Abstract：
:Animal and human research has clearly shown that anticonvulsants are teratogens and pose a risk for fetal malformations. In the case of dilantin it appears that fetal susceptibility correlates with the fetal level of the microsomal detoxifying enzyme epoxide hydrolase. The genetics of seizures in the parents does not predict the risk for fetal teratogenesis. The clinician must work with a mother who has seizures prior to conception to achieve the best control of seizures with a single anticonvulsant at the lowest effective dose to minimize the teratogenic potential, but even if this is done there is still a risk of fetal malformations and developmental delays. Each pregnancy in a woman on anticonvulsants is at risk, and appropriate counseling should be accomplished before conception so the family can make an informed decision. The exact risk of teratogenesis is lower than previously recorded. Dilantin poses approximately a 10% risk, tegretol less than 10%, and valproic acid causes a threefold increase in the risk of neural tube defects as well as an increased risk of other malformations. The positive aspect is that with good medical management and good prenatal care approximately 90% of infants exposed to anticonvulsants in utero will not show evidence of teratogenesis. Finally, it is important to stress that all pregnancies carry a 3% risk for a major birth defect independent of any exposures or genetic history.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Buehler BA,Rao V,Finnell RHsubject
Has Abstractpub_date
1994-11-01 00:00:00pages
741-8issue
4eissn
0733-8619issn
1557-9875journal_volume
12pub_type
杂志文章,评审abstract：:Syncope, or the sudden loss of consciousness, is a common presenting symptom for evaluation by neurologists. It is not a unique diagnosis but rather a common manifestation of disorders with diverse mechanisms. Loss of consciousness is typically preceded by a prodrome of symptoms and sometimes there is a clear trigger....
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2016.04.002
更新日期：2016-08-01 00:00:00
abstract：:Epilepsy surgery is assuming greater importance in treating patients with partial epilepsy whose seizures are uncontrolled with antiepileptic drugs. Many good candidates for surgical treatment are not presented with the option of surgery. The evaluation for epilepsy surgery is extensive and includes several stages of ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1993-11-01 00:00:00
abstract：:The adverse effects of fetal drug exposures are well documented. Evidence for FAS, impaired intrauterine growth, birth defects, and mental retardation related to alcohol is compelling; evidence for alcohol-induced adverse behaviors and impaired speech is tenuous. Teratogenic, cognitive, or behavioral effects associate...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1993-08-01 00:00:00
abstract：:The immune system plays a significant role in Alzheimer disease (AD). β-Amyloid deposition in the cortex is thought to be an initiating event in AD and the widely believed amyloid hypothesis proposes removal of amyloid may delay disease progression. Human trials of active or passive immune agents have failed to show b...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2013.03.012
更新日期：2013-08-01 00:00:00
abstract：:In vitro and in vivo studies of striatal dopamine receptor changes have been reviewed in this article. A background of receptor pharmacology methods has been included to assist the reader in assessing the merits of the published studies. Overall the literature is not consistent in the relevant observations in parkinso...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1992-05-01 00:00:00
abstract：:Shift work and its negative consequences are becoming more relevant as the economy becomes increasing globalized. For many individuals, shift work serves as a significant biological and psychosocial challenge leading to Shift Work Disorder (SWD). Beyond the symptoms of sleep and excessive sleepiness, the range of cons...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2019.03.003
更新日期：2019-08-01 00:00:00
abstract：:The clinician should be alert to the possibility of cerebrovascular disease in cancer patients who develop signs of diffuse or focal cerebral dysfunction. The cause of cerebrovascular disease can usually be determined by knowing the primary tumor type, extent of metastatic disease, and type of antineoplastic treatment...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
abstract：:Eclampsia continues to be a significant cause of maternal and fetal death throughout the world. Neurologists have a specific role to play in the diagnosis and management of patients who have eclampsia, especially those who have recurrent seizures, raised intracranial pressure, and coma. Postpartum patients may be admi...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2004.07.005
更新日期：2004-11-01 00:00:00
abstract：:Drug-induced seizures are a commonly encountered problem for physicians. In this article, drugs that cause seizures are discussed with regards to the incidence of seizures, associated clinical factors, risk factors, and special treatment considerations. This information should help physicians determine appropriate eva...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1994-02-01 00:00:00
abstract：:The nature, prevalence, and course of cognitive and emotional disturbances in multiple sclerosis (MS) are described in this article. Mild to moderate cognitive impairment is common in MS and may be more incapacitating than physical symptoms for some patients. Although existing neurologic and neuroimaging procedures ca...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1993-02-01 00:00:00
abstract：:The use of IH for 24 hours in patients who remain comatose following resuscitation from out-of-hospital cardiac arrest improves outcomes. How-ever, the induction of hypothermia has several physiologic effects that need to be considered. A protocol for the rapid induction of hypothermia is described. At present, the ra...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2005.10.007
更新日期：2006-02-01 00:00:00
abstract：:Approximately 2 per cent of organ transplant recipients develop primary CNS lymphomas. There is no pathognomonic clinical or radiographic presentation of the tumor, although multicentric involvement of deep white matter is common. Evidence has linked PCNSL to immunosuppression and to infection with the EBV. The most r...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-05-01 00:00:00
abstract：:Spontaneous ICH remains a formidable disease that continues to disable and kill the majority of its victims. Treatment of the disease continues to be controversial and without any proved success, such as improvement in the disease mortality or the resulting disability in survivors. Primary prevention is the most effec...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2006.05.005
