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, paraneoplastic, and compressive myelopathies. Advances have been made in the classification and management of spinal vascular malformations. Aortic reconstruction surgery has led to an increased incidence of spinal cord stroke. It is important to recognize a dural arteriovenous fistula as a cause of progressive myelopathy. In the past, noninfectious inflammatory myelopathies have frequently been categorized as idiopathic transverse myelitis. Advances in neuroimaging and discovery of a serum antibody marker, neuromyelitis optica-immunoglobulin G (NMO-IgG), have allowed more specific diagnoses, such as multiple sclerosis and neuromyelitis optica. Abnormalities suggestive of demyelinating disease on brain magnetic resonance imaging (MRI) are known to be highly predictive of conversion to multiple sclerosis in a patient who presents with a transverse myelitis ("clinically isolated syndrome"). Acquired copper deficiency can cause a clinical picture that mimics the subacute combined degeneration seen with vitamin B (12) deficiency. A history of bariatric surgery is commonly noted in patients with copper deficiency myelopathy. Genetics has advanced our understanding of the complex field of hereditary myelopathies. Three hereditary myelopathy phenotypes are recognized: predominantly cerebellar (e.g., Friedreich's ataxia), predominantly motor (e.g., hereditary spastic paraparesis), and a leukodystrophy phenotype (e.g., adrenomyeloneuropathy). Evaluation of myelopathies when no abnormalities are seen on spinal cord imaging is a commonly encountered diagnostic challenge. This article presents some "clinical pearls" in the evaluation and management of spinal cord diseases in context of these recent developments.
journal_name
Semin Neuroljournal_title
Seminars in neurologyauthors
Kumar Ndoi
10.1055/s-0029-1244993subject
Has Abstractpub_date
2010-02-01 00:00:00pages
38-43issue
1eissn
0271-8235issn
1098-9021journal_volume
30pub_type
杂志文章abstract::Lightning and electrical injuries have widespread manifestations involving almost all organ systems of the body, including the central nervous system (CNS) and the eye. This article considers the neuro-ophthalmologic effects of lightning and electrical injury. ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1041041
更新日期:1995-12-01 00:00:00
abstract::Rasmussen encephalitis (RE) is a rare, devastating, progressive pediatric epilepsy. First described 60 years ago, RE continues to present challenges in diagnosis and management. RE causes a unilateral focal epilepsy in children that typically becomes medically refractory, results in significant hemiparesis, and causes...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1708504
更新日期:2020-04-01 00:00:00
abstract::Hypoxic-ischemic encephalopathy (HIE) is a manifestation of perinatal asphyxial insult that continues to evolve over days to weeks following the initial injury. Therapeutic hypothermia has demonstrated that a proportion of this secondary brain injury may indeed be preventable. However, therapeutic hypothermia has also...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0040-1702939
更新日期:2020-06-01 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::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::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::Osteoporosis is a debilitating disease that occurs in epidemic proportions in Western societies and has a large economic impact. Percutaneous vertebroplasty is successful in alleviating subacute and chronic pain caused by osteoporotic compression fractures and pathological vertebral fractures from tumor infiltration. ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2002-36538
更新日期:2002-06-01 00:00:00
abstract::Before the AIDS epidemic, progressive multifocal leukoencephalopathy (PML) was a rare disorder occurring most often in association with leukemia and lymphoma. Current estimates indicate that PML ultimately develops in up to 5% of all patients with AIDS. This demyelinating disease results from infection with JC virus, ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040837
更新日期:1999-01-01 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::Autoimmune encephalopathy represents a complex category of disease with diverse immunologic associations, clinical manifestations, and therapeutic outcomes. Three main subgroups include autoimmune encephalopathies without cancer but with neural nonspecific serologic evidence of autoimmunity (encompassing "Hashimoto's ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1277985
更新日期:2011-04-01 00:00:00
abstract::Small fiber neuropathy (SFN) is common, and can be associated with many medical conditions. The majority of the patients with SFN suffer from painful paresthesia which can negatively impact their quality of life. Skin biopsy with intraepidermal nerve fiber density evaluation is the gold standard diagnostic test. Auton...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1688977
更新日期:2019-10-01 00:00:00
abstract::Chronic insomnia afflicts millions of people in the United States. It is associated with decreased quality of life, accidents, several comorbid conditions, increased morbidity, and substantial direct and indirect costs. Chronic insomnia is a multifactorial and individualized disorder. Its etiology may be cognitive or ...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0029-1237125
更新日期:2009-09-01 00:00:00
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 cond...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-835069
更新日期:2004-09-01 00:00:00
abstract::Telemedicine is the use of electronic communication methods, such as the telephone, the Internet, and videoconferencing, to exchange medical information from one geographic site to another. Telestroke is the use of telemedicine specifically for stroke care. A strokologist is a physician with the special skills require...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1268869
更新日期:2010-11-01 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
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::Arteriovenous malformations of the brain can carry considerable morbidity and mortality in the setting of rupture. The complex angioarchitecture and hemodynamic alteration requires careful consideration in diagnostic and management approaches. In this review, the authors define the pathophysiology, outline diagnostic ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1364212
更新日期:2013-11-01 00:00:00
abstract::Myotonic dystrophies and channelopathies are rare but important causes of muscle diseases which may present with myotonia, episodic attacks of weakness, fixed muscle weakness, and atrophy or their combination. Here, the authors provide an overview of these disorders and describe their clinical and pathophysiological f...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1558979
更新日期:2015-08-01 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::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::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 co...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0029-1241039
更新日期:2009-11-01 00:00:00
abstract::With the advent of combination antiretroviral therapies, the mortality rate from HIV has declined, while the prevalence of long-term HIV-related neurologic complications continues to rise. Thirty-six million individuals are living with HIV around the world, many of whom reside in resource-limited settings. The majorit...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0038-1649334
更新日期:2018-04-01 00:00:00
abstract::Infective endocarditis (IE) is a systemic disease with many potential neurologic manifestations including ischemic and hemorrhagic strokes, cerebral microbleeding, infectious intracranial aneurysms, meningitis, brain abscesses, and encephalopathy. The majority of left-sided (heart) IE patients have brain lesions that ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1688826
更新日期:2019-08-01 00:00:00
abstract::Syndromes characterized by persistent fatigue, musculoskeletal pain, sleep disturbance, and subjective cognitive impairment have been common problems in clinical practice for decades. The chronic fatigue syndrome case definition was created to standardize the patient population in research studies and to foster a syst...
journal_title:Seminars in neurology
pub_type: 历史文章,杂志文章,评审
doi:10.1055/s-2008-1040876
更新日期:1998-01-01 00:00:00
abstract::Deficiencies in reading and writing appear to be major and lasting handicaps for learning-disabled college students. However, gains have been made in program modifications for learning-disabled students in many higher education institutions. Many adults with learning disabilities find that their handicap makes it diff...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1041207
更新日期:1991-03-01 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::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::With the development of multiple options for immunotherapy in multiple sclerosis, the clinician is faced with the challenge of keeping pace with the literature, acquiring familiarity with the various treatment options and opinions, and then offering the patients the most current and appropriate management. Given the i...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2002-33045
更新日期:2002-03-01 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::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