Abstract:
:Dizziness, vertigo, and imbalance are likely the most common presenting complaints among patients 75 years and older in office practices. Although the cause of falls among the aging population is multifactorial, several studies have implicated senescence of the vestibular periphery. It is imperative that clinicians correctly diagnose and treat dizziness and vertigo in the geriatric population, as vestibular impairment is quite responsive to specifically designed rehabilitation. One of the most common causes of vertigo in older adults is benign positional vertigo. The aging otolithic membrane, alterations in calcium metabolism, and microvascular ischemia may all play a role. An age-related deterioration of vestibular function on quantitative testing has been documented, and the age of onset correlates with the age-related cellular loss in the vestibular periphery. Furthermore, longitudinal tests of decline in vestibular function correlate with decline in gait and balance on testing. It is likely that senescence of both the central and peripheral vestibular pathways plays a role in age-related decline in balance. Vestibular disorders in the older patient are associated with a diminished level of independent activities, an increased incidence of falls, and possibly also clinical depression. The author's laboratory is delineating the immunohistochemical expression of proteins in the basement membrane of the vestibular system in older adults as a potential cause of the age-related decline in sensory cell and neuronal number.
journal_name
Semin Neuroljournal_title
Seminars in neurologyauthors
Ishiyama Gdoi
10.1055/s-0029-1241039subject
Has Abstractpub_date
2009-11-01 00:00:00pages
491-9issue
5eissn
0271-8235issn
1098-9021journal_volume
29pub_type
杂志文章abstract::With age, the presence of multiple neuropathologies in a single individual becomes increasingly common. Given that traumatic brain injury and the repetitive head impacts (RHIs) that occur in contact sports have been associated with the development of many neurodegenerative diseases, including chronic traumatic encepha...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1713628
更新日期:2020-08-01 00:00:00
abstract::Mitochondrial disorders are frequently associated with seizures. In this review, the authors discuss the seizure patterns and distinguishing features of mitochondrial epilepsy, alongside the indications for investigating, and how to investigate epilepsy from a mitochondrial perspective. Finally, they discuss managemen...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1552624
更新日期:2015-06-01 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::Vaccines have undoubtedly been a medical milestone, preventing immeasurable morbidity and mortality from infectious diseases worldwide. Modern vaccines have tremendously reduced the global impact of numerous infections; they have succeeded in eliminating smallpox completely. However, the nature by which vaccines confe...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1287655
更新日期:2011-07-01 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::Carotid endarterectomy is an established surgical procedure to prevent stroke. The indications, preoperative evaluation, surgical timing, technical details, complications, and special circumstances for the use of this operation are reviewed. Future developments in the surgical reconstruction of the extracranial caroti...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040902
更新日期:1998-01-01 00:00:00
abstract::Insomnia is the most common sleep complaint. Insomnia is not a disease itself but mostly a clinical sign of an underlying disease. Degenerative and vascular diseases involving the central nervous system (CNS) may impair sleep either as a result of the brain lesion or because of illness-related discomfort (motor immobi...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-867074
更新日期:2005-03-01 00:00:00
abstract::The combination of neurologic disease and ichthyosis defines a heterogeneous group of rare inherited disorders that present in infancy through early adulthood. Although affected patients share the cutaneous feature of ichthyosis, there is variability in the nature and severity of neurologic disease. Impaired cognition...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1306390
更新日期:2012-02-01 00:00:00
abstract::The muscular dystrophies are disorders of progressive muscular degeneration and weakness. As a group they display clinical heterogeneity that reflects the heterogeneity of molecular mechanisms responsible for them, and range from congenital to adulthood onset. Recent advances in the field include improved methods of d...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1329199
更新日期:2012-07-01 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::Psychogenic (nonepileptic) seizures are among the most common and serious of all psychogenic neurological disorders. They account for approximately 20% of all intractable seizure disorders referred to comprehensive epilepsy centers and present with a reported annual incidence of approximately 4% that of true epilepsy....