更新日期：2006-11-01 00:00:00
abstract：:The anatomic and physiologic changes that occur during pregnancy are unique. A neurologist needs to be aware of normal pregnancy-induced physiologic changes in the cardiovascular, renal, hematologic, and autoimmune systems, and the local anatomic changes, which include alteration of body habitus and pelvic ligaments. ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2016.04.009
更新日期：2016-08-01 00:00:00
abstract：:Idiopathic intracranial hypertension is a syndrome of increased intracranial pressure of unknown cause that most often occurs in women of childbearing age. Most patients are overweight or obese with a history of recent weight gain. Following a brief review of the symptoms and signs, we discuss the approach to assessme...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2020.09.008
更新日期：2021-02-01 00:00:00
abstract：:In this article, the authors provide a conceptual framework in which to consider alternative approaches to identify the developmental consequences of exposing the developing brain to neurotoxic substances. Concepts underlying brain development and issues regarding neurobehavioral testing in children are reviewed. In a...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70210-3
更新日期：2000-08-01 00:00:00
abstract：:Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or psychiatric disorders. A comprehensive patient evaluation is needed. Treatment options include pharmacotherapy as well as nonpharmacologic interventions, ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2010.10.006
更新日期：2011-02-01 00:00:00
abstract：:The inflammatory myopathies are a heterogeneous group of disorders with recent evidence demonstrating differences in clinical features, pathologic changes, pathogenesis, and response to therapy. The inflammatory myopathies generally produce predominantly proximal, symmetric muscle weakness and wasting. Additional crit...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-08-01 00:00:00
abstract：:Psychiatric disorders occurring in patients with epilepsy are complications, not an essential part of the illness, and may be prevented or ameliorated. Outlined are risk factors and medical treatment and the need for education concerning epilepsy and for encouragement of the patient by the physician. ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1984-02-01 00:00:00
abstract：:Although intravenous thrombolysis with recombinant tissue plasminogen activator is a proven effective therapy for acute ischemic stroke, it is often insufficient to achieve recanalization in patients with large intracranial artery occlusions. In these cases, intra-arterial reperfusion techniques may be useful. Intra-a...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2013.03.009
更新日期：2013-08-01 00:00:00
abstract：:Viruses are a frequent cause of encephalitis. Common or important viruses causing encephalitis include herpesviruses, arboviruses, enteroviruses, parechoviruses, mumps, measles, rabies, Ebola, lymphocytic choriomeningitis virus, and henipaviruses. Other viruses may cause an encephalopathy. Host factors and clinical fe...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2018.07.001
更新日期：2018-11-01 00:00:00
abstract：:Use of the somatosensory evoked potential (SEP) in the evaluation of the peripheral nervous system is described. When using SEPs to evaluate peripheral nervous system disease, it is assumed that the central nervous system is intact. SEPs can be used to measure conduction through nerves that, by nature of their anatomi...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1988-11-01 00:00:00
abstract：:In a recent trial limited to arteriovenous malformations discovered not to have bled, medical management was superior to medical management plus intervention. The trial was halted after 226 randomizations and a mean follow-up of 3.3 years owing to a disparity favoring the medical arm. Eligible patients were selected a...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2014.12.006
更新日期：2015-05-01 00:00:00
abstract：:The reasonable clinical approach to the patient who has low back pain includes a search for any of the red flags that would prompt consideration of additional diagnostic testing for serious underlying disease. The common patterns of back pain would be explored in an effort to categorize the patient's symptoms and to b...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70113-4
更新日期：1999-02-01 00:00:00
abstract：:There is no single definition of pharmacoresistant (intractable, refractory) epilepsy. Prospective identification of pharmacoresistance is complicated by the variability of its appearance across different types of epilepsy and the variability of seizure control within a given patient over time. Failure of informative ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2009.06.001
更新日期：2009-11-01 00:00:00
abstract：:What the study of EAE has taught us that has relevance to human demyelinating diseases is discussed. ...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：
更新日期：1983-08-01 00:00:00
abstract：:Disorders of the autonomic and small nerve fibers comprise a wide spectrum of disease states that cross a multitude of clinical specialties.The evaluation of these disorders allows the investigator to determine the presence or absence of abnormalities in the lightly myelinated and unmyelinated nerve fibers with minima...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2004.03.002
更新日期：2004-08-01 00:00:00
abstract：:Postamputation phenomena, including painful and nonpainful phantom sensations occur following loss of limbs and other body parts. Peripheral and central nervous system mechanisms play a role in persistent phantom pain. Understanding the pathophysiology of this syndrome has improved in recent years. Comprehensive evalu...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70105-5
更新日期：1998-11-01 00:00:00
abstract：:Face recognition is one of the most complex visual tasks performed by the human brain. Data from monkeys suggest that area IT may play a key role in identifying faces, and functional imaging research suggests that the human homologue of IT may be located in the medial occipitotemporal cortex, where a FFA has been loca...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(02)00106-8
更新日期：2003-05-01 00:00:00
abstract：:Oromandibular disorders are functional disorders and associated pains in the anatomic region of the temporomandibular joint. Their diagnosis and treatment are controversial because of the lack of conformity concerning these disorders among health care providers. This article provides a clear classification of these di...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1990-11-01 00:00:00
