Abstract:
:The natural history of MS is highly variable. There is substantial heterogeneity in the clinical manifestations but, at this point, it is reasonable to consider all idiopathic inflammatory demyelinating diseases of the central nervous system as representing a spectrum of the same disease. In large populations, 20% to 40% have "benign disease," defined as having less than moderate disability after 10 years. Benign is a potentially misleading term because many of these patients subsequently will become disabled. Half will develop progressive MS within 10 years and will require some form of walking aid within 15 years following the onset of MS. Survival is not greatly shortened in mildly disabled patients, but the observed mortality is increased four-fold over the general population in patients with advanced disability. Patients with the greatest risk of disability are those with PP MS and RR patients who are older at onset, have pyramidal or cerebellar involvement at onset, and who have frequent or prolonged attacks with incomplete recovery. The biological basis for the variation in the course of MS is understood only in a very limited way. The short- and long-term course of MS may be determined by different biological variables. Short-term benefit in clinical trials should not be assumed to indicate long-term reduction in the risk of permanent disability.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Weinshenker BGsubject
Has Abstractpub_date
1995-02-01 00:00:00pages
119-46issue
1eissn
0733-8619issn
1557-9875journal_volume
13pub_type
杂志文章,评审abstract::Cerebral ischemia manifests widely in patient symptoms. Along with the clinical examination, imaging serves as a powerful tool throughout the course of ischemia-from acute onset to evolution. A thorough understanding of imaging modalities, their strengths and their limitations, is essential for capitalizing on the ben...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2013.07.005
更新日期:2014-02-01 00:00:00
abstract::Our recommendations for the evaluation of the patient with suspected cardiogenic syncope are as follows: An initial thorough history and physical examination of the patient will suggest the diagnosis of cardiogenic syncope in at least 50 per cent of patients. A sudden occurrence of syncope, or "drop attack", is most s...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-08-01 00:00:00
abstract::The evaluation, diagnosis, and treatment of childhood epilepsy or isolated seizures deserve special consideration. Whenever possible, a working diagnosis of an epilepsy syndrome should be implemented early in the course of evaluation to help plan the necessary investigations and acute and chronic treatment. The plan w...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 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::Motor and phonic tics represent the clinic hallmark of Tourette syndrome. Since there is no diagnostic test for tics, the clinical recognition of phenomenology is essential for proper diagnosis. Some, and possibly most, motor tics are preceded by a premonitory urge or sensation that is relieved by the execution of the...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70311-x
更新日期:1997-05-01 00:00:00
abstract::In this review, the authors present a critical overview of the historical development, indications, complications, operative techniques, and results of procedures for the alleviation of the major dyskinesias. Emphasis is placed upon recent refinement of technique, particularly stereotaxis, as well as neurophysiologic ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-11-01 00:00:00
abstract::Neurologic syndromes in AIDS are of four types: infections, para-infections, neoplastic, and paraneoplastic. All levels of the neuraxis can be affected. Neurologic complications may be the initial symptom or the cause of death. Aggressive evaluation, including biopsy of cerebral lesions, is indicated because effective...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::The three states of mammalian being--wakefulness, REM sleep, and NREM sleep--are not mutually exclusive and may occur simultaneously, oscillate rapidly, or appear in dissociated or incomplete form to produce primary sleep parasomnias. Dysfunctions of a wide variety of organ systems may take advantage of the sleeping s...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70280-2
更新日期:1996-11-01 00:00:00
abstract::Reye syndrome has emerged as the quintessential example of an acute metabolic encephalopathy. The clinical presentation is quite stereotyped in most instances permitting rapid, accurate diagnosis and early therapeutic intervention. Intoxications and certain inborn metabolic errors may mimic Reye syndrome. All patients...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1985-02-01 00:00:00
abstract::The presence of a monoclonal protein in the serum of a patient with peripheral neuropathy raises the suspicion of systemic amyloidosis, POEMS syndrome, macroglobulinemia, multiple myeloma, or lymphoma. If these conditions are excluded, the patient is classified as having a monoclonal gammopathy of undetermined signifi...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Oxidative phosphorylation (OXPHOS) accounts for approximately 95% of the adenosine triphosphate (ATP) produced by the cell. The central nervous system, peripheral nervous system, cardiac muscle, skeletal muscle, and smooth muscle are highly susceptible to dysfunction of this complex enzyme system. Although most OXPHOS...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70180-8
更新日期:2000-02-01 00:00:00
abstract::The last 2 decades represent a period of unparalleled advancement in the understanding of the pathogenesis of Parkinson disease (PD). The discovery of several forms of familial parkinsonism with mendelian inheritance has elucidated insights into the mechanisms underlying the degeneration of dopaminergic neurons of the...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2014.09.010
更新日期:2015-02-01 00:00:00
abstract::Chorea (Greek for "dance") refers to irregular, rapid, flowing, non-stereotyped and random involuntary movements that often possess a writhing quality, referred to as choreoathetosis. When mild, it may be difficult to differentiate from restlessness. The movements can be strikingly asymmetric, as in hemichorea, or gen...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70041-4
更新日期:2001-08-01 00:00:00
