Abstract：
OPINION STATEMENT:Parkinson's disease (PD) has been increasingly recognized as having a multitude of nonmotor symptoms including psychosis, cognitive impairment and dementia, mood disturbances, fatigue, apathy, and sleep disorders. Psychosis and dementia, in particular, greatly affect quality of life for both patients and caregivers and are associated with poor outcomes. Safe and effective treatment options for psychosis and dementia in PD are much needed. Antipsychotics with dopamine-blocking properties can worsen parkinsonian motor features and have been associated with increased morbidity and mortality in elderly, dementia patients. For treating PD psychosis, a first step would be eliminating confounding variables, such as delirium, infections, or toxic-metabolic imbalances, followed by simplifying parkinsonian medications as tolerated. If additional treatment is warranted after such interventions, clozapine or quetiapine can be implemented at the low dose levels typically needed by PD patients. Although quetiapine is easy-to-use in clinical settings, does not require blood count monitoring like clozapine, and is anecdotally beneficial, it remains "investigational" in evidence-based medicine reviews. Though not currently available, the novel 5-HT2a inverse agonist, pimavanserin has shown promise in the treatment of PD psychosis. Current treatments for PD dementia are mostly derived from those utilized in Alzheimer's disease, focusing mainly on cholinesterase inhibitors and memantine, a NMDA receptor antagonist. Rivastigmine, the only Food and Drug Administration approved medication for PD dementia, is a reasonable first choice. Other cholinesterase inhibitors and memantine have not yet achieved recommendation status in evidence-based medicine reviews but are well tolerated in studies of PD dementia patients. At present, there are no approved treatments for mild cognitive impairment in PD, but rasagiline, a selective MAO-B inhibitor, and atomoxetine, a serotonin norepinephrine reuptake inhibitor, have been recently studied. Nonpharmacological interventions, including cognitive therapy, physical activity, music and art therapy, and noninvasive brain stimulation techniques, may be promising options for PD cognitive impairment but await rigorous study.
journal_name
Curr Treat Options Neuroljournal_title
Current treatment options in neurologyauthors
Goldman JG,Holden Sdoi
10.1007/s11940-013-0281-2subject
Has Abstractpub_date
2014-03-01 00:00:00pages
281issue
3eissn
1092-8480issn
1534-3138journal_volume
16pub_type
杂志文章abstract：:Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that usually results in death secondary to respiratory failure. The psychological reaction to the diagnosis of ALS in patient and caregiver has received increasing attention. Reports are highly variable as to the severity of depressive symptoms ...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-006-0030-x
更新日期：2006-09-01 00:00:00
abstract：:The neurorehabilitation program for cerebral palsy changes over time. During the first 2 years of life, an infant stimulation program with an emphasis on more than just improving motor deficits is emphasized. The importance of involvement of a knowledgeable therapist cannot be overemphasized. Realistic expectations mu...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-000-0011-4
更新日期：2000-03-01 00:00:00
abstract：OPINION STATEMENT:CADASIL is a life-threatening and disabling disease. Despite the progress achieved so far, no therapies able to limit the disease progression have been found and only empiric treatments can be employed to relieve the main disease symptoms. Further in vivo studies as well as data aggregation and multi-...
