a result of the alterations in physiology that accompany the pregnant state. The pregnant patient presenting with neurological problems poses both diagnostic and therapeutic challenges, often forcing the clinician to rely on neuroimaging as part of the workup. Thi...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-2007-991123
更新日期:2007-11-01 00:00:00
abstract::Autoimmune epilepsy is increasingly recognized as a distinct clinical entity, driven in large part by the recent discovery of neural autoantibodies in patients with isolated or predominant epilepsy presentations. Detection of neural autoantibodies in high-risk epilepsy patients supports an immune-mediated cause of sei...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1660860
更新日期:2018-06-01 00:00:00
abstract::Establishing an open and honest physician-patient relationship is essential for the proper evaluation and management of headache disorders. Obtaining a complete headache and medical history is the most important part of the initial diagnostic evaluation. This history should include information about headache onset, pa...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040943
更新日期:1997-01-01 00:00:00
abstract::CPP reflects perfusion problems related to increased ICP or inadequate MAP. CPP is a most helpful and practical management tool. The relationship of CBF and CPP depends on cerebral vascular resistance (flow equals pressure divided by resistance). At present, we do not have a practical method to measure vascular resist...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1041328
更新日期:1989-09-01 00:00:00
abstract::Neurotoxic venoms are common among tropical marine creatures, which have specialized apparatuses for delivery of the venoms. These include jellyfish and anemones, venomous cone snails, venomous fish, stingrays, sea snakes, and venomous octopuses. Numerous toxic neuropeptides are found within these venoms, and some can...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-917664
更新日期:2005-09-01 00:00:00
abstract::Although there are several animal models of Lyme disease, only the rhesus monkey model exhibits all of the key manifestations of the disease. After infection with Borrelia burgdorferi, rhesus monkeys develop signs of early localized, early disseminated, and chronic Lyme disease. Specific features include erythema migr...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040913
更新日期:1997-03-01 00:00:00
abstract::Neuroimmunologic and systemic rheumatic diseases are frequently accompanied by inflammation of the eye, ocular adnexa, and orbital tissues. An understanding of the diverse forms of ophthalmic pathology in these conditions aids the clinician in making appropriate preventative, diagnostic, therapeutic, and prognostic de...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1390393
更新日期:2014-09-01 00:00:00
abstract::Before embarking on expensive ancillary testing, it is crucial for the neurologist to distinguish visual loss due to optic nerve dysfunction from other causes of visual loss. This can usually be accomplished based on specific features of the history and bedside examination. Once it has been established that a patient ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-6836
更新日期:2000-01-01 00:00:00
abstract::The vast majority of people living with human immunodeficiency virus (HIV) infection reside in resource-limited settings. As compared with resource-rich settings, there are important differences in the epidemiology and outcomes of HIV infection in resource-limited settings. Nonetheless, little HIV neurology research o...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1372344
更新日期:2014-02-01 00:00:00
abstract::As the population ages, the prevalence of many neurologic diseases is increasing. At the same time, older patients are undergoing more surgical procedures. This confluence of events puts neurohospitalists in a unique position to provide both pre- and postoperative guidance to minimize complications, improve clinical o...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1564302
更新日期:2015-12-01 00:00:00
abstract::The human genome has become a roadmap for elucidation of the pathophysiology of disease. It is likely that mutations in more than 1000 of the approximately 30,000 human genes will lead to autonomic abnormalities, either directly or indirectly. This review highlights some of these, which exert major effects on catechol...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-817723
更新日期:2003-12-01 00:00:00
abstract::Upper limb recovery after a stroke is suboptimal. Only a few individuals achieve full functional use of the hemiparetic arm. Complex primary and secondary impairments may affect recovery of upper limb function in stroke survivors. In addition, multiple personal, social, behavioral, economic, and environmental factors ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1396002
更新日期:2014-11-01 00:00:00
abstract::The demonstration that several agents with presumed differing mechanisms of action each provide partial effectiveness in the treatment of relapsing-remitting multiple sclerosis (MS) has significantly changed the approach to MS clinical trial research. A number of recently published trials have provided support to thes...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040887
更新日期:1998-01-01 00:00:00
abstract::Environmental circumstances that result in ambiguity or conflict with the patterns of sensory stimulation may adversely affect the vestibular system. The effect of this conflict in sensory information may be dizziness, a sense of imbalance, nausea, and motion sickness sometimes even to seemingly minor daily head movem...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1701653
更新日期:2020-02-01 00:00:00
abstract::The catecholamines dopamine and norepinephrine are key central neurotransmitters that participate in many neurobehavioral processes and disease states. Norepinephrine is also the main neurotransmitter mediating regulation of the circulation by the sympathetic nervous system. Several neurodegenerative disorders feature...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1713874
更新日期:2020-10-01 00:00:00
abstract::Mitochondrial oxidative phosphorylation (OXPHOS) disorders are a heterogeneous group of diseases with variable expression that often pose diagnostic dilemmas. Although definitive diagnosis of these disorders usually requires a muscle biopsy and mtDNA and enzymatic testing, standard metabolic studies including organic ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2001-17947
更新日期:2001-09-01 00:00:00
abstract::Rapidly progressive dementia (RPD) or cognitive decline is a common presenting complaint in neurology. While primary dementia is often a concern, other forms of reversible dementia must be thoroughly considered. This article focuses on the growing field of autoimmune encephalitis (AE) as it pertains to the differentia...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1678583
更新日期:2019-04-01 00:00:00
abstract::In addition to sharing several clinical, pathologic, and molecular characteristics, many neurodegenerative disorders show extensive familial histories suggesting a substantial contribution of genetic factors to disease causation and progression. In this review, the authors provide overviews of the status of current ge...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1299791
更新日期:2011-11-01 00:00:00
abstract::Intracerebral hemorrhage (ICH), which constitutes 10 to 15% of all strokes and affects approximately 65,000 people each year in the United States, has the highest mortality rate of all stroke subtypes. Hypertension, cerebral amyloid angiopathy, and anticoagulation underlie the majority of cases of ICH. Warfarin not on...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-923538
更新日期:2005-12-01 00:00:00