abstract::This article reviews the acquired causes of polyneuropathy other than diabetic and acute-onset neuropathies. The author gives a general method to simplify the diagnosis of chronic polyneuropathy. The acquired polyneuropathies are discussed under four main headings: metabolic disorders, toxic or deficiency states, infe...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70331-5
更新日期:1997-08-01 00:00:00
abstract::Through the use of IHS criteria, large population-based epidemiologic studies in Denmark, the United States, France, Canada, and elsewhere have shed light on the descriptive epidemiology of migraine. Although migraine is a remarkably common cause of temporary disability, many migraineurs, even those with disabling hea...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70265-6
更新日期:1996-05-01 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::Research models show a strong interrelationship between sleep quality and immune function. The proinflammatory cytokines, interleukin-1, interleukin-6, and tumor necrosis factor α are classified as official sleep-regulatory substances. However, sleep-promoting properties are also possessed by several other immune and ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2012.08.007
更新日期:2012-11-01 00:00:00
abstract::Rapidly progressive dementias (RPDs) are neurologic conditions that develop subacutely over weeks to months or, rarely, acutely over days. In contrast to most dementing conditions that take years to progress to death, RPD quickly can be fatal. It is critical to evaluate patients who have RPD without delay, usually in ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2007.04.001
更新日期:2007-08-01 00:00:00
abstract::This article describes the physiologic and neural mechanisms that cause neuromuscular fatigue in racquet sports: table tennis, tennis, squash, and badminton. In these intermittent and dual activities, performance may be limited as a match progresses because of a reduced central activation, linked to changes in neurotr...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2007.11.011
更新日期:2008-02-01 00:00:00
abstract::Myasthenia gravis is an autoimmune disorder characterized by fluctuating weakness of extraocular and proximal limb muscles. It occurs in 1 in 5000 in the overall population and is 2 times more common in women than men. The onset in women is most common in the third decade, and risk of severe exacerbation occurs most f...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2018.09.003
更新日期:2019-02-01 00:00:00
abstract::Mortality and morbidity from kidney disease and the spectrum of renal-associated neurologic disease have changed markedly since the introduction of renal dialysis and with the advent of renal transplantation. This article includes historical studies of the neurologic complications of acute uremia, now fairly uncommon,...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(03)00052-5
更新日期:2002-02-01 00:00:00
abstract::Metabolic and mitochondrial myopathies encompass a heterogeneous group of disorders that result in impaired energy production in skeletal muscle. Symptoms of premature muscle fatigue, sometimes leading to myalgia, rhabdomyolysis, and myoglobinuria, typically occur with exercise that would normally depend on the defect...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2014.05.001
更新日期:2014-08-01 00:00:00
abstract::The substantial societal and individual burdens associated with tension-type headache (TTH) constitute a previously overlooked major public health issue. TTH is prevalent, affecting up to 78% of the general population, and 3% suffer from chronic TTH. Pericranial myofascial nociception probably is important for the pat...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2008.11.010
更新日期:2009-05-01 00:00:00
abstract::Addressed are the features of postviral and postvaccinial syndromes affecting the CNS. The relationships among acute disseminated encephalomyelitis, EAE, and MS are discussed. Among the postvaccination syndromes covered are the neurologic sequelae of pertussis immunizations, with a description of a mouse model of this...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract::Neuropathies due to nutritional problems can affect certain patient populations and have a varied presentation because of multiple coexistent nutritional deficiencies. Clinicians should consider nutritional neuropathies in patients presenting with neuropathies. Clinicians should be alert for signs and symptoms of neur...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2013.02.002
更新日期:2013-05-01 00:00:00
abstract::Amyotrophic lateral sclerosis can be described as a disease with a poorly understood pathophysiologic mechanism and no treatment that dramatically impacts the course of the disease. Clinical trialists are faced with finding small treatment effects against a background of multiple potential treatments, a past history o...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2015.07.014
更新日期:2015-11-01 00:00:00
abstract::Encephalitis is an acute infection of brain parenchyma characterized clinically by fever, headache, and an altered level of consciousness. There may also be focal or multifocal neurologic deficits, and focal or generalized seizure activity. This article discusses the clinical presentation, diagnosis, and treatment of ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70168-7
更新日期:1999-11-01 00:00:00
abstract::This article discusses antibodies associated with immune-mediated myasthenia gravis and the pathologic action of these antibodies at the neuromuscular junctions of skeletal muscle. To explain how these antibodies act, we consider the physiology of neuromuscular transmission with emphasis on 4 features: the structure o...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2018.01.001
更新日期:2018-05-01 00:00:00
abstract::The authors divide biological toxins into animal, plant, and bacterial classes and discuss each within a context of demographic, clinical and research examples. Advances in our knowledge are highlighted, and the authors relate the implications of this knowledge to target-specific neurologic involvement. ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70220-6
更新日期:2000-08-01 00:00:00
abstract::Motor fluctuations and dyskinesias are common motor complications that manifest within the first few years from the initiation of therapy in patients with Parkinson disease. These complications negatively affect the quality of life and represent an important source of disability. A growing number of therapeutic option...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2010.03.014
更新日期:2010-11-01 00:00:00