journal_title：Current treatment options in neurology
pub_type： 杂志文章,评审
doi：10.1007/s11940-017-0468-z
更新日期：2017-09-01 00:00:00
abstract：:Spinal muscular atrophy (SMA) is an autosomal recessive disease characterized by degeneration of spinal cord motor neurons and muscular atrophy. Advances in recent research have led to understanding of the molecular genetics of SMA. Therapeutic strategies have been developed according to the unique genomic structure o...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-008-0044-7
更新日期：2008-11-01 00:00:00
abstract：:The initial treatment for trigeminal neuralgia is medical. Carbamazepine is the drug of choice. If the patient proves to be intolerant of carbamazepine, a number of second-line drugs are available, though data on their relative efficacy are nonexistent. Phenytoin, baclofen, clonazepam, and sodium valproate are all wor...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-996-0009-7
更新日期：1999-11-01 00:00:00
abstract：:Vision disturbances following traumatic brain injury (TBI) include anomalies of accommodation, version, vergence (nonstrabismic, as well as strabismic), photosensitivity, visual field integrity, and ocular health. Traumatic brain injury patients with complex diplopia patterns, noncomitant strabismic anomalies, and adv...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-002-0027-z
更新日期：2002-07-01 00:00:00
abstract：OPINION STATEMENT:Cerebral vasospasm (cVSP) consists of the vasoconstriction of large and small intracranial vessels which can lead to cerebral hypoperfusion, and in extreme cases, delayed ischemic deficits with stroke. While most commonly observed after aneurysmal subarachnoid hemorrhage (aSAH), cVSP can also occur af...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-013-0278-x
更新日期：2014-01-01 00:00:00
abstract：:Arteriovenous malformations (AVM) are a leading cause of intracerebral hemorrhage, especially among the young. Because they pose a lifelong risk of serious bleeding, definitive treatment to obliterate the AVM should be pursued in the majority of patients. Microsurgical resection of a small AVM located in the superfici...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-002-0011-7
更新日期：2002-11-01 00:00:00
abstract：:After a patient has initiated an antiepileptic drug (AED) and achieved a sustained period of seizure freedom, the bias towards continuing therapy indefinitely can be substantial. Studies show that the rate of seizure recurrence after AED withdrawal is about two to three times the rate in patients who continue AEDs, bu...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-010-0083-8
更新日期：2010-09-01 00:00:00
abstract：:The treatment of complex partial seizure (CPS) begins with accurate diagnosis. Episodes of staring and unresponsiveness due to nonepileptic causes must be ruled out. Absence seizures (typical and atypical petit mal) must be considered because the treatment strategy and prognosis for these seizures are very different f...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-999-0023-7
更新日期：1999-09-01 00:00:00
abstract：:The treatments for obstructive sleep apnea (OSA) described in this paper represent the latest information and data. Nasal continuous positive airway pressure, initially described in 1981, remains the cornerstone of therapy. Advances in mask interfaces, the use of humidification, the downloading of usage information, t...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-009-0038-0
更新日期：2009-09-01 00:00:00
abstract：OPINION STATEMENT:To date, there are no approved and established pharmacologic treatment options for tauopathies, a very heterogenous group of neuropsychiatric diseases often leading to dementia and clinically diagnosed as atypical Parkinson syndromes. Among these so-called Parkinson plus syndromes are progressive supr...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-012-0168-7
更新日期：2012-04-01 00:00:00
abstract：:There is no controlled study for the best treatment or management of cervico-cerebral artery dissection (CAD). Rationale initial empiric treatment in acute CAD to prevent secondary embolism is partial thromboplastin time (PTT)-guided anticoagulation by intravenous heparin followed by anticoagulation with warfarin. Car...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-001-0034-5
更新日期：2001-09-01 00:00:00
abstract：:Vagus nerve stimulation is a unique therapy for epileptic seizures. Two randomized controlled trials in patients with medically refractory partial seizures have demonstrated efficacy, leading to US Food and Drug Administration approval of vagus nerve stimulation therapy in 1997. Extensive safety testing has not reveal...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-003-0002-3
更新日期：2003-03-01 00:00:00
abstract：:Despite increasing recognition of childhood obstructive sleep apnea syndrome (OSAS) as a significant public health problem, treatment of the condition remains inconsistent. Some children are screened using polysomnography and treated only when objective respiratory disturbances are identified. Many others receive aden...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-005-0028-9
更新日期：2005-09-01 00:00:00
abstract：OPINION STATEMENT:When treating a person with epilepsy, one must consider many factors in addition to the obvious need to treat the seizures. Both epilepsy itself and treatment with antiepileptic drugs (AEDs) subject one to numerous potential secondary long-term health concerns. Poor bone health is one of these concern...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-011-0133-x
更新日期：2011-08-01 00:00:00
abstract：:The primary goal of treatment in nonepileptic seizures (NES) is to improve the patient's quality of life by terminating seizure production or reducing seizure frequency. Initial treatment consists of explaining the diagnosis and its psychological nature to patients without judging them or giving the NES excessive atte...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-000-0034-x
更新日期：2000-11-01 00:00:00
abstract：OPINION STATEMENT:High-grade or malignant gliomas are aggressive cancers. The World Health Organization (WHO) grading system recognizes grade III and grade IV primary brain tumors of astrocytic, oligodendroglial, or mixed lineage. Identification of these tumors is prompted by symptoms such as insidious headaches, seizu...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-010-0077-6
更新日期：2010-07-01 00:00:00
abstract：:Cervicocranial arterial dissection (CCAD) occurs when there is a tear in the intimal layer of the carotid or vertebral arteries with subsequent extravasation of blood into the subintimal layers. The dissection may be extradural, intradural, or extend over both segments. The contents of the subintimal layers are highly...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-007-0031-4
更新日期：2007-01-01 00:00:00
abstract：OPINION STATEMENT:Treatment of myoclonus requires an understanding of the physiopathology of the condition. The first step in treatment is to determine if there is an epileptic component to the myoclonus and treat accordingly. Secondly, a review of medications (e.g., opiates) and comorbidities (e.g., hepatic or renal f...