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-2006-945520
更新日期:2006-07-01 00:00:00
abstract::The clinical hallmark of myasthenia gravis (MG) is fluctuating, painless weakness of muscles that most often affect extraocular, lower bulbar, or limb musculature. Predicting the probability of successful treatment for the patient assumes that the physician has made an accurate diagnosis. In this review, the practical...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-830903
更新日期:2004-06-01 00:00:00
abstract::Parkinsonism is a clinical syndrome, which is characterized by bradykinesia, rigidity, rest tremor, and postural instability. Idiopathic Parkinson disease (PD) is the most common cause of this syndrome, though there are several other important etiologies that must be considered. These include the atypical Parkinsonian...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1585097
更新日期:2016-08-01 00:00:00
abstract::The traditional view of neuromyelitis optica (NMO) as a monophasic inflammatory disorder that affects both the optic nerves and the spinal cord is expanding. Over the last decade, a combination of clinical, radiological, pathological, and serological findings have resulted in evolving definitions of NMO and the apprec...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1019131
更新日期:2008-02-01 00:00:00
abstract::Magnetic resonance imaging plays a key role in diagnosis and treatment monitoring of brain tumors. Novel imaging techniques that specifically interrogate aspects of underlying tumor biology and biochemical pathways have great potential in neuro-oncology. This review focuses on the emerging role of 2-hydroxyglutarate-t...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1618600
更新日期:2018-02-01 00:00:00
abstract::Gastrointestinal motor dysfunctions result when extrinsic autonomic nerves are diseased and are unable to modulate the motor functions of the digestive tract, which depend on the enteric nervous system and the automaticity of the smooth muscles. Gut motor dysfunction may result from disorders at all anatomic levels of...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040977
更新日期:1996-09-01 00:00:00
abstract::The fields of neurology and psychiatry were originally practiced as a unitary model. As the fields dichotomized patients into "organic" and "functional," patients with medically unexplained symptoms fell between the borderlands. Despite their significant prevalence, somatoform disorders (SDs) are grossly under-recogni...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1223875
更新日期:2009-07-01 00:00:00
abstract::Evaluation of patients with cranial neuropathies requires an understanding of brainstem anatomy and nerve pathways. Advances in neuroimaging, particularly high spatial resolution magnetic resonance imaging (MRI), have enabled visualization of these tiny structures and their related pathology. This review provides an a...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1331807
更新日期:2012-09-01 00:00:00
abstract::Primary brain tumors are common causes of focal epilepsy, accounting for 5% of new-onset seizures in adults and over 10% of lesional focal epilepsies. These epilepsies are often refractory to medical treatment, and high rates of seizure freedom can be achieved with gross total resections. However, the management strat...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1552628
更新日期:2015-06-01 00:00:00
abstract::Neuropathic pain management is challenging, and typically requires a multifaceted approach. There are several treatment options, both pharmacologic and nonpharmacologic. Of the available pharmacologic agents, those with the strongest supporting evidence include tricyclic antidepressants, serotonin-norepinephrine reupt...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1673679
更新日期:2018-12-01 00:00:00
abstract::Cardiac arrest is a common disease in the United States, and many patients will die as a result of the neurological damage suffered during the anoxic period, or will live in a neurologically debilitated state. When cardiopulmonary-cerebral resuscitation results in the return of spontaneous circulation, intensive care ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2006-948320
更新日期:2006-09-01 00:00:00
abstract::During the last decade, we have witnessed significant advances in the study of inherited dystonias. This article will review some of those discoveries and summarize their significance for the practicing neurologist. A clinical classification of dystonia based on features that can be determined by the clinician is prop...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-971170
更新日期:2007-04-01 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
abstract::Leptomeningeal metastasis occurs in ~5% of all patients with cancer and is the third most common metastatic complication of the central nervous system. Staging of leptomeningeal metastasis includes contrast-enhanced brain and spine magnetic resonance imaging and radionuclide cerebrospinal fluid (CSF) flow study. Treat...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0030-1255220
更新日期:2010-07-01 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::The clinical history and neurological examination provide the most important data on which the diagnosis of autoimmune myasthenia gravis (MG) is based. MG produces symptomatic weakness that predominates in certain muscle groups and typically fluctuates in response to effort and rest. The diagnosis of MG therefore depe...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-829594
更新日期:2004-03-01 00:00:00
abstract::Treatment of dementias represents an important but relatively neglected part of neurological care of the elderly population. Individual therapeutic interventions may make only small changes to the quality of life of individuals afflicted with dementia, but when used in combination these interventions synergize and can...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1683408
更新日期:2019-04-01 00:00:00
abstract::Clinicians commonly encounter patients with cerebrovascular disorders in the hospital. Now, as never before, there are many effective diagnostic and therapeutic modalities. Several examples of typical cases of stroke and transient ischemic attack are presented in order to illustrate a rational approach to diagnosis an...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-814740
更新日期:2003-09-01 00:00:00
abstract::Acute ischemic stroke (AIS) is a time sensitive medical emergency and a leading cause of morbidity and mortality worldwide. Intravenous (IV) recombinant tissue plasminogen activator (IV alteplase) is currently the only proven effective medication for the treatment of AIS with promising adjuvant medications currently u...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1722720
更新日期:2021-01-20 00:00:00
abstract::The use of technology in neurology education has revolutionized many aspects of medical teaching, addressing some important challenges of modern education such as information overload and the unique needs of millennial learners. However, it also has inherent problems, such as depersonalization and high development cos...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1666985
更新日期:2018-08-01 00:00:00