journal_title：Current treatment options in neurology
pub_type： 杂志文章,评审
doi：10.1007/s11940-016-0404-7
更新日期：2016-05-01 00:00:00
abstract：OPINION STATEMENT:Infantile spasms (IS) represent a major therapeutic challenge, as cessation of spasms and normalization of the electroencephalogram (elimination of hypsarrhythmia) are mandatory to prevent cognitive deterioration in previously healthy infants, or to preserve neurocognitive function among those neurolo...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-012-0181-x
更新日期：2012-08-01 00:00:00
abstract：OPINION STATEMENT:The purpose of this review is to provide an overview of visual snow (VS) and provide information regarding current treatment options for VS. Visual snow (VS) is a rare disorder manifesting with a persistent visual phenomenon of seeing numerous tiny snow-like dots throughout the visual field, and it ca...
journal_title：Current treatment options in neurology
pub_type： 杂志文章,评审
doi：10.1007/s11940-017-0448-3
更新日期：2017-03-01 00:00:00
abstract：OPINION STATEMENT:Melanoma-associated retinopathy is a rare paraneoplastic disorder that is challenging to diagnose and even more difficult to treat. Because of the rarity of the disease, therapy is based on analysis of case series and case reports. Based on evidence from these reports, first-line therapy is cytoreduct...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-009-0057-x
更新日期：2010-01-01 00:00:00
abstract：:Transplantation of bone marrow or peripheral blood stem cells is increasingly being used to treat a variety of oncologic disorders. These procedures are associated with a large spectrum of neurologic complications that significantly contribute to patient morbidity and mortality. These complications may arise at any ti...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-007-0016-3
更新日期：2007-07-01 00:00:00
abstract：OPINION STATEMENT:Solid organ transplantation is frequently complicated by a spectrum of seizure types, including single partial-onset or generalized tonic-clonic seizures, acute repetitive seizures or status epilepticus, and sometimes the evolution of symptomatic epilepsy. There is currently no specific evidence invol...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-012-0180-y
更新日期：2012-08-01 00:00:00
abstract：:A sleep history should be taken routinely in patients with epilepsy. Treatment of sleep disorders and improvement in sleep hygiene may improve seizure control, daytime cognitive functioning, and quality of life. Patients with recurrent sleepiness interfering with daily activities or an Epworth Sleepiness Scale score m...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-006-0017-7
更新日期：2006-07-01 00:00:00
abstract：:Unfortunately, intravenous alteplase, when administered within 3 hours of symptom onset, remains the only US Food and Drug Administration-approved treatment for acute ischemic stroke; it is now 7 years since its approval. Intra-arterial thrombolysis of middle cerebral and basilar artery occlusions within 6 hours of st...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-003-0028-6
更新日期：2003-09-01 00:00:00
abstract：:The treatment of progressive myoclonus epilepsy (PME) remains a major therapeutic challenge in neurology. Generalized convulsive seizures are often well controlled through classic antiepileptic drugs (AEDs) like valproate and clonazepam, whereas myoclonus, the main symptom that is affecting patients most in their dail...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-002-0001-9
更新日期：2002-01-01 00:00:00
abstract：:Spontaneous intracerebral hemorrhage (ICH) is a devastating neurological event with a 30-day mortality of approximately 40%. Recent research provides new insights into the pathophysiology of ICH-associated edema, with potential molecular and cellular targets for future therapy. Neuroimaging techniques such as gradient...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-006-0005-y
更新日期：2006-03-01 00:00:00
abstract：:Respiratory complications account for the majority of deaths occurring in patients suffering from amyotrophic lateral sclerosis (ALS). Patients normally succumb to their illness within an average of 3 to 5 years from the time of diagnosis from complications such as hypoventilation, hypoxemia, hypercarbia, aspiration, ...
journal_title：Current treatment options in neurology
pub_type： 杂志文章
doi：10.1007/s11940-001-0048-z
更新日期：2001-03-01 00:00:00
